ASSESSMENT

Purpose of The Psychiatric Interview

• The psychiatric interview is the most important element in the evaluation and care of persons with mental illness.
• George Engel stated, “Virtually indispensable for the physician–patient interaction, the well-constructed interview truly may be regarded as the most powerful, the most sensitive and the most versatile instrument available to the physician.”
• From the very first moments of the encounter, the interview shapes the nature of the patient–physician relationship, which can have a profound influence on the outcome of treatment.

From the very first moments of the encounter, the interview shapes the nature of the patient–physician relationship, which can have a profound influence on the outcome of treatment.

General Principles

a.     Agreement as to Process:

1. Introduction
2. Explanation

b.     Privacy and Confidentiality:

1. When it should be broken

c.     Respect and Consideration

4. Rapport/Empathy
5. Patient–Physician Relationship
6. Person-Centered and Disorder-Based
7. Safety and Comfort

Parts of the Psychiatric Interview

a.     Identifying data

b.     Source and reliability

c.     Chief complaint

d.     Present illness

e.     Past psychiatric history

f.      Substance use/abuse

g.     Past medical history

h.     Family history

i.      Developmental and social history

j.      Review of systems : Physical  Examinations

Mental State Examination

1. Components of Mental Status Examination:
2. Appearance and behavior
3.  Motor activity
4.  Speech
5. Mood /Affect
6. Thought content Thought process
7. Perceptual disturbances
8. Cognition
9. Insight
10.  Judgment: Stamped envelop test

Counselling Technique

1. Step 1: Relationship Building
2. The first step involves building a relationship and focuses on engaging clients to explore issue that directly affect them.
3. The first interview is important because the client is reading the verbal and nonverbal messages and make inferences about the counselor and the counseling situation.
4.  Is the counselor able to empathize with the client? Does the client view the counselor as genuine?

Step 2: Problem Assessment

1. While the counselor and the client are in the process of establishing a relationship, a second process is taking place, i.e. problem assessment.
2. This step involves the collection and clasification of information about the client’s life situation and reasons for seeking counseling

Step 3: GOAL SETTING

1. Like any other activity, counseling must have a focus.
2.  Goals are the results or outcomes that client wants to achieve at the end of counselling.
3.  Sometimes, you hear both counselor and client complain that the counseling session is going nowhere. — This is where goals play an important role in giving direction

Step 4: INTERVENTION

1. There are different points of view concerning what a good counselor should do with clients depending on the theoretical positions that the counselor subscribes to.
2.  For example, the person-centred approach suggests that the counselor gets involved rather than intervenes by placing emphasis on the relationship. The behavioural approach attempts to initiate

Step 5: EVALUATION, FOLLOW-UP, TERMINATION 0R REFERAL

1. For the beginning counselor, it is difficult to think of terminating the counseling process, as they are more concerned with beginning the counseling process.
2.  However, all counseling successful termination. aims towards .
3. Terminating the counseling process will have to be conducted with sensitivity with the client knowing that it will have to end.