The Psychiatric Interview - Carlat (notes)

what are the 4 tasks of the interview? - build an alliance obtain the Psychiatric database (hx relevant to their presentation today, PHx, Fhx, PMHx etc) interview for dx negotiate a tx plan what is our intitaly first job? how do we do this? - to ease their suffering, this is before making a dx. all our pts are suffering, you have to address this first. how: depression is different for everybody and may present with different sxs. For a 24 y/o college graduate who has been floundering around, may just need help clarifying her goals. this is what we can help them do in their first visit. spend most of this first visit thinking about their lives and not their dx. this alone is an alliance booster, just be sure to ask about their life and that starts it all. what is the overall goal of the interview? - to figure out treatment not to figure out a dx. what percentage drop out of tx brute they're 4th visit? - 50% what is the most important part of the interview? - negotiating a tx plan. if they don't feel comfortable with it then the interview might as well not have been done. length of time for the 3 phases of the interview - opening: 5-10 min body: 30-40 min closing: 5-10 min explain what the 3 phases of the interview - intro: - learn about their life - give a few minutes to tell why they came body: - est. interviewing priorities - HPI - Hx of depression, SI, substance abuse - FHx - determine whether they meet criteria - if have time: social/developmental Hx, PMHx, psych ROS closing: - discuss assessment (w/ pt education) - ne