NR 548 Psychiatric
Assessment for
Psychiatric-Mental Health
Nurse Practitioner Exam 2
Week 3-4 Covered
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1. Psychiatric interview: the process by which psychiatric assessment is conduct- ed
-primary tasks
• building a therapeutic alliance between the PMHNP & client
• obtaining a database of psychiatric info about the client
• establishing a dx
• negotiating a tx plan
2. Therapeutic Alliance: a feeling that you should create over the course of the
diagnostic interview, a sense of rapport, trust, and warmth
-most important goal of the interview process
-the cooperative working relationship between the therapist and client
• begins during the initial or opening phase of the interview
-fundamental component of successful therapy
• Without trust, adherence to treatment recommendations may be compromised
• interview may not elicit the information needed to formulate an appropriate dx & plan
of care without rapport & trust
3. Creating rapport: tips: -Be Yourself
-Be Warm, Courteous, and Emotionally Sensitive
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-Actively Defuse the Strangeness of the Clinical Situation
-Give Your Patient the Opening Word
-Gain Your Patient's Trust by Projecting Competence
4. How to approach threatening topics (sensitive/embarrassing material): -
-Normalization
-Symptom Expectation
-Symptom Exaggeration
-Reduction of Guilt
-Use Familiar Language When Asking about Behaviors
5. Normalization: Introducing Q with some type of normalizing statement
-two principal ways to do this:
1. start the question by implying that the behavior is a normal or understandable
response to a mood or situation
• ex: Sometimes when people are very depressed, they think of hurting themselves. Has
this been true for you?
2. Begin by describing another patient (or patients) who has engaged in the behavior,
showing your patient that she is not alone
• ex: I've talked to several patients who've said that their depression causes them to have
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strange experiences, like hearing voices or thinking that strangers are laughing at them. Has
that been happening to you?
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