The Psychiatric Interview - (notes)

The Psychiatric Interview - (notes)
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whatghareghthegh4ghtasksghofghtheghinterview?gh-ghcorrectghanswers-buildghanghalliance
obtainghtheghPsychiatricghdatabasegh(hxghrelevantghtoghtheirghpresentationghtoday,ghPHx,ghFhx,gh
PMHxghetc)
interviewghforghdx
negotiateghaghtxghplan
whatghisghourghintitalyghfirstghjob?ghhowghdoghweghdoghthis?gh-ghcorrectghanswers-
togheaseghtheirghsuffering,ghthisghisghbeforeghmakingghaghdx.ghallghourghptsghareghsuffering,ghyoughha
veghtoghaddressghthisghfirst.

how:ghdepressionghisghdifferentghforgheverybodyghandghmayghpresentghwithghdifferentghsxs.ghForgh
agh24ghy/oghcollegeghgraduateghwhoghhasghbeenghflounderinggharound,ghmayghjustghneedghhelpghcl
arifyingghherghgoals.ghthisghisghwhatghweghcanghhelpghthemghdoghinghtheirghfirstghvisit.ghspendghmostgh
ofghthisghfirstghvisitghthinkingghaboutghtheirghlivesghandghnotghtheirghdx.ghthisghaloneghisghanghallianceg
hbooster,ghjustghbeghsureghtoghaskghaboutghtheirghlifeghandghthatghstartsghitghall.

whatghisghtheghoverallghgoalghofghtheghinterview?gh-ghcorrectghanswers-
toghfigureghoutghtreatmentghnotghtoghfigureghoutghaghdx.
whatghpercentageghdropghoutghofghtxghbruteghthey'regh4thghvisit?gh-ghcorrectghanswers-50%
whatghisghtheghmostghimportantghpartghofghtheghinterview?gh-ghcorrectghanswers-
negotiatingghaghtxghplan.ghifghtheyghdon'tghfeelghcomfortableghwithghitghthenghtheghinterviewghmightgh
asghwellghnotghhaveghbeenghdone.
lengthghofghtimeghforghthegh3ghphasesghofghtheghinterviewgh-ghcorrectghanswers-opening:gh5-
10ghmin
body:gh30-40ghmin
closing:gh5-10ghmin
explainghwhatghthegh3ghphasesghofghtheghinterviewgh-ghcorrectghanswers-intro:gh
-ghlearnghaboutghtheirghlife
-ghgiveghaghfewghminutesghtoghtellghwhyghtheyghcame

body:gh
-ghest.ghinterviewingghpriorities
-ghHPI
-ghHxghofghdepression,ghSI,ghsubstanceghabuse
-ghFHx
-ghdetermineghwhetherghtheyghmeetghcriteria
-ghifghhaveghtime:ghsocial/developmentalghHx,ghPMHx,ghpsychghROS

closing:
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-ghnegotiatedghtxghplan
whatghtoghputghinghyourghofficegh-ghcorrectghanswers-
makeghitghhomie:ghphotosghofghfamily,ghplants,ghdecorationsghonghwall

arrangeghseating:ghputghclockgheasyghforghyoughtoghseegh(ghjustghbehindghpt)

,guidelinesghforghpatientghcontactgh-ghcorrectghanswers--
ghneverghgiveghhomeghorghcellghphoneghnumber

-ghifghgivingghaghcontractghnumberghspecifyghtimesghtheyghmayghcallghyou
-ghinstructghwhatghtoghdoghinghemergencyghwhenghyoughcan'tghbeghcontacted
-
ghleaveghaghvoicemailghsystemghforghthemghtoghcallghandghletghthemghknowghifghit'sghemergentghyou'll

ghcallghbackghwithingh24ghhrs

-
ghsignghptsghoutghtoghanotherghclinicianghwhenghyou'reghonghvacationghandghinformghhimghofghmoregh

severeghptsghorghchronicallyghsuicidalghpts.ghchangeghvoicemailghtoghhaveghinstructionghtoghconta
ctghthisghclinician.
-
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nythingghmoreghhasghtoghbeghaddedghtoghtheirghEMR).gh
-
ghforghHIPPAghaddghnoteghsaying:gh"pleaseghbeghawareghthatghemailghcommunicationghcanghbeghin

terceptedghinghtransmissionghorghmisdirected.ghyourghuseghofghemailghtoghcommunicateghprotect
edghhealthghinformationghtoghusghindicateghthatghyoughacknowledgeghandghacceptghtheghpossiblegh
risksghassociatedghwithghsuchghcommunication.ghpleaseghconsiderghcommunicatingghanyghsen
sitiveghinformationghbyghtelephone,ghfax,ghorghmail.ghifghyoughdoghnotghwishghtoghhaveghyourghinform
ationghsentghbyghemail,ghpleaseghcontactghtheghstreetghimmediately."
-
ghgetghptsghnumberghandghemail.ghaskghifghit'sghokayghtoghidentifyghyourself ghwhenghyoughcallghbecau

seghsomeghpeopleghdon'tghwantghfamilyghorghemployersghknowingghthey'reghinghtx.ghheyghcontactghi
nfoghforghenergyghcontactghpeople,ghneedghconsentghbeforeghdoingghthis.
rapportghbuildingghtechniquesgh-ghcorrectghanswers--
ghempathicghorghsympatheticghstatements:gh"youghmustghhaveghfeltghTruckeeghwhenghsheghleftghy

ou".ghcommunicateghyourghaverageghandghunderstandingghofghpainfulghemotions.ghbutghdon'tgho
verghuseghthem.gh
-ghdirectghfeelingghquestions:gh"howghdidghyoughfeelghwhenghsheghleftghyou?"
-
ghreflectiveghstatements:gh"youghsoundghdadghwhenghyoughtalkghaboutghher".ghdon'tghoveruseghbe

causeghitghsoundsghlikeghyou'reghstatingghtheghobvious.
-
ghifghyoughnoticeghcountertransference ghhappening,ghseeghthemghasghpsychopathologyghandghde

velopghcompassionghforghthemghonghthatghbasisghfirst
techniquesghtoghmakeghtheghpatientghcomfortablegh-ghcorrectghanswers--
ghgreetghnaturally:ghintroduceghyourself ghandghmakeghsmallghtalkghforghaghminutegh(unlessghinghem

otionalghdistress)
-
ghaskghwhatghtheyghwannaghbeghcalledghandghuseghtheirghnameghaghfewghtimesghduringghtheghintervi

ew
-
ghlearnghsomethingghaboutghthemghsoghthey'reghmoreghcomfortableghsharingghaboutghthemselve

s:gh"beforeghweghgetghintoghwhatghbroughtghyoughhere,ghifghlikeghtoghknowghaghlittleghaboutghyoughasgh
aghperson,ghwhereghyoughlive,ghwhatghyoughdo,ghthatghsortghofghthing."

,-
ghexplainghwhatghwillghhappenghinghtheghinterview:ghmanyghthinkghthey'reghjustghhereghforghpsychot
herapy.ghstartghbyghaskingghifghtheyghknowghwhyghthey'reghhereghandghthenghgiveghyourghexplanati
ongh(lengthghofghinterview,ghwhatghinfoghyou'llghbeghaskingghabout,ghandghfollowghupghgoingghforwa
rd).
-
ghthenghgiveghthemgh5ghminutesghofghfreeghspeechghtoghexplainghwhatghisghgoingghon.ghAskghthemght

oghexplainghtheghmostghtroublingghsymptomsghfirstghandghgoghfromghthere.ghifghthey'reghgivingghyou
gharticulateghinfoghletghthemghkeepghgoingghbutghifghtheygharen'tghyoughhaveghtoghcutghthemghoff ghandg

hdirectghtheghinterviewghmoreghbutghgiveghthemghtheghinitalgh5ghminutes.

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ghafterghthisghmakeghaghgoalghwithghyourghpatientghbyghaskingghthem:ghwhatghwouldghmakeghthisghvis

itghtheghmostghhelpfulghforghyoughtoday,ghwhatghwouldghyoughlikeghtoghgetghitghofghit?
--
ghifghthey'reghreluctantghaskghtheghmiracleghscenario:gh"imagineghthatghtonightghyoughgoghtoghbed,ghli

keghyoughnormallyghdo.ghThen,ghimagineghthatghwhileghyou'reghasleep,ghaghmiracleghhappensghan
dghyourghdepressiongh(orghwhateverghproblem)ghgoesghaway.ghwhatghwillghyourghdayghbeghlikeghto
morrow?"
techniquesghtoghhelpghtheghptghelicitghsensitiveghmaterialgh-ghcorrectghanswers-Mostghcommongh-
ghnormalization:ghnormalizeghitghbyghintroducingghyourghquestionghwithghaghnormalizingghstateme

nt,gh2ghwaysghtoghdoghthis:
-
ghstartghquestionghbyghimplyingghtheghbehaviorghisghnormalghorghunderstandableghresponseghtogh

moodghorghsituation:gh"Withghallghtheghstressghyou'veghbeenghunder,ghIghwonderghifghyou'veghbeengh
drinkingghmoreghlately?"ghorgh"Sometimesghwhenghpeopleghareghveryghdepressed,ghtheyghthinkgh
ofghhurtingghthemselves.ghHasghthisghbeenghtrueghforghyou?"
-
ghdescribeghanotherghptghwhoghhasghhadghthisghbehaviorghtoghshowghyourghptghthey'reghnotghalone:gh

"I'veghseenghaghnumberghofghptsghwho'veghtoldghmeghthatghtheirghanxietyghcausesghthemghtoghavoidg
hdoingghthings,ghlikeghdrivingghonghtheghhighwayghorghgoingghtoghtheghgroceryghstore.ghHasghthatghb

eenghtrueghforghyou?"

Note:ghdoghnotghnormalizeghseverelyghabnormalghbehaviorsghsuchghasghextremeghviolenceghorghs
exualghabuse.gh

Others:
-
ghsymptomghexpectation:ghakaghgentleghassumption.ghyoughinferghthatghaghbehaviorghisghexpecte

dghbyghstatingghyourghquestionghimplyingghyoughassumeghtheghptghisghhavingghsomeghbehaviorghan
dghyoughwon'tghbeghoffendedghwithghaghpositiveghresponse.ghEspeciallyghgoodghifghsuspectghselfghd
estructiveghactivityghlikeghdrugghuseghorghsuicide.ghEx:gh"whatghsortsghofghdrugsghdoghyoughusuallygh
useghwhenghyou'reghdrinking?"ghorgh"whatghkindsghofghwaysghtoghhurtghyourselfghhaveghyoughthoug
htghabout?"

Note:ghonlyghuseghthisghwhenghyoughsuspectghbehavior,ghdon'tghbeghaskinggheverygh70ghy/oghwom
enghwhatghdrugsghthey'reghusing.gh

, -
ghsymptomghexaggeration:ghoftenghusedghwithghsxghexpectationghhelpsghclarifyghseverityghofghsxs
.ghYoughsuggestghaghfrequencyghofghaghbehaviorghthatghisghhigherghthanghyoughexpectation,ghthengh
theirghlowerghfrequencyghwillghseemghnotghasghbad.ghEx:gh"Howghoftenghdoghyoughbingeghandghpurg
egheachghday?gh5ghtimes,gh10ghtimes?"

Note:ghagainghonlyghdoghthisghwhenghappropriateghforghtheghptghandghonlyghifghyoughsuspectghthey'r
eghalreadyghdoingghtheghbehavior.gh

-
ghReductionghofghguilt:ghbeginghbyghaskingghaboutghotherghpeoplegh(haveghtheyghhadghfriendsghinv
olvedghinghtheseghsituationsghetc)
--ghforghdomesticghviol
Termsghtoghuseghtoghbeghmoreghfamiliarghwithghyourghptsgh-ghcorrectghanswers-Insteadghofgh=ghsay
-ghDoghyoughhaveghaghhxghofghIVghdrugghuse?gh=ghHaveghyougheverghshotghup?
-ghdoghyoughsmokeghmarijuana?gh=ghdoghyoughgetghhigh/smokeghdope?
-ghdoghyoughuseghcocaine?gh=ghdoghyoughsnortghorghsmokeghcoke?

Note:ghusingghtheseghtermsghincreasesghhonestyghbygh15%
Tipsghtoghimproveghptghrecallgh(accurateghmemories)gh-ghcorrectghanswers-
AnchorghQsghtoghmemorableghevents:ghptsghforgetghdatesghofgheventsghthatghoccurredghmoreghtha
ngh10ghdaysghinghtheghpast.ghWeghremembergheventsghinghrelationghtoghmemorablegheventsgh(grad
uations,ghbirthdays,ghholidays,ghaccidents,ghmajorghpurchases,ghseasonalgheventsghorghpublicgh
eventsgh[elections]).ghSoghinsteadghofghaskingghhowghmanyghyearsghagoghtheyghbeganghdrinking,g
haskgh"Didghyoughdrinkghwhenghyoughgraduatedghfromghhighghschool?"ghThenghjustghkeepghonghgoi

ngghbackghinghtimeghinghrelationghtogheventsghtoghseeghwhenghitghbeganghandghifghsxsghbeganghpriorghf
orghexample.gh

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ngh"whatghwereghtheghnamesghofghtheghmedicationsghyoughtookghbackghthen?ghwasghitghproxac,ghpa
xil,ghZoloft,ghElavilghetc?


Defineghtechnicalghterms:ghsometimesghptsghjustghdon'tghunderstandghtermsghyoughuse.ghex:ghyou
ghaskghaghptghwhenghtheyghfirstghfeltghdepressed,ghtheyghsayghtheyghalwaysghhaveghbeenghdepresse

d.ghYoughexplainghwhatghclinicalghdepressionghisgh(seriouslyghaffectsghfunctioning),ghwhenghdidghy
oughfirstghexperienceghthat?ghtheyghrespondghwithgh1ghmonthghago.
Tipsghforghtransitioningghinghtheghinterviewgh-ghcorrectghanswers-
smoothghtransition:ghcueghoffghsomethingghtheghptghjustghsaidghtoghintroduceghaghnewghtopic
-
gh"Johnghhasghbeenghgoodghtoghme,ghbutghIghcan'tghstandghtheghwayghhisghdaughtersghexpectghmeght

oghgoghoutghofghmyghwayghtoghmakeghtheirghlivesgheasy;ghafterghall,ghthey'reghadults!"ghrespondghwith
gh"speakingghofghfamily,ghhasghanyoneghelseghinghyourghfamilyghbeenghthroughghtheghkindghofghdepr

essionghyou'veghbeenghgoingghthrough?"