Week 2: Diagnostic interviewing & Differential Diagnosis
Mental Status Exam
Can be conducted during Diagnostic interview. Take note of how the client presents, how they speak, dress, affect, mood, appropriateness of emotional response , insight, judgement, attention, suicideality.
Social History - Social & Sexual functioning
Enquire about relationships and dating in a way that is culturally sensitive. Social: "friendships at school?" "what about friendships now?"
Social History - Educational history
Gives you an idea of the clients intellectual functioning to assist with the PP. "When did you start and finish school"
Perpetuating Factors
Part of the history of PP. Factors which maintaining the problem and keep it going.
Precipitating factors
Part of the history of PP. Factors which cause or trigger the problem
Unstructured interviews
People can talk about what they want Ask follow Q's allow client to lead, have freedom to decide how long you want to spend n one topic.
Diversity
Racial, ethnic, cultural background, gender identity, sexual orientation. "how do you describe your racial background""what language did you speak at home?"
Medical History
Some health conditions can produce psychological effects and may be the source of psychosocial stress. "How would you describe you health? "have you been diagnosed with a serious illness?"
Substance Use History
ask q's to determine if drugs/alcohol use is an explanation for symptoms. "how much alcohol do you drink on average?" "do you use any substances?"
Differential diagnosis
differentiate the diagnosis from other disorders which are quite similar in nature. Follow up Q's can explore FID of symptoms.
Social History - Developmental milestones
"are you aware of any health/developmental problems you had in childhood?"
Safety issues - history of SH or suicide
"i was wondering if there are ever times in your life if you felt like your life was not worth living?"
Trauma & abuse history
"is it ok if i ask you some questions about...have you ever been slapped, shoved, kicked, beaten?"
Work History
History of work activities, did they have a job in school, what kinds of work have you done, volunteer work?
Presenting problem
What has TRIGGERED them to come in at this point? behaviour, symptoms, ongoing situations or symptoms - explore the clients story in-depth, gather info on symptoms that may together meet criteria for a DSM diagnosis.
Social History - Family origin & attachment
Who client feels closest too (resilience factors), who client currently lives with, context of their living environment
Semi structured interviews
used in the first interview, can ask general Qs based on the clients answers, format of clinical diagnostic interview.
