COMPLETE QUESTIONS AND ANSWERS
GRADED A+
◉ what is our intitaly first job? how do we do this? Answer: 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? Answer: to figure out
treatment not to figure out a dx.
◉ what percentage drop out of tx brute they're 4th visit? Answer:
50%
,◉ what is the most important part of the interview? Answer:
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 Answer: opening:
5-10 min
body: 30-40 min
closing: 5-10 min
◉ explain what the 3 phases of the interview Answer: 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)
- negotiated tx plan
◉ what to put in your office Answer: make it homie: photos of family,
plants, decorations on wall
arrange seating: put clock easy for you to see ( just behind pt)
◉ guidelines for patient contact Answer: - never give home or cell
phone number
- if giving a contract number specify times they may call you
- instruct what to do in emergency when you can't be contacted
- leave a voicemail system for them to call and let them know if it's
emergent you'll call back within 24 hrs
- sign pts out to another clinician when you're on vacation and
inform him of more severe pts or chronically suicidal pts. change
voicemail to have instruction to contact this clinician.
- use email but this too needs ground rules (limit to scheduling
needs and refills, anything more has to be added to their EMR).
- for HIPPA add note saying: "please be aware that email
communication can be intercepted in transmission or misdirected.
your use of email to communicate protected health information to us
indicate that you acknowledge and accept the possible risks
associated with such communication. please consider
communicating any sensitive information by telephone, fax, or mail.
, if you do not wish to have your information sent by email, please
contact the street immediately."
- get pts number and email. ask if it's okay to identify yourself when
you call because some people don't want family or employers
knowing they're in tx. hey contact info for energy contact people,
need consent before doing this.
◉ rapport building techniques Answer: - empathic or sympathetic
statements: "you must have felt Truckee when she left you".
communicate your average and understanding of painful emotions.
but don't over use them.
- direct feeling questions: "how did you feel when she left you?"
- reflective statements: "you sound dad when you talk about her".
don't overuse because it sounds like you're stating the obvious.
- if you notice countertransference happening, see them as
psychopathology and develop compassion for them on that basis
first
◉ techniques to make the patient comfortable Answer: - greet
naturally: introduce yourself and make small talk for a minute
(unless in emotional distress)
- ask what they wanna be called and use their name a few times
during the interview
- learn something about them so they're more comfortable sharing
about themselves: "before we get into what brought you here, if like