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Exam (elaborations)

The Psychiatric Interview - Carlat (notes) Questions and Answers

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The Psychiatric Interview - Carlat (notes) Questions and Answers what are the 4 tasks of the interview? - Ans:-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? ho...

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  • October 22, 2024
  • 72
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • The Psychiatric Interview
  • The Psychiatric Interview
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The Psychiatric Interview - Carlat (notes) Questions and Answers



what are the 4 tasks of the interview? - Ans:✔✔-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? - Ans:✔✔-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? - Ans:✔✔-to figure out treatment not to figure out a dx.


what percentage drop out of tx brute they're 4th visit? - Ans:✔✔-50%




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what is the most important part of the interview? - Ans:✔✔-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 - Ans:✔✔-opening: 5-10 min


body: 30-40 min


closing: 5-10 min


explain what the 3 phases of the interview - Ans:✔✔-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

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- if have time: social/developmental Hx, PMHx, psych ROS




closing:


- discuss assessment (w/ pt education)


- negotiated tx plan


what to put in your office - Ans:✔✔-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 - Ans:✔✔-- 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.


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- 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 - Ans:✔✔-- 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



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