1. Dr. Levi Armstrong Amberton University

2.  What is a diagnostic interview?  Usually performed during initial meeting with client  Sometimes takes a few sessions (2 or 3 at most)  Reviews a wide range of the client’s history and symptoms  See next slide  Purpose is to establish a provisional diagnosis so as to delineate a specific plan for treatment  Identifies other conditions in need of a referral to ancillary providers  Should be therapeutic in nature and an effective means for “breaking the ice” during initial sessions with the client  Often erroneously overlooked when practicing counseling  Can be performed with individuals, couples, and families

3.  Review of the Client’s Chief Complaint/Main Areas of Concern  Chief Complaint  Client’s spontaneous list of concerns  WHY SEEK THERAPY NOW?  When did the symptoms begin?  How often do they occur?  What is the severity of the symptoms?  In what context do the symptoms occur? Triggers, etc.?  What, if anything, helps decrease or manage the symptoms?  QUICK TIP: Most, if not all this information, can be gathered with an intake questionnaire to be reviewed by you in the first session.

4.  Background Information You Should Gather  Developmental History  Born and raised where?  Born on time? If not, how many weeks early/late?  Any complications with mother’s pregnancy or delivery? Exposure to any drugs/alcohol/trauma in utero?  Any health complications immediately after birth?  Treatment history of this, if any  Developmental Milestones  Feeding abilities  Motor milestones – sitting up, crawling, walking, running, fine motor dexterity  Speech-Language milestones – early vocalizations, reciprocal vocalizations, first word, first sentences, any speech delays or abnormalities  Early Social Development  Attachment style with parents, siblings, peers  Early Behaviors & Cognitive Abilities  Any inattention/hyperactivity early on?  Impulsivity, defiant behaviors, acting out, explosive anger episodes?  Home Life Growing Up & current relationships with family

5.  Background Information You Should Gather  Academic History  Pre-K – College History  When, Where attended  Any grades repeated/failed?  Behaviors during elementary through college  Any special education services (e.g., speech therapy, 504, IEP, etc.)  Any learning disabilities diagnosed? – any specific testing?  Social development through academic history  Any bullying?  Academic strengths & weaknesses  DIAGNOSTIC INTERVIEW REVIEW TO BE CONTINUED NEXT CLASS…

6.  How Not to Do Therapy….  https://www.youtube.com/watch ?v=4qiQI-zrPvQ

7.  Current Physicians Following Client  Names, Contact Info  Current medical diagnoses  Past medical diagnoses  Medical History:  Current Medications, dosages, frequency, side effects, effectiveness, prescribed for what?  Any major illnesses or injuries  History of brain injuries/disease:  Seizures  TBI/Concussions  Exposure to toxic substances  Etc.  Past Surgeries

8.  Vocational History:  Current/past places of employment  Job titles, reason for leaving, salary earned  Family Medical/Psych History:  Known or suspected diagnoses  LD’s, ADHD, Schizophrenia, Bipolar, Anxiety, Depression, Autism, etc.  Social Functioning:  Current/past marriages  What, if any, problems occurred?  Children  For children, ask about peer relationships at school, etc.  Psychiatric History:  Current/past diagnoses  Current/past medications  Inpatient hospitalizations  Previous suicide attempts  Previous counseling experiences  With Whom? For how long? Why did/didn’t they work?  Previous psychological testing  Diagnoses suspected and why?  Exposure to traumatic events/abuse?  Substance Use/Abuse History

9.  Review of Subjective Symptoms:  Cognitive  Attention  Memory  Language/Speech abilities  Visuospatial skills  Executive Functions  Planning, prioritizing, organizing, etc  Academic skills  Daily Problem Solving Abilities  Legal History:  I typically start here…  Previous arrests/charges, outcomes  Any child-custody/divorce proceedings?  Suing or being sued by anyone?  Name(s) of any attorneys  Contact information too!  Applying for disability? Workers Comp?

10.  Review of Subjective Symptoms:  Emotional/Behavioral Symptoms:  Mood  Mania or hypomania  Suicidal or Homicidal  Thoughts, Plans, Intents  KNOW HOW TO ASSESS THESE DOMAINS CAREFULLY  Anxiety  Irritability  Lability  Inhibitions  Initiation  Psychosis  Review of Subjective Symptoms:  Physical Symptoms:  Pain or Headaches  Energy Level  Appetite  Sleep  Balance/Coordination  Vision/Hearing

11.  Step 9: Start Therapy  Step 10: Assess/Evaluate Effectiveness  Step 11: Document Effectiveness  Step 12: Plan for Termination  Time-limited vs. open-ended  Termination issues  Maintenance Plan  Step 1: KNOW YOUR CLIENT  Step 2: KNOW WHO IS PAYING  Step 3: DIFFERENTIAL DIAGNOSIS  3a Case Conceputalization  Step 4: SELECT LENGTH OF THERAPY  Step 5: SELECT TIMING OF THERAPY  STEP 6: DETERMINE SPECIFIC GOALS  STEP 7: DETERMINE OBJECTIVES  STEP 8: DETERMINE INTERVENTIONS