1. Presenters: Mary Deitch JD, Psy.D (Keystone Center ECU) Ron Neufeld B.S.W, L.A.D.A.C (Vanderbilt) AJ Reid Finlayson, M.D. (Vanderbilt)

2. Objectives Learn what a professional clinical assessment can tell you Learn how assessments are approached and the tools and techniques utilized Learn how to use and understand reports and the information contained therein Learn about different types of assessment

3. Why refer for assessment? When a professional has been accused of inappropriate conduct To gain clarity of the professional’s possible issues For diagnostic clarification To aid those in working with the professional understand potential problematic areas To have an outside party’s perspective

4. How to frame a referral question Have to understand what assessment can and can’t do Can’t tell definitively if a situation occurred (e.g. guilt vs. innocence) Can give you ideas and recommendations for the best way to approach a situation Can give you ideas and recommendations about how best to approach therapy or boundary work

5. Referral Question cont Many times the question involves assistance with treatment planning Many times the question involves assistance with boundaries Many times the question involves how to integrate the professional back to work Many times the question involves how to manage the professional prior to returning to work and what would have to be achieved before returning to safe practice

6. Common Assessment Topics Drug and Alcohol Concerns Sexual compulsivity concerns (hypersexual disorder or paraphilic issues) Boundary violations Disruptive Physician Other mental health concerns Cognitive difficulties

7. Standard Assessment While there are similarities amongst all professionals on how to conduct assessments, there is no “standard” in the field. There are “shoulds” There will be collateral interviews. This is where referral sources can be of assistance. There will be personality, cognitive and emotional functioning Both objective and projective There will be good clinical interview(s)

8. Standards Cont There will be a psychosocial history There will be an assessment of current professional and personal stressors Regardless of the referral question, there should still be some assessment of addiction issues as well as interpersonal issues

9. Keystone “Standard” All clients get basic assessment which includes WAIS-IV MMPI-2 Rorschach Collateral Interview Clinical Interview BDI-2, BHS, BAI, HDQ, SAA, TSI

10. Keystone cont Some clients will get extra assessments such as polygraph and AASI-2 and neuropsychological assessments

11. Vanderbilt “Standard” MOCA MMPI – 2 PAI Eqi BDI, MAST, DAST, SAST, BVI, ACE, Medical History and Physical Exam Clinical interviews Psychosocial interviews Collateral contacts and documentation

12. Vanderbilt cont Other possible assessment services include AASI, extensive neuropsychological testing, consultation with other medical specialties, and polygraph examination.

13. What to expect Answer to referral question Recommendations should be as specific as possible E.g.: “this physician needs to be monitored” vs. “It is recommended that this physician be monitored by….” E.g.: “this physician needs treatment” vs. “it is recommended that this physician seek treatment consisting of…”

14. How to understand the report Typically set up similar: Reason for referral Testing Materials Background Information Behavioral Observations Assessment Information Cognitive Personality and emotional functioning Specialty assessment

15. How to read cont Summary and or diagnosis Recommendations

16. Case examples 2-3 cases illustrating problems encountered during Fitness-for-Duty Evaluations will be briefly presented for discussion Discussion around problem case situations Need for more standardization to ensure quality of evaluation procedure Forum for consultation / review of difficult cases

17. Questions

18. For further information Ron and Reid- Vanderbilt Comprehensive Assessment Program, for Professionals 3rd floor VPH, Suite 3068 1601 23rd Ave. S.Nashville, TN 37212 email: vcap@vanderbilt.eduvcap@vanderbilt.edu Phone numbers: Office: (615) 322-4567 Fax: (615) 322-7526 Mary- Keystone Center Extended Care Unit 2000 Providence Ave Chester PA 19013 800-733-6840 Mary.deitch@uhsinc.com