1. Assessment: Initial Phase The Intake Interview University of South Dakota Dale Pietrzak, Ed.D., LPC-MH, CCMHC

2. Assessment Process  Initial Phase  Intake  Mental Status Exam  Testing (Objective or Projective)  Intermediate Phase  Client-Therapist Interaction  Testing  Initial Phase  Intake  Mental Status Exam  Testing (Objective or Projective)  Intermediate Phase  Client-Therapist Interaction  Testing  Termination Phase  Meet Goals?  Dismissal Dx?  Referral Appropriate?  Termination Phase  Meet Goals?  Dismissal Dx?  Referral Appropriate?

3. Interactional Nature of Assessment Components Intake InterviewTest Results Treatment Plan and Goals Client Behavior

4. Intake Interview most needed Ranked as the most needed and valued skill by practicing mental health professionals 1 1 Morrison, J. (1995). The first interview: Revised for the DSM-IV. New York: Guilford 1 Morrison, J. (1995). The first interview: Revised for the DSM-IV. New York: Guilford

5. Purpose of Intake Interview  Determine areas of concern: type and severity of concerns  Determine appropriate testing process  Set stage for Relationship  Determine areas of concern: type and severity of concerns  Determine appropriate testing process  Set stage for Relationship  Determine general to specific treatment goals (initial and termination)  Serves as framework for interpretation of testing  Determine general to specific treatment goals (initial and termination)  Serves as framework for interpretation of testing

6. Intake Components P General Information P General Concerns P Relationships P Developmental & Medical History P Chemical Use P General Information P General Concerns P Relationships P Developmental & Medical History P Chemical Use P Legal History P Mental Health History P Detailed Concerns P Interview P Checklist P Legal History P Mental Health History P Detailed Concerns P Interview P Checklist

7. Psychiatric Evaluation n Chief Complaint n History of Present Concern n Past History of MI & Family History of MI (screen for neurological impairment) n Med History n Medications & Drugs n Psychosocial History (pg 132-141) Zimmerman (1994).

8. n Mental Status Exam (pg 120-125) n Physical Exam n Differential Diagnosis n Treatment Plan Psychiatric Evaluation Con’t I don’t know if I can do this!

9. Initial Contact  Phone Contact  Waiting Room or Office  Identifying Information  Phone Contact  Waiting Room or Office  Identifying Information Client Attitude – Treatment – Agency – Therapist And you would like the counselor to help with what else?

10. Current Concerns: General What is the difficulty? What made client seek treatment now?

11. Relationships: Past & Present ê How does client handle closeness? ê How does client handle conflict? ê How does client determine friendships? ê How does the client end friendships? ê How does the client handle authority? ê How does the client handle subordinates? ê How does client handle closeness? ê How does client handle conflict? ê How does client determine friendships? ê How does the client end friendships? ê How does the client handle authority? ê How does the client handle subordinates?

12. 4 Physical conditions impacting situation 4 Medications impacting situation 4 Chemicals impacting situation 4 Learning difficulties/Developmental delays 4 Neurological concerns 4 Family history of conditions 4 Physical conditions impacting situation 4 Medications impacting situation 4 Chemicals impacting situation 4 Learning difficulties/Developmental delays 4 Neurological concerns 4 Family history of conditions Medical History

13. Legal/Financial History ê Childhood to date ê Types, severity and chronicity ê Role in motivation in treatment ê Financial difficulties ê Role in concerns ê Childhood to date ê Types, severity and chronicity ê Role in motivation in treatment ê Financial difficulties ê Role in concerns

14. Mental Health History. Conditions. Treatments. Attitudes about Tx & Dx. Releases. Family History. Conditions. Treatments. Attitudes about Tx & Dx. Releases. Family History

15.  Specific Symptoms  Checklist  Interview form  Interview  Duration  Impact on areas of home, friendship, work (school), personal self-care  Things missed so far  Specific Symptoms  Checklist  Interview form  Interview  Duration  Impact on areas of home, friendship, work (school), personal self-care  Things missed so far Current Concerns: Specifics

16.  Summary of Information  Strengths  Weaknesses  Personal Style  Concerns/Diagnosis  Treatment Plan  Short & Long Term Goals  Summary of Information  Strengths  Weaknesses  Personal Style  Concerns/Diagnosis  Treatment Plan  Short & Long Term Goals Integration

17. End The