Intake For Psikodiagnos

Intake, Diagnosis, and TreatmentMHS 6620 Lorayne Thayer &TeresaTilden

Diagnosing the Problem Effective problem solving and decision making involves the ability to collect and select the information that is necessary to solve the dilemma.

The nature of the interaction must be controlled by the helper, who is trained to collect and select the information necessary to solve the dilemma, he/she helps the client facilitate change.Gazda, G.M., Asbury, F.R., Balzer, F. J., Childers, W. C., Phelps, R.E., Walters, R. P., 2003 p.10

Intake and Diagnosis

Before a helper can be of any assistance to a helpee, he or she must understand the helpees problem in depth.

An intake interview is the first step to understanding, and then diagnosing the problem.

Gazda, G.M., Asbury, F.R., Balzer, F. J., Childers, W. C., Phelps, R.E., Walters, R. P., 2003 p.10

What is an intake?An initial interview used to gather data about a client.

Can be conducted by an intake worker or a counselor.

MacCluskie, K.C., Ingersoll E.R., 2001 chapter 5

What is the purpose of an intake?To provide information to guide diagnosis and selection of a treatment plan.

Helps to match the client to a counselor.


What to do during Intake Interviews?!Have a clear idea of why the individual is being interviewed.Be concerned about the physical setting or environment.Empathize and be warm to help establish good rapport with the client.Be alert to verbal and nonverbal behavior.Be in charge and keep the goals of the interview in mind.

Information Obtained During Intake

Demographic InformationPresenting ProblemPast Psychiatric HistoryMedical HistoryMental statusPersonal & Social History

*Pay attention to how the client speaks, thinks, feels, and evaluates situations.

How to Obtain Information: Models of Clinical Assessment During an intake, there are two ways of gathering information, or two models of assessment to help diagnose the client.

!. Psychodiagnostic Model---holistic and intended to describe the client in a variety of ways.

2. Psychometric Model---emphasizes more objective use of tests and assessment instruments. Drummond, R. J., 2004

Types of Intake InterviewsStructured---A set of specific questions. Each client is asked exactly the same questions in the same manner.

Unstructured---Does not follow any specific format. Allows the client to determine what is important to talk about.Drummond, R. J., 2004

Tools for Structure:Data vs. Multimodal Schemas Initial Client Contact Form (ICCF) (DATA)

(Basic ID) (Multimodal)

Mental Status Exam (MSE) (Multimodal) MacCluskie, K.C., Ingersoll E.R., 2001 chapter 5

Multimodal TherapyMultimodal therapy was one of the first attempts at comprehensive assessment and treatment. It was developed by J. Lazarus who saw it as an effective way of tailoring the treatment to the client rather than the other way around.

Structure: Initial Client Contact Form (ICCF)Used by the counselor to gather general data about a potential client, often used during phone interviews.Used by the client in order to access treatment or receive further information about treatment options at an agency.Is not usually fully comprehensive in terms of putting together a diagnosis or treatment plan.


Structure: Basic IDAcronym for the seven elements of the clients experience.Follows the psycho diagnostic model.Comprehensive in initial assessment and treatment.Guides counselors thinking in determining a diagnosis and treatment plan.

Basic ID continuedComprehensive initial assessment and treatment.

Behavior Interpersonal relationshipsAffect Drug (biological)SensationsImageryCognitions

Structure: Mental Status Exam (MSE)Component of diagnostic interviewing.Observation and documentation of: appearance, attitude, activity, affect, speech, language, thought process, content, perception, cognition, insight and judgement.Remember to secure the clients approval to do a mental status exam, or to document that an MSE is being done if you are in an emergency situation.

Tools for Structuring IntakeThe ICCF can be used for quick intake over the phone or in brief interviews that have time constraints.The ICCF is not as comprehensive as Basic ID and MSE which are used to provide general structure for data gathering while the client shares his/her concerns as he/she feels most comfortable. Basic ID and MSE guide the counselors thinking in determining a diagnosis and treatment plan.

What is a Crisis? Hoff (1995) defines crisis as: acute emotional upset arising from situational, developmental, or sociocultural sources and resulting in a temporary inability to cope by means of ones usual problem solving device.

Symptoms of CrisisLowered attention span.Introversion.Emotional reaching out.Impulsive and unproductive behavior.Subjective sense of extreme vulnerability.

Assessing a Client in CrisisAssess lethality and safety needs.Establish rapport and communication; reflect feelings.Identify the major problem.Process feelings and provide support.Explore possible alternatives.Formulate an action plan.Follow-up.

Other Assessment Tools:DSM-IVMerck ManuelTreatment and intake forms and resources available: http://www/4ulr.com/products/counseling/treatmentplannerbooks.html

http://www.coedu.usf.edu/zalaquett/ccs/ccsp.htm intake presentation number two.

Treatment ModesIndividualCoupleGroupFamily

Models of Treatment: Psychotherapy v CounselingCounseling stresses the giving of information, advice, and orders by someone considered to be an expert in a particular area of human behavior or in redirecting human behavior in positive ways .

Psychotherapy is the process of helping people discover why they think, feel, and act in unsatisfactory ways.

Corsini, R.J., Wedding, D., 2005 ch. 1

Psychotherapy v Counseling

What may seem to be a simple problem at first can become more complicated as counseling goes on and may require the more in depth approach of psychotherapy.

Counseling focuses on problem solving while psychotherapy focuses on the person.Corsini, R.J., Wedding, D., 2005 ch. 1

Techniques:Psychotherapy v CounselingPerson-centeredCognitiveBehavioralRational Emotive Behavior TherapyGestaltEclectic

BriefSolution FocusedEclectic

Treatment: Final Thought

Your careful assessment of the clients condition and prognosis determines the extent and type of intervention that needs to occur and helps your clients reach their goals.

References

Corsisni, R. J., and Wedding, D. (2005). Current Psychotherapies. 7th ed. Brooks/Cole.

Gazda, G.M., Asbury, F.R., Balzer, F. J., Childers, W.C., Phelps, R.E., Walters, R.P.(1999).HumanRelations Development.6th ed. Needham Heights, MA: Allyn and Bacon.

MacCluskie, K.C., and Ingersoll, R.E., (2001). Becoming a 21stCentury Agency Counselor. Belmont, CA: Wadsworth/Thomson.

Thomson, R. A.(2003) Counseling Techniques. N.Y.,N.Y.:Brunner-Routledge.

Drummond, R.J. (2004). Appraisal Procedures for Counselors and Helping Professionals. 5th ed. New Jersey:Prentice Hall.

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Intake For Psikodiagnos