{[ promptMessage ]}

Bookmark it

{[ promptMessage ]}

Form33 - FORM 33 —Use the top of this page for your...

Info iconThis preview shows pages 1–2. Sign up to view the full content.

View Full Document Right Arrow Icon

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full Document Right Arrow Icon
This is the end of the preview. Sign up to access the rest of the document.

Unformatted text preview: [ FORM 33 —Use the top of this page for your letterhead.] Intake Interview Questions and Guide Client’s name: Date: Interviewer’s initials: q OK to thank referrer? q Yes q No q Entered into phone book q Entered into birthday book Introductory questions 1. Who suggested that you come to see me? Referral code: 2. What is the problem, in your own words? How do you see the situation? a. Symptoms—frequency, duration, intensity, latency, recurrence, course; distress caused. b. Change efforts. c. Why help is being sought now —precipitants, stressors, consequences; contexts, relevant history; needs, goals, strengths.) Essential information 3. Previous psychological episodes, treaters, and treatments. a. For what? b. Where/by whom? c. Treatment? d. When (from–to)? e. Outcome? f. Satisfaction/difficulties? (Especially follow up any hints of problems/abuse by therapists—e.g., dual relation- ships, sexual intimacies, litigation.) g. Release(s) for records signed?...
View Full Document

{[ snackBarMessage ]}

Page1 / 2

Form33 - FORM 33 —Use the top of this page for your...

This preview shows document pages 1 - 2. Sign up to view the full document.

View Full Document Right Arrow Icon bookmark
Ask a homework question - tutors are online