Treatments that have workednot worked in past

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Treatments that have worked/not worked in past. Symptomatology. Signs from patient’s presentation. Goals: Suitability and readiness for psychotherapy (self or another therapist) Determine need for referral to:  psychiatrist or PCP for medication neurologist for neurological testing and/or neuroimaging social worker, vocational counselor, physical therapist, etc. Signs Noted in Clinical Interview Signs Noted in Clinical Interview Attire & grooming Posture Physical characteristics Skin tone / complexion Weight / stature Symmetry / atrophy / bodily anomalies
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Mannerisms, spasms or tics Speech Articulation Prosody Consciousness Level of alertness, fogginess, hypervigilance Emotional state General attitude Defiant, compliant, guarded, defensive, sincere, plaintive, resistant, apathetic,  etc. Thought content Solicited by free inquiry Thought processes Thought broadcasting, removal, insertion Gen’l knowledge General facts, pop culture Abstract thinking Social judgment Insight Cognitive functioning  Usually, current mental status via MMSE Neuropsychological screens like clock drawing Mini Mental Status Exam  Mini Mental Status Exam  (MMSE; Folstein et al., 1975) (MMSE; Folstein et al., 1975) Orientation (up to x3) Time (year, season, date, day, month) Place (state, county, city, facility) Person (name, age) Registration  Slowly say the names of 3 common objects (“apple”, “table”, “penny”) and ask  patient to repeat them
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Attention & calculation Serial 7’s or  W-O-R-L-D  backwards Recall Ask for names of 3 objects above Language Name a pencil and a watch when pointed to. Repeat “No ifs, ands, or buts.” Follow a 3-stage command:  “Take a paper in your right hand, fold it in half,  and put it on the floor.” Read and obey the following:  CLOSE YOUR EYES Write a sentence. Copy the following design: Clock Drawing as a Neurological Screen Helpful Ancillary Diagnostic Information Helpful Ancillary Diagnostic Information Info from family members  Info from physicians, employers  Medical chart Obtaining this kind of information usually require signed releases and informed  consents, obtained at the beginning of the first session. End End
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