Psych Intake Interview and Assessment

Further information about the research linked to PTSD is incorporated within the Appendix section (Miyahira & Spira, 2010). PTSD is usually assessed by various methods, inclusive of interviews, biological tests, and questionnaires. Under optimal conditions, PTSD assessment and related disorders is on the basis of several information sources, derived from psychometric testing, clinical interview, review of medical and military records, reports from the collaterals that know the veterans, and psychophysiological reactivity studies. Multi-method approaches are specifically useful in addressing concerns regarding either over-reporting or denying the signs and symptoms. Therapies for the veterans with PTSD appear to be less efficient than for the matched populaces, and the veterans having this condition are at higher risks of great levels of social exclusion and dysfunction (Blanco, 2011).

The thought content focused on his semi-compulsive tendency of gazing to his hand (Blanco, 2011). Typically, Carter was lost in ruminations regarding his experience in the forces with an emphasis on the exact moment, which he encountered as affectively charged and intrusive in a painful and adverse manner. He declined any thoughts to harm himself and showed no aggression signs towards other people. Hallucinations had a majorly ego-dystonic and depressive trait. He declined any perpetual instabilities at the examination period. For how long? ________________ What is your relationship? ❏ Parent ❏ child ❏ spouse ❏ friend ❏ relative II. Pre-military History Who were you raised by? Biological / adoptive / foster / step parents /other_____ Until what age? ____, Age at enlistment / draft /commission into the military____________ How would you describe your caretakers (type of work, personality): (mother, father, other) ________________________________________________ ____________________________________________________________________ Check any that you feel you experienced during childhood: ❏ Physical abuse / Assault ❏ Sexual abuse / Assault / Molestation ❏ Emotional abuse ❏ Neglect ❏ Witness of Domestic Abuse ❏ Unwanted sexual advance ❏ Motor Vehicle Accident ❏ Death of family member or close friend ❏ Natural Disaster ❏ Community violence How many siblings do you have (indicate if step, adoptive) _________________ ____________________________________________________________________ What are their names and current ages__________________________________ ____________________________________________________________________ ____________________________________________________________.

What type of relationship / contact do you currently have with your parents? ______________________________________________________________ What type of relationship/ contact do you currently have with your siblings? ______________________________________________________________ Prior to entering the service, how many years of schooling did you complete? ________ Did you earn a high school diploma? ____________________________________ Years of College_______________ Degrees? _______________________________ How would you describe yourself during the time prior to entry into the military_ ____________________________________________________________ How would you describe your pre-military adjustment? ❏ Very good ❏ good ❏ average ❏ marginal ❏ poor. *This Social History Questionnaire may be included in re-exams, for the purpose of expediting completion of the social and industrial survey. How would you describe: School / grades: ❏ very good ❏ good ❏ average ❏ marginal ❏ poor. The results pointed to insufficient reality test with minimal disturbances in perception as well as a hardship in separating fantasy from reality, resulting in mistaken or faulty impressions together with a tendency of acting without forethought in stress’ face.

Specifically, uncertainty was unbearable and adjusting to a novel setting was difficult. Cognitive functions (attention, executive functions, concentration, information processing) were impaired probably because of neurological disorder or cognitive inability. Emotions were controlled with the tendency for impulsive conduct; nevertheless, there was hardship in expressing and processing emotions in adaptive ways (Blanco, 2011). There were different anger and aggression patterns towards several others though articulating those patterns was clearly avoided, changing to denial and passivity instead of succumbing to the mature competitiveness or destructive urges. There are two major kinds of measures employed in the PTSD assessments; self-report questionnaires and structured interviews. The latter comprise of the standard question sets, which interviewers ask whereas the self-report questionnaires are sets of printed questions, which require answers.

If Carter has a screening test outcome indicating the risks of suicide, then it is important to observe him for suicidal behavior or ideation. The recommendations include: a. The initial screening needs to be done on every new patient for PTSD symptoms and then more frequently or annually if clinically shown because of clinical suspicion, or PTSD history. There are several treatment and screening interventions for suicidality in the aging military veterans, which encompass an extensive range of evaluation approaches. The elderly individuals who were war prisoners or in combat might have special health requirements, which might not be apparent (Krebs, 2010). Effective intervention and screening is pertinent in reducing suicidal behavior and ideation encountered by the vulnerable and aged population; and, using the necessary assessment tool in determining suicide indicators.

Propositions for long term care suicide precautions are: Conducting suicide assessments; creating suicide risk assessment/reevaluation procedures; creating close observation sheets for 5 to 15 minutes face-to-face checks; renewing suicide precaution orders every day; and maintaining high suspicion levels even when the signs lighten (Elbogen, 2013). Additionally, the leading cause of inpatient suicides is the failure of clinical evaluations. Even though the onset ideally happens briefly following exposure, the period between PTSD exposure and its full manifestation varies and in some instances long. If the symptoms’ onset happen more than 6 months following the trauma then it is called the delayed onset. PTSD may be recurrent or chronic. In some instances, it takes place singly, though most individuals having PTSD as well have several other psychiatric conditions, like major depressive condition, which occur either simultaneously or after PTSD development.

DSM-IV – Diagnostic Criteria for PTSD A. Persistent stimuli avoidance linked to the trauma as well as the general responsiveness numbing (not available prior to the trauma), as shown by the following: 1. Efforts of avoiding thought, conversations, and feelings linked to the trauma. Efforts of avoiding the activities, people, and places, which arouse trauma recollections. Incapability to recall crucial trauma aspects 4. Feelings of estrangement or detachment from other people 5. Exaggerated startle reaction. E. Disturbance duration (signs in Criteria D, C, and B) is more than a single month. F. This disturbance causes clinically considerable and impairment in occupational, social, and several other critical functioning areas. b. Eye Movement Desensitization & Reprocessing (EMDR) – this will help Carter to process and make sense or understand his trauma.

It entails calling the trauma into mind whilst being attentive to back-and-forth movements or sounds (such as waving the fingers side-by-side, tones, or lights). c. Cognitive Processing Therapy – this will teach Carter to reframe negative perceptions regarding his trauma. Written Narrative Exposure – entails writing regarding the trauma throughout sessions. As the provider, I will give instructions to Carter on the assignment to write, and allow him to complete the work by himself and then return at the session’s ending to briefly discourse any responses to the assignment. Overall, no treatment is perfect for everybody. It is important to discuss the options of treatment with Carter, and determine the most excellent therapy for him based on the risks, side effects, and benefits of all the treatments.