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More About This Title The Psychiatric Interview - Evaluation andDiagnosis
English
While the ABPN has now supplied such standards for psychiatry, psychiatric interviewing instruction has not been standardized in the US or in other countries. Similarly, the few psychiatric interviewing books available are written in textbook form, often long and often from the subpecialty perspective (e.g. psychodynamic interviewing). Critically, no interviewing guides to date take a true biopsychosocial perspective. That is, they limit themselves to “interviewing” as an isolated technique divorced from full patient assessment, which for quality patient care must include the interface of psychological and social components with biological components. Similarly, few interviewing texts are fully integrated with DSM/ICD categorical diagnostic schemata, even though these descriptive diagnostic systems represent the very core of our clinical language—the lingua franca of the mental health professions. Without good descriptive diagnoses there cannot be adequate communication of clinical data among providers.
The proposed book will meet this need for training in biopsychosocial assessment and diagnosis.
The patient interview is at the heart of psychiatric practice. Listening and interviewing skills are the primary tools the psychiatrist uses to obtain the information needed to make an accurate diagnosis and then to plan appropriate treatment. The American Board of Psychiatry and Neurology and the Accrediting Council on Graduate Medical Education identify interviewing skills as a core competency for psychiatric residents.
The Psychiatric Interview: evaluation and diagnosis is a new and modern approach to this topic that fulfills the need for training in biopsychosocial assessment and diagnosis. It makes use of both classical and new knowledge of psychiatric diagnosis, assessment, treatment planning and doctor-patient collaboration. Written by world leaders in education, the book is based on the acclaimed Psychiatry Third Edition by Tasman, Kay et al, with new chapters to address assessment in special populations and formulation. The psychiatric interview is conceptualized as integrating the patient's experience with psychological, biological, and environmental components of the illness.
This is an excellent new text for psychiatry residents at all stages of their training. It is also useful for medical students interested in psychiatry and for practicing psychiatrists who may wish to refresh their interviewing skills.
English
Allan Tasman, MD, is Professor and Chair of the Department of Psychiatry at the University of Louisville. An internationally known educator and psychoanalyst, he has received numerous national and international academic awards. He is the founding Senior Editor of Psychiatry, an internationally acclaimed comprehensive textbook. He is past president of the American Psychiatric Association and the Pacific Rim College of Psychiatrists. He recently completed service as Secretary for Education of the World Psychiatric Association and now leads the WPA Section on Psychotherapy.
Dr. Kay is a Fellow of the American College of Psychiatrists and Distinguished Life Fellow of the American Psychiatric Association and has served as the chair of the APA Committee on Medical Student Education, the Council on Medical Education and Career Development, the Vestermark Award Board, and the Committee on the Practice of Psychotherapy. He chairs the World Psychiatric Association Task Force on Undergraduate and Post Graduate Curriculum as well as the APA Committee on College Mental Health. Dr. Kay is the immediate past chair of the Psychiatry Residency Review Committee of the ACGME and the Founding Editor of the Journal of Psychotherapy Practice and Research and Associate Editor of the American Journal of Psychotherapy. He has published extensively on the topics of medical and psychiatric education, medical ethics, child psychiatry, psychoanalysis, psychotherapy, the neurobiology of psychotherapy, and psychosocial aspects of AIDS and of cardiac transplantation, and has edited numerous books. Dr. Kay serves as the Associate Director of the Comprehensive Neuroscience Center at Wright State University. He received the 2001 APA Seymour Vestermark Award for contributions to psychiatric education. Dr. Kay's current research examines fMRI in borderline personality disordered patients with self-harm behavior.
English
Contributors ix
Preface xi
Acknowledgments xiii
Chapter 1 Listening to the Patient 1
Listening: The Key Skill in Psychiatry 1
The Primary Tools: Words, Analogies, Metaphors, Similes, and Symbols 3
How Does One Hear Words in This Way? 4
Listening as More Than Hearing 6
Common Blocks to Effective Listening 7
Crucial Attitudes That Enable Effective Listening 10
Theoretical Perspectives on Listening 14
Using Oneself in Listening 16
To Be Found: The Psychological Product of Being Heard 18
Listening to Oneself to Listen Better 20
Listening in Special Clinical Situations 23
Growing and Maturing as a Listener 26
Chapter 2 Physician–Patient Relationship 31
Formation of the Physician–Patient Relationship 34
Special Issues in the Physician–Patient Relationship 42
The Physician–Patient Relationship in Specific Populations of Patients 44
Conclusion 46
Chapter 3 The Cultural Context of Clinical Assessment 47
Introduction: The Cultural Matrix of Psychiatry 47
What Is Culture? 48
Culture and Gender 50
The Cultural Formulation 51
Ethnocultural Identity 52
Illness Explanations and Help-Seeking 53
Psychosocial Environment and Levels of Functioning 55
Clinician–Patient Relationship 56
Overall Assessment 57
Cultural Competence 57
Working with Interpreters and Culture-Brokers 60
Conclusion: The Limits of Culture 62
Chapter 4 The Psychiatric Interview: Settings and Techniques 65
Goals of the Psychiatric Interview 66
The Psychiatric Database 75
Database Components 77
Mental Status Examination 81
Conduct of the Interview: Factors That Affect the Interview 83
General Features of Psychiatric Interviews 85
Chapter 5 Psychiatric Interviews: Special Populations 103
Randon Welton and Jerald Kay
Psychiatric Interview in Special Circumstances 104
Psychiatric Interview in Special Patient Populations 115
Conclusions 131
Chapter 6 Formulation 135
Allison Cowan, Randon Welton and Jerald Kay
Biological Contributions 136
Social Factors 138
Psychological Factors 140
Summary 146
Chapter 7 Clinical Evaluation and Treatment Planning: A Multimodal Approach 147
Psychiatric Interview 147
Identifying Information 149
Chief Complaint 149
History of Present Illness 150
Past Psychiatric History 150
Personal History 150
Family History 151
Medical History 152
Substance Use History 152
Mental Status Examination 153
Physical Examination 157
Neurological Examination 158
Psychological and Neuropsychological Testing 159
Structured Clinical Instruments and Rating Scales 159
Laboratory Assessments 159
Neurophysiologic Assessment 159
Brain Imaging 162
Special Assessment Techniques 163
Assessment of Risk 164
Suicide Risk 164
Differential Diagnosis 167
Initial Treatment Plan 170
Conclusion 171
Chapter 8 Professional Ethics and Boundaries 173
Introduction 173
Ethical Behavior and Its Relationship to the Professional Attitude 174
WPA Guidelines on Euthanasia 176
WPA Guidelines on Torture 177
WPA Guidelines on Sex Selection 177
WPA Guidelines on Organ Transplantation 177
WPA Guidelines on Genetic Research and Counseling in Psychiatric Patients 177
WPA Guidelines on Ethnic Discrimination and Ethnic Cleansing 178
WPA Guidelines on Psychiatrists Addressing the Media 178
The Coherent Treatment Frame and the Role of Therapeutic Boundaries in Effective Psychiatric Treatment 178
Boundary Violations 179
Components of the Coherent Psychiatric Frame 180
Stability 181
Avoiding Dual Relationships 182
Autonomy and Neutrality 183
Coherent and Noncollusive Compensation 183
Confidentiality 184
Anonymity 184
Abstinence 185
Self-respect and Self-protection 186
Summary 187
Index 191
English
“This book is not only a first rate introduction for psychiatric residents and medical students interested in psychiatry but arguably should be a mandatory reading for all medical students given the importance of general interviewing skills, the prominence of psychiatric issues throughout medicine, and the importance of the techniques presented for building the foundations of the physician-patient relationship.” (Journal of Nervous and Mental Disease, 1 December 2014)
