Diagnosis
Initial Evaluation and Assessment: Before beginning treatment, or making any recommendations, it is good practice to perform a comprehensive evaluation. This is usually accomplished in the first session or if more time is needed, in subsequent meetings. Although patients may be interested in immediate intervention and help, it is wise to consider the full context and history of each individual rather than trying for a one size fits all approach.
A comprehensive evaluation will include such things as:
· Developmental History
· Medical History
· Psychological Treatment History
· Family and Social History
· Assessment of Presenting Problems
· Initial Mental Status Examination
as well as an assessment of cultural, religious, educational, and vocational background.
After this comprehensive evaluation, the patient and therapist are able to chart a course of treatment that understands the patient in all of their rich individuality and uniqueness.
Psychiatric Evaluation: The psychiatric evaluation is undertaken by a psychiatrist for purposes of assessing the need for psychotropic medication, providing a more complete medical evaluation, and conducting a comprehensive mental status examination.
The psychiatrist is a medical doctor who is trained to diagnose physical disorders and prescribe medication.
Alcohol and Substance Abuse Assessment: The Alcohol and Substance Abuse Assessment is a detailed interview elaborating a patients use of mind and behavior altering drugs. The interview charts the history and pattern of use clarifying such factors as drugs used, frequency, dosages, reactions, patterns of use and the patients readiness for treatment.
Psychological Testing: Psychological testing is performed by psychologists who have special training and education in the administration and interpretation of standardized tests. Results from these structured interviews can be compared to those of the general population as well as special populations to aid in diagnosis.
Cognitive Evaluation: The cognitive evaluation examines mental processes such as memory, concentration, perceptual motor skills, abstract thinking and attention. Tests such as the Wechsler intelligence scales, The Bender Gestalt visual motor test and with children one of the academic achievement tests are commonly used. The cognitive evaluation aids in treatment planning by assessing the ability for insight oriented psychotherapy, measuring cognitive impairment, and establishing realistic expectations.
Personality Evaluation: The personality evaluation assesses emotional functioning and aids in personality diagnosis. Measures commonly used include the Rorshach Test, the Thematic Apperception Test (TAT) and the Minnesota Multiphasic Personality Inventory (MMPI).
By integrating the results of a battery of tests, the psychologist can offer diagnostic and treatment planning advice.
Neuropsychological Evaluation: A neuropsychological evaluation is an assessment of the brain/behavior relationship. Used to diagnose learning disabilities, closed head injuries, dementia, and drug and alcohol impairment among other things; the neuropsychological evaluation uses cognitive, perceptual and motor tests to measure variation among skills and/or the difference between current functioning and either measured or predicted base rates.
Educational Assessment: An educational assessment is conducted to help in academic planning. Achievement tests, interviewing and possibly input from teachers and parents is used to help in school planning and placement. This is sometimes included in the intellectual evaluation.
School Readiness Evaluation: The school readiness evaluation is conducted before entering nursery school, kindergarten or first grade. It is used to assess readiness and clarify alternatives.