This was one of my class textbooks and is written for psychology students, but it’s easily accessible to the layperson. If you’re a writer and are thinking about writing a character who’s a therapist or psychiatrist, this book will give you all you need to know about diagnosing mental illness in America. (It’s based on the diagnoses in the DSM-IV.)

In easy-to-follow logic and clear prose, Morrison lays out the steps for diagnosing a patient with a mental illness, or concluding that they’re not mentally ill. He has his own hobbyhorses, most notably his fondness for somatoform disorders, but other than that, the way he thinks is the standard way that diagnosticians think. My caveat is that he doesn’t get into cultural/social factors at all. Otherwise, this is a very good basic text.

Diagnosis Made Easier
kore: (Default)

From: [personal profile] kore


When I was in training, students bore the honorific title of Doctor, but everyone, including the patients, knew it was a fraud. Much better to introduce yourself, “I’m Pat Marshall, a medical student.” Ask if the patient is agreeable to the interview, and point out how long you expect to take. Also mention that you’ll probably take some notes.

I like him already.

Also, yeah, if you're doing a psychiatric evaluation, no fucking small talk. That used to drive me fucking nuts (well. Nuttier). One immortal goon at the UW Outpatient Psychiatry used to ask me how I was doing every single time I checked in until I finally snapped, "Not that well, else why would I be coming here every week?" He looked abashed and I felt ashamed, but my God, someone needs to write up a paper on "Inane Small Talk That Makes Depressives Unhappy" or something.
kore: (Default)

From: [personal profile] kore

other intake interview peeves.....venting really


While I'm bending your ear.....(also this is not addressed to YOU really, but a grab-bag of shit, I'm sure that is oh so helpful.)


- No "How are you?", "How are you feeling?", or "How are you doing?" to start off with. Too big and too reminiscent of real-world fake-talk "How are YOU? Great? Great!" crap.

- "What brings you here today?" is better altho it's still way too wide and someone depressed is going to clam up. Someone manic is going to talk your ear off. "What made you want to make this appointment?" is better. Or "What do you want to address right now?"

- I know you're supposed to ask at several different times during the conversation if I'm hearing voices, but if it's more than once and you ask it the same way every time, IT'S REALLY FUCKING ANNOYING. Also, a better way of telling whether or not someone is really hearing voices, since they tend to cover it up, is watching their face to see if it looks like they're either trying to tune something out, or listening. This is hard to do in a short interview, and takes practice, but gets better results, especially if you can then ask the person, "Are you hearing something right now?" They will be happy you can pick it up.

- MAKE EYE CONTACT. I think a lot of new psych residents must feel shock at having to deal with OMG Actual Crazy People or something, or maybe they're just terrified at the sudden burden of responsibility, because they stare at their goddamn clipboards (or palm pilots or whatever) all the goddamn time. Going obviously down a checklist might provide a structure or help the doc fill out paperwork, but it makes the person feel invisible.

- No reeling off "Any suicidal thoughts? Feelings? Do you have a plan?" like you're a short order cook. Not. Helpful.

- No looking down at the clipboard and saying "Well it says here...." or reading it silently while ignoring the patient. Bad move. "I have some beginning information here, but I'd like you to tell me about what's wrong in your own words," is better. Read the clipboard in the hallway before going in.

UND SO WEITER.
notemily: Photo of me, a white girl in her mid-20s, wearing glasses, smiling, looking up and to the right (Default)

From: [personal profile] notemily

Re: other intake interview peeves.....venting really


I hate having to answer the same questions ten times. No, I don't hear voices. No, I don't have manic episodes, no matter which way you phrase it. No, I am not suicidal. Can we get on to the things I AM dealing with please?

Also, I have a psychiatrist who gives me a checklist of depression symptoms at EVERY appointment. I ALWAYS ANSWER THE SAME WAY for like three quarters of them. I know my own symptoms of worsening depression, but this guy is condescending as hell and thinks his checklist is the ONLY way to tell if someone is getting better or worse.
kore: (Default)

From: [personal profile] kore

Re: other intake interview peeves.....venting really


I know they throw in the questions more than once to get people to disclose or whatever, but for the love of God, you think they'd ask them in at least a slightly different way. It can just really reinforce the impression they're not listening.
notemily: Photo of me, a white girl in her mid-20s, wearing glasses, smiling, looking up and to the right (Default)

From: [personal profile] notemily

Re: other intake interview peeves.....venting really


ALSO ALSO, this same psychiatrist once decided to read me his clinical summary about me. Please, please never do that. Not only is it written in clinical language, it's very distancing and condescending and makes your patient feel like a numbered case file instead of an actual person.
kore: (Default)

From: [personal profile] kore

Re: other intake interview peeves.....venting really


Oh man, reading about yourself in medical jargon is Just Bad. I requested my medical records once, and found out that a really hostile college therapist who'd cut me off after about three sessions had decided I had BPD within about five minutes of meeting me and started her notes with a description of what I was wearing: "Leather jacket, black jeans, casual grooming, long hair pulled straight back, hostile, untrusting, borderline (?)" Like that.
yhlee: Sandman raven with eyeball (Sandman raven (credit: rilina))

From: [personal profile] yhlee

Re: other intake interview peeves.....venting really


I disagree that this should never be done. It probably depends on the client. I had this done and I *prefer* to know my status; I despise having things hidden from me, and I find clinical language helpful and reassuring because it gets away from touchy-feely crap.

Of course, that psychiatrist also said I have an overdeveloped left brain. But I would prefer this assessed per individual.
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