Chapter: Essentials of Psychiatry: Clinical Evaluation and Treatment Planning: A Multimodal Approach
Clinical Evaluation and Treatment Planning: A Multimodal Approach
Clinical Evaluation and Treatment Planning: A Multimodal Approach
Every psychiatric evaluation must be specific to
the context in which it occurs. The evaluation of a patient in the psychiatric
emergency room is different from the evaluation of a graduate student applying
for psychoanalysis, a member of a couple who seeks consultation for marital
distress, or an indicted prisoner who is being evaluated for competence to
stand trial. In each case, the evaluation and treatment plan are tailored to
the situation.
We present an outline of a comprehensive ap-proach
to psychiatric evaluation. The complete psychiatric evalu-ation consists of the
psychiatric interview; physical examination
including neurological assessment; laboratory
testing; and, as appropriate, neuropsychological testing, structured interviews
and brain imaging. The results of the evaluation are then used to assess risk,
reach tentative and, if possible, defi nitive diagnoses, and complete initial
and comprehensive treatment plans. Clearly, the length, detail and order of the
evaluation need to be modified when it is conducted in different settings. The
clinician needs to assess the goals of the interview, the patient’s tolerance
for questioning, and the time available. Table 19.1 shows the variation of the
psychiatric evaluation with the type of setting.
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