Download the Comprehensive Psychiatric Evaluation Template, which you will use t
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Download the Comprehensive Psychiatric Evaluation Template, which you will use to complete this Assignment. Also review the Comprehensive Psychiatric Evaluation Exemplar to see an example of a completed evaluation document.
By Day 1 of this week, select a specific video case study to use for this Assignment from the Video Case Selections choices in the Learning Resources. View your assigned video case and review the additional data for the case in the “Case History Reports” document, keeping the requirements of the evaluation template in mind.
Consider what history would be necessary to collect from this patient.
Consider what interview questions you would need to ask this patient.
Identify at least three possible differential diagnoses for the patient. Complete and submit your Comprehensive Psychiatric Evaluation, including your differential diagnosis and critical-thinking process to formulate a primary diagnosis. Incorporate the following into your responses in the template:
Subjective: What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What is the duration and severity of their symptoms? How are their symptoms impacting their functioning in life?
Objective: What observations did you make during the psychiatric assessment?
Assessment: Discuss the patient’s mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses with supporting evidence, listed in order from highest priority to lowest priority. Compare the DSM-5-TR diagnostic criteria for each differential diagnosis and explain what DSM-5 criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case.
Reflection notes: What would you do differently with this client if you could conduct the session over? Also include in your reflection a discussion related to legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), health promotion and disease prevention taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).
About “Training Title 3”
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00:00:00
BEGIN TRANSCRIPT:
00:00:00
[sil.]
00:00:15
OFF CAMERA Specialist Blair, what, what do you prefer I call you?
00:00:15
PATIENT Some used to call me Arnold, but you can call me Arnie. Arnie is fine.
00:00:20
OFF CAMERA Arnie, okay. Why did you come here today?
00:00:25
PATIENT I had the flu a couple months ago and it developed into some bad pneumonia and I had to go see a family doctor. Uh, I went to see her. Yeah. She referred me to a psychiatrist. You. I guess she was kind of worried about how I was homeless, almost homeless. And uh, that was a couple months ago. And I was kinda hesitant to come in. And uh, I think… recently I think I’m ready. Ready to come in.
00:00:55
OFF CAMERA Good. Good. What did you mean by “homeless” or “lmost homeless?”
00:01:05
PATIENT There’s this trailer, uh… abandoned trailer that I had found. It’s in the West Virginia wilderness. It’s kind of near the Maryland state line but it’s in a campground that’s used only during the summer most of the year it’s, it’s pretty empty. I’m there mostly by myself.
00:01:25
OFF CAMERA So, uh, living in a trailer like that in the wilderness do you have electricity, running water, things like that?
00:01:35
PATIENT No I just have some candles and flashlights that I use. For water I have a bucket that I bring up water from the Potomac. So far its been okay. I haven’t gotten sick from it or anything. It tastes okay.
00:01:55
OFF CAMERA So, out there are you pretty much alone? 00:02:00
PATIENT There is a train that comes by twice a day, and I do have a dog. A dog named Chops. He’s a mutt. He’s just a stray that came by. I adopted him.
00:02:15
OFF CAMERA Do any people know you’re out there? Family members? Friends?
00:02:20
PATIENT No. Not. I haven’t really talked to anybody since I got back from Iraq. I haven’t really called ’em. I didn’t really, didn’t really feel the need. Didn’t. Honesty I don’t want them to see me like I am right now.
00:02:40
OFF CAMERA What do you mean like you are now?
00:02:45
PATIENT Like. War in Iraq was tough. My nerves were shattered pretty bad. I just… Didn’t really feel like talking to anybody. Didn’t really want to go anywhere. Didn’t really want to do anything. Didn’t feel good.
00:03:10
OFF CAMERA And you were in Iraq, is that right?
00:03:15
PATIENT Yeah. The, uh… I was a specialist in the infantry.
00:03:20
OFF CAMERA Did you quit? Were you discharged?
00:03:25
PATIENT I was discharged. Uh, you know. My superiors didn’t really like the way I kind of… sunken into myself I guess. I wasn’t really responding to them. Their orders. They’d have questions. You know. It was like I wasn’t even there. So they had enough of that. They shipped me back real quick.
00:03:50
OFF CAMERA What happened, that you withdrew into yourself like that?
00:04:00
PATIENT [Cough] I’ve never really talked about that with anybody. It’s something I haven’t talked about in a long time.
00:04:20
OFF CAMERA If you, Arnie if you feel comfortable enough with me in here, uh… Just talk about whatever part of it you ca
00:04:45
PATIENT Well, there’s. There was this one time. And… you know. I think there. We were running this checkpoint. And. Um. There, there was some confusion. You know. At the checkpoint. There’s a lot of hand signals being used. Uh. There, there was this driver in a car and he was coming toward the checkpoint and it didn’t seem like he was slowing down at all. And. You know. He uh, the hand signals that we use are a little different than what the Haji’s use.
00:05:30
OFF CAMERA The Haji’s?
00:05:35
PATIENT Yeah. The Arabs. Sorry.
00:05:35
OFF CAMERA Oh.
00:05:35
PATIENT The Arabs. So our hands signals for stopping were different. I guess. This driver kept coming at the checkpoint like he wasn’t going to stop. And you know our sergeant was getting worried and he was like, “fire at the vehicle. So we fired at the vehicle. The vehicle still didn’t stop. So, sergeant was “fire at the driver.” We fired at the driver. The vehicle stopped then. You know when we went to the vehicle, to inspect the vehicle, you know we found, uh… there was a family inside and in the backseat, I think there was a 9-year-old daughter and a 3-year-old son were, had been shot and killed. And… The rest of the family, the mother, the father, and there was 4 other kids, they were all wounded as well. But… I think they survived their injuries. That’s what they told me.
00:07:10
OFF CAMERA So, Arnie, do you, uh, do you think that you killed them?
00:07:20
PATIENT You know, I can’t say for sure that I killed them. But I know our group did. We killed them.
OFF CAMERA Thinking about that, how did you change after?
00:07:40
PATIENT Well, to be honest I wasn’t really a big socially, big social guy back in school, high school. I did play football but I didn’t really go to any of the functions or you wouldn’t really see me at a dance or anything. So after those kids got killed in Iraq I just kind of withdrew into myself and…
00:08:10
OFF CAMERA So are you feeling, uh, guilty, feeling ashamed?
00:08:20
PATIENT Yeah, both of those. I felt, felt pretty bad after that. I didn’t really want to do anything.
00:08:30
OFF CAMERA Were you feeling, perhaps feeling guilt or perhaps feeling ashamed?
00:08:35
PATIENT Yeah. I think I feel both of those you know guilty and ashamed I guess. Yeah, I can’t. Yes. That’s definitely how I feel.
00:08:55
OFF CAMERA Since, since that happened, or other things have happened in Iraq have you had any nightmares or flashback about what happened?
00:09:05
PATIENT Um, flashback. I haven’t had any nightmares about that incident, flashbacks about that incident. You know, but, I do, I do think about what happened that day, all the time. Like everyday. You know I even pray about it and stuff, what happened there.
00:09:35
OFF CAMERA And how long have you been living out in the wilderness?
00:09:40
PATIENT Almost two years. Yeah.
00:09:40
OFF CAMERA Two years. What do you think would happen if you left your trailer and the camp and went into town and saw people, talked to people, people saw you, talked to you?
PATIENT They would, they would see what I did. You know they would see that I’m this killer and committed this, this sin. And… killed these kids that didn’t deserve that. You know, felt that they would tell right away. They would know right away. They would see me.
00:10:30
OFF CAMERA And what about if you saw your family members, talked to them, saw them, they saw you?
00:10:40
PATIENT I haven’t talked to them since I’ve been back. I think they would see immediately. Like right away. You know. They know me best. They would see this, that I changed into this person, you know, this, this killer. I said. I think they would, they’d just know. It’s hard to even think about.
00:11:10
OFF CAMERA And trying to make yourself somewhat more comfortable, to ease the pain do you ever drink alcohol or use drugs?
00:11:25
PATIENT Nope. No, I cannot afford them. There’s a lot of times overseas, you know, resorted to using drugs and alcohol to help them forget but I can’t. Naw. I can’t afford it.
00:11:45
OFF CAMERA Living out there in the wilderness like you do, how do you get food or afford food?
00:11:55
PATIENT There’s this Amish church a couple miles down the road I visit every week or so. Um. You know they, they’re nice to me, you know. I don’t think… I don’t think they, they know what happened. Or maybe they do. You know, they don’t ask any questions um, you know I don’t really care if they do or not. Um. But they do give food for about a week or so and they do give me food for my dog Chops. You know they like Chops.
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