Describe the elements of a mental status exam
What will be an ideal response?
The mental status exam typically consists of the following items (Gallo et al., 2000; Lukas, 1993):
Appearance
• How does the client look and act?
• Stated age, dress, and clothing
• Psychomotor movements, tics, facial expressions
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Reality Testing
• Judgment
• Dangerous, impulsive behaviors
• Insight
? To what extent the client understands his or her problem
? How the client describes the problem
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Speech
• Volume: low, inaudible
• Rate of speech: rapid, slow
• Amount: poverty of speech
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Emotions
• Mood: how the client feels most of the time
? Anxious, depressed, overwhelmed, scared, tense, restless, euthymic, euphoric
• Affect: how the client appears to be feeling at this time
? Variability (labile)
? Intensity (blunted, flat)
?
Thought
• Content: What the client thinks about
? Delusions: unreal belief, distortion
o Delusions of grandeur: unusual or exaggerated power
o Delusions of persecution: unreal belief that someone is after the client
o Delusions of control: someone else is controlling the client's thoughts or actions
o Somatic delusions: unreal physical concerns
? Other thought issues
o Obsessions: unrelenting, unwanted thoughts
o Compulsions: repeated behaviors, often linked to an obsession
o Phobias: obsessive thoughts that arouse intense fears
o Thought broadcasting: belief that others can read the client's mind
o Ideas of reference: insignificant or unrelated events that have a secret meaning to the client
? Homicidal ideation: desire or intent to hurt others
? Suicidal ideation: range from thought, desire, intent, or plan to die
? Process: how the client thinks
o Circumstantiality: lack of goal direction
o Perseveration: repeated phrase, repeated topic
o Loose associations: move between topics without connections
o Tangentiality: barely talking about the topic
o Flight of ideas: rapid speech that is unconnected
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Sensory Perceptions
• Illusions
? Misperception of normal sensory events
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Hallucinations
? Experience of one of the senses: olfactory (smell), auditory (hearing), visual (sight), gustatory (taste), tactile (touch)
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Mental Capacities
• Orientation times four: oriented to time, person, place, and situation
• General intellect: average or low intelligence
• Memory: remote (past presidents), recent (what the client ate yesterday for breakfast), and immediate (remember three items)
• Concentration: Distraction during interview, count backward by 3s Attitude Toward Interviewer
• How the client behaves toward the interviewer: suspicious, arrogant, cooperative, afraid, reserved, entertaining, able to trust and open up, forthcoming
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Which of the following helps social workers to effectively employ interpretation and additive empathy?
A) ?Using additive empathy liberally during the first meeting with a client B) ?Using several additive empathic responses in succession C) ?Phrasing interpretive responses in tentative terms D) ?Pushing clients into rapidly acquiring new insights
According to Becvar and Becvar, in addition to the results of our assessment and classification activities the following is equally important:
a. The certainty that the process was objective b. That the family members did not know the assumptions on which the assessment was based c. A consideration of the models used in the assessment and classification process d. All of the above
The systemic analysis/multidimensional assessment is unique as function of:
a. Its use of the term stories b. Inclusion of the therapist's perspective c. A focus that is holistic d. All of the above