How do the skills affect rapport?

Before moving through diagnostic decision making, a social worker needs to conduct an interview that builds on a biopsychosocial assessment. New parts are added that clarify the timing, nature, and sequence of symptoms in the diagnostic interview. The Mental Status Exam (MSE) is a part of that process.

The MSE is designed to systematically help diagnosticians recognize patterns or syndromes of a person’s cognitive functioning. It includes very particular, direct observations about affect and other signs of which the client might not be directly aware.

When the diagnostic interview is complete, the diagnostician has far more detail about the fluctuations and history of symptoms the patient self-reports, along with the direct observations of the MSE. This combination greatly improves the chances of accurate diagnosis. Conducting the MSE and other special diagnostic elements in a structured but client-sensitive manner supports that goal. In this Assignment, you take on the role of a social worker conducting an MSE.

To prepare:

• Watch the video describing an MSE. Then watch the Sommers-Flanagan (2014) “Mental Status Exam” video clip. Make sure to take notes on the nine domains of the interview.
• Review the Morrison (2014) reading on the elements of a diagnostic interview.
• Download the Conducting a Diagnostic Interview with a Mental Status Exam template (ATTACHED)

Submit a 2- to 3-page paper in which you:

• Write up your MSE for Carl based upon his interview with Dr. Sommers-Flanagan. Be professional and concise for all nine areas.
• Explain the presenting problem for the referral and the identifying descriptors for Carl
• Identify any areas in your MSE that require follow-up data collection.
• Explain how using the cross-cutting measure would add to the information gathered.
• Identify elements of Dr. Sommer-Flanagan’s interview with Carl and his variations from the formal MSE

Describe skills Dr. Sommers-Flanagan uses to engage Carl during the assessment.

• What impact does the use of these skills seem to have on Carl?
• How do the skills affect rapport?
• Do Carl’s answers add to your ability to diagnose him in any specific way? Why or why not?

Finally, consider the following questions:

• What concerns would you have about Carl’s mannerisms in the interview or his spontaneous content and unusual beliefs?
• How would you address these mannerisms and beliefs?
• Would you discuss them with Carl now or in the future? Why?