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Admission and Emergency Assessments: A Handbook for Clinicians provides a conceptual framework and concrete practice examples to conduct effective assessments for mental health crises and psychiatric admissions. Behavioral health treatment starts with an accurate and thorough assessment of a client's daily functioning, level of risk, and needs. This assessment serves as the clinician's lens for conceptualizing the patient's presentation and aptitude for expressing their problems. Through narrative descriptions, diagrams, and vignettes, this book provides the necessary tools to assess patients in behavioral health crises. It serves as a reference for specific clinical situations-from working with translators, busy doctors, and adversarial insurance agencies to assessing a variety of patient dispositions and demographics. This book seeks to elevate and accelerate clinical skills that can be integrated into other practice settings.
List of contents
Authors' Note
Acknowledgments
Chapter 1:IntroductionComment on Diversity
Chapter 2: The Purpose of the InterviewCriteria
The Patient's or Family's Agenda
Reconciling Criteria and Motivation
Concluding Thoughts
Chapter 3: The Reality of the Emergency and Assessment Interview: Challenges to Validity and ReliabilityThe Deciphering Filters: The Assessment Questions, Observations, and Criteria
The Curve of Ability
The Different Levels of Motivation
The External Factors of the Collateral Sources and Climate
Vignettes
Concluding Thoughts
Chapter 4: Interviewing Skills and PatternsThe Structured versus the Unstructured Interview Pattern
Joining with the Patient: Formality, Tone of Voice, and Confidence
Case Vignettes
Concluding Thoughts
Chapter 5: Suicide AssessmentThe Criteria of Suicide Assessment: Immediate versus Potential Safety Risk
Applying the Curve of Ability
The Value of Collateral Sources
Becoming Accustomed to Asking Patients about Suicide
Vignettes of Suicide Assessment
Concluding Thoughts
Chapter 6: The Disruptive, Aggressive, and Anti-Social PatientAnger Due to Unmet Human Needs
Risks Associated with the Disruptive, Aggressive, and/or Anti-Social Patient
Safety Measures to Protect Therapists, Patients, and Guests
Concluding Thoughts
Chapter 7: Assessing Children and AdolescentsInterviewing Considerations
The Immediate Safety Risk
Out of Control, Reckless, Risky Behavior
Assets and Liabilities of the Caregiver in the Assessment Process
Legal Obligations
Vignettes
Concluding Thoughts
Chapter 8:Substance Use AssessmentTaking the History
Scope of Drug and Alcohol Types
COWS Questions
Criteria for Hospital Admission
Immediate Safety Risk versus Potential Safety Risk
Concluding Thoughts
Chapter 9:Language InterpretationLegal and Ethical Considerations
Expectations for the Interview
Telehealth
Vignettes
Working with the Interpreter
Concluding Thoughts
Chapter 10: Staffing with the DoctorsThe Script and Its Elements
The Structure of the Script
Delivery of the Script: Tone and Pace
Getting to Know the Doctors You Work With
When a Doctor Passes
The Risk of Bad Recommendations
Extraordinary Situations
Vignettes
Concluding Thoughts
Chapter 11: Telling People "No"Reviewing Boundaries
Understanding Assertiveness
Vignettes
Concluding Thoughts
Chapter 12:Insurance Prior AuthorizationsPrior Authorization as an Element of Utilization Management
The Phone Call Prior Authorization
The Fax Authorization
The Online Authorization
The Peer-to-Peer or Physician Review
What If There Is a Denial?
Concluding Thoughts
Chapter 13: The High UtilizerDescribing High Utilizers
Overall Perspective
Serial Behavioral Patterns
Challenges to Interviewing
Strategies for Interviewing Difficult High Utilizers
Sometimes You Can Divert the High Utilizer
Vignettes
Concluding Thoughts
Chapter 14: Concluding Thoughts: Learning and Appreciating the Value of CommunicationJohn's Experiences
David's Experience
ReferencesIndexAbout the Authors
About the author
David Houvenagle, PhD, LCSW, is a board-approved clinical supervisor in the state of Kentucky. He has thirty years of professional experience in outpatient, partial hospitalization, intensive outpatient, inpatient hospitalization, and assessment settings. His previous published works include Local Healthcare Politics: Louisville’s Growth Machine 1947–2007 and Clinician’s Guide to Partial Hospitalization and Intensive Outpatient Practice. John Schmanski, M.Ed, LPC is a behavioral health case manager for an insurance company. His experience in the behavioral health field spans fifteen years. As an assessment clinician at a psychiatric hospital, he evaluated patients for more than a decade and trained novice clinicians, and he has experience in inpatient and outpatient mental health settings.
