Psych Interview Guide

Interview Guide – New Patients

1) Alertness/Orientation
 What’s your full name & birthdate?
 What is this place called?
 What day is today?
 Day of the week, day of the month, year, actual date?
 How did you get here?
2) Any Psychiatric Problems?
 When did your problem start?
 How long have you had this problem in your life?
 In-Patient hospitalizations?
 Out-Patient care/therapy?
 How many times and for how long?
 When was the last time?
 Are you on any medications for your mental health?
 Dose, route, frequency, effects?
 What are each of these medications for/what are they treating?
 Do they work for you?
 If not, have you tried anything that does work?
 Any family history of mental health problems?
3) Any Medical problems?
 Any medications for those medical problems?
 Dose, route, frequency, effects?
 Any allergies to medicine, food or other?
 Think about other medical problems (ie. Thyroid, stroke, dementia, DM, etc that can lead to presented
problems)
4) Do you have a good support system through family/friends?
 Who do you live with?
 Do you have a good relationship with this person?
 Where do you live?
 House, apartment, mobile home, shelter, homeless
 Do you work?
 What do you do?
5) Any drug or alcohol or other substance use now or in the past?
 What kind do you use?
 How much do you use per day?
 How long have you been using?
 When was the last time you used?
 How does use affect you?
 Symptoms, withdrawal, home life, work life
 Have you ever had to go through treatment/rehab?
 When? How long? Did it help? Why?
 What is stopping you from quitting?
6) What is the most schooling you have completed?
7) START MEMORY TEST – 3 objects  TREE, PEARL, 35
 Test immediate recall by having the pt repeat it.
 Ask pt to spell “WORLD” and then backwards “DLROW”
8) Do you want to hurt yourself or others?
 Do you have a plan? (if yes)
 Have you ever wanted to hurt yourself or others?
 Ask about SI attempts or what kept the pt from going through with a plan.
 If you ever do have these thoughts or feelings, who are you going to tell?
9) Have you ever been in a situation that was life-threatening or you thought was traumatic?
 How does that affect you today?
10) Do you have anything you love or enjoy doing?
11) Physical effects?
 How are you eating?
 Loss of appetite, increased appetite, etc.
 Any weight loss or weight gain recently? (were you trying to gain/lose weight?)
 How do you sleep at night?
 Any nightmares?
 How much sleep on average do you get?
 Do you feel rested/refreshed when you wake up?
 Have you ever heard any voices or sounds that aren’t there?
 What do you hear?
 Have you ever seen anything that wasn’t there?
 What do you see?
 Any strange smells?
 What do you smell?
 Have you ever felt something on your body like someone touching you, crawling feelings, or other
sensations from things that aren’t there?
12) CRITERIA CHECK:
 Have you felt hopeless or guilty?
 Have you ever felt a feeling of emptiness?
 Have you felt sad?
 How long does it last? Is it constant or does it come & go?
 When you have these feelings, are you ever able to find joy in activities you enjoy or have
moments of happiness at all?
 Do these feelings tend to happen around this time of year or did something happen to lead you
to have these feelings?
 Do you ever feel like you are too tired to do the things you love?
 Do you have trouble with anger?
 Do you ever feel like your thoughts or your mind is racing?
 Opposite – Do you ever feel like your mind is foggy or slow?
 Do you ever have moments of extreme happiness or lots of energy and feel like you don’t need sleep?
 How long does it last?
 Do you ever feel like there is someone or something that is out to get you?
 Have you ever had times where you didn’t feel in control (impulsive) or were putting yourself in
dangerous or life-threatening situations?
 Are you worried about anything?
 Is there anything you can do about it? Or anything you have done about it?
 How does this affect your life?
13) RECHECK MEMORY TEST – tree, pearl, 35
14) What can we do for you to help you?
EXISTING PATIENT CHECK-UP
1) Alert/Orientation – Person, Place, Time, Situation
2) Has anything been bothering you since you last spoke with the doctor?
3) How are you feeling? How is your mood?
4) What has changed since you last met with the doctor?
 Your goals, feelings, thoughts, etc.
 Any physical symptoms?
5) MEMORY TEST – TREE, PEARL, 35 & SPELL WORLD DLROW
6) How are your medications working for you?
 If not working, is there anything you have tried in the past that has worked or something you wanted to
try?
7) Have you seen or heard anything that wasn’t actually there? Strange smells? Sensations on your body that
don’t make sense?
8) Have you had any thoughts of wanting to hurt yourself or others?
 Who are you going to tell if you do have these feelings?
9) How are you eating?
 Have you been keeping food down? No N/V/D/C?
10) How are you sleeping?
 How much sleep did you get/have you been getting?
 Any nightmares?
 Are you waking up feeling rested or refreshed?
11) Where do you want to go after this?
 Is there someone who can come get you or do you need transportation?
12) RECHECK MEMORY – TREE, PEARL, 35
13) Do you think there anything that we can do for you to help you?

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Interview Guide – New Patients

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