Psychiatric assessment, diagnosis and formulation....⬇️
Humans are complicated beings fraught with all sorts of "problems with living". At any given time, some people's "problems with living" are more complicated than others. Such problems are usually attributable to a complex web of biological vulnerability, external stress, adversity, trauma, substance abuse and abstract influences such as bad luck, fate, spirituality and culture.
An initial assessment can usually be completed within an hour (see what to expect) but for specialist assessments or where a person's problems are very complicated, I may need two separate one hour sessions to undertake a comprehensive assessment.
The primary purpose of a psychiatric assessment is to obtain an understanding or hypothesis as to why a particular patient may have problems with living (with a view to doing something about it). The assessment aims to determine :
- Why you are experiencing psychological symptoms at this point in time
- Why you developed your problems with living or symptoms in the first place
- Why things have taken this particular course over the course of a persons' life
- What (if any) is the most appropriate way to describe your problems with living in the form of a psychiatric diagnosis
- Why things are not getting better (or changing)
- A "roadmap" for change (in those motivated to do so)
One could argue that this sort of opinion could be obtained from a good friend, family or even a stranger. To some extent this is true but others will often be unable to apply objectivity, medical expertise and experience in psychological medicine to provide a truly comprehensive opinion. I will also provide suggestions for tailored treatment where appropriate.
Assessments and the resulting opinion can occasionally be interpreted as character assassination or an insult to some people.
A psychiatric diagnosis is based on both the subjective information that the patient supplies along with my objective assessment of biological, psychological and social factors across the lifespan.
I am always amenable to discuss and amend my opinion. I encourage patients to obtain a second opinion if they feel that my assessment is unsatisfactory in any way. I am also willing to talk to family members or significant others.
With your permission I will speak to a person whom you feel is a good source of collateral information as well as your GP, physician or surgeon.
I will provide an objective diagnostic opinion as well as a detailed formulation. I will spend time explaining this to you as well as providing copies of written reports within 7 working days. With your permission, I will also provide feedback to the GP (or physician) by telephone if this is deemed appropriate.