A biopsychosocial interview allows a counselor to determine the origin of the observed problems and to clearly identify these problems in order to propose an effective treatment approach. The client who participated in an interview session with a counselor was Jane Roberts, a 28-year-old White female (Perkinson, 2017). The purpose of this paper is to present the critique of the conducted interview with the focus on certain criteria suggested for organizing biopsychosocial interviews.
According to the principles of conducting a biopsychosocial interview, it should start with informing the client about the purpose of this conversation. Referring to the data provided in the protocol, it is possible to state that the counselor did not mention the purpose of the interview for the client. Still, the client’s demographic data were collected, and the counselor made notes regarding Jane’s behavior while answering the first questions, but there were no notes regarding the characteristics of the informant (reliable or unreliable). The chief complaint was presented effectively, with reference to the client’s actual words.
Much attention should be paid to the client’s presentation of her history of the observed problem. Jane’s story was detailed, and effective comments on the client’s words were provided in the interview protocol. These comments indicate that the counselor was looking for the problem areas in the client’s past history in order to find the origin of the current issue and possible explanations. The counselor was able to determine the origin of the client’s feeling of abandonment and analyze her relations with parents and men. The preliminary notes regarding the client’s problems and disorders were made at that stage.
However, when shifting to the discussion of the drinking problem, the counselor did not pay attention to previous treatment followed by the client. Moreover, the counselor began to ask questions about the present problem before the client finished telling her story. As a result, some of the important information on drinking patterns could be missed (Chandler & Andrews, 2018). The discussion of the patterns and consequences related to the problem, tolerance, blackouts, and withdrawal was mixed with the client’s notes on her relationships (Perkinson, 2017). The counselor was focused not only on assessment but also on the provision of brief comments regarding the client’s relationships to accentuate their unhealthy nature.
At the next stage of the interview, the counselor asked questions about the past history. It is possible to state that more attention could be paid to asking about Jane’s ethnic heritage and culture because only the ethnicity of the client was mentioned without focusing on the significant impacts of her cultural background on her life and development (Brooks & McHenry, 2015). The other details were provided appropriately, but there was no information on gambling. In addition, it is possible to assume that the counselor took the information on sexual and physical abuse from the client’s story without asking direct questions. No attention was paid to identifying the client’s personal preferences, needs, and abilities, but strengths and weaknesses were discussed.
What is more important is that the client reported her problem with taking Valium only during the second part of the interview, without focusing on this problem while describing her alcohol consumption. This aspect allowed the counselor to conclude about the client’s readiness to withdraw and receive treatment. Moreover, additional comments on Jane’s tendency to lie or conceal the information could be added. The data regarding the client’s medical history were presented partially, and the comments on the mental status and memory assessment were absent.
Referring to the analysis of the conducted interview with Jane Roberts, it is possible to state that almost all the required data in order to complete the client’s assessment were collected. Only some points from the biopsychosocial interview protocol were not discussed with the client, and the information on the mental status and memory was not included in the analysis. The counselor effectively guided the client during her speech and provided brief comments on her statements without intentions to start any intervention. Still, the organization of the client’s telling about her current problem could be improved in order to pay more attention to collecting additional data on the client’s drinking problem or learn more about her substance use with the focus on Valium.
Critique of the Sample Interview Summary
The summary of the biopsychosocial interview under discussion includes other sections in contrast to those ones mentioned in the protocol proposed for conducting the biopsychosocial assessment. Thus, the summary presents the demographic data for Jane Roberts, the chief complaint, the information on the history of the present disease, the past history, the medical history, the family history, and the mental status. There is also a diagnostic summary, including the description of the client’s condition, possible diagnoses, the list of problems and recommendations, as well as the treatment plan (Perkinson, 2017). The purpose of this paper is to provide the analysis of this interview summary taking into account the criteria set for biopsychosocial interviews.
The most important demographic data are mentioned, and the client’s chief complaint is presented as a quote according to the recommendations. It is also important to note that the history of Jane’s present illness is summarized in much detail and references to her actual words are included to support the counselor’s conclusions. The counselor provides the analysis of the client’s behavior during the interview and emphasizes the fact that Jane is in the withdrawal stage in relation to alcohol consumption and substance abuse (Valium). In this section, the client’s actual words and the counselor’s observations are presented along with the counselor’s interpretation of Jane’s claims and her physical and emotional state.
Brief comments on the client’s past history, medical history, and family history provide all the important information for Jane’s assessment, and the missed data are minimal: details regarding the client’s cultural heritage, her gambling history, income, needs, abilities, and personal preferences. The section describing the client’s mental status is detailed, and the information on the client’s description (appearance and dress), sensorium, orientation, attitude to the counselor, motor behavior, speech, and effect is presented in the summary. The given comments on the client’s thought process, suicidal ideation, homicidal ideation, delusions, obsessions, compulsions, and concentration are enough in order to conclude regarding the client’s mental status and the presence of possible psychological disorders (Andrasik, Goodie, & Peterson, 2015). The counselor appropriately concludes that Jane demonstrates some denial regarding her drinking problem and even more denial regarding her use of Valium.
The diagnostic summary related to Jane’s problems is detailed, and it is organized rather chronologically according to the recommendations for biopsychosocial interviews. Thus, the aspects from the client’s childhood that could influence the development of the problem are mentioned, and Jane’s words are effectively interpreted to conclude what problems she has in terms of her alcohol consumption and abuse of Valium. The counselor notes that the client suffers from withdrawal complications, and biomedical conditions are mentioned (anemia, cold, arthritis, and heart murmur). Emotional conditions are effectively described with reference to the results of psychological tests. This evidence-based approach is important for the successful interpretation of the problem and diagnosing (Brooks & McHenry, 2015). Jane is described by the counselor as ready to change, and she demonstrates only minimal resistance. The counselor’s conclusions regarding the recovery environment are accurate (a poor environment) despite the fact that the client claimed her relatives and friends supported her. Diagnoses are listed with reference to the DSM-5 coding, and it is a requirement for such an assessment.
The overall effectiveness of the evaluation can be determined with reference to criticizing the proposed treatment plan. It is important to note that the offered plan of treatment based on the list of problems and recommendations is detailed and potentially effective in order to address the client’s conditions and related issues. The reason is that the counselor has identified eight problems to address that is related to biological aspects (anemia, the upper respiratory infection), psychological aspects (withdrawal, the need for the program of recovery, the fear of abandonment), and social aspects (poor relationship and assertiveness skills). This complex approach based on formulating the goals and interventions for the client to cope with the problem is in correlation with the principles of biopsychosocial assessment and is important in order to achieve the desired results in the client’s treatment.
References
Andrasik, F., Goodie, J. L., & Peterson, A. L. (Eds.). (2015). Biopsychosocial assessment in clinical health psychology. New York, NY: Guilford Publications.
Brooks, F., & McHenry, B. (2015). A contemporary approach to substance use disorders and addiction counseling (2nd ed.). Alexandria, VA: John Wiley & Sons.
Chandler, C., & Andrews, A. (2018). Addiction: A biopsychosocial perspective. Thousand Oaks, CA: SAGE Publications.
Perkinson, R. R. (2017). Chemical dependency counseling: A practical guide (5th ed.). Thousand Oaks, CA: SAGE Publications.