THE MENTAL STATUS ASSESSMENT THE MENTAL STATUS EXAM IN CONTEXT - - PowerPoint PPT Presentation

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Jan 06, 2023 11 likes •202 views

THE MENTAL STATUS ASSESSMENT THE MENTAL STATUS EXAM IN CONTEXT Part of a comprehensive intake and assessment Although not a formal psychometric instrument, it is essential Informs any/all assessment procedures Can result in a

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THE MENTAL STATUS ASSESSMENT

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THE MENTAL STATUS EXAM IN CONTEXT

Part of a comprehensive intake and

assessment

Although not a formal psychometric

instrument, it is essential

Informs any/all assessment procedures
Can result in a provisional diagnosis

(working hypothesis)

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THERAPIST APPROACH TO THE MSE

Orient to the task
Establish rapport
Position of the therapist
Safety considerations
Combination of therapist skills
Observation
Inquiry
Observation/inquired
MSE in the context of intake/work-up
Record review
Intake paperwork

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THERAPIST APPROACH TO THE MSE (CONT .)

Important!!

When conducting a MSE, investigate, observe, notate, inquire! Counseling skills and approach are essential Counseling/therapy does not happen during the MSE **see Polanski reading pg. 361

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MSE: TYPICAL DOMAINS

Appearance
Behavior/Activity
Mood/Affect
Speech & Language
Thought Processes, Content, Perception
Cognition
Insight & Judgement

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APPEARANCE

Observation

Grooming
Poise
Clothing (appropriate for weather)
Body-type/nutrition
Age
Presentation of self
Cultural sensitivity essential

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BEHAVIOR/ACTIVITY

Observed

Quantitative & Qualitative
Looking for:
Psychomotor agitation
Psychomotor retardation
Akathesia

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MOOD & AFFECT

Inquired/Observed

Mood –subjective report of “the way they

feel”

Emotion perceived by client
Affect –How the client presents
Examiner looking for:
Congruence/incongruence
Appropriateness

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SPEECH & LANGUAGE

Observed

Describe it. . .
Physical characteristics
Relevance to topic
Paralinguistic
loudness
Rhythm
Intonation, phonation
Articulation
coherence

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THOUGHT PROCESSES, CONTENT , PERCEPTION

Observed/Inquired

Perception

Hallucination or illusions?
Hallucination –false perception

without sensory stimuli

Auditory, Visual, Tactile, olfactory
Illusion –misperception of sensory

stimuli

Auditory, Visual

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THOUGHT PROCESSES, CONTENT , PERCEPTION (CONT .)

Thought & Thought Content

Form of thought –the way in which a

person thinks and gets it across

Flight of ideas
Loose associations
Tangentiality

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THOUGHT PROCESSES, CONTENT , PERCEPTION (CONT .)

Content of Thought

Description of what the client is actually thinking

about, what is inside their head. . .

Delusions, paranoia, suicidal/homicidal
Delusions: fixed false beliefs that are usually not

bizarre and therefore believable

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COGNITION/ SENSORIUM

Observed/Inquired

Alertness, Level of Consciousness
Orientation to time
Orientation to place
Orientation to person

Note: distinguish between dementia and disassociation

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COGNITION/ SENSORIUM (CONT .)

Memory
Recent
Remote
Recent past
Immediate retention
Recall

(Don’t forget to check it out)

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COGNITION/ SENSORIUM (CONT .) Concentration & Attention

Serial 7’s or 3’s
Can you spell _______

backwards

Errors in mood disorders

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COGNITION/ SENSORIUM (CONT .)

Check capacity to read/write
Visual spatial ability (complex

figure)

Abstract thinking
Fund of information
Impulse control

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INSIGHT & JUDGMENT

Insight –refers to the awareness of how one’s
wn personality traits and behaviors contribute

to what is troubling the client

Judgment –process, and formulation that leads

to a decision about an appropriate course of action to achieve realistic goals.

Judgments require adequate insight and

cognitive functions

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UNDERSTANDING THE MSE -- BARRY

http://youtu.be/6ss827LbbtA