An initial client meeting can be unpredictable and even a bit challenging. Personalities may not mesh, nor is it always easy to engage in conversation. Social work assessments can help facilitate the initial encounter with a client. Imagine that you are meeting a new client for the first time. In your toolbox

ready to use are the GIM, your interviewing skills, and the ability to express genuineness and empathy. What assessment will you use?

For this Assignment, you practice assessing an individual by conducting an interview with a friend or colleague in order to complete a psychosocial assessment. Recall that it is important to assess the individual within the context of her or his environment, which includes assessing all systems levels: micro, macro, and mezzo. You will also need to consider any cultural influences that might affect your assessment, and strengths and resources should be identified.

To Prepare: Choose an individual to interview in order to obtain the necessary information to write a comprehensive psychosocial history.

Use the Psychosocial History document found in the Learning Resources to conduct the interview.

*** It can be a friend or anybody make up ***

Submit a 6- to 10-page paper that includes the following:

• Complete a biopsychosocial history of the person you interviewed by completing the Psychosocial History document.
• Assess the challenges/needs and strengths of the client based on the completed Psychosocial History document.

References

Kirst-Ashman, K. K., & Hull, Jr. G. H. (2018). Understanding generalist practice(8th ed.). Stamford, CT: Cengage Learning

EXAMPLE

Psychosocial History

Name

Date

Agency

IDENTIFYING DATA

Age

Ethnicity

Marital Status

Date of Birth

Emergency Contact/Relationship/Telephone Number

REFERRAL SOURCE

Who referred this individual for treatment? Was the informant a reliable historian?

Was information gleaned from previous treatment records, court documents, etc.?

MENTAL STATUS

Attitude/Appearance/Behavior Affect/Mood/Psychomotor Activity

Orientation/Memory/Cognition Thought Process/Content Speech

Insight/Judgment Homicidal/Suicidal Ideation Hallucination(s)/Delusion(s)

PRESENTING PROBLEM(S)

Client Self-Assessment of Problem(s)/Reason(s) for Seeking Treatment/Motivation Onset/Duration/Intensity/Frequency Precipitating Stressors/Stressful Events Symptoms (in Client's/Informant's Own Words)

HISTORY OF PSYCHIATRIC ILLNESS AND PREVIOUS TREATMENT

Previous Diagnoses/Medications/Inpatient and Outpatient Treatment History of Suicidal Ideation/Suicide Attempts/Self-Mutilation/Homicidal Ideation/Aggression

SOCIAL HISTORY

A. PRENATAL/BIRTH/DEVELOPMENT

Pregnancy and Labor Developmental Milestone(s)

B. EARLY CHILDHOOD

Family of OriginParents/Siblings/Extended Family, as Relevant

Geographic/Cultural/Spiritual Factors/as Relevant

Abuse/Trauma History

Physical/Emotional/Sexual Abuse History

C. SOCIAL DEVELOPMENT

Cultural/Peer Group/Environment School

Adolescence

D. EDUCATIONAL HISTORY

Public or Private School(s) Where Attended

Performance

Educational Level

Extracurricular Activities

E. MILITARY HISTORY What Branch

Duty Assignment (when/where) Rank/Discharge

INTERPERSONAL/MARITAL HISTORY

Age of Involvement in Relationships

Sexual Orientation

Length of Relationships

Relationship Patterns/Problems

Partner's Age/Occupation

LEGAL HISTORY

Previous Arrests/Convictions

Pending Charges

Child Custody Disputes

Involvement in Lawsuits

History of Court Ordered Treatment Guardian/Power of Attorney Probation/Parole

Is Treatment a condition of legal involvement?

Is Treatment to be a part of current or contemplated lawsuit?

Disability Claim or Divorce Proceeding?

SUBSTANCE ABUSE HISTORY

Type/Onset/Duration/Amount Frequency/Pattern of Use Involvement in Treatment

RELIGION/SPIRITUALITY

CULTURAL/ETHNIC FACTORS

MEDICAL HISTORY/HEALTH STATUS

History of Traumatic Injuries/Illnesses/Chronic Health Problems

Describe Current Illness

Is Client in Good General Health?

Is Client Allergic to Any Medications? Who Is Client's Primary Care Physician?

Is the Client Being Treated by Any Other Physician(s)?

What Are the Client's Current Psychiatric and Nonpsychiatric Medications?

Describe Client's Health Habits: Appetite, Sleep, Exercise, Nicotine, Alcohol, Illicit Drugs, and Vitamins/Herbal Supplements?

Sexual Functioning: Preference/Problems

Pregnancy/Birth Control

Risk Behaviors for STDs

CURRENT SITUATION

Living Situation

Dependents/Care for Dependents Employment/Disability/Seeking Disability Income/Source of Income

Insurance Transportation Daily Living Skills

Social/Leisure Activities

Available Social Support

RISK OF DANGER TO OTHER PEOPLE

OTHER SIGNIFICANT FACTORS

SUMMARY