You can use some of the following types of questions in the course of your interview (Slattery, 2004). Your psychosocial history should follow this general format, with headers for each section. Here is an example of a psychosocial history.
Problem | |
| What symptoms does the person report? How severe are they? How chronic are they? When did they begin? How much are they interfering with functioning? Are they specific to certain situations or do they occur across situations?
Because people often have difficulty reporting "bad" symptoms, be careful to assess major concerns, especially about suicide, rather than expecting clients to freely disclose them. Ask, What else? | |
| What are his or her beliefs about what is wrong? about the appropriate treatment for his or her symptoms? Does he or she expect to get better? | |
of psychological disorders | Has the person experienced symptoms similar to or different from current symptoms at some time in the past? What was helpful then?
If he or she received formal treatment in the past, how might this affect current treatments? Were previous therapists respectful? hopeful? effective? empowering? Is current therapy an extension of previous work or, from his or her viewpoint, working on the same old issues? |
of psychological disorders | Does the person's family have a history of psychological disorders or symptoms? How did family members handle these problems? Specifically, was suicide used to cope with psychological problems? |
Current context | |
| What negative or positive events have occurred recently at home, work, school, and in important relationships? What ongoing stressors are present in his or her life? Are reactions proportional or disproportional to the stressor? | |
| Can any medical conditions account for the symptoms reported? Have these been ruled out? | |
| Is the person taking any drugs (medicinal or recreational) that could cause symptoms? Is he or she taking any street drugs that could interact with medications prescribed to treat symptoms? | |
| What are his or her intellectual strengths and deficits? Could symptoms be caused by cognitive deficits? | |
| Is he or she engaging in generally adaptive or maladaptive coping strategies? When is he or she most successful in coping with the problem? What works? Are coping strategies generally short-term or long-term solutions? | |
| What are his or her beliefs about himself or herself (e.g., I'm helpless with regard to the winds of fate)? What beliefs about self or problems in the past are particularly helpful? Does he or she have a generally strong or weak sense of self-efficacy? | |
| In what culture was this person raised? How long has he or she been in this country? Why did he or she come to this country? What are his or her connections to his or her homeland? What is his or her level of acculturation? What other group identifications (e.g., race, affectional orientation, gender, age, physical abilities, etc.) are most important?
How does his or her culture or group influence reactions to symptoms? How does cultural background influence your assessment of symptoms? Could the behavior be "normal" in his or her culture and not in yours (or vice versa)? Could differences in group identification influence the nature and quality of your relationship? | |
| What (if any) religious affiliation does he or she report? Is it important to the person? How do religious beliefs influence current functioning? Do they provide a supportive network? | |
Resources and barriers | |
| What does he or she do particularly well or feel good about? How can these attributes (e.g., persistence, loyalty, optimism, intelligence) be resources for treatment? How might they undermine it? | |
family and school/work) | How supportive are your client's family, friends, and work relationships? Are they sufficient in both quantity and quality to meet your client's needs? Do they increase or decrease your client's stress levels? Do they empower your client or undermine him or her? |
| What agencies (if any) are involved? How supportive are they? How well do they work together? Are they at loggerheads, undermining each other's recommendations, or do they generally share information in an open and collaborative manner? | |
| How does your client contribute to the community? Does this feel useful and meaningful to him or her? Are contributions acknowledged by important people in his or her support system? | |
| What real, historical, or metaphorical figures serve as pillars of support or spiritual guides? How have they handled similar problems? Note: Some models may be primarily negative in tone. What are the positive aspects of these "negative" models? | |
| What things might serve as potential obstacles to change? These can be financial, educational, social, intellectual, etc. What does he or she believe will (or might) happen when change happens (e.g., marriage dissolves, family becomes angry, loses financial support, etc.)? | |
| What sort of relationship do the two of you have? Can he or she be honest about symptoms, actions, side effects and concerns? Can he or she honestly disclose the level of compliance with your recommendations? Does he or she feel comfortable contradicting you or correcting any misassumptions you may have made? |
Slattery, J. M. (2004). Counseling diverse clients: Bringing context into therapy. Belmont, CA: Brooks/Cole.
| Grading the Psychosocial History |
An example |
Page by jms
Last updated January 8, 2004
URL= http://psy1.clarion.edu/jms/intpsychosoc.html