Interviewing Skills: Psychosocial history

Psychosocial history

This is a psychosocial history for Mervyn, who is 52 and suffers from a series of unexplained physical problems (Slattery, 2004).

Problem

Current symptoms Reports a history of infections and other relatively minor, but extremely bothersome illnesses over the last two years. These have led to him taking one brief medical leave.

Beliefs about symptoms Saw symptoms as primarily medical in nature, although willing to consider his physician's suggestion that these are psychosomatic in origin.

Personal history
of psychological disorders No history of psychological symptoms reported, although we might infer some depression following his son's death based on reported history. Has never seen a therapist in the past.

Family history
of psychological disorders None reported. Family, his father in particular, have strongly negative feelings about expressing negative emotions or having problems.

Current context

Recent events Wife has been diagnosed with breast cancer. She has quit her job and is unable or unwilling to perform many chores around the home.

Physical condition His symptoms have baffled his physician and medical syndromes have been ruled out.

Drug and alcohol use Only moderate social drinking has been reported. He denies drug use.

Intellectual and cognitive functioning Average intelligence. He is persistent, with strong problem solving skills.

Coping style He describes "swallowing things" and working harder when under stress. He does not talk to family or friends because he believes he will "overwhelm" them, although is willing to talk to and listen to his next door neighbor.

Self-concept Sees himself as a good person, buffeted by fate. Tends to see his past as a series of failures and bad luck. Pessimistic about the future and his ability to make effective change in his life.

Sociocultural background Is a middle class male in a rural Euro-American community. He reports being fair-minded and concerned about issues of justice.

Religion and spirituality Although he had been active in the Catholic church until his son's death, he now describes himself as an agnostic.

Resources and barriers

Individual resources Describes himself as responsible, dedicated and determined. Sees himself as identifying a problem and being able to attack it successfully. Reports having enjoyed gardening and camping in his early adulthood, but says that they "wouldn't work now."

Social resources (friends,
family and school/work) Has one superficial friendship with a neighbor. He reports (friends and family) being afraid that he would "overwhelm" his friend if he would share his stressors or if he would do anything which would make this relationship more genuine.
Family relationships are distant and conflictual for the most part at the present time, although he reports having had close relationships with his wife, mother, son, and sister in the past. Mother and son are both dead, his mother as a result of leukemia, his son as a result of a drowning.

School and work He describes himself as a "workaholic," although he does not enjoy the amount of time he is currently putting in at work. He does not feel appreciated and feels taken advantage of, but is concerned about losing his job if he asks to make changes.

Community resources Has regular yearly physicals with his doctor, as well as almost monthly visits to handle "infections." No other agencies are involved.

Community contributions None currently. He had been a Boy Scout leader and an usher in his church until his son's death.

Mentors and models Sees himself as being like Job (showered with problems, but survived these). Pulls on his mother's memory during times of stress and wishes he were more like her. Admires his employer who he describes as decisive, efficient and capable.

Obstacles to change Afraid that setting limits with his wife, family of origin, or work would have negative consequences, that they would be, respectively, overwhelmed, rejecting, or fire him.

Therapeutic relationship Open and honest with symptoms because "that's what you're here for." Not concerned about the possibility that therapist would be overwhelmed. Feels listened to and understood. Accepts minimal direction and extends this tenfold.

Slattery, J. M. (2004). Counseling diverse clients: Bringing context into therapy. Belmont, CA: Brooks/Cole.

Psychosocial History

Grading the
Psychosocial History

Page by jms
URL= http://psy1.clarion.edu/jms/intpsychosocex.html

Last updated January 8, 2004

Problem
Current symptoms	Reports a history of infections and other relatively minor, but extremely bothersome illnesses over the last two years. These have led to him taking one brief medical leave.
Beliefs about symptoms	Saw symptoms as primarily medical in nature, although willing to consider his physician's suggestion that these are psychosomatic in origin.
Personal history of psychological disorders	No history of psychological symptoms reported, although we might infer some depression following his son's death based on reported history. Has never seen a therapist in the past.
Family history of psychological disorders	None reported. Family, his father in particular, have strongly negative feelings about expressing negative emotions or having problems.
Current context
Recent events	Wife has been diagnosed with breast cancer. She has quit her job and is unable or unwilling to perform many chores around the home.
Physical condition	His symptoms have baffled his physician and medical syndromes have been ruled out.
Drug and alcohol use	Only moderate social drinking has been reported. He denies drug use.
Intellectual and cognitive functioning	Average intelligence. He is persistent, with strong problem solving skills.
Coping style	He describes "swallowing things" and working harder when under stress. He does not talk to family or friends because he believes he will "overwhelm" them, although is willing to talk to and listen to his next door neighbor.
Self-concept	Sees himself as a good person, buffeted by fate. Tends to see his past as a series of failures and bad luck. Pessimistic about the future and his ability to make effective change in his life.
Sociocultural background	Is a middle class male in a rural Euro-American community. He reports being fair-minded and concerned about issues of justice.
Religion and spirituality	Although he had been active in the Catholic church until his son's death, he now describes himself as an agnostic.
Resources and barriers
Individual resources	Describes himself as responsible, dedicated and determined. Sees himself as identifying a problem and being able to attack it successfully. Reports having enjoyed gardening and camping in his early adulthood, but says that they "wouldn't work now."
Social resources (friends, family and school/work)	Has one superficial friendship with a neighbor. He reports (friends and family) being afraid that he would "overwhelm" his friend if he would share his stressors or if he would do anything which would make this relationship more genuine. Family relationships are distant and conflictual for the most part at the present time, although he reports having had close relationships with his wife, mother, son, and sister in the past. Mother and son are both dead, his mother as a result of leukemia, his son as a result of a drowning.
School and work	He describes himself as a "workaholic," although he does not enjoy the amount of time he is currently putting in at work. He does not feel appreciated and feels taken advantage of, but is concerned about losing his job if he asks to make changes.
Community resources	Has regular yearly physicals with his doctor, as well as almost monthly visits to handle "infections." No other agencies are involved.
Community contributions	None currently. He had been a Boy Scout leader and an usher in his church until his son's death.
Mentors and models	Sees himself as being like Job (showered with problems, but survived these). Pulls on his mother's memory during times of stress and wishes he were more like her. Admires his employer who he describes as decisive, efficient and capable.
Obstacles to change	Afraid that setting limits with his wife, family of origin, or work would have negative consequences, that they would be, respectively, overwhelmed, rejecting, or fire him.
Therapeutic relationship	Open and honest with symptoms because "that's what you're here for." Not concerned about the possibility that therapist would be overwhelmed. Feels listened to and understood. Accepts minimal direction and extends this tenfold.