Instructions
Students will conduct an intake/developmental history review with a child and their parent(s). You will be provided an informed consent form that explains that you are a student in training. Students will write out their results in an assessment format which is provided below. Students will then write a critical analysis paper, based on their interview and cumulative knowledge from the course, addressing the following; presentation of your “client”, assessment of developmental history and salient life course issues citing children and adolescent theories as supporting evidence, interpersonal dynamics, family, social, community, cultural contexts as well as any information about neurobiology. Assessments should also include clinical intervention strategies (identify at least 3), theories to support your selected interventions (identify at least 3) and specifically how you would engage the client and their parent(s) and/or family members, specific family intervention strategies and community intervention strategies or additional supports and any special considerations. All assessments and strategies must be supported by at least 6 cited scholarly sources. .
Biopsychosocial Assessment Outline for SW660 (revised January 2022)
Please use the same headings to divide the content but do not use the letters in the details of the outline; rather, write the information in a narrative (sentence) format.
The following areas must be addressed in the assessment.
- Demographic Data
Date, name, age, sex, race, source of income, marital status, living arrangements, etc.
- Presenting Problem
Pertinent details of who is the client and why are they there. What’s the problem, how long has it lasted, do they have a theory of what’s happening, is it related to something, have they had this problem (or similar) in the past, etc.
- Family History
Brief summary of childhood, born and raised, were parents married, with whom did you live growing up, who did you feel closest to, extended family relationships, are there family members you avoid or aren’t speaking to, significant relationships, how many times married/divorced, number of children and ages.
- Education and Work History/Military
- Psychiatric and Medical History
Mental health history and current situation. Medications and doses, taking as prescribed or not, history of suicidal/homicidal ideation, describe attempts, history of abuse, current stressors (deaths, divorce, financial, etc.)
- Substance Use History
Is there any use of alcohol, tobacco, vaping, misuse of prescribed medications, illicit use of prescriptions, street drugs, other chemicals such as huffing and over the counter meds like cough medicine or stuff you buy at gas stations. Ask about each category of drugs and document first use, method of use, current use, last use. If there’s current use, how often and how much. Tobacco, Alcohol, cannabis, stimulants for attention, anxiety medications, sleep medications, pain medications/opioids, illicit drugs such as cocaine, heroin, methamphetamine, hallucinogens. Any history of treatment, history of problems with withdrawal, including seizures, DT’s, requiring medically monitored detox, family history of substance use problems. Be sure to note any periods of abstinence and recovery. What did they do for support?
- General Observations and Mental Status:
- Appearance, grooming/hygiene, size/weight, is clothing appropriate to the weather/setting
- Ability to participate/Effort made/Motivation
- Orientation (who, what, where, day, date, time)
- Cooperation/Attitude
- Attention, posture, Eye Contact, psychomotor agitation or retardation
- Speech (rate, tone, volume, content, fluidity, accent)
- Affect and its congruence with mood
- Mood (as they describe it and your assessment)
- Memory (does it appear intact, did you do memory test, obvious problems? Consider short and long-term)
- Thought Process (logical, linear, tangential, circumstantial, etc)
- Thought Content (bizarre, typical, appropriate to the setting and situation, etc)
- Perceptual Disturbances, hallucinations, loss of rational thinking, suicidal/homicidal
- Judgment
- Insight
- Clinical Impressions (theories with rationale)
- Recommendations (interventions with rationale)
Final Project for SW660: Interview Consent
Instructions
(1) Informing your Participant:
When an individual is approached to be interviewed, either with or without electronic recording, it is important that you explain to them very clearly who you are, what the project is about, why you are doing it, what risks it poses to them, who will benefit, and what will become of the materials. This makes for “informed consent,” meaning they truly understand what they are participating in. You can read the materials to them, and you may also give them the option of reading the description themselves by providing them a copy of the informed consent document.
(2) The Agreement to Interview Form
The Agreement to Interview form is a very good and appropriate way to insure that your participants understand what they are agreeing to. After you have read the project description to them, and explained clearly what the project is about, why you are doing it, and what will become of the interviews and other materials.
You may then, if you feel it’s appropriate, ask them to sign the Agreement to Interview form, and give them a copy. Attach this with your final project submission. Students are welcome to also obtain a copy for their own records.
Informed Consent:
SW 660: Practice with Children and Adolescents
Assignment Description:
Procedure and Risks:
For this assignment, the interview will not be recorded by electronic means. No personal identifiers be used during the interview, to ensure your anonymity. Please feel free to say as much or as little as you want. You can decide not to answer any question, or to stop the interview any time you want
There are no known risks associated with participation in this interview.
Benefits:
It is hoped that through my engagement with this assignment, that I will be able to continue to enhance my learning in the area of child and adolescent mental health.
Cost Compensation:
Participation in for interview will involve no costs or payments to you.
Confidentiality:
All information collected during this interview will be kept strictly confidential and is only to be use for educational purposes.
Interview Agreement Form
SW 660: Practice with Children and Adolescents
I, _____________________________________, agree to have my child/adolescent be interviewed for the Child & Adolescent mental health final project assignment which is being facilitated by ______________________ an MSW student of Saint Mary’s University of Minnesota.
I certify that I have been told of the confidentiality of information collected for this project and the anonymity of my child/adolescent’s participation; that I have been given satisfactory answers to my inquiries concerning this interview process; and that I have been advised that I am free to withdraw my consent and to discontinue my child/adolescent’s participation in the interview at any time without prejudice.
I agree to participate in one or more interviews for this project. I understand that such interviews and related materials will be kept completely anonymous, and its content is used for educational purposes only.
________________________________________ Date ________________________
Signature of child/adolescent interviewee
________________________________________ Date ________________________
Signature of parent/guardian
_______________________________________ Date ____________________________
Signature of SMUMN Social Work Student
If you cannot obtain satisfactory answers to your questions or have comments or complaints about your treatment during this interview, contact:
Dr. Mallory Knipe, DSW, LISW
Pronouns: She/Her/Hers
Interim Program Director & Associate Professor, Master of Social Work Program
St. Mary’s University of Minnesota
Office: 612-728-5204
Email: [email protected]
