Content uploaded by Fredrick Norfleet
Author content
All content in this area was uploaded by Fredrick Norfleet on Feb 28, 2023
Content may be subject to copyright.
Frederick Norfleet, Author
Open For Discussion Online Journal
https://fbnorfleetpublishing.com/open-for-discussion-online-journal
Interviewing Techniques - biopsychosocial
According to Grace Hennessy, M.D., the goals of assessing patients with substance-
related disorders are:
1. identify the presence of a substance-related disorder, as well as signs of harmful or
hazardous use so that prevention and early intervention may take place
2. make an accurate diagnosis and relating this to any other co-occurring medical or
psychiatric disorders
3. identify barriers to treatment as well as strengths and supports
4. assess and enhance the patient's motivation to change
5. formulate and help to initiate appropriate evidence-based interventions and treatments
Source: The American Psychiatric Publishing textbook of substance abuse treatment (4th
ed.).
The skilled clinician uses the interview during the assessment process to 'illicit a
substance use, psychiatric, and medical history, from the patient, and formulate an accurate
diagnosis' (Galanter, M., & Kleber, H. D., 2008). The interview style that the clinician chooses to
elicit substance abuse history from the patient is essential. The clinician is responsible for
facilitating a thorough and accurate assessment of the client. The interview style that the
clinician chooses must prevail over the shame, discomfort, fear, distrust, and hopelessness felt by
the patient. The feelings mentioned above are barriers keeping the patient from complete and
honest disclosure. According to Schottenfeld and Pantalon, 'obstacles to obtaining an accurate
history also include the patient's defenses, such as denial, minimization, rationalization,
projection, and externalization' (Schottenfeld & Pantalon). To bypass the defenses mentioned
above, the clinician should use open-ended questions during the assessment interview process.
The open-ended question interview-style also helps the clinician understand the patient's problem
and set the assessment interview direction.
Based on my observation of the addictions professional in the Sample Biopsychosocial
Interview (Perkinson, 2016, p. 254), the clinician effectively searched for leads to develop a
diagnosis and treatment plan. The purpose of the biopsychosocial interview, according to
Perkinson, 'is to find out exactly what the problems are and where they came from' (Perkinson,
2016, p. 37). It is essential to know that all diseases have biological, psychological, and social
causes impacting the clients' dysfunctional behavior. Furthermore, keep in mind that all major
psychiatric disorders have biopsychosocial elements. Thus, 'all addiction affects the cells (bio
from biology); the emotions, attitudes, and behavior (psycho from psychology); and the social
relationships (socio from sociology)' (Perkinson, 2016, p. 37).
The following is an example of how the Biopsychosocial Interview illicit biological information
from the client Jane Roberts.
1. Bio – biology
a. Demographic Data
i. 28-year-old, white female
b. History Of The Present Illness
i. Has in increasing tolerance to alcohol
ii. Experience blackouts
iii. Ingest Valium
iv. Currently suffering from acute alcohol and anxiolytic withdrawal
v. Feels restless and sleeping poorly
c. Past History
i. Reports normal birth and development milestones
ii. Irish ethnic heritage
iii. Hetorsexual orientation
d. Medical History
i. Illnesses: Measles, mumps, chicken pocks
ii. No hospitalizations
iii. No allergies
iv. Medications at present: 5 milligrams of valium three times a day for
withdrawal
e. Family History
i. Mother: history of alcoholism
f. Mental Status
i. Tall and thin
ii. 28-year-old female
iii. Curly hair
iv. Light-brown hair
v. Blue eyes
vi. Freckled face
Source: Appendix 6: Sample Biopsychosocial Interview (Perkinson, 2016, p. 254)
Considering the above example, the clinician effectively extracted biological information
from the client Jane Roberts. The bio (biology) information along with the psycho (emotions,
attitudes, and behavior) and social (social relationships) enabled the clinician to make the
following diagnosis;
DIAGNOSIS:
303.90 Alcohol Use Disorder, severe304.10 Anxiolytic Use Disorder, moderate291.80 Alcohol
withdrawal292.00 Anxiolytic withdrawal (Perkinson, 2016, p. 256)
Therefore, the clinician effectively modeled the biopsychosocial interview strategy within
the Sample Biopsychosocial Interview (Perkinson, 2016, p. 254) due to the resulting diagnosis.
The interviewing techniques used in the example are compelling, and I would not avoid using
any method used to elicit the information needed for diagnosis.
References:
Galanter, M., & Kleber, H. D., (2008). The American Psychiatric Publishing textbook of
substance abuse treatment (4th ed.). Washington, DC: American Psychiatric Publishing.
Schottenfeld R, Pantalon M: Assessment of the patient, in The American Psychiatric Press
Textbook of Substance Abuse Treatment, 2nd Edition. Edited by Galanter M, Kleber HD.
Washington, DC, American Psychiatric Press, 1999, pp 109–120
Perkinson, R. R. (20160811). Chemical Dependency Counseling: A Practical Guide, 5th
Edition. [[VitalSource Bookshelf version]]. Retrieved from vbk://9781506307367