What happens at initial evaluation?
Most initial psychiatric evaluations at Life Change Associates take about 60 minutes to complete. The purpose of the evaluation is usually to serve as a diagnostic assessment in order to move treatment in the appropriate direction. In an effort to gather and assess relevant information for accurate diagnosis and treatment, it is critical that a comprehensive approach is taken beginning with the initial evaluation.
Towards the end of the initial evaluation Dr. Ravsten, or one of his Allied Health Providers (AHP), will advise and review recommended treatments based on the diagnostic information gathered from the initial psychiatric evaluation. These recommendations include both medication and non-medication options.
There are specific areas to be covered and considered during the diagnostic evaluation but the initial assessment can be broken into 3 parts. These include:
Part I (15-20 minutes)
- Brief introduction consisting of a review of basic personal information including reason for visit, desired result of the visit, living situation, employment status and source of the referral
- Brief review and identification of signs and symptoms that are possibly the result of a mental disorder
- Review of completed Online Intake History:
- Review of all current medications (including herbs, over-the-counter pills, supplements, vitamins, etc)
- Review of medical history
- Review of personal and family history
Part II (15-20 minutes)
- Focused, actively-guided review of one’s history of mental health disorder symptoms
- Identification of periods in which the onset, type, severity and duration of symptoms are characterized
- Mental status examination allowing Dr. Ravsten to create a “snapshot” of your presentation (General Appearance, Movements, Attitude, Behavior, Mood, Speech, Thinking style and content, Judgment, Insight, Orientation, Memory, Concentration, Cognitive Abilities)
Part III (10-20 minutes)
- Review of diagnostic impressions, relevant treatment options and Dr. Ravsten’s recommendations.
- Particular attention to medication treatment options includes specific information about treatment such as pros and cons of treatment as well as the pros and cons of NO treatment.
- The PROs of medication treatment refers to the desired outcome and the likelihood of that result.
- The CONs of medication treatment refers to possible side effects and the likelihood of adverse effects of medication treatments.
- The agreed upon medication treatment approach and plan of treatment is then set in motion with prescription medications sent electronically to the pharmacy of the patient’s choice. The starting of medication therapy implies that follow up will be needed in order to re-assess the result of the initial treatment plan. At each subsequent visit the treatment plan is reviewed and adjustments made accordingly.
For most mental health disorders, there is rarely a single “best” treatment option or approach to consider. More typically, there will be several treatment approaches to consider. Dr. Ravsten or the AHP that performs the initial evaluation will provide recommendations based on the current progress of medical science, his/her experience with proven and recommended treatments. This includes a discussion of patient preferences and individual circumstances as part of creating goals and agreement regarding treatment. The ultimate goal of medication therapy is to allow each patient to feel and do as well as possible with few, if any, side effects.