WHO's
Patient Health Questionnaire 9 is for the amount of questions
What is confidentiality? Can it be broken? Why/why not?
Any and all information is kept private UNLESS safety is a concern.
finish the phrase "If you didn't document it...."
"it didnt happen"
What does DSM-TR stand for?
Diagnostic and Statistical Manual of Mental Disorders - Text Revision
A minor patient is on your schedule for a telehealth visit. You attempt outreach and parent answers and informs you the patient is at school but parent is ok with answering assessment questions. What do you do?
Inform parent patient needs to be present and reschedule to a time that fits patients schedule. If you continue with the appointment without the patient that is insurance fraud!
Excluding a positive question 9, what is the minimum score that automatically initiates a WHO?
15<
You are seeing a 12y/o through school-based services, and they have asked to keep services confidential. Students' mom finds out and demands to speak to you. What do you do?
Initiate contact with student and inform them of the request and what outcome they'd like.
A minor patient discloses of reportable child abuse. You have made your report and are now documenting. How would you document this session?
something along the lines of "patient disclosed of reportable incident writer reported to appropriate agency" We never want to document we called CPS specifically; always generalize.
How long does an adult patient have to exhibit symptoms of depression in order to be diagnosed? Is there a different timeline for minors?
2 years of adult patient experiencing symptoms more days than not
1 year for a minor patient experiencing symptoms more days than not and less criteria needs to be met for minors
List the next steps the clinician must take if patient scores positively on question 9 and is not answering our call?
*Attempt to contact minimum 3x
*initiate a wellness check
*Document attempts and wellness call
A patient requests a treatment summary letter for their lawyer. Who do you address the letter to? Is an ROI needed?
You ALWAYS address letter to the patient. The patient has the discretion to give to whomever and remember we do not participate in any legal matters which is another reason why we address all letters to the patient. ROI is not needed because we are addressing the patient specifically.
What billing code do you use for your visits?
TX016
What is Mania? Hypomania?
Mania: A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy, lasting at least 1 week and present most of the day, nearly every day (or any duration if hospitalization is necessary).
Hypomania: A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently increased activity or energy, lasting at least 4 consecutive days and present most of the day, nearly every day.
What to look out for in order to help distinguish: timeline and severity
When initiating a wellness call what information is given to dispatch? What information are we required to obtain from the call?
*Only reportable information
*time and date
*officers name/badge number
*outcome of officer contact
Medical Records sends you a message informing you parent is requesting behavioral health records for their 14 y/o child because they want to "understand them more". Your patient recently disclosed of their sexuality and is fearful of what parents will think. What do you do with the request?
A new BH patient is scheduled for an intake however, during the intake session patient is in crisis and we are implementing crisis intervention. Soon the end of the session comes and we have no intake information. How do you document?
Change visit to crisis/WHO and provide supporting information (e.g how pt presented, crisis interventions used, ect.)
what does BPD stand for?
Trick question- we dont ever want to abbreviate BPD specifically because this can stand for 2 different things Bi-Polar Disorder vs Bi-Polar Depression If we abbreviate this can leave room for misinterpretation.
You receive a telephone WHO for a pediatric patient 17y/o with active SI, plan of taking all the medicine in the medicine cabinet, and patient discloses they are unsure if they will attempt and disclose they've never attempted before. Patient requests parents are not made aware. What next steps do we take?
Lead with empathy and re-explain confidentiality and its limitations (as this should be done after you introduce yourself) and share with the patient we hear them AND due to my concern for your safety I'd like to add parent/guardian in the conversation so we can ensure you're safe at home. Remember Safety trumps Confidentiality!
You have been working consistently with your Bi-Polar Depression 1 patient for 3 years. They have been consistent with services for the most part and have been emotionally well over the last 3 sessions. Today in session patient informs you their brother was murdered and they know who did it and they're "seeing red" you assess further and determine patient has not slept in 4 days and is exhibiting symptoms correlated to mania. What should you do?
Validate the patients grief and inform the patient they need to be evaluated at the ER for homicidal Ideation.
Patient meets criteria for major depression and pica. Which diagnosis do you choose for documenting?
BOTH- There will be patients we see that meet more than one diagnosis and its ok to document and diagnose each one the patient meets.
A patient requests to see the DSM because they feel they don't agree with the diagnosis you provided. What do you do?
Do not give in OR be offended instead explore their concerns and redirect questions back to them.