By As a quick Google search can confirm, psychiatry as a word, comes from two Greek words: psukhe (soul, mind) and iatrea (healing). So, healing the mind. There is nothing implied about a medical degree and even less about the use of medications.
Yet, when we hear Psychiatric Evaluation we tend to think (at least these days) that it refers to the process through which somebody can be diagnosed with a Psychiatric Disorder, for which a Psychiatric Medication may be needed.
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All practitioners that are involved in some aspects of ‘healing the mind’ are doing Psychiatry. And anybody interested may develop very strong evaluation skills.
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We should think of the Psychiatric Evaluation as the Comprehensive Evaluation that should inform all aspects that relate to diagnosis and treatment, both on the medical and on the non-medical aspects. Trying to see as much as possible of ‘the big picture’ should help us figure out the better thing to do.
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All evaluations (or assessments) have reasons. Some are called ‘symptoms’, some are called ‘concerns’, some are ‘problems’ and it can be confusing as we try to understand the situation. What all these reasons have in common is that they create impairment. The process is that we evaluate everything we can think of about the impairment with the purpose to develop a formulation (diagnosis), based on which to implement a set of interventions that hopefully will reduce the impairment.
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The evaluation can be broken down in two steps. The first is data gathering, and that is looking for information. The second is data interpretation. It is important to mention that in reality things may be more complicated. As we carry our interviews with children and their parents we may need to provide support, some reassurance, or we may need to set limits. These ‘therapeutic interventions’ take time away from ‘data gathering’ and balancing the two may be quite challenging.
The following image is attempting to break down the information by source and by type.
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Data gathering
– from interviews, questionnaires, checklists, collateral information.
Data organization
– presenting problem and its history, family, school and developmental history etc.
Data interpretation
– assembling the data by virtue of best judgment possible in the most convincing set of diagnoses.
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It is too early to get in details about data interpretation or the diagnostic formulation. We can start though by indicating that case formulation is the process by which we establish the relative contributions of the biological, the psychological and the social factors to the impairment. Otherwise said, the impairment is the result of psychiatric conditions, developmental delays, defensive patterns of behaviors, relational patterns and social environments. These are the main categories we will have to consider during the concluding phases of diagnosing.
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Yes, I know, we no longer have axes in DSM-5 but it is still a fairly good heuristic.