Psy 601: Assessment Seminar - Writing the Report
I.	Session II: 10/5/05
A.	Interview with Dr. Migalski
1.	Presenting Problem
a.	Michael Jones
b.	Overwhelmed not sure where to start
c.	Here because found out difficult news and anxious about it
d.	HIV Positive, don't know what to do, overwhelmed
(1)	found out 2 weeks ago
(2)	at regular check up
e.	Can't sleep since
f.	Feel hopeless
g.	Don't know what to do
h.	So sad
i.	Afraid to tell people
j.	here because dr. said it would be a good idea to talk to you
k.	freqing out for 2 weeks
l.	appetite gone
m.	not interest int things
n.	can't get to work
2.	Life before this event happened
a.	35
b.	Social worker
(1)	enjoy job
(2)	works with kids and family
c.	Single with friends
d.	Feeling I was just getting into my career
e.	Things were good
f.	Don't know where I am at this time - where has this event put me in life
3.	No other medical concerns
4.	Was eating well, but not now
5.	"Does this mean I'm going to die"
a.	Will I get really sick right away
b.	I don't know what to really expect
6.	I am a gay man
7.	Had friends who became HIV positive, but now it is me, and I don't know what to do
8.	Medical History
a.	Always been in good shape
b.	but none really
c.	6'4'' 195lbs
d.	family High BP and CVD
9.	Counseling before 30th birthday
a.	coming to terms with being gay
b.	she really helped a lot
c.	really sad at that time and really down
d.	3 or 4 weeks couldn't get out of bed, no energy
e.	5 years ago
f.	felt better in 3-4 mos
10.	HS and Grade school
a.	not always a happy kid
(1)	8th Grade and Frsh Year of HS
(a)	down like that before
(b)	isolated self
(c)	then really got into sports and school, and just put it aside for a while
b.	Felt alone and disconnected
(1)	realizing gay at 13 is hard
(2)	fear of people not liking me or accepting me including family
c.	Had a temper then and really down for those two years
11.	Family
a.	mom and dad married now for 40 years
b.	older bro, younger sister
c.	middle class and polish
d.	grandparents from poland
e.	went to catholic shcool
f.	mom stay at home
g.	dad electric ian
h.	went to church
(1)	not into it right now, though
i.	good memories of childhood, but 8th grade was the turning point finding out I was gay
j.	Came out to parents 5 years ago when a special relationship
(1)	parents were wonderful about it
(2)	should have told older
12.	Partner died in 2004 in a car accident, very sudden
a.	very sad, low affect
b.	hurt and sad
c.	couple of months when really in grief
(1)	life goes on
(2)	went to a grief group in gay community
(3)	affect is still sad and upset by observation
13.	Afraid to disclose HIV
a.	Happenend when
(1)	Working at Ill Masonic
(2)	Working with patient
(3)	pricked self with needle from HIV patient
(4)	Drs and Rns said he would be fine, but now I'm HIV positive
(a)	all because of a stupid mistake
(5)	I wasn't thinking - social worker is stressful
(a)	reached for a towel and needle in it.
14.	History
a.	Family Medical
(1)	High BP in family - father has it
b.	Family Psychiatric
(1)	Mom depressed after younger sibling
(2)	post-partum depression then
(3)	struggle with it on and off
(4)	sometimes really down, no energy, and listless
c.	Bro. has problem with alcohol
(1)	has gone to some support groups
d.	Older sister +1
(1)	married to a professor
e.	Younger Bro -1
(1)	married to an Episcopalian Minister
f.	Married and both have kids
15.	Came out 5 years ago
a.	did date women over the years
b.	had one night stands with guys until I met "Fred" in 1999
(1)	a year before we started dating
(2)	social worker at same hospital
(3)	Working on pediatric unit and he at another department
(4)	friends for a year before realized wanted to date
(5)	only man ever had a serious relationship with
(a)	now he's gone
(b)	makes me feel angry
(6)	It was a perfect relationship, he was my best friend
(a)	then accident
(b)	feel so alone
(c)	he got me, it was a true reationship
16.	More about Social Life before Fred
a.	had a lot of friends, do have a lot now
b.	good work relationshiops
c.	teach part time at a JC and hang out with faculty
d.	in 20's when actively dating women, not satisfying and short lived
(1)	3-4 close romantic relationships with woment, but agreed grown apart , no longer than a year, still in contact with 3 of 4 as friends
17.	Current Social
a.	I do have supports
b.	They have been good after Fred
c.	Who is going to want me now that I am HIV
18.	"I know in my head there are ways for me to stay healthy"
a.	hard to see it the same when when it is you
b.	have examples of long term success from observing hopital patients
c.	But now it is me
d.	When Dr. found out HIV, put me on Sustiva 500mg, heavy duty antivirals
(1)	one a day
(2)	said if I keep diet and exercise good can be well for 10-20 years
(3)	on 
e.	Dr. said go see a Psychiatrist and saw him
(1)	Welbutrin SR b.i.d, 300mg total per day
(a)	started 5 days ago
(2)	I've seen these meds help my clients, so I'm sure it will help me elevate my mood
(3)	still feel very fatigued, and not interested. Hoping meds help with that
19.	A/D
a.	Ever illegal
(1)	long time ago
(a)	Marijuana
(b)	once cocaine
(2)	never been a regular useer
(3)	alcohol once or twice a week
(4)	last time drunk, probably when I was 20
(5)	brother is a binge drinker
(a)	beer on weekends
(6)	rest of family not much for drinkers
(7)	DK about family and drugs
20.	Education
a.	15 Semester Hours past Master's from Loyola
b.	Don't think I will go back to finish my Ph.D.
c.	Undergrad
(1)	U of I, BA in Psych., 1993
d.	St. Mary's Grade School and St. Pat's HS
(1)	always been a good student
(a)	A's and B's 3.75 GPA
e.	Still in contact with friends from school years
(1)	yes, but not that much, everyone is so far away
21.	Other jobs?
a.	case manager before graduate degree
(1)	4-5 years right after BA in Psy.
b.	painted houses (internal) during summers
c.	restaurants, part time jobs
d.	Like job
(1)	yes
(2)	what most
(a)	working with kids, diabetic kids and families
(b)	dislike hours
i)	work 45-50 hours per week
(c)	when I work at JC it adds, but not teaching this term
i)	teching 2 years
(3)	Rate job satisfaction
(a)	8-10
22.	I'm feeling very tense
a.	losing track of thoughts
b.	have a lot of tension in my forehead
c.	feel so overwhelmed
23.	Looks to side tisk, tisking
a.	beginning to look distracted and anxious
24.	Rate Family Life
a.	9-10
25.	Rate Social Life
a.	5
26.	Any Legal
a.	bounced a check once
(1)	was quite embarassed, not thinking clearly
27.	Military - no
28.	Abuse
a.	Sexual
(1)	no, parents watched us like hawks
29.	Grew up Catholic
a.	now consider myself a Quaker
(1)	meaningful
(2)	like silent spirituality
(3)	society of friends - Friendship
(4)	not a community nearby, hard to do 
(a)	don't have the strength
b.	Has gone to Unitarian services also
30.	Describe Mood
a.	Sad and Anxious
b.	Hopeless (teary eyed)
(1)	acts like he's losing it
(2)	hard to talk about these things
(3)	hard to hear me call myslef hopeless, i'm not usually this way
c.	When feeling sad and hopeless, what do you think about
(1)	Morbid thoughts about dying
(a)	Fred died last year
(b)	now HIV - a terrible accident
(2)	Used to like "Six Feet Under"
(a)	keep seeing myself in a coffin and in the ground
(b)	don't like the thoughts and images
(c)	never had those thoughts before this
31.	Unusual thoughts and beliefs
a.	You're trying to find out if I have Delsions, no...
(1)	but these images keep intruding upon my thoughts, they keep poping up
(a)	happen when I'm by myself
i)	very troubling
(b)	don't happen when I'm with people
b.	Ever see things or experience things around you that others don't expereince
(1)	No
(2)	Although I have to tell you when I have these images of seeing myself in a coffin
(a)	I feel cold
(b)	feel myself slightly outside of myself
(c)	worries me, I don't like that feeling
(d)	Anxiety, but not panic
32.	Ever feel that life isn't worth living
a.	No, I love life
b.	I would never hurt myself
c.	I believe life is a gift and needs to be shared with others
33.	Desires to hurt others
a.	Revenge
(1)	when I found out which nurse left that needle in the towel had a fantasy about sticking her with it so she would deal with what I'm dealing with now
(a)	wanteed to make her pay for her carelessnes
34.	Insight-Judgment
a.	Why do you think all this has happened to create this mood?
(1)	Client becomes agitated and expresses anger about all that should not have happened
(2)	Says life is not what it is supposed to be
(3)	it just sucks
35.	MSE
a.	100's backward by 3's
(1)	ok
b.	Orientation
(1)	I need to asses the clarity of your thinking and see if you are oriented
(a)	contextualize the question
(2)	Yes, oriented
c.	Recent Memory
(1)	what time was the appt. - hour ago at 1p
(2)	where were you on 9/11
(a)	yes, recalls
(3)	Last 5 presidents
(a)	W
(b)	Clint
(c)	Daddy B
(d)	Reagan
(e)	Carter
d.	Similarities - fine
e.	Sayings - bird in hand worth
(1)	never understood really
f.	Glass houses
(1)	imperfect people should not judge others
36.	He asks, what is next
a.	Will discuss with supervisor
b.	Mental health team will discuss
c.	I'll discuss it with you.