Preface

^{From: Psychiatric Clinical Skills: Revised 1st Edition}

"Go interview that new patient." This instruction from a clinical teacher or supervisor may be the immediate prelude to a first clinical encounter in a clinic, an inpatient unit, an emergency room, or a home visit. For the student in any of the mental health professions—psychiatry, psychology, social work, nursing, occupational therapy, and counseling—there may be a sense of dread related to not knowing what to ask or how to ask it. Lectures and readings on the theoretical causes of psychiatric disorders, memorized mnemonics of diagnostic criteria, and laminated cards of algorithmic treatment approaches provide little help for that ultimately human encounter of two individuals.

Psychiatric assessment and engagement are not entirely separable concepts. The art of asking the right questions in the right way leads to a sense in the person being interviewed that the interviewer knows what he or she is doing and understands the problem at hand. This combination of expertise and empathy can result in the provision of hope and trust, which serve as foundations for engagement.

Psychiatry is virtually alone in medicine in lacking any diagnostic laboratory or imaging tests. The absence of such external markers of validity that make both the patient and the mental health professional know that the problem is "real" dramatically heightens the need for clinical skills of assessment and engagement. Understanding the problem helps confer legitimacy to the associated distress; understanding the person helps cement the therapeutic alliance necessary for trust and hope to be buttressed by help.

Psychiatry is all about the reconciliation of the unique nature of human experience and individuality with the highly reproducible patterns of human behavior and psychiatric illness across centuries and cultures. Pattern recognition is the foundation of all expertise in medical diagnosis, and no less so in psychiatry, but the reduction of assessment to diagnostic checklists robs the field of its richness as a human encounter and deprives people with mental illness of the hope that can emerge from a sense of connection with a professional who knows and understands.

Through the contributions of numerous senior academic clinicians, this book provides a guide to psychiatric assessment and engagement across a number of clinical problems and settings. While this book is targeted toward students in the mental health professions, all of us benefit from the clinical pearls of our colleagues, whose years of dedication and experience are reflected in these pages.

David S. Goldbloom

Preface

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