Exam 2
 Psychiatric history components:
o chief complaint
o history of the present illness (HPI)
o psychiatric history
o medical history
o family history
o social and developmental history
 Alliance Building: Establishing a therapeutic alliance with the client begins during the initial or opening phase of the
interview as the PMHNP and client are getting acquainted. Trust is essential for a therapeutic alliance. According to Peplau's
Theory of Interpersonal Relations, establishing early rapport allows the role of the nurse to evolve from stranger to resource
person, teacher, leader, surrogate, technical expert, and counselor
 Interview Phases:
o Opening phase, the first five to ten minutes of the interview are used to establish rapport and therapeutic
alliance. This is often the most important phase of the interview as it establishes the foundation for the remainder of
the interview. The interview often begins with a PMHNP asking the question, what brought you in to see me
today? This question helps the client begin to share what is on their mind.
o Body of the interview. This stage of the interview is about 30 to 40 minutes, at which time the chief complaint is
established and additional questions are asked to elicit information related to the complaint. It serves as the basis
for diagnosis and treatment formulation. The questioning process is often directed by responses to initial
questions asked in phase one.
o Closing the interview. This is the final phase of the interview. Five to ten minutes are needed to adequately complete
this phase. Closing the interview entails a wrap-up statement and inquiry about missing information that may be of
value. Patient education is provided regarding the working diagnosis and recommended plan of
treatment. Medications may be recommended to target symptoms. Education about the rationale for the medication
regimen and expected benefits, timeframe for efficacy and possible side effects should be included. Homework
maybe assigned, especially in cognitive behavioral therapy. A return visit is agreed upon, including the client
in decision-making when possible.