Psychiatric Interview of Children and Adolescents

516 Pages·2016·6.022 MB·English

by  Claudio Cepeda, Lucille Gotanco

PSYCHIATRIC INTERVIEW

OF

CHILDREN
AND

ADOLESCENTS

Claudio Cepeda, M.D.
Lucille Gotanco, M.D.
Psychiatric Interview of

Children and

Adolescents

Psychiatric Interview of

Children and

Adolescents

Claudio Cepeda, M.D.

Adjunct Clinical Professor, Department of Psychiatry,

University of Texas Health Science Center at San Antonio

Lucille Gotanco, M.D.
Assistant Medical Director of Inpatient Services,

Clarity Child Guidance Center, San Antonio, Texas;

Adjunct Assistant Professor, Child and Adolescent

Psychiatry Division, University of Texas Health Science

Center at San Antonio
Note: The authors have worked to ensure that all information in this book is accurate
at the time of publication and consistent with general psychiatric and medical stan­
dards, and that information concerning drug dosages, schedules, and routes of ad­
ministration is accurate at the time of publication and consistent with standards set
by the U.S. Food and Drug Administration and the general medical community. As
medical research and practice continue to advance, however, therapeutic standards
may change. Moreover, specific situations may require a specific therapeutic re­
sponse not included in this book. For these reasons and because human and me­
chanical errors sometimes occur, we recommend that readers follow the advice of
physicians directly involved in their care or the care of a member of their family.
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sent the policies and opinions of American Psychiatric Association Publishing or the
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Copyright © 2017 American Psychiatric Association Publishing
ALL RIGHTS RESERVED
First Edition
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Library of Congress Cataloging-in-Publication Data
Names: Cepeda, Claudio, author. | Gotanco, Lucille, author. | American Psychiatric
Association Publishing, publisher.
Title: Psychiatric interview of children and adolescents / Claudio Cepeda, Lucille
Gotanco.
Description: First edition. | Arlington, Virginia : American Psychiatric Association
Publishing, [2017] | Includes bibliographical references and index.
Identifiers: LCCN 2016039069 (print) | LCCN 2016039706 (ebook) | ISBN
9781615370481 (pbk. : alk. paper) | ISBN 9781615371174 (ebook)
Subjects: | MESH: Interview, Psychological–methods | Child | Mental Disorders—
diagnosis | Adolescent | Child Psychiatry—methods | Adolescent Psychiatry—methods
Classification: LCC RJ499.3 (print) | LCC RJ499.3 (ebook) | NLM WS 105 | DDC
618.92/89—dc23
LC record available at https://lccn.loc.gov/2016039069
British Library Cataloguing in Publication Data
A CIP record is available from the British Library.
To my wife, Rosalba,

and to my children,

Claudio Rene and Mary, Adrian and Michelle,

and Joe and Chante

C.C.

Contents

Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ix

Claudio Cepeda, M.D.
1
Diagnostic and Therapeutic Engagement. . . . 1

2
General Principles of Interviewing . . . . . . . . . 15

3
Special Interviewing Techniques. . . . . . . . . . .53

4
Family Assessment . . . . . . . . . . . . . . . . . . . . . .93

5
Providing Post-evaluation Feedback

to Families . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .113

6
Evaluation of Special Populations. . . . . . . . . 123

7
Psychiatric Evaluation of Preschoolers

and Very Young Children . . . . . . . . . . . . . . . . 143

8
Documenting the Examination . . . . . . . . . . . 165

9
Evaluation of Internalizing Symptoms . . . . . 191
10
Evaluation of Externalizing Symptoms . . . .239

11
Evaluation of Abuse and Other

Symptoms. . . . . . . . . . . . . . . . . . . . . . . . . . . . .273

12
Neuropsychiatric Interview and

Examination . . . . . . . . . . . . . . . . . . . . . . . . . . .297

13
Comprehensive Psychiatric Formulation . . 373

14
Symptom Formation and Comorbidity . . . . 401

15
Diagnostic Obstacles (Resistances). . . . . . . .411

16
Countertransference . . . . . . . . . . . . . . . . . . . .429

Appendix: Sample Format/Protocol for

Documentation of Psychiatric Evaluation

of Children and Adolescents . . . . . . . . . . . . . 441

Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . .453

Index. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .477
Preface

This book has its roots in the late 1990s, when I was preparing to teach a class
on child and adolescent interviewing to fellows in the Child and Adolescent
Psychiatry Division at the University of Texas Health Science Center at San
Antonio (UTHSCSA). As I began to think about my upcoming course, I
sketched out some ideas in writing, which would later serve as the preliminary
work for my first book. When I was a medical student, I was highly inspired by
one of my internal medicine professors, Professor Rios, whom I grew to ad­
mire greatly. He was very detailed in his physical examinations, and he seemed
able “to read” the patient’s body, listening to the signs and determining organ
impairment, by thoroughly inspecting the physical body. This mystified me
and my fellow medical student peers. As I began to sketch out the initial ver­
sion of my book, I wondered whether something similar could be achieved in
psychiatry.
This book is the result of an evolution that started with Concise Guide to
the Psychiatric Interview of Children and Adolescents, published in 2000 by
American Psychiatric Press. That book was translated into Japanese, Span­
ish, and Slovak. A revised and augmented version became Clinical Manual
for the Psychiatric Interview of Children and Adolescents, published in 2010 by
American Psychiatric Publishing. (It was an honor to have Doody Enterprises
Inc. review this book and award it five stars and 100 points, the maximum score
given by these reviewers.) That text was translated into Polish. I am extraor­
dinarily pleased by the reception of these prior two versions of the present
book. The acceptance of these books in the United States and in the inter­
national market has been beyond this author’s wildest dreams!
The present publication is an updated and revised version of the clinical
manual. The chapter on interviewing preschoolers is new, as is the first sub­
section on bullying in the chapter on the evaluation of abuse and other
symptoms.
ix