**Clinical Interview Role-Play Part 1 - Family, Social, and Mental Health History — Transcript & Summary | SozAI** Source: https://sozai.app/transcript/clinical-interview-roleplay-family-social-mental-health/ Dr. Todd Grande conducts a clinical intake interview focusing on anxiety, alcohol use, and family/social history. ## Key Takeaways - Anxiety and alcohol use are the primary presenting problems affecting the patient's functioning. - Family dynamics, especially sibling comparison, contribute to emotional distress. - The patient has some social support but lacks deep emotional connections for discussing problems. - Previous treatment attempts were limited and unsuccessful due to patient readiness. - The intake process builds rapport and gathers comprehensive biopsychosocial information. ## What the video covers - The video features a clinical intake role-play with a patient presenting anxiety and problematic alcohol use. - The clinician explains the intake process and obtains patient consent for emotionally detailed questions. - The patient describes long-term anxiety impacting multiple life areas and rates current anxiety at 6/10. - Alcohol use is discussed as a coping mechanism, with episodes of excessive drinking and blackouts. - Family history is explored, revealing distant sibling relationships and parental comparisons affecting self-esteem. - Social relationships are described as cordial but not deeply supportive regarding mental health issues. - The patient has had limited prior counseling experience and no medication treatment. - The clinician emphasizes that topics like family dynamics and mental health can be revisited in future sessions. - The intake covers medical history, social support, and readiness for treatment. - The patient expresses motivation for help now, contrasting with past ambivalence toward therapy. ## Chapters 1. 00:00 Introduction and Intake Explanation 2. 00:40 Consent and Comfort with Intake Questions 3. 02:04 Presenting Problems: Anxiety and Alcohol Use 4. 06:02 Details on Anxiety and Alcohol Patterns 5. 10:02 Family History Overview 6. 12:10 Sibling Relationship and Parental Comparisons 7. 14:30 Extended Family and Social Relationships 8. 19:07 Previous Treatment and Readiness for Help Answers ## Questions about this video What are the main issues the patient is seeking help for? The patient is primarily seeking help for anxiety and problematic alcohol use, including episodes of excessive drinking and blackouts. How does the patient describe their relationship with their family? The patient describes a distant relationship with their sister, who is seen as the 'ideal child,' and mentions parental comparisons that negatively impact self-esteem. Has the patient received any prior mental health treatment? Yes, the patient had brief counseling previously but did not engage fully and was not prescribed medication; they now express readiness for help. ## Full Transcript — Download SRT & Markdown 00:15 Speaker A Hi. How are you doing today? All right. You doing all right? Yeah. I see that this is the first time you've come in. 00:23 Speaker A You've filled out some of the other paperwork. Yeah. About 20 of them. A lot of pages. 00:28 Speaker A Yeah. How'd that go? It went. I mean, I've seen that stuff before, but it wasn't too bad. 00:33 Speaker A Nothing surprising in there? No. Pretty standard. Pretty standard. Nothing distressing? Not yet. Not yet. 00:40 Speaker A Okay. I'm going to ask you a series of questions as part of the process called intake. 00:51 Speaker A So this document that I'll be making notes on will go in your chart, and it'll help guide your care for the time that you're with me. 01:02 Speaker A Okay. All right. So these questions are going to be more detailed and more emotionally oriented than a lot of those questions that you were answering on the forms you filled out before. 01:18 Speaker A Okay. That was more like factual information that we need for insurance or record-keeping. This is more about you and what you've been going through. 01:30 Speaker A Okay. You comfortable with that? Yeah. It's okay. It's okay. All right. If at any time you don't like one of the questions or you don't want to answer one of the questions, just let me know and we'll just skip over that one. 01:43 Speaker A Okay, fair enough. All right. So what brings you in today? I brought myself in. 01:51 Speaker A Things have just not been fantastic. So I figured I might as well — I'd get some help before it got worse. 01:58 Speaker A Things haven't been fantastic. Yeah. And you're worried they're going to get worse. Seems like it, yeah. 02:04 Speaker A Yeah. What would you say that your main problem is, that motivates you to come in? 02:16 Speaker A Probably my anxiety and — I'm just nervous about a lot of things a lot of the time. 02:23 Speaker A And it's kind of trickling into every area of my life now. So anxiety. Uh-huh. 02:28 Speaker A You said it's like a nervousness? Yeah. Just like nervousness about going places; nervousness about doing things like going to school or work or — you know, graduating college. 02:40 Speaker A Just kind of that whole stage, and it's been like that for a while. How long? 02:46 Speaker A I can remember as far back like 13 or 14 maybe. How old are you now? 02:53 Speaker A 23. So say around 10 years you've been — Yeah. [Crosstalk]. Off and on, yeah. 02:58 Speaker A Yeah. Off and on. Yeah. So there's times when you're not anxious? Not as bad. 03:04 Speaker A I mean, I'm still anxious but not as extreme or I don't deal with it the same way. 03:10 Speaker A If you were to rate your anxiety on a scale of 1 to 10 with one being really no anxiety and 10 being the worst it's been in the last 10 years, how much anxiety do you have right now? 03:23 Speaker A I think a 6. When was the last time you were a 10? Last weekend. 03:36 Speaker A When was the last time you were at one? Not really sure. No. Approximately? Maybe a couple months ago when I was just hanging out with my friends. 03:51 Speaker A We went out and we were partying a little bit and it was nice and I wasn't too anxious. 03:57 Speaker A About a couple months ago? Yeah. Okay. So the anxiety is one problem. Any other problems? 04:07 Speaker A I don't think it's a huge problem, but I have been drinking a lot — that it helps with the anxiety but it makes going out, you know — I'm more relaxed that way. 04:17 Speaker A That I can — kind of compulsive person. So once I start I keep going. 04:25 Speaker A So it's not all the time. It's just when I'm going out that I end up drinking too much. 04:31 Speaker A So sometimes when you go out you drink more than you want to? Yeah. What happens then? 04:37 Speaker A I make bad decisions, or I get sick. Or the next morning I'm showing up hung-over going to class if I make class. 04:47 Speaker A And, you know, it's fun for the time being but it's not fun afterwards. So the consequences of drinking in the longer run. 04:58 Speaker A You're not too fond of those but in the short run — ? Yeah, it helps in the moment. 05:06 Speaker A Okay. So you want the anxiety to be lessened. Do you want the drinking to be lessened? 05:13 Speaker A Probably. Yeah. I mean, I'd like to still have fun in college, but I would like to not be like blacking out or being able to stop would be nice. 05:23 Speaker A Is that what happens now, blacking out? Occasionally. Not every time but sometimes. Sometimes. Yeah. 05:28 Speaker A Do you remember the last time you blacked out? Maybe a month ago. A month ago. 05:38 Speaker A Yeah. It's not all the time. At what age did you start drinking? Fourteen. At 14? 05:45 Speaker A Yeah. All right. Any other problems? You have anxiety. You have drinking alcohol. Any other problems? 05:55 Speaker A I don't think so. Okay. So those are the two main things that are bothering you. 06:02 Speaker A Yeah. Okay. All right so I want to ask you some questions about your history. 06:12 Speaker A Okay. All right. And I'm going to try to divide this up into different areas and just kind of move from one area to the next. 06:20 Speaker A There'll be some overlap. Okay. So if I ask you the same question more than once it's just kind of part of that overlap that occurs, all right. 06:30 Speaker A First I'd like to cover your family history. So can you tell me about your immediate family? 06:37 Speaker A I have one sister — and a mom and a dad. Pretty typical. My sister is really successful. 06:48 Speaker A She's a doctor. Both my parents are really successful too. So basic family. All right. 06:58 Speaker A What type of relationship do you have with your sister? Kind of like a Merry Christmas, Happy Easter type of relationship. 07:09 Speaker A We're more like acquaintances than we are siblings. Would you describe it as distant? Yeah, you can say so. 07:16 Speaker A I mean, we're nice. We're not like — we're not going to be like involved in each other's lives. 07:21 Speaker A Do you know what caused the relationship to end up that way? I don't know. 07:33 Speaker A She was always kind of like the ideal child. She went and did everything she was supposed to do and it was easy for her. 07:40 Speaker A So constantly being compared to that doesn't really foster a great relationship. Who compares you to your sister? 07:49 Speaker A My dad usually. Sometimes my mom. Was this a frequent occurrence, the comparison? Yeah. For sure. 08:01 Speaker A Do you feel like it had an impact on you? Probably. You know, it wasn't like I wasn't trying, but not everything can be as easy as it is for some people. 08:11 Speaker A So a little acknowledgement might have been nice. All right. So let's move on a little further. 08:19 Speaker A So you talked about your mother and father, your sister. Any other siblings? Nope. No. How about grandparents? 08:30 Speaker A They're around. Typical grandparents, aren't super involved, but they're there sometimes. Good relationship? Yeah. I mean, you know, grandparents show up and it's always like, "Hi. 08:42 Speaker A How's it going?" And, you know, you see them at the next holiday type of thing. 08:46 Speaker A All right. So there's not one grandparent that you're typically close to? I do have one grandfather I talk to on the — like on a more personal level than I would my other ones, but that's gotten more distant in the past couple years. 09:04 Speaker A Okay. How about aunts, uncles, cousins? I have a couple of cousins that I would hang out with or I would see out when I'm hanging out with my friends or whatever. 09:14 Speaker A So we'll hang out if we run into each other. Aunts and uncles, I do have. 09:20 Speaker A They're not super involved either, but everybody's cordial. Everybody's cordial. Yeah. Nice when I see you type of thing. 09:28 Speaker A All right. So when's the last time you spoke, say for example, with one of your cousins? 09:39 Speaker A I think I ran into one of them like two weeks ago when we were just out. 09:43 Speaker A A couple weeks ago? Yeah. All right. Do any of the relatives that you mentioned, are any of them aware of your anxiety and/or your drinking? 09:55 Speaker A My parents are. Yeah. Nobody else? My sister knows about the anxiety part of it. 10:03 Speaker A And I think — I'm pretty sure she knows about the drinking but she doesn't bring it up. 10:08 Speaker A But if my parents know I'm sure she knows. So you believe that they told her? 10:16 Speaker A I'm sure. Yeah. But she's not mentioned that to you directly? No. We don't have those types of conversations. 10:25 Speaker A It's more like — oh. She messed up again and it's just like a funny thing and then I move on. 10:31 Speaker A So — All right. So I see this bothers you. Yeah. It's annoying. Annoying. Yeah. All right. 10:45 Speaker A Some of these topics that we're going to touch on in this intake we can talk about in greater detail later on. 10:54 Speaker A Okay. All right. And maybe your relationship with your mother and father and your sister could be topics we touch on later on, maybe not. 11:03 Speaker A But I want to let you know that we can c 11:09 Speaker A All right. So I want to move kind of out of family history a bit and move to social relationships. 11:18 Speaker A Okay. All right. Again it's kind of similar, a little bit of overlap here. Can you tell me about any romantic interests, friends. 11:27 Speaker A Anything like that. Yeah. I have a guy I've been seeing for like six months, so it's pretty serious for college. 11:33 Speaker A Okay. And some of my college friends I'm really close with so they're there [inaudible] a lot. 11:40 Speaker A About how many? There's three girls that I'm super close with and -- you know, college. 11:47 Speaker A There's a lot of people I'm acquaintances with or I'll see or talk to in class or whatever, but those three girls are kind of the ones I will go to if I needed something. 11:53 Speaker A All right. Then you have some other friends that you're not as close to? Yeah. I mean we're nice and we have fun and you know I'm sure if something happened they would bail me, but they're not like people that I talk to about my problems 12:08 Speaker A or anything like that. They know about your problems? I don't know. I guess you could -- when I show up to class hung-over. 12:18 Speaker A But I'm sure I'm not the only one doing that so. How about these -- the guy you're seeing for six months. 12:25 Speaker A Does he know about your problems? Somewhat, Yeah. He is [inaudible]. He definitely knows about the anxiety. 12:32 Speaker A And he's with me often when I go out. So if something does happen he's usually helps me out or make sure I get home or whatever. 12:40 Speaker A So he's supportive? Yeah. Really supportive. All right. So some of the questions I'm going to ask you -- this gives me a good opportunity to talk about this. 12:53 Speaker A I've probably could guess the answer too but I still want to ask, not be presumptuous. 12:58 Speaker A Okay. Do you have any children? No. All right. Okay. How about nieces and nephews? 13:09 Speaker A No. Any other social relationships that I missed here that are important to you? I don't think so. 13:20 Speaker A Those are the main ones right now. Yeah. All right. So you said you're 23. 13:30 Speaker A Uh-huh. I want to ask you some questions about your medical history? Okay. All right. 13:39 Speaker A Have you had any surgeries in your lifetime? I got my appendix removed. Appendix moved? 13:45 Speaker A Yeah. Any other serious medical conditions? No. I had my wisdom teeth taken out. Wisdom teeth extracted Yeah. 14:00 Speaker A Are you on any medications for physical problems? No. All right. How about your activity level? 14:17 Speaker A Do you stay fairly active? Yeah, I try to. I go to the gym like twice a week or whatever. 14:22 Speaker A And then I go to yoga sometimes. So yeah ,I think I do get out. 14:30 Speaker A All right. So you consider yourself an active person? Yeah, I try to be in between classes and everything else. 14:38 Speaker A But when I do have the time I enjoy going out and doing things. Okay. Would you generally say you're in good health then? 14:45 Speaker A Yeah. Typically, Yeah. Physically. Yeah. All right. No other illnesses, surgeries, procedures of note? No. 14:59 Speaker A All right. So I want to shift gears a little bit again and we'll now talk about psychiatric history. 15:08 Speaker A Okay. All right. And what I'm getting at here is kind of a history of any diagnoses, medications, all the times you've been treated by a counselor or somebody like a counselor. 15:19 Speaker A So let's start with medications. Are you on any medications? No. No. How about history of diagnoses. 15:35 Speaker A Ever been diagnosed with a mental health condition? Yeah I was. I was seeing a therapist before a couple of years ago and I saw him a couple of times. 15:46 Speaker A And I think he said I had some sort of anxiety disorder or something. Do you remember specifically what he said? 15:52 Speaker A Something more general. So like it wasn't about any particular thing. So I saw him for a little while but I just really wasn't on board with the whole therapy thing at that point. 16:04 Speaker A I didn't think it was going to help so -- How old were you? 15 or 16. 16:10 Speaker A Yeah. All right. And that was a counselor? Yeah. Yeah. All right. So you saw the counselor. 16:20 Speaker A The counselor indicated you had some type of anxiety disorder. Yeah. Do you feel that was a fair assessment? 16:30 Speaker A I think so. Yeah. And how long did you see the counselor. I think five or six times maybe. 16:38 Speaker A Five or six sessions? Yeah. And why did you discontinue the treatment? I don't know. 16:50 Speaker A I just didn't really feel like I was really involved in it and it felt like it was more a waste of my time and his. 16:55 Speaker A I wasn't ready. I don't know that I was super on board with the whole anxiety thing at that point. 17:02 Speaker A I mean he was nice; it wasn't like an issue with him. I wasn't there. 17:09 Speaker A Any mention at that time about the drinking? I think I brought it up but I didn't really see it as an issue then. 17:18 Speaker A All right. Are there other mental health professionals like a psychiatrist, a psychologist, a [inaudible] and family therapist. 17:27 Speaker A My parents made me see a psychiatrist like maybe once or twice but I didn't really stick with that either. 17:34 Speaker A You weren't prescribed any medication? No. And what do you think happened there that you didn't stick with that? 17:40 Speaker A I think kind of the same thing. Kind of -- I knew that obviously there was something going on but I didn't think I was ready to deal with it, and I kind of felt like I had it under control at that point. 17:53 Speaker A Can you tell me about when you saw the psychiatrist in relation to when you saw the counselor? 17:58 Speaker A It was all up in that same time period. I think I saw the counselor first, and then maybe the psychiatrist like a week or two later and then followed up with the counselor. 18:10 Speaker A But I just wasn't really present during any of it. You feel you're in a different state of mind now? 18:20 Speaker A Yeah, I think so. Tell me about that. I realize now that I'm not handling it like I thought I was and it's affecting other areas of my life. 18:30 Speaker A And, you know, in my senior year of college I need to get my life together and I'm not really doing that so well. 18:39 Speaker A So I think it's time to figure something out. All right. So you feel like you're ready to commit to treatment a little more vigorously at this point? 18:58 Speaker A Yeah. I want the help now. And back then? No. No, okay. And no other treatment providers? 19:06 Speaker A No, just this. Okay [inaudible]. Topics: clinical interview intake assessment anxiety alcohol use family history social history mental health Dr. Todd Grande therapy readiness substance use --- This is the markdown twin of https://sozai.app/transcript/clinical-interview-roleplay-family-social-mental-health/ — the same content, without the markup. 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