{"id":19000,"date":"2018-02-20T23:50:30","date_gmt":"2018-02-20T23:50:30","guid":{"rendered":"https:\/\/writemyessayfree.com\/biopsychosocial-history"},"modified":"2017-06-05T17:12:38","modified_gmt":"2017-06-05T17:12:38","slug":"biopsychosocial-history","status":"publish","type":"post","link":"https:\/\/www.benedictsol.com\/blogs\/biopsychosocial-history\/","title":{"rendered":"Biopsychosocial History"},"content":{"rendered":"<p>Name<br \/>\n_________________<br \/>\nPatient ID<br \/>\n_______<br \/>\n__<br \/>\nPatient SSN<br \/>\n___________<br \/>\nDate<br \/>\n_________<br \/>\nDate of Birth _<br \/>\n__<br \/>\n_______<br \/>\nPage<br \/>\n1<br \/>\nBiopsychosocial History<br \/>\nPresenting Problems<br \/>\nPrimary<br \/>\n_____________________________________________________________________________________________<br \/>\n______<br \/>\nSecondary<br \/>\n_____________________________________________________________________________________________<br \/>\n______<br \/>\n_____________________________________________________________________________________________<br \/>\n______<br \/>\nCurrent Symptom Checklist<br \/>\n(Rate intensity of symptoms<br \/>\ncurrently present)<br \/>\nMild<br \/>\n= Impacts quality of life, but no significant impairment of day<br \/>\n&#8211;<br \/>\nto<br \/>\n&#8211;<br \/>\nday functioning<br \/>\nModerate<br \/>\n= Significant impact on quality of life and\/or day<br \/>\n&#8211;<br \/>\nto<br \/>\n&#8211;<br \/>\nday functioning<br \/>\nSevere<br \/>\n= Profound impact on quality of life and\/or day<br \/>\n&#8211;<br \/>\nto<br \/>\n&#8211;<br \/>\nday functioning<br \/>\nSymptom<br \/>\nImpact<br \/>\nSymptom<br \/>\nImpact<br \/>\nNone<br \/>\nMild<br \/>\nModerate<br \/>\nSevere<br \/>\nNone<br \/>\nMild<br \/>\nModerate<br \/>\nSevere<br \/>\nAggressive Behaviors<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\nLaxative\/Diuretic<br \/>\nAbuse<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\nAgitation<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\nLoose Associations<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\nAnorexia<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\nMood Swings<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\nAppetite Disturbance<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\nObsessions\/Compulsions<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\nBingeing\/Purging<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\nOppositional Behavior<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\nCircumstantial Symptoms<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\nPanic Attacks<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\nConcomitant Medical Condition<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\nParanoid Ideation<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\nConduct Problems<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\nPhobias<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\nDelusions<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\nPhysical Trauma Perpetrator<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\nDepressed Mood<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\nPhysical Trauma Victim<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\nDissociative States<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\nPoor Concentration<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\nElevated Mood<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\nPoor Grooming<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\nElimination Disturbance<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\nPsychomotor Retardation<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\nEmotional Trauma Perpetrator<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\nSelf<br \/>\n&#8211;<br \/>\nMutilation<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\nEmotional Trauma Victim<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\nSexual Dysfunction<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\nEmotionality<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\nSexual Trauma<br \/>\nPerpetrator<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\nFatigue\/Low Energy<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\nSexual Trauma Victim<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\nGeneralized Anxiety<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\nSignificant Weight Gain\/Loss<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\nGrief<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\nSleep Disturbance<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\nGuilt<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\nSocial Isolation<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\nHallucinations<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\nSomatic<br \/>\nComplaints<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\nHopelessness<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\nSubstance Abuse<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\nHyperactivity<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\nWorthlessness<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\nIrritability<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\nOther<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\n?<br \/>\nName<br \/>\n_________________<br \/>\nPatient ID<br \/>\n_______<br \/>\n__<br \/>\nPatient SSN<br \/>\n___________<br \/>\nDate<br \/>\n_________<br \/>\nDate of Birth _<br \/>\n__<br \/>\n_______<br \/>\nPage<br \/>\n2<br \/>\nEmotional\/Psychiatric History<br \/>\n?<br \/>\nNo<br \/>\n?<br \/>\nYes<br \/>\nPrior<br \/>\nout<br \/>\npatient psychotherapy?<br \/>\nIf yes, on<br \/>\noccasions. Longest treatment by<br \/>\nfor<br \/>\nsessions from<br \/>\n\/<br \/>\nto<br \/>\n\/<br \/>\nProvider Name<br \/>\nMonth\/Year<br \/>\nMonth\/Year<br \/>\nPrior provider name<br \/>\nCity<br \/>\nState<br \/>\nDiagnosis<br \/>\nIntervention\/Modality<br \/>\nBeneficial?<br \/>\n____________________<br \/>\n___________<br \/>\n____<br \/>\n________________<br \/>\n___________________<br \/>\n__________<br \/>\n____________________<br \/>\n___________<br \/>\n____<br \/>\n________________<br \/>\n___________________<br \/>\n__________<br \/>\n?<br \/>\nNo<br \/>\n?<br \/>\nYes<br \/>\nHas any family member had outpatient psychotherapy?<br \/>\nIf yes, who\/why (list all):<br \/>\n_____________________________________________________________________________________<br \/>\n___________<br \/>\n________________<br \/>\n_________________________________________________________________________________________________________<br \/>\n_______<br \/>\n?<br \/>\nNo<br \/>\n?<br \/>\nYes<br \/>\nPrior<br \/>\nin<br \/>\npatient<br \/>\ntreatment for a psychiatric, emotional, or substance use disorder?<br \/>\nIf yes, on<br \/>\noccasions. Longest treatment<br \/>\nat<br \/>\n____________<br \/>\nfrom<br \/>\n\/<br \/>\nto<br \/>\n\/<br \/>\nName of facility<br \/>\nMonth\/Year<br \/>\nMonth\/Year<br \/>\nInpatient facility name<br \/>\nCity<br \/>\nState<br \/>\nDiagnosis<br \/>\nIntervention\/Modality<br \/>\nBeneficial?<br \/>\n____________________<br \/>\n___________<br \/>\n____<br \/>\n________________<br \/>\n___________________<br \/>\n___________<br \/>\n____________________<br \/>\n___________<br \/>\n____<br \/>\n________________<br \/>\n___________________<br \/>\n___________<br \/>\n?<br \/>\nNo<br \/>\n?<br \/>\nYes<br \/>\nHas any family member had inpatient treatment for a psychiatric, emotional, or substance use disorder?<br \/>\nIf yes,<br \/>\nwho\/why (list<br \/>\nall):<br \/>\n___________________________________________________________________________________________________________<br \/>\n___<br \/>\n______________________________________________________________________________________________________________<br \/>\n?<br \/>\nNo<br \/>\n?<br \/>\nYes<br \/>\nPrior or current psychotropic medication usage?<br \/>\nIf yes:<br \/>\nMedication<br \/>\nDosage<br \/>\nFrequency<br \/>\nStart<br \/>\nDate<br \/>\nEnd<br \/>\nDate<br \/>\nPhysician<br \/>\n____________________<br \/>\n___________<br \/>\n____<br \/>\n_____<br \/>\n___________<br \/>\n_____________<br \/>\n___________________<br \/>\n_________<br \/>\n_<br \/>\n____________________<br \/>\n___________<br \/>\n____<br \/>\n_____<br \/>\n___________<br \/>\n_____________<br \/>\n___________________<br \/>\n_________<br \/>\n_<br \/>\n?<br \/>\nNo<br \/>\n?<br \/>\nYes<br \/>\nHas any family member used psychotropic medications?<br \/>\nIf yes, who\/what\/why (list all):<br \/>\n_____________________________________________________________________________________________________________________<br \/>\n____________________________________________________<br \/>\n_________________________________________________________________<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Name _________________ Patient ID _______ __ Patient SSN ___________ Date _________ Date of Birth _ __ _______ Page 1 Biopsychosocial History Presenting Problems Primary _____________________________________________________________________________________________ ______ Secondary _____________________________________________________________________________________________ ______ _____________________________________________________________________________________________ ______ Current Symptom Checklist (Rate intensity of symptoms currently present) <a href=\"https:\/\/www.benedictsol.com\/blogs\/biopsychosocial-history\/\" class=\"read-more\">Read More &#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[],"tags":[],"class_list":["post-19000","post","type-post","status-publish","format-standard","hentry"],"_links":{"self":[{"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/posts\/19000","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/comments?post=19000"}],"version-history":[{"count":0,"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/posts\/19000\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/media?parent=19000"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/categories?post=19000"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.benedictsol.com\/blogs\/wp-json\/wp\/v2\/tags?post=19000"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}