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Re: Evaluation? What does that mean? - October 9th 2010, 11:21 AM

There are various "red flags" when talking to someone, things you don't need to be trained to notice. By saying there's a separate presence, the assumption is that there may be a psychotic disorder, delusion disorder or depression disorder with psychotic features, which requires proper psychiatric medication. It's a flag that there's something much more serious than what was previously expected. It's like if you were the counselor and your client tells you that they enjoy tearing living animals apart and building and testing torture devices for humans their father helped them build. That's going to be sending red flags all over the place and as someone who deals with the basic depression, anxiety, eating disorder and a few personality disorders, this is way out of your league. So, you would refer them to someone who knows more.

The psychiatrist is going to want to talk with you, try to understand how you've been feeling and coping, asking about your life, family and building a rapport. The first session allows them to get a good amount of information and may go for more sessions to get an accurate diagnosis. They may prescribe medications on the first session just to see if it helps. Sometimes they will ask for additional tests, such as brain-image scans (CAT, MRI or EEG, doubtful to use PET and other ones) or written or verbal tests.

The way it works is the psychiatrist uses a diagnostic tree. These are a set of yes-no questions and depending on the answer, it either leads to a diagnosis or you go further down the tree. At the bottom of every tree, the diagnosis is NOS or possibly none.

They may want to talk to your parents because your parents act as observers to your behaviour and can help the psychiatrist verify and gain further information. You can choose to have your parents in the room with you as the psychiatrist talks with you, there is no law (at least in Canada as far as I'm aware) for someone your age to have the parents present. They may be interviewed in a different room by another person, either a social worker, therapist or psychiatrist. Since you're a minor, the psychiatrist has to tell the parents their findings. They don't have to mention specific things you said unless something stands out a lot.


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