NOTE: Physical exams are often the “first pit stop” in assessing mental health, because many patients visit a primary care physician first. For example, a PMHNP might ascertain whether panic attacks are the result of a heart or respiratory condition, or whether depression could be due to the side effects of a medication. Physical exams are not typically conducted in outpatient clinics. They are more common in inpatient or hospital settings, or in the case of mental illnesses that are likely to affect physical functioning (e.g., substance use disorders, eating disorders, somatic symptom disorders, disorders in which a patient is taking meds with a lot of side effects, e.g., schizophrenia).

Teaching Tip: Have students generate a list of possible medical problems that could cause symptoms of psychological disorders (e.g., diabetes, anemia, vitamin deficiencies, etc.). Use this as a basis for a discussion about the differences in perception, stigma and treatment between “medical” vs. “psychological” problems.

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Behavioral Assessment

Behavioral observation

Identification and observation of target behaviors

Target behavior: Behavior of interest (e.g., something that needs to be increased or decreased)

Direct observation conducted by assessor (e.g., therapist) or by individual or loved one

Goal: Determine the factors that are influencing target behaviors

The ABCs of observation

Antecedents

Behavior

Consequences