Psychiatry & Psychology--General/post-traumatic anxiety

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Question
QUESTION: hello,

I have patients who come in for treatment after a motor vehicle crash who often seem to have trouble with some anxiety and occasionally, panic afterward.

Do you know of a questionnaire-type instrument I can have these patients fill out to try to document the existence of this problem as well as any recovery from it?

Further, is it your opinion that psychotherapy for this is useful? So far, I've had limited success in getting patients to go for treatment of it but will press the issue if warranted.

Thanks very much in advance.

ANSWER: Hi, Mike, thanks for your questions. You asked, "Do you know of a questionnaire-type instrument I can have these patients fill out to try to document the existence of this problem as well as any recovery from it?"
---- Probably the MMPI-2 and MMPI-2-RF, but why would you need to document it? Either the client feels that they have a problem they want help with or they don't.


"Further, is it your opinion that psychotherapy for this is useful?"
---- yes, cognitive-behavioral therapy is generally accepted as the most effective for anxiety-related problems.


"So far, I've had limited success in getting patients to go for treatment"
--- sometimes the most difficult task is to determine what the patient's goals are. You shouldn't assume that you know what they are. For example, if the patient has filed a lawsuit, they may have disincentives to get better.  Generally people go for the things they want. Also, you can help them figure out what their goals are - they may not be able to articulate them.

---------- FOLLOW-UP ----------

QUESTION: Thanks, Bruce.

My job is to get the patient the help they need and document any and all effects of a car crash as accurately as I can. The more objective or quantifying, the better.

While I have you on the horn, so to speak, what about  mild traumatic brain injury. What instrument would you favor for that?

Thanks very, very much for sharing your expertise with a total stranger.

Answer
"My job is to get the patient the help they need and document any and all effects of a car crash as accurately as I can. The more objective or quantifying, the better."

----- Mike, this seems like 2 conflicting roles to me. If you help someone, then you don't need to document anything. If you are documenting for forensic purposes, then you should not be providing treatment.


"what about  mild traumatic brain injury. What instrument would you favor for that?"
---- I'm sure you have heard about neuropsychological evaluations, so I'm have no idea what you are asking here.

Psychiatry & Psychology--General

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Bruce Borkosky, Psy.D.

Expertise

any related to psychology, especially related to forensic psychology

Experience

15 years as a licensed psychologist, 15 years in private practice. My practice began primarily doing individual and group psychotherapy, is now devoted to assessments, but I occasionally do take on clients in therapy.

Organizations
American Psychological Association

Education/Credentials
B.A. psychology, B.A., music, Ohio Wesleyan U., 1978 MCS, computer science, University of Dayton, 1984 MA, psychology, Miami Inst. of Psychology, 1991 Psy.D., psychology, Miami Inst. of Psychology, 1993 post doctoral training in Neuropsychology, Fielding Institute, 1995-1997

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