Problem: Article: A psychological evaluation is a fact-gathering session in which a mental health worker (counselor, therapist, social worker, psychologist or psychiatrist) interviews a client about current psychological problems, past mental health issues, family history and current and past social problems with work, school and relationships. A psychosocial evaluation can also examine past and current substance abuse problems as well as any psychiatric drugs the client has used or is currently on. The mental health worker may also consult a client's medical and mental health records during the evaluation process. Make sure appropriate releases of information (ROI documents) have been signed. Make sure you also appropriately explain the limits to confidentiality. Tell the client that what you talk about is confidential, but the exceptions are if the client intends to harm himself, someone else, or is aware of abuse occurring in the community. Be prepared to halt the evaluation if it becomes apparent the client is in crisis. For example, if the client has suicidal or homicidal ideations, you will need to switch gears and follow crisis intervention procedures immediately. Most mental health facilities provide the mental health worker with an evaluation template or form to complete during the interview. An example of sections for a mental health assessment include (in order): Reason for referral Why is the client coming in to treatment? How was he referred? Current symptoms and behaviors Depressed mood, anxiety, change in appetite, sleep disturbance, etc. History of the problem When did the problem begin? What is the intensity/frequency/duration of the problem? What, if any, attempts have been made to solve the problem? Impairments in life functioning Issues with home, school, work, relationships Psychological/psychiatric history Such as previous treatment, hospitalizations, etc. Current risk and safety concerns Thoughts of harming self or others. If the patient raises these concerns, stop the assessment and follow crisis intervention procedures. Current and previous medication, psychiatric or medical Include the name of the medication, the dosage level, the length of time the client has been taking the medication and whether he is using it as prescribed. Current substance use and substance use history Abuse or use of alcohol and other drugs. Family background Socioeconomic level Parent's occupations Parent's marital status (married/separated/divorced) Cultural background Emotional/medical history Family relationships Personal history Infancy developmental milestones, amount of contact with parents, toilet training, early medical history Early and middle childhood adjustment to school, academic achievement, peer relationships, hobbies/activities/interests Adolescence early dating, reaction to puberty, presence of acting out Early and middle adulthood career/occupation, satisfaction with life goals, interpersonal relationships, marriage, economic stability, medical/emotional history, relationship with parents Late adulthood medical history, reaction to declining abilities, economic stability Mental status Grooming and hygiene, speech, mood, affect, etc. Miscellaneous Self-concept (like/dislike), happiest/saddest memory, fears, earliest memory, noteworthy/reoccurring dreams Summary and clinical impression A short summary of the client's problems and symptoms should be written in narrative form. In this section, the counselor can include observations about how the patient looked and acted during the evaluation. Diagnosis Use the information collected to form a (DSM-V or descriptive) diagnosis. Recommendations Therapy, referral to psychiatrist, drug treatment, etc. This should be guided by the diagnosis and clinical impression. An effective treatment plan will lead to discharge. The counselor will conduct a mini-mental-status exam (MMSE) which involves observing the client's physical appearance and his or her interactions with the staff and other clients at the facility. The therapist will also make a decision about the client's mood (sad, angry, indifferent) and affect (the client's emotional presentation, which can range from expansive, showing a great deal of emotion, to flat, showing no emotion). These observations assist the counselor in making a diagnosis and writing an appropriate treatment plan. Examples of subjects to cover on the mental status exam include: Grooming and hygiene (clean or disheveled) Eye contact (avoidant, little, none, or normal) Motor activity (calm, restless, rigid, or agitated) Speech (soft, loud, pressured, slurred) Interactional style (dramatic, sensitive, cooperative, silly) Orientation (does the person know the time, date, and situation he is in) Intellectual functioning (unimpaired, impaired) Memory (unimpaired, impaired) Mood (euthymic, irritable, tearful, anxious, depressed) Affect (appropriate, labile, blunted, flat) Perceptual disturbances (hallucinations) Thought process disturbances (concentration, judgment, insight) Thought content disturbances (delusions, obsessions, suicidal thoughts) Behavioral disturbances (aggression, impulse control, demanding) The diagnosis is the main problem. Sometimes a client will have multiple diagnoses such as both Major Depressive Disorder and Alcohol Use. All diagnoses must be made before a treatment plan can be completed. A diagnosis is chosen based on the client's symptoms and how they fit with the criteria outlined in the DSM. The DSM is the diagnostic classification system created by the American Psychiatric Association (APA). Use the most recent version of the Diagnostic and Statistical Manual (DSM-5) to locate the correct diagnosis. If you don't own a DSM-5, borrow one from a supervisor or colleague. Do not rely on online resources for a correct diagnosis. Use the main symptoms the client is experiencing in order to come to a diagnosis. If you are unsure about the diagnosis or you need expert assistance, speak to your clinical supervisor or consult with an experienced clinician.
Summary: Gather information. Follow the sections of the evaluation. Note behavioral observations. Make a diagnosis.

In one sentence, describe what the following article is about: Try on the pants and pinch the excess fabric at the waist until the waist is as tight as you like. Use a tape measure to see how much fabric is between the tip of your fingers and the inseam. For example, if you need a small adjustment, you might only need to remove 1 inch (2.5cm) of fabric. For a larger alteration, you could remove 2 to 3 inches (5.1 to 7.6cm). Take off the pants and use a seam ripper to pull out all of the stitches that are securing the back belt loop to the waist of the pants. Then, remove the loop and set it aside. Keep the back loop so you can reattach it to the pants after you've adjusted the waist. Use the seam ripper to remove the stitches from the middle of the waist on the back of the pants. Remember to start in the center and remove an equal length of stitches along both sides of the waist. For example, if you wanted to take in the waist by 2 inches (5.1cm), you'll need to take out the center 2 inches (5.1cm) of stitches on the back of the waist. Once you've removed the stitches, you should be able to open up and unfold this part of the waistband. Fold the inside-out pants in half so the creased pant legs are stacked. Then, pinch the excess fabric along the waist that you want to remove. For example, if you want to make the waist 2 inches (5.1cm) narrower, pin 1 inch (2.5cm) of the fabric from the center seam. Since the pants are folded, this will mean you're reducing the waist by 2 inches (5.1cm). Start stitching where you pinched the fabric together. You will probably need to remove pins as you sew so you don't stitch over them. Straight stitch until you reach the bottom of the waist. You can use a sewing machine or stitch the waist by hand. Once you've sewn the waist, try on the pants to see if the waist fits better. Keep in mind that the excess fabric will form a small loop inside the waist of the pants. If you're happy with how the waist now fits, fold the waistband back down. The waistband stitches should line up with where they were before you seam ripped them out. Then, sew the waistband back in place and reattach the back belt loop if you like. Turn the pants right side out before you're ready to wear them.
Summary:
Decide how much fabric to remove from the waist. Remove the belt loop from the back of the pants. Seam rip along the back of the waist near the middle. Turn the pants inside out and pin the excess fabric from the center seam. Straight stitch from the top to the bottom of the waist. Fold the waistband and straight stitch it closed.