Interveiw Paper

Guidelines for Social History Paper

-Choose an individual that you do not know or a client if you are in an internship this semester or employed in a work site in which you have access to clients.

-A legitimate problem must be shared by the client

The format is as follows all roman numeral headings

must be in bold black. Paper should be typed Double Spaced.

I: Identifying information:

-Under this heading you must include Name

(made up one) Age, Race, Marital Status, Sex,

Characteristics to include appearance.

II: Presenting Problem (s)

-What are the issues the client is dealing with?

III: History of presenting problem.

-How long has this been an issue for the client

IV: Past Problem (s)/Treatment (s).

-Mental/Behavioral problems in past (what kind,

when, where treated? If applicable)

V: Family/Developmental History

-Where was the client born and raised?

-Parents Names (made up) current ages, or ages

died (reason for death), any parental health,

mental/behavioral problems-describe. Parent’s

relationship, siblings in birth order, clients birth

order,

How did the family get along? Happy,

cooperative, feel wanted, who was in charge, how

disciplined. Any problems experienced as a child.

Social, childhood friends and interests. Any

current memories of childhood that remain

influential? Any turning points?

VI: Education/Vocation History

-Highest level of school/training.

-Employment, past jobs, current employer, job

duties, how long employed? Do they enjoy it?

Future plans for employment, and training.

Military service? Financial situation?

VII: Social/Relationship(s) History

-Social outlets, current friends interests and

recreation

-Intimate Relationships. Dating past and

current. Marriage (s) in past. If partnered

how do they describe the relationship? If

marriage (s) failed, why?

-Family. Children? How does the family get

along? Any parenting issues?

VIII: Medical History

-Past and current medical problems

-Current medication (s)

-Allergic to any medications

-How sleeping, eating?

-Use of alcohol or drug use.

IX: Legal History

-Any current or past legal charges? If so

please briefly describe.

X: Mental Status

-General Appearance

-Attitude

-Speech (rate of)

-Mood/Affect

-Cognition; intelligence estimated to be within

the _______ range. (your estimate, i.e below

average, above, etc…)

-Insight/judgment (your estimation)

-Motivation for resolving issue.

-Suicidal Ideation or Intent?

-Homicidal Ideation or Intent?

-Is client oriented to time, place, person?

XI: Formulation:

-This is your inferences of the above

information.

XII: Initial Treatment plan

-Recommendations that are specific and

numbered if they are in excess of one.

*** Do not do an Initial Diagnosis*****