psych follow up HPI. smith

This is a follow up appointment with [select name="variable_1" value=" patient.| patient accompanied by mom.| patient accompanied by adopted mom. | patient accompanied by adopted dad. | patient accompanied by dad |patient accompanied by mom and dad.|"] patient reported [select name="variable_24" value="strict adherence to medication regimen | non compliance with medication regimen "][text name="variable_11953" default=""].There has been [select name="variable_1111" value=" no |few |many "] side effects from the medication usage. [text name="variable_13953" default=""]  Patient reports doing[select name="variable_2" value=" better| worse| ok| possibly better| well| good | somewhat better| slightly worse | slightly better| about the same| fine| not well|not good"] since the last visit.[text name="variable_10953" default=""] Patient states that medication has[select name="variable_241" value=" helped with psychiatric symptoms.| slightly made symptoms better| not been taken daily so not as effective.| no effect on psychiatric symptoms.| made psychiatric symptoms worse.| not changed psychiatric symptoms.| not helped psychiatric symptoms due to not taking the medication. | made psychiatric symptoms slightly worse.| somewhat of an effect.| been working well.| been effective.| possibly made symptoms better.| been doing great.| not been doing well.|has not been taken consistently.| been taken consistently with little to no effect."] [text name="variable_105953" default=""] Patient expressed that anxiety is [select name="variable_31117621" value="nonexistent.|mild.|decreasing|increasing|somewhat better.|moderate.|severe.|going well.|getting worse.|about the same|improving.|somewhat worse.|better.|worse.|manageable.|not manageable.|good.|bad.|not constant.|ok.|overall well.|slightly better.|slightly worse."][text name="variable_3684221" default=" "] Patient expressed that depression is [select name="variable_33100621" value="nonexistent.|mild.|decreasing.|increasing.|about the same.|somewhat better.|moderate.|severe.|somewhat worse.|better.|worse.|manageable.|going well.|going not so well.|good.|somewhat manageable.|improving."][text name="variable_39921" default=" "] Patient states[select name="variable_431" value=" no suicidal ideation and contracts for safety.|no suicidal ideation and contracts for safety but | suicidal ideation but contracts for safety and will not act on it.| suicidal ideation and can not contract for safety."][text name="variable_1" default=""]Patient expressed [select name="variable_69691" value="no self harm.||self harm recently and does not contract for safety.| self harm recently in the form of"][text name="variable_1" default=""] Patient states[select name="variable_4561" value=" no homicidal ideation.| homicidal ideation directed towards |"][text name="variable_8231" default=""] When asked about sleep the patient stated[select name="variable_2161" value=" no changes to sleep| that sleep is better | it is better| it is fine| difficulties initating sleep.| difficulties with continous sleep| that sleep is worse| a decrease of sleep| somewhat better| somewhat worse| sleep is good| about the same| sleep is going well| sleep is broken throughout the night| sleep is not as broken since last time we talked|an increase of sleep | sometimes broken but mostly good"] and sleeps for about[select name="variable_4521" value=" 8 hour nightly.|1 hour nightly.| 2 hours nightly.| 3 hours nightly. | 4 hours nightly.| 5 hours nightly. | 6 hours nightly.| 7 hours nightly.| 9 hours nightly.| 10 hours nightly| 11+ hours nightly.| 0 hours nightly."][text name="variable_6241" default=""] Patient added since last session their appetite is[select name="variable_45671" value=" about the same.|fine.| worse.| getting slightly worse.| slightly improving.| decreasing.| increasing.| better.|good|going well."][text name="variable_5241" default=""] Patient[select name="variable_7891" value=" denies hallucinations.| has hallucinations in the form of |no hallucinations but"][text name="variable_52241" default=""] Patient [select name="variable_7791" value=" denies delusions.| has delusions in the form of|denies delusions but does have paranoia|"][text name="variable_52141" default=""] Patient states[select name="variable_2561" value=" no mood swings.|mood swings are somewhat getting better.| mood swings are about the same.| mood swings are manageable| decrease in mood swings.| increase in mood swings."][text name="variable_2881" default=""] The patient [select name="variable_2551" value="denied symptoms of mania.|denied symptoms of hypomania.|states symptoms of hypomania.| states symptoms of mania.|denied symptoms of mania since last visit.|denied symptoms of hypomania since last visit.|states decrease in symptoms of mania.|states increase in symptoms of mania.|states increase in symptoms of hypomania.|states decrease in symptoms of hypomania.| states symptoms of possible mania.|"][text name="variable_28181" default=""]Patient concentration is[select name="variable_252251" value=" good.| worse| better| doing better with medication.| fair. | poor.|somewhat improving|about the same.|going well.| getting worse."][text name="variable_281811" default=""] This prescriber provided active listening, reflection, summarization, and reframing throughout the session. Therapeutic support was provided which included normalization, validation, and psycho education. Therapeutic modalities included CBT, reality therapy, motivational interviewing, therapeutic confrontation, and person centered therapeutic strategies. The client was encouraged to use positives self talk and to stay connected positive and energy producing people and activities.