Interpersonal Process Analysis Worksheet

Please follow the rubric and directions. Which is attached.

Goals: you’ll have to have a total of 5 student goals and 5 pt goals. You cannot repeat goals for a section; for example, for pt goals, you cannot have two boxes that say, “pt will understand his triggers for his anxiety.”

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Non-verbal goal examples: pt would smile at me; pt will make eye contact, etc.

Verbal goal examples: pt will respond in a calm/cooperative tone, pt will agree to a safety plan, etc.

Please list defense and coping mechanisms–if there are none, indicate so.

Legal status: please indicate “N/A”

Descriptions of the pt and environment: please use as much detail as possible of what you see/hear in the video SIM clip, link is located at the end of this message.

Cite your sources! APA format, please.

IPA 1: Use this scenario: https://youtu.be/7LD8iC4NqXM

The video is about a depressed student by the name of Lucy.

Student: Date:

Clinical Instructor:

Name (initials only): Unit:

Current Legal Status (Vol., 5150, 5250, 30 day, T-Con, LPS-Conservatorship):

Multiaxial Diagnostic System: Axis I (Clinical Disorder):

Axis II (Personality Disorder / Mental Retardation):

Axis III (General Medical Conditions):

Axis IV (Psychosocial and Environmental Problems):

Axis V (Global Assessment of Functioning Scale):

Description of the patient: Age? Sex? Ethnicity? Marital Status? What precipitated hospitalization? Number of days in the hospital? Mental Status, etc.

Description of environmental setting where interaction took place. Explain the reasons for a supportive or non-supportive environment. (e. noise, distractions, light, temperature, etc.)

INTERPERSONAL PROCESS ANALYSIS

NAME: DATE:

Student:

· Verbal (quotes) and Nonverbal Communication (behavior, tone of voice, eye contact, mannerisms, etc.)

· Document at least 5 interactions

· Goal for each interaction (realistic and measurable)

Patient:

Verbal (quotes) and Nonverbal Communication (behavior, tone of voice, eye contact, mannerisms, etc.)

Communication Techniques

· Identify communication technique used then define your communication techniques

· Was the communication therapeutic or non- therapeutic?

· Which defense and coping mechanisms didthe patient use? Rationale based on your patient.

Critique and Analysis

(effective or not effective? Could have said…) Document your thoughts and feelings during the interaction.

Was your goal met?

Goal:

Verbal:

Nonverbal:

Verbal: Nonverbal:

Goal:

Verbal:

Nonverbal:

Verbal: Nonverbal:

Goal:

Verbal:

Nonverbal:

Verbal: Nonverbal:

Goal:

Verbal:

Nonverbal:

Verbal: Nonverbal:

Goal:

Verbal:

Nonverbal:

Verbal: Nonverbal:

INTERPERSONAL PROCESS ANALYSIS SUMMARY

Evaluation: After analyzing the interaction, provide a description on how the interaction progressed. Identify the reasons for successful process or unsuccessful process. What did you learn from the interaction with your patient?

How did you personally feel about the interaction? What would you change if you had to redo the interaction?