COMPREHENSIVE PSYCHIATRIC EVALUATION 

A comprehensive psychiatric evaluation is necessary to diagnose most of the emotional, behavioral, or developmental disorders. An evaluation of a child, adolescent, or adult is made based on behaviors present and in relation to physical, genetic, environmental, social, cognitive (thinking), emotional, and educational components. Many times, families, spouses, or friends are the first to suspect that their loved one is challenged by feelings, behaviors, and environmental conditions that cause them to act disruptive, rebellious, or sad. This may include, but is not limited to, problems with relationships with friends and family members, work, school, sleeping, eating, substance abuse, emotional expression, development, coping, attentiveness, and responsiveness. It is important for families who suspect a problem in one, or more, of these areas to seek treatment as soon as possible. Each evaluation is different, as is each individual's symptoms and behaviors are different. The following are the most common components of a comprehensive, diagnostic psychiatric evaluation. 

• Psychiatric interview with detailed description of present problems and symptoms 

• Information about health, illness and treatment (both physical and psychiatric), including current medications 

• Parent and family health and psychiatric histories 

• Childhood developmental history           

• Information about school and friends 

• Information about family relationships 

• In case of children & adolescents, the interview of the child/adolescent & parents/guardians 

• If needed, laboratory studies such as blood tests, x-rays, or special assessments (for example, psychological, educational, speech and language evaluation)

 

These are some of the conditions that can be assessed at Dr Aju's Clinic:

PSYCHOPHARMACOLOGICAL TREATMENT 

Biological treatments act directly on the biological mechanisms that cause, or are involved in, mental illness. This can be, for example, by altering the function or availability of a neurotransmitter, changing the way certain cells in the nervous system function, or removing dysfunctional parts of the nervous system. Drugs that have been found to usefully treat mental illnesses generally work by changing the amount of a neurotransmitter that is available at a synapse. If, for example, a certain neurotransmitter causes a certain behaviour, then stopping the neurotransmitter working, by making less of it available, may reduce the behaviour it causes. Similarly, it may be useful to increase the quantity of a certain neurotransmitter so the the behaviour it influences may be increased. Contrary to the common belief, most of the psychopharmacological treatments available are not addictive. There are newer innovations on the treatment modalities which make the treatments more effective & more tolerable. Quite often the patients who have opted for this form of treatment mention it as a life changing experience as they never knew that there can be so much difference in their life, with treatment. However, this form of treatment should be done by a psychiatrist with specialist experience in the treatment & monitoring of psychiatric conditions. 

COGNITIVE BEHAVIOURAL THERAPY (CBT)

Cognitive Behavior Therapy (CBT), is a form of psychotherapy (a common type of mental health therapy) in which you work with a mental health practitioner (therapist) in a structured way, as a team, to identify and solve problems. Therapists use the Cognitive Model to help clients become aware of distorted, inaccurate or negative thinking and then overcome these difficulties by changing these thoughts, behaviors, and the emotional responses that result from these. Cognitive behavioural therapy has been found to be effective in a number of psychiatric disorders, including depression, anxiety disorders, obsessive compulsive disorder, eating disorders, phobias, panic attacks, post traumatic stress disorder, anger management, sexual problems, relationship problems and substance abuse. It has also been demonstrated to be effective as an adjunctive treatment to medication for serious mental disorders such as bipolar disorder and schizophrenia. Cognitive behavioural therapy is valuable as a treatment in children, adolescents, couples, and families as well. Its effectiveness has also been established in the treatment of certain medical disorders, such as irritable bowel syndrome, chronic fatigue syndrome, hypertension, fibromyalgia, chronic pain, migraine, general health problems due to stress, post-myocardial infarction depression, noncardiac chest pain, cancer & diabetes. A course of cognitive behavioural therapy may last from 6 weeks to 6 months. It will depend on the type of problem you have and how well it is working for you.

INDIVIDUAL PSYCHOLOGICAL COUNSELLING 

Individual counseling is a process through which clients work one-on-one with a trained therapist—in a safe, caring, and confidential environment—to explore their feelings, beliefs, or behaviors, work through challenging or influential memories, identify aspects of their lives that they would like to change, better understand themselves and others, set personal goals, and work toward desired change. People need therapy for a wide variety of reasons, from coping with major life challenges or childhood trauma, to dealing with depression or anxiety, to simply desiring personal growth and greater self-knowledge. A client and therapist may work together for as few as five or six sessions or as long as several years, depending on the client’s unique needs and personal goals for therapy. Individual counseling can help people to resolve barriers which interfere with positive qualities, such as joy, compassion, peace, self-esteem, spiritual connection, and love. Many people enjoy therapy and relish the journey of becoming more conscious about themselves, their inner world, and their relationships.

FAMILY THERAPY 

The goal of family therapy is to help family members improve communication, solve family problems, understand and handle special family situations (for example, death, serious physical or mental illness, or child and adolescent issues), and create a better functioning home environment. For families with one member who has a serious physical or mental illness, family therapy can educate families about the illness and work out problems associated with care of the family member. For children and adolescents, family therapy most often is used when the child or adolescent has a personality, anxiety, or mood disorder that impairs their family and social functioning, and when a stepfamily is formed or begins having difficulties adjusting to the new family life. Families with members from a mixture of racial, cultural, and religious backgrounds may also benefit from family therapy. Family therapy involves multiple therapy sessions, usually lasting at least one hour each, conducted at regular intervals (for example, once weekly) for several months. Typically, family therapy is initiated to address a specific problem, such as an adolescent with a psychological disorder or adjustment to a death in the family. However, frequently, therapy sessions reveal additional problems in the family, such as communication issues. In a therapy session, therapists seek to analyze the process of family interaction and communication as a whole and do not take sides with specific family members.

MARITAL/COUPLES COUNSELLING 

Marital counseling affords you and your spouse numerous ways to bring about change that you would not normally know how to accomplish on your own. It provides a safe and supportive environment for you to identify and communicate the issues, feelings and behaviors that are bothering you, to facilitate understanding and positive change. As part of the marriage counseling process we will look at the challenges your relationship faces and stabilize the relationship immediately by establishing safety, security, education, and direction. Marriage counseling is usually a short-term therapy that may take only a few sessions to work out problems in the relationship. Typically, marriage counselors ask questions about the couple's roles, patterns, rules, goals, and beliefs. Therapy often begins as the couple analyzes the good and bad aspects of the relationship. The marriage counselor then works with the couple to help them understand that, in most cases, both partners are contributing to problems in the relationship. When this is understood, the two can then learn to change how they interact with each other to solve problems. The partners may be encouraged to draw up a contract in which each partner describes the behavior he or she will be trying to maintain. Marriage counselor asks questions about the couple's roles, patterns, rules, goals, and beliefs. Therapy often begins as the couple analyzes the good and bad aspects of the relationship. The marriage counselor then works with the couple to help them understand that, in most cases, both partners are contributing to problems in the relationship. When this is understood, the two can then learn to change how they interact with each other to solve problems. The partners may be encouraged to draw up a contract in which each partner describes the behavior he or she will be trying to maintain.

BIOFEEDBACK 

Biofeedback is a technique that trains people to improve their health by controlling certain bodily processes that normally happen involuntarily, such as heart rate, blood pressure, muscle tension, and skin temperature. Electrodes attached to your skin measure these processes and display them on a monitor. With help from a biofeedback therapist, you can learn to change your heart rate or blood pressure, for example. At first you use the monitor to see your progress, but eventually you will be able to achieve success without the monitor or electrodes. Biofeedback is an effective therapy for many conditions, but it is primarily used to treat high blood pressure, tension headache, migraine headache, chronic pain, and urinary incontinence.

BEHAVIOURAL THERAPY 

Behavior therapy is focused on helping an individual understand how changing their behavior can lead to changes in how they are feeling. The goal of behavior therapy is usually focused on increasing the person’s engagement in positive or socially reinforcing activities. Behavior therapy is a structured approach that carefully measures what the person is doing and then seeks to increase chances for positive experience. Behavioral therapy is a psychological technique based on the premise that specific, observable, maladaptive, badly adjusted, or self-destructing behaviors can be modified by learning new, more appropriate behaviors to replace them. Behavioral therapy can be a useful treatment tool in an array of mental illnesses and symptoms of mental illness that involve maladaptive behavior, such as sub-stance abuse, aggressive behavior, anger management, eating disorders, phobias, and anxiety disorders. It is also used to treat organic disorders such as incontinence and insomnia by changing the behaviors that might be contributing to these disorders. Cognitive-behavioral therapy, an offshoot of behavioral therapy that focuses on changing maladaptive behaviors by changing the faulty thinking patterns behind them, is a recommended treatment option for a number of mental disorders, including affective (mood) disorders, personality disorders, social phobia, schizophrenia, obsessive compulsive disorder (OCD), agoraphobia, post-traumatic stress disorder (PTSD), Alzheimer's disease, and attention-deficit hyperactivity disorder (ADHD. Behavioral therapy techniques are sometimes combined with other psychological interventions such as medication. Treatment depends on the individual patient and the severity of symptoms surrounding the behavioral problem.

SOMATOTHERAPY  

Somatic or Body Oriented Psychotherapy encourages the communication of experience between the mind and the body, allowing greater understanding of the issues and enabling sustainable movement towards greater health and wellbeing. Somatic Psychotherapy achieves this by exploring your presenting challenge and looking at the connection between the narrative and history behind it. We also look at your breathing patterns, physical sensations - discomforts or limitations and support you in developing greater awareness of these connections between your body/mind. With this evolving awareness, it may be appropriate to use Integrative Bodywork to further examine bodily-held stories, and how these are held within the body. This may also include exploring any existing injury or emotionally based trauma. The wonderful aspect of using bodywork is that it potentially opens other doorways of understanding allowing greater awareness of the issues. Our bodies are miracles of healing. By supporting you through the exploration and expression of these deeper understandings, Somatic Psychotherapy can facilitate this healing. With this greater insight comes aliveness, creativity, self regulation and a new-found self awareness that enables you to deepen your personal relationships and helps forge stronger relationships with others.

 

Psychometry is a specialized field dealing with the measurement and assessment of individual functioning. Psychometric tests are in fact psychological assessment tools which use measured, criterion-based and standardized interview techniques - in addition to background information, to provide a powerful way of obtaining objective, comprehensive, and relevant information about a person’s ability to function in a wide variety of areas. Psychometrists use a variety of educational, clinical and developmental tests to determine individual functioning in many areas. We use a variety of standardized psychological tests to answer the referral questions for adults and children. We assess for IQ, achievement, aptitude, mental retardation, personality, attention, memory, academic difficulties, behavioral difficulties, childhood disorders and learning difficulties. We also assess typical children who are functioning within the normal range whose parents would like to know about their psychological profile. The standard assessment will give you a deeper understanding of your child’s cognitive, academics, behavior, personality, and social strengths and weaknesses. 

Psychometric Assessments Done At The Clinic:

Weschler Intelligence Scale for Children IV – (WISC-IV) 

The WISC-IV is designed to measure children’s global intellectual abilities. It evaluates a variety of abilities associated with school success. The task distinguishes between aspects of verbal comprehension, perceptual reasoning, working memory and processing speed. The WISC-IV provides composite scores of Verbal Comprehension, Perceptual Reasoning, Working Memory and Processing Speed as well as an overall intelligence quotient (IQ). These scores represent estimates of a child’s true scores. The WISC is used not only as an intelligence test, but as a clinical tool. It is used to diagnose attention-deficit hyperactivity disorder (ADHD) and learning disabilities. It reveals talents of many children and improve educational opportunities for gifted students. This test measures a child’s ability to compete in society in ways that have economic and social consequences. WISC provides a profile of cognitive strengths and weaknesses. It is also used to assess the effects of changes associated with special programs, treatments, training, and recovery from illness 

Kaufman Assessment Battery for Children, Second Edition (KABC-II) 

The Kaufman Assessment Battery for Children II (KABC-II) is an intelligence test for children between 3 and 18 years of age designed to test the processing and cognitive abilities of children and adolescents. The core of the Kaufman and Kaufman battery consists of 18 core and supplementary subtests; however, the number of subtests depends both on the age of the child and the model the clinician chooses to use. The KABC also gives special attention to certain emerging testing needs, such as use with handicapped groups, application to problems of learning disabilities, and appropriateness for cultural and linguistic minorities. 

Raven’s Educational Tests 

Raven's Progressive Matrices and Vocabulary Scales are useful in the assessment of general cognitive abilities in children. The Matrices measure educative ability, with the Vocabulary Scales providing measures of reproductive ability. Together these two components can be thought of as measuring general ability.The Progressive Matrices usefully provide an assessment of non-verbal ability, an important feature for ethnically diverse population, and the Vocabulary Scales provide scores in the verbal domain. Raven’s tests are the measures of educative ability – the ability to make sense and meaning out of complex or confusing data; the ability to perceive new patterns and relationships, and to forge (largely non-verbal) constructs which make it easy to handle complexity. Verbal scales are the measures of reproductive ability – the ability to store, process and utilize a culture’s store of (largely verbal) information and knowledge. This test is designed to measure the reasoning ability, which is often referred to as general intelligence. Raven’s test is a leading global non-verbal measure of mental ability, helping to identify children with advanced observation and clear thinking skills. Raven’s offers information about children's capacity for analyzing and solving problems, abstract reasoning, and the ability to learn – and reduces cultural bias with a nonverbal approach. Raven’s Educational Tests include following tests: • Raven’s Standard Progressive Matrices • Mill Hill Vocabulary Scale • Raven’s Coloured Progressive Matrices • Crichton Vocabulary Scale  

Memory tests:

Children’s Memory Scale 

The Children's Memory Scale (CMS) fills the need for a comprehensive learning and memory test for children. This battery comprehensively assesses the integrity of memory functions in children and enables comparison with measures of both ability and achievement. It plays a vital role in assessing learning disabilities and attention deficit disorders. It helps to plan remediation and intervention strategies for school and clinical settings. As a screener or diagnostic instrument, CMS measures learning in a variety of memory dimensions: • Attention and working memory • Verbal and visual memory • Short- and long-delay memory • Recall and recognition • Learning characteristics. Wechsler Memory Scale (WMS IV) 

Wechsler Memory Scale IV (WMS IV) 

The Wechsler Memory Scale is a neuropsychological test designed to measure different memory functions in a person. A person's performance is reported as five Index Scores: Auditory Memory, Visual Memory, Visual Working Memory, Immediate Memory, and Delayed Memory. 

Achievements Tests:

The Wechsler Individual Achievement Test Second Edition (WIAT-II)

WIAT-II assesses the academic achievement of children, adolescents, college students and adults, aged 4 through 85. The test enables the assessment of a broad range of academics skills or only a particular area of need. There are four basic scales: Reading, Mathematics, Writing, and Oral Language. It can be used to identify the academic strengths and weaknesses individuals possess as well as inform and aid intervention planning. An individually administered achievement test such as the WIAT-II can be used in a variety of settings where there is concern over educational progress. The WIAT-II can provide meaningful information to assist with diagnostic, eligibility, placement, and intervention decisions. Best practice suggests the results obtained from the WIAT-II should be interpreted in combination with the evaluation and review of the individual’s background, personality, current emotional functioning, and attention and motivation levels. 

 

Test of Everyday Attention for children (TEACH) 

The Test of Everyday Attention for Children (TEA-Ch) attempts to assess and quantify attentional ability. The TEA-Ch comprises 9 subtests which measure children's abilities to selectively attend, to sustain their attention, to divide their attention between two tasks, to switch attention from one thing to another and to withhold (inhibit) verbal and motor responses. This provides more objective and straightforward measures of children’s attentional abilities. The subtests of the TEA-Ch measure how well children can control their attention inorder to achieve goals that will be useful for them. The terms selective attention, sustained attention, and attentional control/switching are used within the TEA-Ch to describe the assessment’s areas of focus. Selective attention is the ability to resist distraction, to sort through information, and to discriminate elements that are important to the task. Sustained attention is the ability to keep one’s mind on a job. Attentional control/switching is representative of orienting and attentional shift in the above-mentioned perspectives and denotes a person’s ability to shift attention evenly from one task to another. 

Test of Variable Attention (TOVA)

The Test of variables of attention is an objective, neuropsychological assessment that measures a person's attention while screening for attention deficit hyperactivity disorder, or ADHD. Generally, the test is 21.6 minutes long, and is presented as a simple, computer game. The test is used to measure a number of variables involving the test takers response to either a visual or auditory stimulus. These measurements are then compared to the measurements of a group of people without attention disorders who took the T.O.V.A. It is a computer game of sorts, it measures the patient’s response to visual and auditory stimuli. The test results can serve to confirm the original clinical impressions, verify the best possible trajectory for treatment, and to create a baseline upon which to base progress in focus and attention over time as treatment progresses. 

Aptitude Tests:

Differential Aptitude Test (DAT) 

DAT for Guidance assesses eight different types of ability, or aptitude, which are related to success in different areas of employment. It is essentially a profiling instrument. Its co-standardised tests provide an eight point profile which portrays relative strengths and weaknesses in an individual's key aptitudes. This assessment, assesses aptitudes relating to job suitability and performance using the following subjects: verbal reasoning, numerical reasoning, abstract reasoning, perceptual, speed and accuracy, mechanical reasoning, space relations, spelling and language usage. 

Behavioral Scales:

Vineland Adaptive Behavior Scale 

The Vineland Adaptive Behavior Scale is an effective assessment tool for identifying various special needs of children. The Vineland Adaptive Behavior Scale or VABS is one of the various assessment tools that can be used to help diagnose and evaluate the special needs of students. The focus of this particular test is the measurement of the adaptive behaviors, including the ability to cope with environmental changes, to learn new everyday skills and to demonstrate independence. Adaptive behavior is multidimensional and reflects the individual’s personal and social skills as he interacts with his environment. This is one of many assessment tools available for special needs students. The primary purpose of the VABS is to assess the social abilities of an individual, whose age ranges from preschool to 18 years old. The results reliably reveal crucial information for diagnosing various disabilities, including autism, Asperger syndrome, mental retardation, and speech impairment. 

Vineland Social Emotional Early Childhood Scales 

The Vineland Social Emotional Early Childhood scale assesses social and emotional function, examining the child's world of feelings and relationships and documenting how he or she interacts in the home and external environment. For example: skills of paying attention, entering into intentional social interactions, and developing self-regulating behaviors are looked at. The instrument is used to interview the adult who is most familiar with the child's social-emotional behavior. Three scales, which combine into a Social-Emotional Composite, are used to evaluate a child’s ability to pay attention, understand emotional expression, cooperate with others, construct and observe relationships, and develop self-regulation behaviors. The three scales are: Interpersonal Relationships, Play and Leisure Time , and Coping Skills. This assessment is administered as a semi-structured interview with the child’s parent or caregiver, in which the psychologist asks general open-ended questions relating to the child’s activities and behavior to ascertain key developmental milestones. 

Behaviour Assessment Schedule for Children 2 (BASC-2) 

The BASC–2 is useful for the evaluation of children, adolescents, and young adults, ages two through twenty five. The BASC is designed to measure maladaptive and adaptive behaviors and self-perceptions of children. In order to gather adequate assessment data, this tool uses various components to measure multiple dimensions of the child. This assessment measure consists of five components that can either be used in combination or separately. The five components include: the Teacher Rating Scales (TRS), the Parent Rating Scales (PRS) aqn the Self-Report of Personality (SRP). This assessment is useful in the assignment of educational classification of various child emotional and behavioral disorders. The BASC-2 also identifies the child’s positive attributes that can be helpful in informing treatment planning. 

Developmental Assessment:

Bayley Scales of Infant and Toddler Development 

The Bayley Scales of Infant and Toddler Development is an assessment instrument designed to measure physical, motor, sensory, and cognitive development in babies and young children. It involves interaction between the child and examiner and observations in a series of tasks. As with other assessments, the tasks range from basic responses to more complex responses. For example, a basic response might involve introducing an interesting object for the child to track with his eyes. A more complex task might involve a toddler finding hidden objects. A valuable recording tool of milestone achievements, the BSID can be used to help to diagnose and plan treatment for infants who experience developmental delays and disabilities. Perhaps most importantly, the BSID identifies both strong and weak points, along with competencies, that help establish a plan for further assessment if problems in development are suspected. The five areas of assessment that are measured include adaptive behavior, cognitive, language, motor and social-emotional development. The adaptive behavior scale focuses on communication, health and safety and self-direction. Concept formation, visual permanence, and sensorimotor development make up parts of the cognitive scale. The language scale consists of expressive (such as babbling) and receptive (identifying referenced pictures, for example) communication. Both gross and fine motor skills are measured in the motor scale, while the social-emotional scale allows for the discovery of early abilities of growth by examining how the child functions in a setting with other children. 

Personality Tests:

Minnesota Multiphasic Personality Inventory Adolescent (MMPI – A) 

The MMPI-A is a self-report instrument designed to aid in the assessment of a wide range of clinical conditions and it is most widely used personality inventory for adolescents The MMPI – A is used to screen for personality and psychosocial disorders In adolescents . It is also frequently administered as part of a neuropsychological test battery to evaluate cognitive functioning. The questions asked on the MMPI-A are designed to evaluate the thoughts, emotions, attitudes, and behavioral traits that comprise personality. The results of the test reflect an adolescent's personality strengths and weaknesses, and identify certain disturbances of personality (psychopathologies) or mental deficits caused by neurological problems. 

Minnesota Multiphasic Personality Inventory (MMPI) 

The Minnesota Multiphasic Personality Inventory (MMPI) is a psychological test that assesses personality traits and psychopathology in adults. It assesses an individual and produces a clinical psychological profile. Such a profile may indicate, for example, that the subject is outgoing and sociable, the presence of significant emotional problems, has trust in others, honesty, risk-taking and social anxiety, antisocial and paranoid traits. It is primarily intended to test people who are suspected of having mental health or other clinical issues. The test is also used to evaluate the effectiveness of treatment programs, including substance abuse programs. The inventory is often used as part of differential diagnosis , and outpatient evaluations.. The MMPI has also been used to evaluate candidates for employment in some fields, and in educational counseling. 

Millon Clinical Multiaxial Inventory (MCMI) 

The Millon Clinical Multiaxial Inventory (MCMI) is used to assess adults with a suspected or known psychological disorder to refine the diagnosis. Patients are asked a series of true/false questions which can be used to score them, looking for particular personality traits and indicators of clinical syndromes that can be used for diagnostic purposes. This test is designed to be used specifically with adults. It is also sometimes used as an assessment tool for a patient without a known psychological disorder. It can sometimes provide insights into personality traits that can help people in psychotherapy and other settings. Millon Adolescent Clinical Inventory (MACI) The Millon Adolescent Clinical Inventory (MACI) is a self-report measure designed to assess adolescent personality patterns, concerns, societal pressures, and clinical symptoms. MACI surveys a wide range of personality characteristics and clinical symptoms that tend to be a focus in psychological evaluations of teenagers that either have or are suspected of having emotional or behavioral difficulties. The MACI test helps to measure a number of factors closely associated with adolescents, including sexual discomfort, substance abuse proneness, suicidal tendency and eating Dysfunctions. 

Millon Adolescent Clinical Inventory (MACI) 

It is useful primarily in the evaluation of troubled adolescents, and may be used for diagnostic assistance, in formulating treatment plans, and as an outcome measure. This scale helps to evaluate adolescent expressed concerns, personality styles, and coping patterns to help select the best approach to treatment and identify behavior patterns and issue that may need further exploration during therapy. 

16 PF 

The 16PF personality assessment measures a set of 16 traits that describe and predict a person's behavior in a variety of contexts. It provides more in-depth information about a person than instruments which only measure a few dimensions, revealing potential, confirming capacity to sustain performance in a larger role, and helping to identify development needs. The in depth personality profile provided by the 16PF Questionnaire helps to gain an integrated understanding of the whole person from the start. This information coupled with the 16PF report's insights as to how the individual will present in therapy, guides the professional in his/her approach to the counseling sessions. And, while it is an assessment of normal personality, the 16PF Questionnaire provides with measures of anxiety, adjustment, and other behavioral trends to facilitate diagnostic decisions and the development of treatment strategies.