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TAPD
Triage
Assessment of Psychiatric Disorders
by
Norman G. Hoffmann, Ph.D.
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BENEFITS
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Quick identification of more commonly occurring psychiatric
disorders
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Efficient means to determine whether a more complete
diagnostic work-up is required
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Quick documentation of both positive and negative findings
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The
TAPD is a brief structured interview that provides triage information for nine
Axis I and five Axis II diagnostic categories. The TAPD is presented as a
triage instrument rather than simply a screen because it is explicitly based on
the DSM-IV diagnostic criteria and typically will provide evidence for one of
three conclusions: 1) information elicited by the TAPD may be sufficient to
support a DSM-IV diagnosis with minimal additional inquiry or clarification; 2)
problems are suggested, but a more comprehensive evaluation will be required to
support or rule out a diagnosis; or 3) the negative responses to the TAPD make
a diagnosis for a given condition very unlikely.
APPLICATIONS: The TAPD is
appropriate for screening clients in a variety of clinical settings. The
breadth of conditions covered make it a useful instrument for initial inquiries
in mental health facilities, substance abuse programs, EAP offices, and primary
health care settings.
A
brief inquiry to identify potential problem areas can greatly assist in
confirming assessments and facilitating treatment planning. The TAPD also helps
clinicians document that they conducted a reasonable inquiry over a sufficient
domain of problem areas. This is particularly useful where the results are
negative due to the respondent’s deliberate falsification or underreporting. In
such cases, the clinician can document that the attempt was made to identify
prevalent conditions.
ADMINISTRATION: The TAPD is
designed such that, in many of the diagnostic categories, several general
screening questions are used with branching instructions to skip questions in
areas when it is improbable that the individual will meet diagnostic criteria
for a given disorder. For example, if an individual denies periods of depressed
mood and/or diminished interest or pleasure in activities, criteria for a major
depressive episode will not be met according to DSM-IV criteria.
The
TAPD can be administered by a clinician or an appropriately trained staff
person with good interviewing skills. It is also possible to establish local or
clinic decision rules for referral to further evaluation based on the TAPD
responses.
TIME REQUIREMENTS: The TAPD
interview requires only 15 to 20 minutes to complete because the branching
usually eliminates some of the questions for conditions where a diagnosis is
highly unlikely.
INTERPRETATION: Because the TAPD
findings should be interpreted in the context of the DSM-IV, only an
appropriately trained clinician should be given this responsibility. Although a
technician or other interviewer can administer the TAPD and record responses,
many experienced clinicians will administer the interview as part of their
initial assessment. This allows them to focus further assessments and avoid
spending time on areas that are unlikely to require attention. In such cases,
the TAPD data are simply integrated into a more general summary of findings.
COPYRIGHT: The TAPD is copyrighted
by Norman G. Hoffmann and may not be adapted or photocopied. To do so is a
violation of copyright law and constitutes unethical conduct.
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2002 Evince Clinical Assessments
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