During a session with a 67-year-old woman who reports loss of interest in her spouse after 40 years, feelings of disconnection from friends, and agitation, what should the social worker do FIRST?

During a session with a 67-year-old woman who reports loss of interest in her spouse after 40 years, feelings of disconnection from friends, and agitation, what should the social worker do FIRST?

• A. Determine when the client's problems first began.
• B. Refer the client for psychiatric evaluation.
• C. Obtain a signed release to consult with the client's doctor.
• D. Schedule a comprehensive medical assessment.

Answer: (A)

The most important first step is to determine when these problems began. Pinpointing the timing and trajectory of symptoms in an older adult is crucial because it helps distinguish between a mood disorder like major depression, normal aging or life-stage changes, bereavement/grief, and potential medical or medication-related issues. Asking when the loss of interest, social withdrawal, and agitation started provides the clinician with a timeline, duration, and whether there were any preceding events or triggers. This information guides the differential diagnosis and informs whether medical or psychiatric evaluation is needed next, and how urgent that evaluation should be. Once the onset and course are understood, you can decide if a medical assessment, a referral for psychiatric evaluation, or coordination with the client’s doctor is appropriate. Referencing a release or scheduling a comprehensive medical assessment may be appropriate steps later in the process, but they hinge on understanding the onset and progression of symptoms first.

The most important first step is to determine when these problems began. Pinpointing the timing and trajectory of symptoms in an older adult is crucial because it helps distinguish between a mood disorder like major depression, normal aging or life-stage changes, bereavement/grief, and potential medical or medication-related issues.

Asking when the loss of interest, social withdrawal, and agitation started provides the clinician with a timeline, duration, and whether there were any preceding events or triggers. This information guides the differential diagnosis and informs whether medical or psychiatric evaluation is needed next, and how urgent that evaluation should be. Once the onset and course are understood, you can decide if a medical assessment, a referral for psychiatric evaluation, or coordination with the client’s doctor is appropriate.

Referencing a release or scheduling a comprehensive medical assessment may be appropriate steps later in the process, but they hinge on understanding the onset and progression of symptoms first.