Entrevisrta psicologica
Enviado por psicologojohnny • 20 de Noviembre de 2015 • Trabajos • 397 Palabras (2 Páginas) • 64 Visitas
ENTREVISTA PSICOLOGICA
Fecha:__________________________
FICHA DE IDENTIFICACION
Nombre_________________________________________________ Edad__________
Fecha y lugar de nacimiento_______________________________________________
Dirección______________________________________________________________
Estado civil_____________ Escolaridad_______________________________
Ocupación________________Religión_____________
DESCRIPCION DEL PACIENTE
Aspectos generales, características físicas
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Vestimenta
____________________________________________________________________________________________________________________________________________
Porte y actitud (modales)
____________________________________________________________________________________________________________________________________________
Movimientos. Voz y lenguaje
____________________________________________________________________________________________________________________________________________
Afecto
______________________________________________________________________
MOTIVO DE CONSULTA
Historia del problema
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Clase de ayuda que espera encontrar
____________________________________________________________________________________________________________________________________________
Historial del conflicto (clínica)
____________________________________________________________________________________________________________________________________________
SITUACION ACTUAL
Descripción de un día de vida. Especificar cambios particulares en los fines de semana
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
CONSTELACION FAMILIAR
Antecedentes patológicos
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Descripción de madre y padre
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Relación padres paciente
__________________________________________________________________________________________________________________________________________________________________________________________________________________
Hermanos
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Papel del paciente dentro de la familia
____________________________________________________________________________________________________________________________________________
Uniones y fricciones dentro de la familia
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Normas sociales, culturales, morales y religiosas dentro de la familia
__________________________________________________________________________________________________________________________________________________________________________________________________________________
Cambios en la constelación familiar (abandono, divorcio, muertes etc.)
__________________________________________________________________________________________________________________________________________________________________________________________________________________
RECUERDOS TEMPRANOS
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
HISTORIA PERSONAL
Embarazo y nacimiento
______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
...