IPA Example - INTERPERSONAL PROCESS
ANALYSIS TEMPLATE
Mental Health 1 / 2
pg. 2 Name (initials only): Unit:
Current Legal Status (Vol., 5150, 5250, 30 day, T-Con, LPS-Conservatorship):
Multiaxial Diagnostic System: Axis I (Clinical Disorder): Schizoaffective Disorder
Axis II (Personality Disorder / Mental Retardation): NA
Axis III (General Medical Conditions): NA
Axis IV (Psychosocial and Environmental Problems): Social environment in gaining attention Axis V (Global Assessment of Functioning Scale): 20 since patient has been in danger of hurting herself.
- Description of the patient: Age? Sex? Ethnicity? Marital Status? What precipitated hospitalization?
- Description of environmental setting where interaction took place. Explain the reasons for a supportive or
Number of days in the hospital? Mental Status, etc.Patient is a 23-year-old single Asian Female. She was admitted on 09/06/2020 and is not currently on a 5250 hold as of 09/13/2020 . Patient is waiting a hearing for her 5250 . Patient is DTS and GD . She was admitted for calling the cops and stating she wanted to jump off the bridge or get hit by a car . She has been off her medication of Risperdal . Patient’s medical diagnosis is Schizoaffective disorder . She has been in Unit B for seven days .Patient is A&OX3 . She does not fully state her name and asks everyone to call her by another name . She is alert and cooperative . Patient is hyperactive , hypersensitive , and loud . Throughout my time observing and talking to her she was dancing and was also asking inappropriate questions . Patient would dance in front of patient’s and would ask girls to be her girlfriend . When she was asked to be respectful , she was annoyed and told the lead nurse . She was dressed appropriately , and hair was not combed out. Her thought process was all over and overly stimulated.
non-supportive environment. (e.g. noise, distractions, light, temperature, etc.) Patient had a supportive environment. She was in a unit were there 27 other patients’, but she was inactive with them all . She did prefer music playing and her dancing . The temperature was acceptable and light inside was also acceptable . She was able to go outside three times while I was there . She like talking to both me and my partner and was always asking us personal questions . We would change the direction of the conversation by asking her something about herself . When she was outside , she preferred playing ping pong . She had asked both me and my partner to play ping pong with her . As I observed I realized that all the nurses were familiar with her case . She has been in and out of the facility for a couple of years already . They were all very helpful throughout the process of meeting her . At one point , she was stating vulgar comments and the
Course: NURS 223L INTERPERSONAL PROCESS ANALYSIS TEMPLATE
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