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TAPD

Triage Assessment of Psychiatric Disorders

by
Norman G. Hoffmann, Ph.D.

BENEFITS

  • Quick identification of more commonly occurring psychiatric disorders
  • Efficient means to determine whether a more complete diagnostic work-up is required
  • Quick documentation of both positive and negative findings

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 respondentís 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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