Case Illustration · Assessment
Healthcare Mistrust and Assessment
Before any formulation can be built, something else has to happen first. The exercise works through what that is and how it is done.
The presentation
A Black woman in her late twenties is referred by her family physician for sexual health concerns, specifically describing low desire and discomfort during intercourse of approximately eight months' duration.
She arrives at the first session having declined to complete the intake questionnaire, stating that she does not know what information will be shared with her physician.
On assessment, her discomfort during intercourse has not been medically evaluated, and she reports having avoided raising the concern with her physician because of a prior experience in which a pain complaint was dismissed without investigation.
Her interpersonal style in the first session is watchful and concise.
Estimated time to complete this exercise: 12 minutes
Part 1 of 5
She has declined the intake questionnaire, saying she does not know what information will be shared with her physician. What do you do?
References
- American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787
- Hoffman, K. M., Trawalter, S., Axt, J. R., & Oliver, M. N. (2016). Racial bias in pain assessment and treatment recommendations, and false beliefs about biological differences between blacks and whites. Proceedings of the National Academy of Sciences, 113(16), 4296–4301. https://doi.org/10.1073/pnas.1516047113