Practicum Laboratory Mental Status / Behavioral Checklist Client: Counselor-in-training: Date: Present No Somewhat Yes physically unkempt, unclean clothing disheveled, dirty Appearance clothing atypical, unusual, bizarre unusual physical characteristics Comments: Present No Somewhat Yes slumped Posture rigid, tense unusual, inappropriate anxiety, fear, apprehension B Facial depression, sadness Expression anger, hostility E Suggests unchanging or fixed expression H bizarreness, inappropriateness accelerated, increased speed, hyper A General Body decreased, slowed V Movements peculiar, inappropriate restlessness, fidgety I increased, loud Speech O decreased, slowed unusual, slurring stammering R domineering Client’s Attitude submissive, overly compliant Toward provocative suspicious uncooperative Comments: Present No Somewhat Yes emotion inappropriate for situation emotional swings Feeling flat, unvarying mood Affect euphoric, elated(happy) mood angry, hostile mood Mood fearful, anxious, apprehensive depressed, sad Comments: Mental Status / Behavioral Checklist, continued
Practicum Laboratory Mental Status / Behavioral Checklist Client: Counselor-in-training: Date: Present No Somewhat Yes Appearance physically unkempt, unclean clothing disheveled, dirty clothing atypical, unusual, bizarre unusual physical characteristics Comments: Present No Somewhat Yes B E H A V I O R Posture slumped rigid, tense unusual, inappropriate Facial Expression Suggests anxiety, fear, apprehension depression, sadness anger, hostility unchanging or fixed expression bizarreness, inappropriateness General Body Movements accelerated, increased speed, hyper decreased, slowed peculiar, inappropriate restlessness, fidgety Speech increased, loud decreased, slowed unusual, slurring stammering Client’s Attitude Toward domineering submissive, overly compliant provocative suspicious uncooperative Comments: Present No Somewhat Yes Feeling Affect Mood emotion inappropriate for situation emotional swings flat, unvarying mood euphoric, elated(happy) mood angry, hostile mood fearful, anxious, apprehensive depressed, sad Comments: Mental Status / Behavioral Checklist, continued