The behavioral flow sheet. A tool for the primary care provider

Behavioral flow sheets are tools that can be used outside the domain of mental health. For the knowledgeable health care provider in any setting, they render a cost-effective, noninvasive mechanism for diagnosis and management of a variety of patient problems of organic as well as behavioral natures. Though there exists an assortment of standardized formats, flow-sheet design can be tailored to address the unique circumstances of each patient. They provide an avenue for actively involving patients and families in problem assessment as well as in the planning and evaluation of treatment regimens. In addition, flow sheets provide a feedback mechanism that can enhance patient/family self-esteem and increase the likelihood of adherence to treatment recommendations. There is both an art and a science to their design and use, but the skills involved are readily acquired by any interested practitioner. The conscientious professional will become acquainted with the potential pitfalls and thus avoid irresponsible or unethical application. The authors provide guidelines for developing and implementing flow sheets and illustrate their value through the sharing of several clinical vignettes.