Screening Protocol


1. History of changes in:

• behavior at home, school, or in other settings

• school performance or attendance

• sleeping and eating patterns

• socialization patterns, or dramatic change in peer group

• mood

• depression

• anxiety

• temper flare-ups

• suicidal ideation or gestures

• intensification of PMS

2. History of changes in activity level, that could be suggestive of Lyme


Sudden loss of interest, or inability to participate in activities,

such as organized sports, music, dance, drama, youth group, etc.

3. A discreet point in time at which problems began

4. History of onset of other psychiatric symptoms (panic attacks,

hallucinations, attentional problems not present in early childhood)

5. History of use of psychiatric medications, with either no success in

symptom reduction or a paradoxical response

6. History of any physical illness (flu, mononucleosis, bronchitis)

occurring prior to start of psychiatric, learning or behavioral problems

7. History of short term antibiotic treatment for medical problem (strep

infection, etc.) with temporary improvement of symptoms

© 2002


Sandy Berenbaum, LCSW, BCD, Lyme-Literate Psychotherapist

Family Connections Center For Counseling

Offices in Brewster, NY and Southbury, CT

Phone: (203) 240-7787