diagnosis and treatment of psychopathology, class 3
TRANSCRIPT
DIAGNOSIS AND TREATMENT OF PSYCHOPATHOLOGY
Course: CED 5979Presenter: John Grady, LPC, LCADC, CCS, ACS, NCCClass #: Three
TODAY’S OBJECTIVES Checking in…
DSM 5 Criteria – The Process of Diagnosing Modified suggested format Screening instruments
Components of a DSM 5 disorder
Tx Team Exercise – Diagnostic Report interviews
… Checking Out (Summary)
INSPIRATIONAL QUOTE – THE ZONE
SHAUN WHITE, 2X-OLYMPIC GOLD MEDALIST
QUESTIONS FOR THE CLASS“CHECKING IN…”
Let’s review our group #s Note: Treatment Team Case Study Presentation Format (Final Project) review will
be next week
From our Reading: What is are some purposes of the intake interview? When completing an intake interview, how important is establishing a good
connection with your client? What makes securing childhood data (e.g. behavioral issues) important if the client
is an adult?
General What are your thoughts, concerns, ideas, etc. regarding the intake interview
process?
SUGGESTED DIAGNOSTIC PROCESS
Gather data both qualitatively & quantitatively (if possible)
Consult a Jongsma Treatment Planner Look up chapter that seems to apply to your
client’s presenting issue Go to the “diagnostic suggestions” part of the
chapter Identify possible applicable diagnoses
Go to the DSM 5
Review the “Diagnostic Criteria” of the Jongsma-suggested diagnoses
PROCESS, CONT.. Reading concretely from the text, see if the symptoms
reported by client, family, etc. or observed behaviors “fit” the diagnostic criteria
If so, diagnose the disorder – but also continue exploring the Jongsma-suggestions or DSM 5’s “Differential Diagnosis” and “Comorbidity” sections This might lead to additional diagnoses or you to discover a more
appropriate diagnosis
If not, continue exploring the Jongsma-suggestions and/or the DSM 5 “Differential Diagnosis” part of the disorder’s segment
Continue process until solid diagnosis(es) is(are) found
Review with supervisor – be prepared to justify your conclusion using DSM 5 criteria
TWO TYPES OF DATA (INFORMATION) GATHERING Qualitative methods: Through interviews
Quantitative: Through instruments
TESTS AND INVENTORIES Many instruments can be used to help screen for possible
ailments – and help us gain quantitative data
Although some guidelines are less strict, we must –
review ethical guidelines
the screen’s guidebook/instruction manual to ensure we can use the instrument
Responsibilities of Users of Standardized Tests (RUST):
http://aac.ncat.edu/documents/rust.html
Note: Most require one to have a Master’s in Counseling or related field
SAMHSA-HRSA CENTER FOR INTEGRATED HEALTH SOLUTIONS
Suggestion: Just focus on this resource for now – lots of options
Depression Screens
Drug & Alcohol Screens
Bipolar Disorder Screens
Suicide Risk Screens
Anxiety Screens
Trauma Screens
http://www.integration.samhsa.gov/clinical-practice/screening-tools
QUALITY EXAMPLES: SCREENS General Functioning
World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) Depression
Patient Health Questionnaire (PHQ 9) Bipolar Disorder
Mood Disorder Questionnaire (MDQ) Anxiety
Generalized Anxiety Disorder 7-Item (GAD-7) PTSD
Primary Care PTSD Screen (PC-PTSD) Not on SAMHSA Resource – must look up
Alcoholism The Alcohol Use Disorders Identification Test (AUDIT)
Drug Use Drug Use Questionnaire (DAST -10)
Drug and Alcohol Use NIDA Quick Screen V1.O NIDA-Modified Assist V2.0
OUTCOME QUESTIONNAIRE-45 (OQ-45)
Many use as a quantitative measure for counseling effectiveness
Measures
Symptom Distress (e.g. anxiety disorders)
Interpersonal Relations (e.g. family strife)
Social Role (e.g. worker)
Also provides an overall score that adds up the three subscales above
Provides thresholds for ”indicates symptoms of clinical significance”
COMPONENTS OF MOST DSM 5 DISORDERS
Diagnostic Criteria
Info needed to diagnose the disorder
Diagnostic Features
More detail about key symptoms
Associated Features Supporting Diagnosis
Prevalence
Data regarding how disorder affects gender, age, ethnic populations
Development & Course
Common life span development factors
How and when the disorder challenges a person
COMPONENTS, CONT. Risk and Prognostic Factors
Conditions that are associated with the disorder’s manifestation
Culture-Related Diagnostic Issues Cultural variation in the disorder’s expression
Gender-Related Diagnostic Issues
Functional Consequences of the Disorder
Differential Diagnosis List of disorders that have similar symptoms Provides information on what distinguishes the disorders Great for pointing a clinician to other possibly appropriate disorders
Comorbidity Other disorders that may, or may have in the past, occur in the client with the featured
disorder
TX TEAM EXERCISE We will spend the last hour conducting the diagnostic report exercise Role-playing “Clients” – please provide some quality info for your
partner to decipher
If you are using a client from Practicum/Internship, fantastic – Please be prepared to be a "client"
If both partners are using actual clients for your report the three of us can meet to discuss your experience
When completed, please feel free to discuss experience with me or take the evening off Please review the “checking out” slide for reading assignment
TONIGHT’S SUMMARY
Today’s important topic: DSM 5 disorder components
Upcoming Responsibilities: DSM 5 Presentation (one team)
Read: DSM-5 Chapters 3&4
RESOURCESAmerica Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th
ed.). Washington, DC: Author.
Dailey, S.F., Karl, S.L., Gill, C.S., & Barrio-Minton, C.A. (2014). DSM-5 learning companion for
counselors. Alexandria, VA: American Counseling Association.
Jongsma, A. E., Peterson, L.M., & Bruce, T.J. (2014). The complete adult psychotherapy treatment
planner (5th ed.). New York, NY: Wiley.
Morrison, J. (2014). DSM-5 made easy: The clinician’s guide to diagnosis. New York, NY: The Guilford
Press.
Seligman, L. (2004). Diagnosis and treatment planning in counseling (3rd ed.). New York, NY: Springer
Science+Business Media.
Preston, J., & Johnson, J. (2015). Clinical psychopharmacology made ridiculously simple (8th ed.).
Miami, FL: MedMaster, Inc.