WK2 DISS Assessment and Diagnosis “Under the Gun”

1st Peer

The case that will be focused on developing a proper diagnosis within 48 hours to ensure that insurance can cover this client is a 33 year old male. The patient is coming for help due to suicidal intentions. There are some other aspects to acknowledge to help the patient they are currently suffering from a divorce in the process as well as fear of losing their means of income. These are big factors because due to these major situations, the patient also has an emotional impact with anger, sadness, stress, and agitation.

To make any diagnosis an assessment is usually done first. According to Carlson (2013), in counseling and or clinical testing, an interview is the first contact to be made, and be within an hour. During this time frame, is when the professional seeks to obtain consent from the patient to provide further care. During the meeting with a patient, the professional follows and informs the patient of the ethical principles and code of conduct (American Psychological Association, 2010)

After obtaining proper consent, the assessment technique for this specific case would be an interview and survey to help narrow down what proper diagnosis it is. For instance, some questions that would be asked in an interview process are how often to never on situations and emotions. Based on the case and the openness of the client and with their proper consent, a professional focusing on questions of emotions and reactions can determine what time of mood disorder they have. Based on cognitive and behavioral theoretical orientation would help aid the diagnosis. The patient has suicidal intentions, as well as more negative emotions that have physically affected themselves. This then shows me that the concerns are not only cognitive but behavioral as well.

With the timeframe given, it can be possible to achieve a diagnosis if all proper ethical principles and codes of conduct are made. This is only if the patient is consenting to care and provides more information during the assessment. However, if the patient does consent and only provides the information given then providing a proper diagnosis might be difficult but there are very key characteristics that are presented that meet criteria such as depressive disorder. I believe this ethical to enter due to the fact the patient has mentioned they have suicidal intentions which is a criterion for depression as well as the other emotions presented. This is important because if a person is wanting to commit suicide it is the responsibility of the professional to provide care assistance. It is justifiable to obtain a third-party payment because this patient meets the criteria of depression and also due to the suicidal intention needs more care.

 

Reference

American Psychological Association. (2010).  Standard 9: Assessment Links to an external site  Links to an external site. . Retrieved from http://www.apa.org/ethics/code/index.aspx?item=12

American Psychiatric Association. (2013). DSM-5: The diagnostic and statistical manual of mental disorders (5th ed.)[E-book]. Washington, D.C.: American Psychiatric Publishing.

Carlson, J. F. (2013). Clinical and counseling testing. In K. F. Geisinger, B. A. Bracken, J. F. Carlson, J.-I. C. Hansen, N. R. Kuncel, S. P. Reise, & M. C. Rodriguez (Eds.), APA handbook of testing and assessment in psychology, Vol. 2: Testing and assessment in clinical and counseling psychology. (pp. 3–17). American Psychological Association. https://doi.org/10.1037/14048-001

Maltzman, S. (2013). The assessment process. In APA handbook of testing and assessment in psychology, Vol. 2: Testing and assessment in clinical and counseling psychology. (pp. 19–34). American Psychological Association. https://doi.org/10.1037/14048-002

In your responses, evaluate whether your peer took into account the ethical guidelines outlined in the APA’s Ethical Principles of Psychologist and Code of Conduct when he or she assessed and diagnosed the client. Suggest additional questions your peer might ask the client. Propose an alternative diagnosis that might arise from the additional questions you have suggested.

2nd Peer

The Case of Charles

My client, Charles, is an African American male who is going through a divorce. He is concerned about the possibility of losing his job. My role as a psychologist is to provide Charles with a diagnosis. Understanding that Charles is experiencing a devastating blow from his divorce and feeling his employment is in jeopardy is necessary. However, Charles is at my agency seeking help due to suicidal ideation.

Assessment

The purpose behind a psychological assessment is to find answers questions. These answers can be linked to any combination Charles’ intellectual, psychological, emotional, behavioral, or psychosocial functioning. From these answers, psychologists interpret test results, and provide Charles with this information (Maltzman, 2013). Section 9.01 Ethical Principles of Psychologists and Code of Conduct states that psychologists have the responsibility to disclose opinions regarding the psychological characteristics of Charles after the psychologist has conducted an examination that support the psychologist’s statements or conclusions (APA, 2017).

 

For Charles, this assessment could be used to better evaluate him and his determined needs.  By gaining more information regarding Charles’ personality characteristics, symptoms, and problems; a better conclusion made in order by the psychologist to make more practical decisions regarding Charles’ behavior (“Psychological assessment,” 2004). In my opinion, the use of an interview and observational data could be used in an effort to assist Charles.

Review your case with DSM-V and make a tentative diagnosis.

As a psychologist, based upon the information provided, I would feel Charles could be diagnosed with depression or adjustment disorder. Depression is one the most commonly diagnosed mental health disorders. In fact, almost one in ten individuals will be diagnosed with depression during the individual’s life (Fowells, 2016). The depression Charles is experiencing can range anywhere from mild to moderate to severe (Tallent, 2012).  For Charles his divorce is a substantial risk factor for his poor mental health (Zineldin, 2019). It is possible for Charles due to his divorce to fear for the loss of his employment. Counseling from a qualified psychologist will help Charles better cope with the stress of divorce, and rebuild his life.

Charles could be diagnosed with adjustment disorder. Adjustment disorder is commonly diagnosed in the event that an individual has experienced a stressful or traumatic event. Thereafter these same individual experiences an exaggerated response. Those with adjustment disorder may suffer from impairment in day-to-day functioning. In order to be diagnosed with adjustment disorder, a trigger must be identified (Casey et al., 2016).  Adjustment disorder can be defined as a response to an identifiable stressor or stressors. These stressors result in functional damage. Adjustment disorder is linked to a higher risk of suicide. Additionally, those with adjustment disorder are also known to have higher tendencies of substance misuse. Adjustment disorder is extremely common (Wright, 2009). For Charles this stressor or trigger can probably be linked to his divorce.

Review the timeline you have regarding insurance reimbursement

The scenario detailed that Charles has eight sessions to assist him with his mental health. These eight sessions could provide Charles with the needed direction he might need moving forward. Charles is probably experiencing feelings of abandonment, hurt and betrayal. Charles divorce is a risk factor or trigger to his depression.

Whether or not it is ethical to render a diagnosis within the required timeframe. 

As a psychologist working for an agency, I have a policy that states that an assessment and diagnosis must be given for Charles within 48 hours of an initial session with a client. This would not be ethical to render a diagnosis within this timeframe. Additionally, I would be giving my agency and Charles a disservice by providing a diagnosis within this timeframe. In order to give Charles, the correct diagnosis, more time interviewing, observing, and assessing would be necessary.      

Describe any additional information you would need to help formulate your diagnosis.

Additional information could be used be used in order to formulate a diagnosis:

· Interviews from family, friends, if possible ex-spouse

· Charles’ drug/medication/dietary supplement history

· Charles’ clinical history

· Charles’ family clinical history

                                                                                                 

Specific questions to ask Charles

1. Talk to me about your biggest fear regarding your relationship/end of your marriage?

2. What is it that is making you seek professional help?

3. What are your expectations to receive from our sessions?

4. What do you consider to be your biggest problem? Tell me what you think was the biggest issue/problem in your relationship?

5. What makes you feel the most stressed/depressed?

6. What are some things you wish your spouse would have started doing? What are some things you wish you could have started doing?

7. What are some things you wish your spouse would have stopped doing? What are some things you wish you could have stopped doing in your relationship?

8. What are some things you would have done differently in your relationship?

9. Can you tell me how you feel about your own life?

10. What are some of the aspects of your life that may make you feel/think that your life is not worth living?

11. What are some of the aspects of your life that make it worth living?

Conclusion

After attending sessions with a psychologist, one noticeable problem with the psychological diagnostic systems is the struggle in determining what constitutes a mental illness and what does not (Garfield, 2004). In my opinion, Charles is acting in a similar manner a male would experience if going through an unwanted divorce. I feel diagnosing him with a mental illness could provide more harm than good. From reading the scenario, I feel that divorce was probably unwanted by Charles, and his significant other was probably the one initiating the divorce.

Reference

American Psychological Association. (2017). Ethical principles of psychologists and code of conduct (2002, amended effective June 1, 2010, and January 1, 2017).  http://www.apa.org/ethics/code/index.htmlLinks to an external site.

Casey, P. Strain, J. (2016). When somebody has an Adjustment Disorder . Psychiatric News,  https://doi.org/10.1176/appi.pn.2016.1a18Links to an external site.

Fowells, A. (2016). Diagnosing depression.  Chemist & Druggist, 285(6974), 18–20. https://web.p.ebscohost.com/ehost/detail/detail?vid=12&sid=a6e928f9-4f8b-4f7d-8e62-1e1ee6436aa5%40redis&bdata=JkF1dGhUeXBlPXNoaWImc2l0ZT1laG9zdC1saXZl#db=bsh&AN=116884755

Garfield, S. L. (2004). Methodological issues in clinical diagnosis. In P. B. Sutker, & H. E. Adams (Eds.),  Comprehensive handbook of psychopathology (3rd ed.). Springer Science+Business Media. Credo Reference:  https://go.openathens.net/redirector/ashford.edu?url=https%3A%2F%2Fsearch.credoreference.com%2Fcontent%2Fentry%2Fsprhp%2Fmethodological_issues_in_clinical_diagnosis%2F0%3FinstitutionId%3D3165Links to an external site.

Maltzman, S. (2013). The assessment process. In  APA handbook of testing and assessment in psychology, Vol. 2: Testing and assessment in clinical and counseling psychology. (pp. 19–34). American Psychological Association. https://doi.org/10.1037/14048-002

Maye, M. (2021). Psychological assessment. In F. R. Volkmar (Ed.),  Springer reference: Encyclopedia of autism spectrum disorders (2nd ed.). Springer Science+Business Media. Credo Reference:  https://go.openathens.net/redirector/ashford.edu?url=https%3A%2F%2Fsearch.credoreference.com%2Fcontent%2Fentry%2Fsprautismdis%2Fpsychological_assessment%2F0%3FinstitutionId%3D3165Links to an external site.

Psychological assessment. (2004). In W. E. Craighead, & C. B. Nemeroff (Eds.),  The concise Corsini encyclopedia of psychology and behavioral science (3rd ed.). Wiley. Credo Reference: https://go.openathens.net/redirector/ashford.edu?url=https%3A%2F%2Fsearch.credoreference.com%2Fcontent%2Fentry%2Fwileypsych%2Fpsychological_assessment%2F0%3FinstitutionId%3D3165

Tallent, R. J. (2012). Report it right: Depression and traumatic brain injuries.  Quill, 100(3), 30. https://web.p.ebscohost.com/ehost/detail/detail?vid=23&sid=a6e928f9-4f8b-4f7d-8e62-1e1ee6436aa5%40redis&bdata=JkF1dGhUeXBlPXNoaWImc2l0ZT1laG9zdC1saXZl#db=lkh&AN=77709703

Wright, E. J. (2009). Adjustment disorder. In E. R. Ingram,  The international encyclopedia of depression. Springer Publishing Company. Credo Reference:  https://go.openathens.net/redirector/ashford.edu?url=https%3A%2F%2Fsearch.credoreference.com%2Fcontent%2Fentry%2Fspiedep%2Fadjustment_disorder%2F0%3FinstitutionId%3D3165Links to an external site.

Zineldin, M. (2019). TCS is to Blame: The Impact of Divorce on Physical and Mental Health.  International Journal of Preventive Medicine, 1–4.  https://doi.org/10.4103/ijpvm.IJPVM_472_18

In your responses, evaluate whether your peer took into account the ethical guidelines outlined in the APA’s Ethical Principles of Psychologist and Code of Conduct when he or she assessed and diagnosed the client. Suggest additional questions your peer might ask the client. Propose an alternative diagnosis that might arise from the additional questions you have suggested.