Diagnostic Skill Application II

Submission Requirements

· Written communication: Written communication must be grammatically correct and free of errors that detract from the overall message. Writing should be consistent with graduate level scholarship.

· APA formatting: Title page, main body, and references should be formatted according to the current APA style and formatting.

· Number of resources: Minimum of six scholarly resources. Distinguished submissions typically exceed this minimum.

· Length of paper: 8–12 typed double-spaced pages. Abstract and Table of Content pages are not necessary.

· Font: Times New Roman, 12 point.

 

This assignment will require you to utilize assessment tools to aid in the diagnosis of clients as part of the assessment strategy. Some of the assessments listed in the List of Assessment Tools for the assignment in Unit 9 may be familiar to you from a previous assessment course you have taken. You will want to take time to review these assessments using the resources provided to help you prepare for the assignment. In addition, you will want to view the video vignettes of the clients and the assignment template provided. Finally, review the National Institute of Mental Health (NIMH) resource on psychopharmacology. This resource identifies many types of medications used to treat mental disorders and discusses their efficacy and side effects.

Refer to the assignment description, its related scoring guide, and template for information on how you will be graded.

Learning Components

This activity will help you achieve the following learning components:

· Identify the main symptoms observed in persons who are experiencing psychological disorder.

· Review assessment tools and their application.

· Identify the potential benefits and risks of psychopharmacological interventions by medical professionals.

· Instructions

For each case, you will complete a diagnostic analysis you select from the list of assessment tools provided late in this assignment. Each case requires the following information to be addressed:

· Describe presenting concerns and relevant history.

 

· Explain what information has been provided in each case that helps to determine which disorders are appropriate for consideration (differential diagnoses) for a final diagnosis. Evaluate how at least one assessment tool, which is listed in the List of Assessment Tools resource, will aid in obtaining further information to back up your final diagnosis. The Differential Diagnosis Decision Tree may be helpful to guide this process.

 

 

· Present DSM-5 and ICD-10 codes including relevant Z codes. Assume that the client has presented for treatment with their partner or parents.

 

· Provide a descriptive rationale for the DSM diagnosis that best fits the information provided, including relevant ICD codes. This should be written in a narrative form using complete sentences. Support your rationale with scholarly sources. Optional readings found in the course syllabus may be particularly relevant.

 

· Describe indications or contraindications that help determine whether a medication consultation is appropriate, and provide rationale with support from scholarly sources.

Diagnostic Skill Application II Scoring Guide

CRITERIA	NON-PERFORMANCE	BASIC	PROFICIENT	DISTINGUISHED
Describe presenting symptoms, issues, and relevant history, for case studies. 15%	Does not describe presenting symptoms, issues, and relevant history.	Identifies but does not describe presenting symptoms, issues, and relevant history, for case studies.	Describes presenting symptoms, issues, and relevant history, for case studies.	Evaluates presenting symptoms, issues, and relevant history, for clients; supports with relevant sources.
Explains the methods used for differential diagnosis in case studies. 15%	Does not explain methods used for differential diagnosis of clients.	Explains the methods used for differential diagnosis in case studies, but with errors or omissions.	Explains the methods used for differential diagnosis in case studies.	Explains the methods used for differential diagnosis in case studies; supports with scholarly sources.
Evaluate the use of assessment results to diagnose developmental, behavioral, and mental disorders for case studies. 25%	Does not evaluate the use of assessment results to diagnose developmental, behavioral, and mental disorders.	Explains the use of assessment results to diagnose developmental, behavioral, and mental disorders for case studies, but with errors or omissions.	Evaluates the use of assessment results to diagnose developmental, behavioral, and mental disorders for case studies.	Evaluates the use of assessment results to diagnose developmental, behavioral, and mental disorders for case studies; supports with scholarly sources.
Apply the DSM-5 system to the diagnosis of a child or adult seen in family counseling, providing support for diagnostic choices. 15%	Does not apply the DSM-5 system to the diagnosis of a child or adult seen in family counseling.	Applies some aspects of the DSM-5 system to the diagnosis of a child or adult seen in family counseling but does not provide support for diagnostic choices.	Applies the DSM-5 system to the diagnosis of a child or adult seen in family counseling, providing support for diagnostic choices.	Applies the DSM-5 system to the diagnosis of a focus child or adult seen in family counseling and an additional family member, and providing support for diagnostic choices.
Describe the indications and contradictions of psychopharmacological medications for appropriate medical referral and consultation. 15%	Does not describe the indications and contradictions of psychopharmacological medications for appropriate medical referral and consultation.	Identifies but does not describe the indications and contradictions of psychopharmacological medications for appropriate medical referral and consultation.	Describe the indications and contradictions of psychopharmacological medications for appropriate medical referral and consultation.	Describes the indications and contradictions of psychopharmacological medications for appropriate medical referral and consultation supported by scholarly literature.
Communicate effectively through the consistent use of APA guidelines for grammar, punctuation, and mechanics expected of a counseling professional. 15%	Does not use APA guidelines for grammar, punctuation, and mechanics.	Uses APA guidelines for grammar, punctuation, and mechanics inconsistently.	Communicate effectively through the consistent use of APA guidelines for grammar, punctuation, and mechanics expected of a counseling professional.	Communicates clearly and effectively through the consistent and correct use of APA guidelines for grammar, punctuation, and mechanics expected of a counseling professional.

 

 

 

Decision trees organized by DSM-5 diagnostic grouping

Decision trees organized by mental status examination domain

Diagnostic Skill Application II

For this assignment, you are provided with four case studies. Review the cases of Julio and Kimi, and choose either Reese or Daneer for the third case.

Review these two

· The Case of Julio: Julio is a 36-year-old single gay male. He is of Cuban descent. He was born and raised in Florida by his parents with his two sisters. He attended community college but did not follow through with his plan to obtain a four-year degree, because his poor test taking skills created barriers. He currently works for a sales promotion company, where he is tasked with creating ads for local businesses. He enjoys the more social aspects of his job, but tracking the details is challenging and has caused him to lose jobs in the past. He has been dating his partner, Justin, for five years. Justin feels it is time for them to commit and build a future. Justin is frustrated that Julio refuses to plan the wedding and tends to blame Julio’s family. While Julio’s parents hold some traditional religious values, they would welcome Justin into the family but are respectfully waiting for Julio to make his plans known. Justin is as overwhelmed by the details at home as he is at work.

 

THE CASE OF JULIO

Julio: Since I was young, as long as I can remember, this has been a thing with me. Focusing, it’s been a problem, and now it’s affecting my career. It’s always affected me career to some degree, but now it’s really kind of affecting things in a bigger way. I’m making a lot of careless mistakes and that’s a problem. At times my boss will be talking to me and I won’t even know it. I’ll just be spaced out somewhere, I won’t even know he’d talking to me and then someone will knock me in the side and I’ll realize it. For example, they tasked me with organizing office events and things like that sometimes. They did a couple times, until I screwed them up so many times, but it was always the details, I just forgot the details and certain things that would make things fall apart. I lose things a lot and forget important dates, and just basic information all the time too, and so it’s a frustrating thing. It’s something that’s been going on for a while and something that’s definitely been affecting me.

 

· The Case of Kimi: Kimi is a 48-year-old female currently separated from her husband, Robert, of 16 years. They have no children, which was consistent with Kimi’s desire to focus on her career as a sales manager. She told Robert a pregnancy would wreck her efforts to maintain her body. His desire to have a family was a goal he decided he needed to pursue with someone else. He left Kimi six months ago for a much younger woman and filed for divorce. Kimi began having issues with food during high school when she was on the dance team and felt self-conscious wearing the form-fitting uniform. During college, she sought treatment because her roommate became alarmed by her issues around eating. She never told her parents about this and felt it was behind her. Her parents are Danish and value privacy. They always expected Kimi to be independent. Her lack of communication about her private life did not concern them. They are troubled by Robert’s behavior and consider his conspicuous infidelity as a poor reflection upon their family. Kimi has moved in with her parents while she and Robert are selling the house, which has upended the balance in their relationship.

 

TRanscript: THE CASE OF KIMI

Kimi: My husband left me about six months ago. That’s really where it all started again. I had a lot of trouble when as a teenager, well, all the way through college. I just eat a lot sometimes. Usually when I’m feeling bad. Then I throw up. I just ate so much, I just throw up, and it’s just the relief. I know that sounds gross, but I just feel such a release. When I’m feeling bad, it can just really help me just feel better. But anyway, my husband left about six months ago. He left me for a younger woman. He was cheating.

I thought I had a handle on all this. I’m a professional woman, and feel on top of the world. My career is going great. I was on top of my weight. Just since he’s gone, I just feel really awful again, and the only thing that makes me feel better is just sitting down, when I’m home alone at night. It’s not every night, but maybe a couple times a week. I just eat. I eat and eat. I mean I can do a whole thing of ice cream, and a whole tray of cookies. Just go through it, and then I just throw up. I hate myself, because of course I’m going to gain weight. I mean, I know that. But then once I get rid of it, just kind of washes over me that I just feel better.

 

 

 

 

 

 

 

For a third case, choose one of these transcripts

· The Case of Reese: -Reese is a 44-year-old married African American female. Her parents live in another state, and she is their only child. Her father is a retired Marine Lieutenant Colonel who was stationed both in the United States and overseas while Reese was growing up. She entered the Air Force as soon as she graduated high school at age 17 and has achieved the rank of Chief Master Sergeant. She has been married 15 years to John, and they recently discovered she is pregnant. The unexpected pregnancy has been quite disorienting for someone who has planned and structured major decision her entire life. Reese is fiercely loyal to her extended family and frequently travels to help her parents care for her aunts, uncles, and cousins whenever they experience hardships. Her efforts are not always appreciated, because she offers very specific guidance and is easily frustrated by their lack of follow through.

 

 

TRanscript: THE CASE OF REESE

Reese Matthews: Hi. I am chief master Sargent Reese Matthews. The United States Air Force. I pride myself on the 27 year Air Force veteran and I quite enjoy the structure that my job allows me to have. Life has been wonderful pretty much. I come from a very structured background. Here recently, though, things have kind of fallen apart. I’ve been married for a bit, and a part of being married is that of course I tell my husband or I told my husband what I expected of him and made it very clear to him what’s expected in being a husband by writing it down. He agreed to it. He’s in the Air Force as well. That has worked well for both of us. We like our routine. That’s very important to us.

Here lately, I’ve been struggling because things have fallen apart in my marriage. I suspect that will impact my structure at my job. A part of my marriage contract with my husband was that we would save a certain amount of money so we could have children eventually. Specifically, we needed to save $497,000 so that everything would be perfect when we had a baby. Well, we have not saved $497,000. We have saved only $383,000. I discovered that we are going to have a baby. I don’t know what to do. This is so far out of our plans. This is not something that we bargained for. this is not something that I bargained for. I don’t want this to happen like this. I don’t know what to do with this situation.

We are struggling through that process. I feel let down or I feel disappointed because a part of our marital contract was that my husband would earn rank like I did. Of course, he didn’t. I’m very disappointed because I did all the work, earned the rank, and he has been goofing off. He has not earned the rank that he should have earned. I have tried to help him. I’ve given him lesson plans, helped him study to earn his rank and yet he has not done that. In addition to not earning the rank, that’s one part of the plan that’s falling apart and now we’re having a baby. That’s a second part of the plan that’s falling apart. I am really truly, truly at wits end. I don’t know what to do because everything in life has fallen apart. My life is a shambles of a mess right now. I don’t know what to do.

Of course, I have done a very, very good job of sticking to the list of things that I’m supposed to do as a wife and I’ve done that. The same as what I’ve done as a member of the military. I’ve done everything that’s on my list to do. It is my husband who has not done everything that’s on his list to do. He doesn’t seem to understand that he has to do these things and these things have to be done in the order that he is supposed to do them. Now I am stuck, literally stuck in this crazy place that I can’t figure out what I need to do next or what we need to do next because he had wrecked all the plans. We had a perfectly laid out set of plans that we could easily follow, that anybody could easily follow, that he should have easily followed. I followed the plan. I did everything step by step by step that I was supposed to have done. Now he has wrecked the plan. He really has just screwed up our marriage.

Now, it’s easy to see that the fault here is not mine. The fault is my husband’s. Although he has been whining about this for years. He says, “Oh my goodness, Reese. You are just too rigid. Oh my goodness, Reese. We don’t have to follow this list.” I keep telling him we do have to follow a list of things to do. For example, I make a list for him all the things we have to do on Mondays and then all the things we have to do on Tuesdays. That has worked for us. That has worked for us for the last 15, 20 years. Even when we were dating, he would make little snide remarks about it. About the fact that I’m too rigid, I’m too structured, I’m too regimented. That I make all these crazy, crazy lists and he has to follow things in this rigid order, but it has worked. It has worked very, very well up until now. I think that he is just sabotaging everything that I have worked so hard to achieve.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The Case of Daneer:

Daneer is a 50-year-old male. He emigrated to the United States from Serbia with his parents and older brother when he was four years old. Daneer and his brother were harshly disciplined by their parents when they failed to follow family rules or did not live up to their standards. It was not unusual for his parents to refuse to speak to the boys for days when their grades were low. Daneer’s parents are practicing Muslims, but Daneer rejected their faith when he reached adulthood. His relationships with his parents and brother are strained by his tendency to alternate between being a doting son and lashing out when they rebuke his lifestyle. They disapprove of his life choices that are inconsistent with their religious beliefs. Daneer was briefly married in his 20s, but his wife left him after six months and filed an order of protection. He was briefly hospitalized after a serious suicide attempt shortly after his marriage ended. He has worked several jobs as a waiter and often quits before he is fired due to conflicts with other staff.

 

Transcript: THE CASE OF DANEER

Daneer: I was at this party the other day. There was this fine looking woman over there. I thought, “I’ll do my old shtick like I always do. I’ll see if I can pick her up, take her home, have my way with her.” I went over there, I approached her and then she was a fat chick, so I figured she probably needed some help. I let her know that I was around so that maybe she could come home with me. She’s kind of desperate. I was thinking maybe I could do like I did with the last chick that I had, the last girl I picked up here at this bar. That one went okay but she seemed like an angel but then I found out later she was a devil. I mean she caused me a lot of pain. I got really, really mad with her. In fact, I even told her, I said, “If you don’t do what I ask you to do, what I tell you to do, I’m gonna kill myself.”

I was thinking about that when I approached this woman. Well, she wasn’t too excited about hanging out with me. I thought for sure being the good looking guy that I am, that it wouldn’t be any trouble. I approached her, she was not interested, so I went out and I slashed her tires because I saw what she drove in. Then I went home. Then I thought about it a little bit more and I thought, “I wonder what would happen if I slashed my wrist? Maybe I’d get her attention at that point.” What do you think?

Use the Assignment Template in attachments to complete the assignment.

List of Assessments and Supporting Resources

· Derogatis, L. R. (1977). Symptom Checklist-90–Revised. Psyctests, doi:10.1037/t01210-000

. Grande, T. L., Newmeyer, M. D., Underwood, L. A., & Williams, C. R. (2014). Path analysis of the SCL-90-R: Exploring use in outpatient assessment. Measurement and Evaluation in Counseling and Development, 47(4), 271–290.

· Hain, S., Schermelleh-Engel, K., Freitag, C., Louwen, F., & Oddo, S. (2016). Personality Styles and Disorder Inventory—Short form. Psyctests, doi:10.1037/t58367-000

. Hain, S., Schermelleh-Engel, K., Freitag, C., Louwen, F., & Oddo, S. (2016). Development of a short form of the Personality Styles and Disorder Inventory (PSDI-6): Initial validation in a sample of pregnant women. European Journal of Psychological Assessment, 32(4), 283–290.

. Review this source toto be able to interpret the Personality Styles and Disorder Inventory—Short form.

· ​Henderson, K. A., Buchholz, A., Perkins, J., Norwood, S., Obeid, N., Spettigue, W., & Feder, S. (2010). Eating disorders symptoms severity scale. Psyctests. doi:10.1037/t10209-00

· Henderson, K. A., Buchholz, A., Perkins, J., Norwood, S., Obeid, N., Spettigue, W., & Feder, S. (2010). Eating disorder symptom severity scale: A new clinician rated measure. Eating Disorders, 18(4), 333–346.

. Review this source to be able to interpret the Eating Disorder Symptom Severity Scale.

· Kessler, R. C., Adler, L., Ames, M., Demler, O., Faraone, S., Hiripi, E., & Walters, E. E. (2005). Adult ADHD Self-Report Scale Symptom Checklist. Psyctests. doi:10.1037/t03454-000

· Leithead, L., & Freeborn, D. (2013). A practical guide for diagnosing adult attention deficit hyperactivity disorder. The Journal for Nurse Practitioners, 9(10), 688–694.

. Review this source to be able to interpret the ADHD Self-Report Scale Symptom Checklist.