Therefore, when clients say they have panic, it should alert you to gather additional information about a range of different anxiety disorders. Nevertheless, we recommend using established diagnostic criteria. Using checklists to aid in recalling specific diagnostic criteria helps. In fact, you may leave the first interview more confused than when you began.
Fear not. These include the following:. F This code refers to Unspecified Mental Disorder. Provisional diagnosis: When a specific diagnosis is followed by the word provisional in parentheses, it communicates a degree of uncertainty.
A provisional diagnosis is a working diagnosis, indicating that additional information may modify the diagnosis. Even when time is limited, social-developmental history information helps ensure accurate diagnosis. For example, the DSM-5 lists numerous disorders that have depressive symptoms as one of their primary features, including 1 persistent depressive disorder, 2 major depressive disorder, 3 various adjustment disorders, 4 bipolar I disorder, 5 bipolar II disorder, and 6 cyclothymic disorder.
Many other disorders include depressive symptoms or symptoms that are comorbid with one of the previously listed depressive disorders. Among others, these include 1 posttraumatic stress disorder, 2 generalized anxiety disorder, 3 anorexia nervosa, 4 bulimia nervosa, and 5 conduct disorder. The question is not whether depressive symptoms exist in a particular client but rather which depressive symptoms exist, in what context, and for how long.
In some cases, accurate diagnosis is directly linked to client history. For example, a panic disorder diagnosis requires information about previous panic attacks. A few significant issues should be reviewed and emphasized.
Each of these areas can provide information crucial to the diagnostic process. He wrote:. In some cases, it can be critical to obtain diagnostic information from people other than the client, especially when interviewing young clients.
Parents are often interviewed as part of the diagnostic work-up see Chapter However, even when interviewing adults, you may need outside information:. Adults can also be unaware of their family histories or details about their own development. Patients with psychosis or personality disorder may not have enough perspective to judge accurately many of their own symptoms.
In any of these situations, the history you obtain from people who know your patient well may strongly influence your diagnosis. Morrison, , p. Whether you need to interview a collateral informant to obtain diagnostic information should be determined on a case-by-case basis.
Client coping skills may be related to diagnosis and can facilitate treatment planning. Coping skills also may be assessed by using projective techniques or behavior observation.
You might try having clients imagine an especially stressful scenario sometimes referred to as a simulation and describe how they would handle it. Behavioral observations may be collected either in an office or in an outside setting school, home, workplace.
Collateral informants also may provide information regarding how clients cope when outside your office. When interviewing new clients, therapists should inquire about the most recent physical examination results. Some therapists ask for this information on their intake form and discuss it with clients.
Physical and mental states can have powerful and reciprocal influences on each other. For instance, a long-term illness or serious injury can contribute to anxiety and depression. Consider the following options when completing a diagnostic assessment:.
Making sure that potential medical or physical causes or contributors to mental disorders are considered and noted is an ethical mandate. Clients who come for professional assistance may have lost sight of their personal strengths and positive qualities. Further, after experiencing an hour-long diagnostic interview, clients may feel even more sad or demoralized.
For example:. I appreciate your telling me about your problems and symptoms. Exploring client strengths provides important diagnostic information. Clients who are more depressed and demoralized may not be able to identify their strengths. Nonetheless, be sure to provide support, reassurance, and positive feedback. Formal assessment procedures are often viewed solely as a means of uncovering and discovering deficiencies and deviancies with clients and their lives.
Throughout the interview, skilled diagnosticians express compassion and support for a fellow human being in distress. You are commenting using your WordPress. You are commenting using your Google account. You are commenting using your Twitter account.
You are commenting using your Facebook account. Notify me of new comments via email. Notify me of new posts via email. Therapists systematically ask clients a menu of diagnostically relevant questions.
Diagnostic interview schedules generally produce a diagnosis, consequently relieving clinicians of subjectively weighing many alternative diagnoses. Diagnostic interview schedules show better diagnostic reliability and validity than less structured methods. Diagnostic interviews are well suited for scientific research.
Valid and reliable diagnoses support research on the nature, course, prognosis, and treatment responsiveness of particular disorders. Disadvantages Associated with Structured Diagnostic Interviewing There are also disadvantages associated with structured diagnostic interviewing: Many diagnostic interviews require considerable time for administration.
This is cumbersome because experts in psychiatric diagnosis might require less information to accurately diagnose clients than would beginning therapists. Segal Michel Hersen. Represents a clear, jargon-free overview of diagnostic categories with helpful hints regarding a psychiatric interview Completely revised and updated, detailing current innovations in theory and practice, including complete alignment with the DSM Front Matter Pages i-xiv.
Basic Issues in Interviewing and the Interview Process. Segal, Andrea June, Meghan A. Pages Interviewing Strategies, Rapport, and Empathy. Philinda Smith Hutchings, Thomas B. Mental Status Examination. Dealing with Defenses and Defensiveness in Interviews. Consideration of Neuropsychological Factors in Interviewing. Anxiety Disorders. Rose C. Smith, Lisa S. Elwood, Matthew T. Feldner, Bunmi O. Mood Disorders. Personality Disorders. Brian P.
Alcohol Problems. David C. Hodgins, Katherine Diskin, Jonathan N. Drug Abuse. Jessica F. Magidson, Marina A. Bornovalova, Stacey B. Sexual Dysfunctions and Deviations. Caroline F. Pukall, Marta Meana, Yolanda Fernandez. Eating Disorders. Risa J. Stein, Ryan D. Field, John P. Psychophysiological Disorders. Posttraumatic Stress Disorder. Marital Dyads. William Fals-Stewart, Wendy K. Lam, Michelle L. Sexually and Physically Abused Children.
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