Discussion Diagnostic Conceptualization
Please no plagiarism and make sure you are able to access all resources on your own before you bid. You need to have scholarly support for any claim of fact or recommendation regarding treatment. Grammar, Writing, and APA Format: I expect you to write professionally, which means APA format, complete sentences, proper paragraphs, and well-organized and well-documented presentation of ideas. Remember to use scholarly research from peer-reviewed articles that is current. Sources such as Wikipedia, Ask.com, PsychCentral, and similar sites are never acceptable. Please follow the instructions to get full credit for the discussion. Please refer to the helpful tips and look at all the attachments. I need this completed by 09/16/20 at 5pm.
Discussion – Week 3
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Ethically Sound Practices for Discussing a Diagnosis
In the Learning Resources this week, you listened to four Walden faculty discuss their experiences navigating potential ethical considerations related to the process of rendering a diagnosis. In these discussions, you likely considered how you, as a mental health professional, would be prepared to navigate the ethical dilemmas inherent within the process of mental health assessment and diagnosis.
In this Discussion, you will practice the process of rendering a diagnosis to a fictional client, Jane. As you are role-playing a conversation with a client, you will want to take special care to provide information in an easy, understandable way.
To prepare for the Discussion:
- Review the Learning Resources, including the case of Jane available in Chapter 9 of your Kress and Paylo (2019) course textbook.
- Consider the diagnosis that would best fit Jane’s presenting concerns.
- Read the handout, Jane: Diagnostic Conceptualization Example, in the Learning Resources and render a diagnosis based on the case study.
- Imagine you are completing your second counseling session with Jane during which you will discuss the diagnosis that you have rendered.
- Think about the ethical concerns you will need to consider when delivering the diagnosis to Jane.
- Review the Kaltura Media Uploader link in the left-hand navigation of the classroom for helpful guidelines for creating and uploading your video for this Assignment. (Note: Please be mindful of the technical requirements needed when creating your video.)
- Record a short (i.e., 2–3 minutes) video in which you role-play (i.e., do not read a script) providing Jane psychoeducation about the diagnosis. Do not use a partner for this role-play; simply speak into the camera as if you were speaking to your client.
- Be sure to include the following:
- A discussion of the diagnostic criteria delivered in a way Jane can understand
- An explanation to Jane about how her symptoms match the diagnostic criteria
By Day 3
Write a post that includes your formatted DSM-5 diagnosis with associated ICD-10 code for the DSM-5 diagnosis. Attach your monologue video to the post.
Be sure to support your postings and responses with specific references to the Learning Resources.
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Required Resources
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
- “Cautionary Statement for Forensic Use of DSM-5”
- Section II, “Personality Disorders”
- Section III, “Alternative DSM-5 Model for Personality Disorders”
Kress, V. E., & Paylo, M. J. (2019). Treating those with mental disorders: A comprehensive approach to case conceptualization and treatment (2nd ed.). New York, NY: Pearson.
- Chapter 3, “Safety-Related Clinical Issues and Treatment Planning”
- Chapter 9, “Personality Disorders”
American Counseling Association. (2014). 2014 ACA Code of Ethics. Retrieved from https://www.counseling.org/docs/default-source/ethics/2014-aca-code-of-ethics.pdf?sfvrsn=fde89426_5
Handout: Jane: Diagnostic Conceptualization Example (Word Document)
Required Media
Walden University (Producer). (2019b). Mental health counselors: Ethical guidelines for diagnosing mental health disorders [Video file]. Minneapolis, MN: Author.
Case Study: Jane
Jane is a withdrawn, 35-year-old Caucasian female from the Midwest who attended 1 year of community college while in her 20s. When asked about her religious and spiritual beliefs and practices, she says, “If there were a God, he wouldn’t have let my life turn out this way.” Jane expresses some interest in Buddhism; she would like to learn more about this religion and “develop her spirituality.”
She has lived with her mother her entire life and has struggled to maintain stable friendships. Jane’s relationships have been tumultuous and often end with people pushing her away as they increasingly perceive her as being “needy” and “depressing.” She describes a pattern of relationships that begin with an intense feeling of connection, yet end with her feeling victimized and rejected. She often lashes out in anger as these relationships begin to unravel, and she even slashed the tires of one friend after that relationship ended. She has identity struggles, and it is difficult for her to describe herself, her interests, beliefs, values, and hopes for her future. She tends to take on the interests of the people with whom she is associating with as her own. In talking with her, she is negativistic in her thinking; she often sees the world in black-and-white terms.
As a child, Jane experienced an extensive sexual abuse history by both her older brother and her father’s best friend. Jane does not believe that her mother was aware of the sexual abuse she experienced, and to this day Jane has maintained these “family secrets.” Jane was repeatedly and violently sexually abused from the age of approximately 4 to about 14, when her brother left the home. Adding to her shame and confusion is the fact that her older brother now works as a high-ranking military general and is what she calls the “family hero.” In her family, Jane received the message that women were less valued than men. She witnessed her mother being physically and emotionally abused by her father until his death when Jane was 18 years old. Jane has internalized the family belief that her brother is special, makes excuses for his abuse of her, and expresses no anger toward him. Jane indicates that she is leery of most men, and she generally only seeks relationships with women. She has never had any sexual or romantic contact with men or women, and the thought of doing so makes her feel exceptionally anxious.
Since she was about 20 years old, Jane has engaged in severe self-injury. She has had upward of 15 stitches during various incidents in which she has self-injured. She also sometimes bangs her head against the wall, and she will burn herself using bathroom cleaning chemicals. Jane self-injures about three times per week. Jane’s self-injury is typically precipitated by either conflicts with her mother or people with whom she works; feelings of loneliness and emptiness that sometimes overwhelm her, especially when she has unstructured down time; or flashbacks and intrusive memories of her past sexual abuse.
Every few months, Jane experiences what she calls “dark times” when she is overwhelmed by feelings of sadness and hopelessness, during which she spends her weekends in bed. She denies having made any suicide attempts since her teen years; however, she regularly wishes she were dead and fantasizes about suicide.
Jane also has a history of bulimia that ensued from the age of 13 until she was about 23. As her bulimia dissipated, the rate at which she self-injured increased. She refers to herself as “the original self-injurer” and takes pride in her knowledge of the topic. Jane has read a great deal about self-injury and has even shared her story with a local newspaper that published a story on the topic.
Jane also has asthma, and she is able to induce asthma attacks, which result in her making frequent trips to the emergency room at her local hospital. She has been to the emergency room at least twice a week for the past year, and she only feels “safe” and “loved” when receiving medical treatment at the hospital. Jane is especially fond of a female medical intern with whom she perceives she has made a special connection over the past few months.
Jane has spent the past 2 years in counseling. She refers to her counselor as her “surrogate mother.” Jane used the internet to find her counselor’s home address, and she used to drive by the counselor’s house when she felt agitated and needed to self-soothe. Jane also secured her counselor’s phone number and would frequently call her at home, resulting in the counselor setting firm boundaries with Jane around out-of-session contact. Jane was initially angry when her counselor set these boundaries, and she left treatment. Eventually Jane settled and returned to treatment.
Four years ago, Jane was fired from her previous job because she self-injured at work with a box cutter after an altercation with a colleague. Despite Jane’s interpersonal struggles, she has maintained employment at a factory for the past 4 years. She reports that some of her colleagues are hostile toward her and she has occasional conflicts, but for the most part her job is stable. She perceives that working in an all-male environment is adaptive for her, as she isolates herself from her colleagues and rarely has a need to interact with them.
Jane is intelligent and creative, enjoys photography and nature, and has a passion for taking wildlife photos, but recently she has not been engaged in this activity. She is also intermittently involved in a wildlife photography club in her community. She is interested in possibly returning to school to earn a graphic arts degree, but her mother has been discouraging, stating that she “does not see the point in it.” While she describes her relationship with her mother as “cold,” Jane’s mother, in some ways, serves as a source of support. Jane also has occasional contact with a friend from high school whom she admires and respects. Jane is able to seek help and support, and she is quite knowledgeable about many of the issues with which she struggles. She presently takes Paxil as prescribed by her primary care physician.
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