Clinical Assessment, Diagnosis, and Treatment
What are the tools for clinical assessment?
Critical assessment is used to determine the person’s abnormal behavior occurs how and why, and how to help the person. This also helps the clinicians to evaluate the progressive report of the patient who have been in treatment for a while and decide to change. All the clinical assessment tools in present are mainly focused and designed by the three categories. They are Clinical Interviews, Clinical Tests, and Clinician Observations. To use these tools they must be standardized and must have clear reliability and validity.
Clinical Assessment is the process of collecting and interpreting required information about the client or the Research Participant.
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Reliability means various clinicians with their diagnosis on the same client. The DSM-5 has the greater reliability comparing previous DSM’s (APA, 2013, 2012: Hyman, 2011). DSm-5 having around 400 classifications of disorders, over the future, many clinicians will meet the difficulty in distinguishes the kind of DSM-5 anxiety disorder from another. On specified patient’s disorder may be classified as Generalized Anxiety Disorder by one clinician, on another hand, another clinician described as agoraphobia (Fear in traveling), and yet another defines as social anxiety disorder (fear of social situations).
Validity means the classification system must provide the accuracy of the information which diagnosed by the clinicians. Most clinicians demonstrate ‘Predictive Validity’ to categories the predictive future symptoms or events. Insomnia or excessive sleep could be the common symptom of major mind depressive disorder. Moreover, such predictions are accurate and greater predictive validity. As a resulted criteria and categories by DSM-5 are appear with stronger validity than those of the earlier versions of the
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Interviews are categorized by their achievements, they are
i. Psychodynamic Interview – Clinicians concentrate on client’s past events and relationships. It is Unstructured type of interview ii. Behavioral Interview – Clinicians gather the pinpoint information about client and response their consequences. This is a type of Structured Interview. iii. Cognitive Interview – Clinicians discovers here the assumption and interpretation of the client influence. This is a type of Structured Interview. iv. Humanistic Interview – Clinicians reveal the client’s self-evaluation, concept, and values by this interview. It is Unstructured type of interview
v. Biological Interview - Clinicians finding signs of biochemical or brain dysfunction from the client. vi. Sociocultural Interview – Here clinicians deals with their family, social and cultural environments
Interviews held by the clinicians are could be structured or unstructured. In an unstructured interview, clinicians use the open-ended question and never prepared one. On another side, the structured interviews clinician ask the prepared
A classification system such as the DSM-5 is judged by its reliability and validity. Define and discuss both reliability and validity and why they are important criteria for DSM-5.
233). From this, clients should want to change as well as believe in their capacity for change. For Jim, he can benefit from motivational interviewing since it can be used to help him overcome ambivalence to change. A collaborative, and nonconfrontational relationship are part of motivational interviewing. This is important for the client Jim in order to respect and encourage his self-determination. Motivational interviewing gives clients like Jim the opportunity to discover their own reasons for making change. One of the principles for motivational interviewing is expressing empathy where it gives clients the chance to freely explore their values, perceptions, goals and the implications of their present situation without being judged. The counsellor who is working with Jim can use active listening skills for expressing empathy in order for Jim to feel like he is being heard. The second principle is developing
The Motivational Interviewing film was very informative. I was able to get a clear understanding of what is to be expected by the therapist during a session. The film explained the therapist should engage in reflective listening, develop a growing discrepancy, avoid arguing with clients, roll with resistance and support self-advocacy. Miller believed that this approach was far more effective than traditional methods, where the therapist pushed for change. In contrast, Miller explained that motivational interviewing focused on empowerment and helping clients to become motivationally driven to change. Also, Miller stressed the importance of working alongside clients, a term he referred to as dancing. The process in which the client leads
I let my client tell me how he felt about illness based on his own values and beliefs. I also used therapeutic communication techniques such as general lead, listening, sitting at eye level with the client etc. to make this as comfortable as possible for him. I think I was appropriate and very successful at retrieving my client’s beliefs about illness and sickness without pressuring him too much. In the future when conducting an interview with another person about their culture, I would use the same techniques and approach as I found it to be very successful, and my client was very comfortable and established a trust worthy relationship with him regarding his illness based on his cultural beliefs and values. This interview contributed in preparing me for the future and also gave me insight on how to conduct a successful cultural assessment without making assumptions. I learned that every culture is unique and has somewhat of a similarity to other cultures, but one must never assume before doing a thorough assessment. This also prepared me in being more culturally competent while providing care to clients and their families from different cultures and
Classification refers to the procedure in which ideas or objects are recognized, distinguished and understood. Currently, two leading systems are used for grouping of mental disorder namely International Classification of Disease (ICD) by World Health Organization (WHO) and the Diagnostic and Statistical Manual of Mental disorders (DSM) by the American Psychiatric Association (APA). Other classifications include Chinese classification of mental disorder, psycho-dynamic diagnostic manual, Latin American guide for psychiatric diagnosis etc. A survey of 205 psychiatrists, from 66 different countries across all continents, found that ICD-10 was more customarily used and more valued in clinical practice, while the DSM-IV was more valued for research [1].
Motivational interviewing is a more direct, client-centered approach, and is best used for clients who are showing a great deal of uncertainty about change. The goal of motivational interviewing in human service work is to help resolve the client’s uncertainty about change, encourage change in the client’s life, and motivate the client into change. This is a short term interviewing skill used to gauge where the client is at in the counseling process and where to go forward from there.
Motivational interviewing is based on a client centered approach to therapy that uses open-ended questions, affirmation, reflective listening and summaries to help the client recognize the pros and cons of change and their reasons for resisting change thereby eliminating their ambivalence about change. Once the client deals with their ambivalence the Miller and Rollick believe that the client will be able to make the necessary changes. In addition, motivational interviewing gets the client to argue for change not the counselor. Furthermore, the client not the counselor is responsible for their progress.
Interviews are very popular among most individuals especially researchers and scholars as they attempt to obtain information and data from an interviewee. However, there are many factors that influence the interview and which determines its success or failure. Often, the interviewer takes charge of the situation, and they have the sole responsibility of asking the questions while the interviewee provides an explanation or an answer to the question asked. As a result, an interview can be defined as a consultation or a discussion in person through which information and data are exchanged regarding a particular phenomenon event with the intention of establishing the interviewee’s position. It is easy to tell the mood and success of the interview
Motivational interviewing is an important technique and counseling style that was created by William Miller and Stephen Rollnick in the 1980’s. The brief definition of motivational interviewing (MI) that is provided by Miller and Rollnick in their influential text is “a collaborative conversation style for strengthening a person’s own motivation and commitment to change” (Miller & Rollnick, 2013). Motivational interviewing is considered to be a style that evolved from client-centered therapy. The style is considered to be empathic but requires the counselor to consciously directive so that they may help their client resolve the ambivalence they are experiencing and direct them towards change. The important thing to note is that client autonomy is key to the process (Hettema, Steele, & Miller, 2005). However, despite being able to currently give a definition of MI, one that could be considered a working definition, motivational interviewing is “a living, evolving method” (Miller & Rollnick, 2009). It will continue to evolve as times change and it is implemented in use with other maladaptive behaviors. MI is a relatively new style that it still has the ability to undergo changes to adapt to what purpose it is serving (Miller & Rollnick, 2009).
Understanding the counseling session from the client’s perspective is a very important aspect in the development of a therapeutic relationship. A clinician must be an excellent listener, while being to pay attention to the client’s body language, affect and tone. The dynamics in the counseling session that is beneficial to the client include the recognition of the pain that the client is feeling. The detrimental part of this includes a misunderstanding of the real issues, a lack of consideration of the cultural aspects of the client, and a lack of clinical experience or listening skills. In this presentation, we will discuss the positive and negative aspects of the counseling session from the client’s perspective which includes the client’s attitudes, feelings, and emotions of the counseling session. We will next examine the propensity of the client to reveal or not reveal information to the counselor, and how transference, and counter-transference can have an effect on the counselor-client relationship.
The reliability and validity were researched by using three types of studies: mixed diagnostic group, certified patients diagnosed with DSM-III-R anxiety disorders and a non-clinical sample. It should be noted that the that was used population were psychiatric patients s...
The Diagnostic and Statistical Manual of Mental Disorders (DSM) has been used for decades as a guidebook for the diagnosis of mental disorders in clinical settings. As disorders and diagnoses evolve, new versions of the manual are published. This tends to happen every 10 years or so with the first manual (DSM-I) having been published in 1952. For the purpose of this discussion, we will look at the DSM-IV, which was published originally in 1994, and the latest version, DSM-5, that was published in May of 2013. Each version of the DSM contains “three major components: the diagnostic classification, the diagnostic criteria sets, and the descriptive text” (American Psychiatric Association, 2012). Within the diagnostic classification you will find a list of disorders and codes which professionals in the health care field use when a diagnosis is made. The diagnostic criteria will list symptoms of disorders and inform practitioners how long a patient should display those symptoms in order to meet the criteria for diagnosis of a disorder. Lastly, the descriptive text will describe disorders in detail, including topics such as “Prevalence” and “Differential Diagnosis” (APA, 2012). The recent update of the DSM from version IV-TR to 5 has been controversial for many reasons. Some of these reasons include the overall structure of the DSM to the removal of certain disorders from the manual.
This piece of work will be based on the pre-assessment process that patients go through on arrival to an endoscopy unit in which I was placed in during my second year studying Adult diploma Nursing. I will explore one patient’s holistic needs, identifying the priorities of care that the patient requires; I will then highlight a particular priority and give a rational behind this. During an admission I completed under the supervision of my mentor I was pre-assessing a 37 year old lady who had arrived to the unit for an upper gastrointestinal endoscopy. During the pre-assessment it was important that a holistic assessment is performed as every patient is an individual with unique care needs as the patient outline in this piece of work has learning disabilities it was imperative to identify any barriers with communication (Nursing standards 2006).
The Diagnostic and Statistical Manual of Mental Disorders (DSM) is the comprehensive guide to diagnosing psychological disorders. This manual is published by the American Psychiatric Association (APA) and is currently in its fifth revision. Moreover, the manual is utilized by a multitude of mental health care professionals around the world in the process of identifying individuals with disorders and provides a comprehensive list of the various disorders that have been identified. The DSM serves as the essential resource for diagnosis of mental disorders based off of the various signs and symptoms displayed by individuals while also providing a basic reference point for the treatment of the different disorders. The manual attempts to remain scientific in its approach to identifying the underlying symptoms of each disorder while meeting the needs of the different psychological perspectives and the various mental health fields. The DSM has recently gone through a major revision from the DSM-IV-TR to the DSM-5 and contains many significant changes in both the diagnosis of mental disorders and their classifications.
The intake interview assists in establishing and diagnosing any problems the client may have. The therapist may then explain to the client what to expect during the interview, including the time duration. A good assessment/ or intake will focus on the individual situation, strength and coping mechanism. The intake form is for the client, it gives the therapist more information and an idea of who you are. The intake process that is considered of a series of questions and consent form that the client has to sign and agree to. A professional relationship between a counselor and a client begins with an intake interview.