Advanced Therapy, Essay Example

Question One: Describe how the DSM categories, diagnoses, and diagnostic criteria are established. Discuss what you think about the way the manual is constructed.

The Manual is published by the American Psychiatric Association and covers all mental problems for adults and children. It lists the causes of disorders, statistics in terms of gender, age at onset, and prognosis as well as some research concerning the optimal treatment processes. It is constructed with five Axes’s which include clinical syndromes, developmental disorders and personality disorders, physical conditions and severity of psychosocial stressors and lastly highest level of functioning. At level one is where the diagnosis takes place. At level two is where developmental disorders in children usually first surface. Personality disorders in adults usually surface at this axis, also. In axis three is where physical conditions that affect the brain usually surface. At level four is where symptoms such as death of a loved one, unemployment or starting of a new job surface. At level five is where a person has the highest functioning ability as compared to the previous year so a specialist can compare their condition. The DSM is like a road map or classification of different diseases of the mind and is mapped out so the specialist can diagnose each one separately with different symptoms.

Question Two: Discuss the Five Axes system of diagnosis. Be sure to specify what types of information is recorded on each axis. Also, discuss how you see the five axes working together to form a more complete picture of the client.

Axis one describes clinical disorders that may require immediate attention from a psychiatrist.

Axis two describes personality disorders and contains a rating for mental retardation. They do not necessarily require immediate attention but may complicate treatment.

Axis three describes the by-product of a physical illness such as diabetes or heart disease. This is a label for general medical conditions that affect the patient.

Axis four describes psychosocial and environmental problems such as poverty and dysfunctional family environments. These issues may have an impact on the patient’s ability to function normally.

Axis five “represents the Global Assessment of Functioning Scale. It is an overall ability of a person to cope with life in a normal setting. The scores can range from 10 which means they have the ability to hurt themselves or others to 100 which means they have a superior functioning in a wide variety of activities.” (“The Five Axes of DSM-IV”).

Question Three:

Part A: Describe how you would personally do an assessment of a person presenting with this story:

Jane is a 25 year old female. She reports that she is having trouble sleeping at night, trouble concentrating at work, and feels that life is not worth living any longer. She also finds that she is not confident in social situations any longer and she feels nervous around just about everyone. This has been going on since her husband left her 12 months ago.

Part B: Give a Five Axis Diagnosis of this woman (you will have to make up some of the information because it wasn’t given to you in the above case summary).

First thing I would note is the possibility of social anxiety disorder. Then I would note she has severe depression and anxiety possibly suicidal. I would also note this was brought on by severe environmental stressors. Axis one I would say depression for immediate attention and prescribe depression pills with the possibility of in house care for her to be watched for suicide. Axis two she possesses no personality disorder. Axis three she has no physical conditions. Axis four she has come from a divorce which has put severe stress in her life leaving her unable to cope with life on life terms. Axis five she is approximately a 20 and unable to live life on life’s terms. She is unable to enjoy life. She either needs to be hospitalized for depression or put on medication for depression and anxiety and closely monitored.

Question Four: Looking at your DSM IVTR, look up the diagnostic criteria for Adjustment Disorder with depressed mood, Major Depressive Disorders, Depressive Disorder NOS, and dysthymia. Discuss how you as a clinician would make decisions about which of these diagnoses to give someone who was presenting with symptoms of depression. Please be very thorough and specific.

Major Depressive Disorder: Depressed mood or major loss of interest or pleasure in daily activities for more than two weeks. The mood must represent a change in their normal mood, social, occupational, educational or important functioning.

Dysthymia Disorder: Depressed state of mind for most of the days for more than two years. In children and adolescents mood can be irritable for at least one year. Person must not have gone for more than two months with the following symptoms: poor appetite or overeating, insomnia or hypersomnia, low energy or fatigue, low self-esteem.

Question Five: Answer each part of this question:

Part A: Discuss what is meant by a theory based treatment plan (be sure to include information about what a treatment plan is in this part of your answer).

Theory based treatment plans are those that have not been fully tested through practical knowledge and experience rather they are theorized by doctors and psychologists to be thought of as mathematically and scientifically sound enough to be effective in the practice of psychology/psychiatry. They are exactly as they are pronounced, based on theories rather than practice.

Part B: What are the components of a treatment plan and what is the structure of a treatment plan?

There is a privacy statement, personal information, claim number, the referral person, the list of current practical problems, the current DSM-IV diagnosis (axes), the identity risk factors for recovery, the past mental health problems, the agreed treatment plan and measures, the duration of the treatment and the approval, the multidisciplinary coordination of medications, other comments and issues, agreement by the psychologist and the patient and the patient’s authorization.

Part C: Discuss why to use treatment plans in general and why to use theory based treatment plans.

Treatment plans are designed to keep the health of the patient organized so that the psychologist can better treat the patient. The information on the plan helps the psychologist to better understand the background of the patient to treat him/her and to keep the patient’s record and issues organized to make a proper diagnosis.

Part D: What are some issues in treatment planning that should be considered.

Issues of past diagnosis should be considered, family history of mental illness should be considered, any mental retardation or physical and emotional illness that could impede a proper diagnosis should be considered. If the patient is currently taking any medications that should be seriously considered, also.

References

Psychiatric Disorders Retrieved October 12, 2010 from, http://allpsych.com/disorders/dsm.html

The Five Axes of DSM-IV Retrieved October 12, 2010 from, http://www.psywww.com/intropsych/ch12_abnormal/five_axes_of_dsm-iv.html

Mental Health (Psychology) Retrieved October 12, 2010 from, http://www.tac.vic.gov.au/jsp/content/NavigationController.do?areaID=22&tierID=1&navID=B9EC32EA7F0000010104A4B61AE334F6&navLink=null&pageID=671