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TRANSCRIPT
C H A P T E R 2
CLASSIFICATION AND TREATMENT
PLANS
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EXPERIENCESOF CLIENT AND CLINICIAN
PSYCHOLOGICAL DISORDER: EXPERIENCES OF CLIENT AND CLINICIAN
• Psychologist: Healthcare professional offering psychological services
• Client: Person seeking psychological services
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CASE STUDY
• Kristen is a 38 year-old divorced mother of two teenagers. She has
had a successful, well-paying career for the past several years in
upper-level management. Even though she has worked for the same,
thriving company for over 6 years, she’s found herself worrying
constantly about losing her job and being unable to provide for her
children. This worry has been troubling her for the past 8 months.
Despite her best efforts, she hasn’t been able to shake the negative
thoughts.
• Ever since the worry started, Kristen has found herself feeling restless,
tired, and tense. She often paces in her office when she’s there
alone. She’s had several embarrassing moments in meetings where
she has lost track of what she was trying to say. When she goes to
bed at night, it’s as if her brain won’t shut off. She finds herself
mentally rehearsing all the worse-case scenarios regarding losing her
job, including ending up homeless.
GENERALIZED ANXIETY DISORDER
• Persistent worrying or obsession about small or large concerns that's out of proportion to
the impact of the event
• Inability to set aside or let go of a worry
• Inability to relax, restlessness, and feeling keyed up or on edge
• Difficulty concentrating, or the feeling that your mind "goes blank"
• Worrying about excessively worrying
• Distress about making decisions for fear of making the wrong decision
• Carrying every option in a situation all the way out to its possible negative conclusion
• Difficulty handling uncertainty or indecisiveness
• Physical signs and symptoms may include:• Fatigue
• Irritability
• Muscle tension or muscle aches
• Trembling, feeling twitchy
• Being easily startled
• Trouble sleeping
• Sweating
• Nausea, diarrhea or irritable bowel syndrome
• Headaches
THE CLIENT
• Client - People in treatment collaborate with those who treat them
• Patient carries with it the connotation of a passive
rather than active participant
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THE CLINICIAN
• Clinician: The person providing treatment
• Psychiatrists: People with degrees in medicine (MDs)
• Receive specialized advanced training in diagnosing and
treating people with psychological disorders
• Clinical psychologist: A mental health professional with training in the behavioral sciences who
provides direct service to clients
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THE CLINICIAN
• Two types of doctorates in psychology:
• Doctor of philosophy (PhD)
• Doctor of psychology (PsyD)
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DIAGNOSTIC AND STATISTICAL MANUALOF MENTAL DISORDERS
DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS (DSM)
• Reliability: The degree to which clinicians provide diagnoses consistently across individuals who have
a particular set of symptom
• Validity: The extent to which a test, diagnosis, or rating accurately and distinctly characterizes a
person’s psychological status
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DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS (DSM)
• A book published by the American Psychiatric
Association that contains standard terms and
definitions of psychological disorders
• Axis: A class of information in DSM-IV regarding an aspect of the individual’s functioning
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DIAGNOSTIC AND STATISTICAL MANUALOF MENTAL DISORDERS (DSM)
• Multiaxial system
• A multidimensional classification and diagnostic system that
summarizes a variety of relevant information about an
individual’s physical and psychological functioning
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THE FIVE AXES OF THE DSM-IV
• Axis I: Clinical disorders
• Axis II: Personality disorders and mental retardation
• Axis III: General medical conditions
• Axis IV: Psychosocial and environmental problems
• Axis V: Global assessment of functioning (helps
assess prognosis)
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TABLE 2.1- AXIS I DISORDERS OF THE DSM-IV-TR
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SOURCE: Reprinted with permission from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text
Revision. Copyright © 2000 American Psychiatric Association.
TABLE 2.1- AXIS I DISORDERS OF THE DSM-IV-TR
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may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
SOURCE: Reprinted with permission from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text
Revision. Copyright © 2000 American Psychiatric Association.
TABLE 2.2 - EXAMPLES FROM AXIS IV OF THE DSM-IV-TR
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TABLE 2.3 - AXIS V: GLOBAL ASSESSMENT OF FUNCTIONING SCALE (GAF)
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CULTURE-BOUND SYNDROMES
• Recurrent patterns of abnormal behavior or
experience that are limited to specific societies or
cultural areas
• http://listverse.com/2009/08/21/top-10-bizarre-
cultural-disorders/
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THE INTERNATIONAL CLASSIFICATION OF DISEASES (ICD)
• Mental health professionals outside the U.S. and
Canada use the World Health Organization’s (WHO)
diagnostic system, which is the International
Classification of Diseases (ICD)
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THE DIAGNOSTIC PROCESS
• Principal diagnosis: The disorder that is considered to be the primary reason the individual seeks
professional help
• Comorbid: The situation that occurs when multiple diagnostic conditions occur simultaneously within
the same individual
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THE DIAGNOSTIC PROCESS
• Differential diagnosis: The process of systematically ruling out alternative diagnoses
• Case formulation
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CULTURAL FORMULATION
• Includes the clinician’s assessment of the client’s
degree of identification with the culture of origin
• The culture’s beliefs about psychological disorders, the ways
in which the culture interprets particular events, and the
cultural supports available to the client
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PLANNING THE TREATMENT
• Treatment plan: The outline for how therapy should take place
• Goals of treatment
• Immediate goals
• Short-term goals
• Long-term goals
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PLANNING THE TREATMENT
• Determine treatment site
• Psychiatric hospitals
• Specialized inpatient treatment centers
• Outpatient treatment
• Halfway houses and day treatment programs
• Other treatment sites
• https://www.youtube.com/watch?v=1nVEN1Reea
w&list=PLzvHgGKrywgDXAzwKC9uE5QPagEaeNfKU
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MODALITY OF TREATMENT
• Modality: Form in which the clinician offers psychotherapy
• Individual psychotherapy
• Family therapy
• Group therapy
• Milieu therapy
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EVIDENCE-BASED PRACTICEIN PSYCHOLOGY
• Clinical decision making that integrates the best
available research evidence and clinical expertise
in the context of the cultural background,
preferences, and characteristics of clients
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TREATMENT IMPLEMENTATION
• Course of Treatment
• The clinician’s role in treatment
• The client’s role in treatment
• Outcome of Treatment
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