Course: CED 5972Presenter: John Grady, LPC, LCADC, ACS, CCS, NCCClass Two

Clinical Mental Health

Counseling

*Inspirational Quote

*Today’s Goals

*Intro selves * Q’s for the class* Ethics & Legal Considerations* DSM-5: Fundamentals & Classification System* Article Discussion

Half-Time! (or go right through)

*WHODAS 2.0*Global Assessment of Functioning (no long used)*Mental Status Exam (MSE) components *Tx Team Meeting Exercise

*Class Member Brief Intros

*How far along are you in the Counseling program?

*What licensure are you pursuing?

*What are your strengths?

*What are your favorite accomplishments?

*Questions for the Class

*What did you find most useful from last week’s class?

*Does the DSM-5 adhere more to the Medical Model or the Wellness Model?

*How does the answer affect your view of diagnosing clients as part of their treatment?

* What subjects are you interested in (for your article presentation)?

*Any remaining questions regarding the many career paths you may wish to pursue?

*Article Presentation

*As we discuss our topics, please sign up for your article presentation date…

Ethical & Legal Considerations

*ACA Code of Ethics* Influenced by 5 moral principles *2014: 9 sections*Ethics Support: Erin T. Shifflett; 800-347-6647; ethics@counseling.org

*Using Evidenced-Based Practices*ACA Ethics - C.7.b.: Scientific basis for Tx

* Boundaries of Competence (C.2.a) *Law & Legal Regulations: Governing Entities, Clinical Practice*Ethics: Decision Making, Professionalism *Legal resources:*American Bar Association *Legal Action Center*ACA Risk Management Service (legal): Anne Marie Wheeler * Referred after speaking to Ethics support

*Conflicts – Ethics vs. Laws*ACA Ethics – I.1.c

*Evidenced-Based Programs, Practices, &

Therapies

* Substance Abuse and Mental Health Services Administration (SAMHSA) webguide: Evidence-Based Practices (EBP)*http://www.samhsa.gov/ebp-web-guide

*SAMHSA’s National Registry of Evidence-Based Programs & Practices*http://www.samhsa.gov/nrepp*Cognitive Behavioral Therapy (CBT)*Motivational Interviewing (MI)

*Effective Child Therapy*http://effectivechildtherapy.org/*For Professionals & Educators*CBT, Family Therapy, *Offers specific EB Tx Programs summaries w/links to additional info

*DSM-5 Fundamentals

*DSM-5: The World Standard for evaluation & assessment.*International Classification of Diseases, 10th Rev. (ICD-10) codes*ACA Ethics: Diagnosis of Mental Disorders – E.5*“Essential Features”/”Prototype Method” to establish Dx *Use to generate additional exploration

*Mental Disorder defined*Physical Conditions & Disorders*Can directly impact mental Dx or the management of mental

disorder*Psycho-social & Environmental Problems*May be independent of mental disorder or caused by it*ICD-10 Z codes (used by DSM-5)

DSM-5 Classificatio

n System

* 5 Axis system of previous editions: Eliminated* All mental, personality, physical disorders

are recorded in the same place*Principal Dx first *Reflects the Dx most responsible for current

evaluation*Provisional Dx*Unspecified Dx; Other Specified Dx*Consider “The D’s”*Specifiers; subtypes; severity

*Example: DSM 5 Criteria

*Article Discussion

* What is a meta-analysis?* What are some symptoms of PTSD?* What is a “bona fide” treatment for PTSD?* What was the conclusion?* How do the results of such studies compare to

your clinical experiences working with clients?*Which have more impact on your clinical

estimation of client needs?*Or, if you have yet to work with clients, how do

you think your decisions will be affected by studies vs. professional experiences?

Half-Time

Please Return in 10 minutes…

*WHODAS 2.0

*World Health Organization Disability Assessment

Schedule, Version 2.0*Replaces the Global Assessment of Functioning (GAF) of previous versions*Generic assessment for health and disability*6 Domains of Functioning*12 and 36-item versions, covering previous month*Scoring: 0-100* 0=no disability *100= full disability

*Weighted towards physical abilities*Review Manual

*Global Assessment of

Functioning

*In use from DSM-III-TR through DSM IV-TR*100 point scale *Reflected overall occupational,

psychological, & social functioning *Did not consider physical limitations or

environmental problems*Subjective in nature – was useful for

tracking changes in patients level of functioning over time

GAF

*Intro & Examples:Mental Status Exam

*Appearance: *Posture, clothes, grooming, gait

*Behavior: *Mannerisms, gestures, expressions*Psychomotor activity (rate of movement)*E.g. Talking speed, fidgeting, repetitive

movements*Eye contact, ability to follow discussion,

compulsions*Attitude: *Cooperative, hostile, open, defensive,

apathetic*Secretive, evasive, disinterested, focused

Tx Team Exercise – “Observing”

*What mental status exam (MSE) information – Appearance, Behavior, Attitude – did you observe?

*Bonus Q: How do you feel about Paul’s absolute refusal to provide judicious self-disclosures (especially about family)?

*Summary

*Key info to remember: *Ethical & Legal considerations*DSM-5 Classification System

*Upcoming responsibilities: *TIP 59: Chapters 2&3* http://

store.samhsa.gov/product/TIP-59-Improving-Cultural-Competence/SMA15-4849

*STEP Notes Guidelines webpage:http://www.ncda.org/aws/NCDA/pt/sd/news_article/88604/_PARENT/layout_details_cc/false

*References

America Psychiatric Association. (2013). Diagnostic and statistical manual of mental

disorders (5th ed.). Washington, DC: Author.

Diamond, R. J. (2009). Instant psychopharmacology, 3rd ed. New York, NY: W.W. Norton

& Company.

Jongsma, A. E., Peterson, L.M., & Bruce, T.J. (2014). The complete adult psychotherapy

treatment planner (5th ed.). New York, NY: Wiley.

Morrison, J. (2014). DSM-5 made easy: The clinician’s guide to diagnosis. New York, NY:

The Guilford Press.

Preston, J., & Johnson, J. (2015). Clinical psychopharmacology made ridiculously simple

(8th ed.). Miami, FL: MedMaster, Inc.