PSY 650 WEEK 2 DISCUSSION Reply to Timothy Morin post on Assessment and Diagnosis “Under the Gun”
Question
Details: Review several of your colleagues’ posts and respond to at least two of your peers who chose a different case. You are encouraged to post your required replies earlier in the week to promote more meaningful interactive discourse in this discussion.
In your responses, evaluate whether your peer took into account the ethical guidelines outlined in the APA’s Ethical Principles of Psychologist and Code of Conduct when he or she assessed and diagnosed the client. Suggest additional questions your peer might ask the client. Propose an alternative diagnosis that might arise from the additional questions you have suggested. (SEE TIM’S POST BELOW)
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Tim Morin
Assessment and Diagnosis “Under the Gun” (Case Study: Amanda)
Clinical and counseling psychologists are trained to provide counseling and psychotherapy services by obtaining information through various assessment methods such as interviews, behavioral observations, and testing. The use of tests within both fields can help reveal distinct aspects needed for clinicians to provide effective treatments for each client in areas of academic achievement, interests, values, cognitive ability, personality, and psychopathology (Carlson, 2013). Also, there are similar and dissimilar tests that clinical and counseling psychologists may utilize for particular clients. For example, clinicians may use the Minnesota Multiphasic Personality Inventory (MMPI), Wechsler IQ scales, Wide-Range Achievement Test, Thematic Apperception Test (TAT), Bender Visual-Motor Gestalt Test, Sentence Completion, and the Rorschach test (Carlson, 2013). In contrast to testing, a counseling psychologist may use the Inventory of Common Problems (ICP) test designed for college counseling centers, while a clinical psychologist may use the Symptom Checklist-90-R (SCL-90-R) in a clinical setting. Although there are various approaches to obtaining information and evaluating clients, each method is specifically selected for the client’s overall benefit of reaching their treatment goals.
Assessment Techniques
Amanda is a 16-year-old female of Hispanic descent, and she has been referred for treatment regarding issues with her body image. Amanda’s parents disclosed that they believe she has an eating disorder associated with negative habits of excessively working out and food intake restrictions. Amanda has reported symptoms of anxiety, trouble sleeping, and feelings of unworthiness but denies any compensatory behaviors (Moten, 2014).
In my evaluation of Amanda, the assessment techniques I would utilize are interviews, behavioral observation, and psychological testing. Interviews produce opportunities for information to be obtained and shared through open-ended questions, allowing rapport to be established and trust to be gained within the client-psychologist relationship. Behavioral observations help the psychologist recognize any abnormal behaviors that can assist with diagnosis and treatment plans. In this case, observing Amanda’s behaviors and appearance will provide some clarity on the situation regarding her body image. The psychological tests that can be utilized in Amanda’s case are the Beck Anxiety Inventory and the Beck Depression Inventory-II. Since Amanda presents symptoms of anxiety and feelings of unworthiness, the test assessments can help diagnose and determine the severity of the symptoms.
Additional Information
There is additional information that needs to be obtained to make a diagnosis in Amanda’s case. For example, Amanda’s parents have expressed that they believe she has an eating disorder due to food intake restrictions and excessive workouts, but Amanda denies any compensatory behaviors. The following questions can help clarify any problems, concerns, and presenting symptoms:
• Approximately how much do you weigh, and is that your normal body weight?
• How long ago did the weight loss begin?
• Can you illustrate your daily eating habits (i.e., food intake, diet, and restrictions)?
• How often do you exercise within a week, and can you describe a typical workout?
• Do you have any fears of gaining weight or becoming fat?
• Have you been diagnosed with a nutritional deficiency and do you take any oral dietary supplements?
• Do your eating and exercise habits affect your social, educational, or work activities?
• Do you believe you have a problem?
Theoretical Orientation
A theoretical orientation that can assist with Amanda’s case is the behavioral learning perspective. The behavioral theory assumes that behaviors are learned through interactions with the environment, and the individual can adopt new behaviors through conditioning techniques such as positive and negative reinforcements (Wonderlich et al., 2012). Amanda could potentially be exhibiting signs of an eating disorder on account of food intake restriction and excessive exercising. In a recent study, results disclosed that 80% of patients with anorexia nervosa engage in unhealthy exercise patterns as a means to control body weight (Bardone-Cone et al., 2016). A psychologist can use any obtained information to help condition Amanda to learn healthy eating habits, mindful physical activities, and strategies for positive self-images during the diagnostic process.
Proposed Diagnosis
Amanda may be exhibiting signs of anorexia nervosa or avoidant/restrictive food intake disorder based only on the information obtained. In order for Amanda to be diagnosed with anorexia nervosa, she must meet the following DSM-5 requirements: restriction of energy intake, leading to significantly low body weight in relation to her age, sex, physical health, and developmental orientation; an intense fear of becoming fat or gaining weight, or persistent behavior that interferes with weight gain; and a disturbance in the self-evaluation of body shape or weight, or there is a continued lack of recognition of the seriousness for the current low body weight (American Psychiatric Association, 2013). To be diagnosed with avoidant/restrictive food intake disorder, Amanda must meet the following DSM-5 requirements: an eating disturbance associated with a significant weight loss, dependence on nutritional supplements, notable nutritional deficiency, and recognizable psychosocial functioning interference. In conjunction, this disorder cannot be explained by a lack of available food, cannot occur exclusively during the course of anorexia nervosa, and the disorder is not attributable to a concurrent medical condition (American Psychiatric Association, 2013).
Ethical Perspective
Based on the amount of information I currently have on the client, it is not ethical to render a diagnosis within the required timeframe. Psychologists must base their recommendations on information that can sufficiently substantiate their findings (American Psychological Association, 2010, 9.01(a)). When there is inadequate information after the conduction of an examination, the psychologist must document the efforts they made, the results of their actions, clarify probable impacts of reliability and validity of opinions, and limit their conclusions and recommendations (American Psychological Association, 2010, (b)). These processes will allow the psychologist to re-evaluate the client to obtain the necessary information to make an informed diagnosis, provide recommendations, and ethically receive a third-party payment.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: American Psychiatric Publishing.
American Psychological Association. (2010). Standard 9: Assessment (Links to an external site.). Retrieved from http://www.apa.org/ethics/code/index.aspx?item=12
Bardone-Cone, A. M., Higgins, M. K., St. George, S. M., Rosenzweig, I., Schaefer, L. M., Fitzsimmons-Craft, E. E., Henning, T. M., & Preston, B. F. (2016). Behavioral and psychological aspects of exercise across stages of eating disorder recovery. Eating Disorders, 24(5), 424-439. https://doi-org.proxy-library.ashford.edu/10.1080/10640266.2016.1207452
Carlson, J. F. (2013). Clinical and counseling testing. In APA handbook of testing and assessment in psychology, Vol. 2: Testing and Assessment in clinical and counseling psychology. (pp. 3-17). Washington, DC: American Psychological Association. https://doi-org.proxy-library.ashford.edu/10.1037/14048-001
Moten, S. (2014). PSY650 week two case studies [PDF]. College of Health. University of Arizona Global Campus: San Diego, CA.
Wonderlich, S., Mitchell, J. E., Crosby, R. D., Myers, T. C., Kadlec, K., LaHaise, K., Swan, K. L., Dokken, J., Lange, M., Dinkel, J., Jorgensen, M., & Schander, L. (2012). Minimizing and treating chronicity in the eating disorders: A clinical overview. International Journal of Eating Disorders, 45(4), 467-475. https://doi-org.proxy-library.ashford.edu/10.1002/eat.20978
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