Fluent Essays

Before moving through diagnostic decision making, a social worker needs to conduct an interview that builds on a biopsychosocial assessment. New parts are added that clarify the timing, nature, and sequence of symptoms in the diagnostic interview. The Mental Status Exam (MSE) is a part of that process. The MSE is designed to systematically help diagnosticians recognize patterns or syndromes of a person’s cognitive functioning. It includes very particular, direct observations about affect and other signs of which the client might not be directly aware. When the diagnostic interview is complete, the diagnostician has far more detail about the fluctuations and history of symptoms the patient self-reports, along with the direct observations of the MSE. This combination greatly improves the chances of accurate diagnosis. Conducting the MSE and other special diagnostic elements in a structured but client-sensitive manner supports that goal. In this Assignment, you take on the role of a social worker conducting an MSE. To prepare: Watch the video describing an MSE. Then watch the Sommers-Flanagan (2014) “Mental Status Exam” video clip. Make sure to take notes on the nine domains of the interview. Review the Morrison (2014) reading on the elements of a diagnostic interview. Review the 9 Areas to evaluate for a Mental Status Exam and example diagnostic summary write-up provided in this Week’s resources. Review the case example of a diagnostic summary write-up provided in this Week’s resources. Write up a Diagnostic Summary including the Mental Status Exam for Carl based upon his interview with Dr. Sommers-Flanagan. Submit a 2- to 3-page case presentation paper in which you complete both parts outlined below:     Complete the following two parts of your Case Presentation: Part I: Diagnostic Summary and MSE Provide a diagnostic summary of the client, Carl. Within this summary include a paragraph on each of these topics with title for each paragraph. Identifying Data/Client demographics Chief complaint/Presenting Problem Present illness Past psychiatric illness Substance use history Past medical history Family history Mental Status Exam – in summary format following example provided rather than filling in template.  (Be professional and concise for all nine areas)  Appearance Behavior or psychomotor activity Attitudes toward the interviewer or examiner Affect and mood Speech and thought Perceptual disturbances Orientation and consciousness Memory and intelligence Reliability, judgment, and insight Part II: Analysis of MSE After completing Part I of the Assignment, provide an analysis and demonstrate critical thought (supported by references) in your response to the following: Identify any areas in your MSE that require follow-up data collection. Explain how using the cross-cutting measure would add to the information gathered. Do Carl’s answers add to your ability to diagnose him in any specific way? Why or why not? Would you discuss a possible diagnosis with Carl at this point in time? Why? Thoroughly support your explanations and analyses with concepts, theories, models, research findings, and frameworks from the assigned text and learning resources for this week. Document and cite your references following APA guidelines.   Your paper should be at least two to three pages in length in addition to a cover page and a reference page.To prepare: · Review the 9 Areas to evaluate for a Mental Status Exam and example diagnostic summary write-up provided in this Week’s resources. · Review the case example of a diagnostic summary write-up provided in this Week’s resources. · Write up a Diagnostic Summary including the Mental Status Exam for Carl based upon his interview with Dr. Sommers-Flanagan. Watch the video describing an MSE. https://youtu.be/RdmG739KFF8 Then watch the Sommers-Flanagan (2014) “Mental Status Exam” video clip. Make sure to take notes on the nine domains of the interview. https://waldenu.kanopy.com/video/clinical-interviewing-intake-assessment-ther · Watch the “Suicide Assessment Interview” segment starting at 01:44:37. This is the interview with Tommi, which will be used for the Discussion. · Watch the “Mental Status Examination” segment starting at 01:22:23. This is the case of Carl, which will be used for the Application. Review the Morrison (2014) reading on the elements of a diagnostic interview. · Chapter 10, “Diagnosis and the Mental Status Exam” (pp. 119–126) · Chapter 17, “Beyond Diagnosis: Compliance, Suicide, Violence” (pp. 271–280) https://bookshelf.vitalsource.com/home/subscribe/devaka_smith\%40yahoo.comDIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS F I F T H E D I T I O N DSM-5TM American Psychiatric Association Officers 2012-2013 P residen t D ilip V. J este, M.D. P resid en t-Elect J effrey A. Lieberm a n , M.D. Tr ea su rer Da v id F a ssler, M.D. Secreta ry R cxser Peele, M.D. Assembly Spea k er R. Sc o tt B en so n , M.D. S peaker-Elect M elin da L. Yo u n g , M.D. Board o f Trustees Jeffrey A ka ka, M .D. C aro l A. B ern stein, M.D. B rL·̂ ̂C ro w ley, M.D. An ita S. Everett, M.D. J effrey G eller, M .D., M .P.H . M ^ c D a v id G ra ff, M.D. J ^ e&A. G i^ eneVM.D. Ju d ith F. Ka sh ta n , M.D. M o lly K. M c Vo y, M .D. J a m es E. N in in g er, M.D. Jo h n M. O ldh a m , M .D. A lan F. Sc h a tzberg , M.D. A lik s . W id g e, M .D., P h .D. E r ik R. V an d erlip, M .D ., M em ber-in-T raining Tr u stee-E lect DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS7 F I F T H E D I T I O N DSM-5TM New School Library /«44 Amcriccin O svch iatric ADivi«ono(AmCT»MlVhijtiKAMod<tk>n W ashin g ton , DC Lon d on , E n gland Copyright © 2013 American Psychiatric Association DSM and DSM-5 are trademarks of the American Psychiatric Association. Use of these terms is prohibited without permission of the American Psychiatric Association. ALL RIGHTS RESERVED. Unless authorized in writing by the APA, no part of this book may be reproduced or used in a manner inconsistent with the APAs copyright. This prohibition apphes to unauthorized uses or reproductions in any form, including electronic applications. Correspondence regarding copyright permissions should be directed to DSM Permissions, American Psychiatric Publishing, 1000 Wilson Boulevard, Suite 1825, Arlington, VA 22209­ 3901. Manufactured in the United States of America on acid-free paper. ISBN 978-0-89042-554-1 (Hardcover) ISBN 978-0-89042-555-8 (Paperback) American Psychiatric Association 1000 Wilson Boulevard Arlington, VA 22209-3901 www.psych.org The correct citation for this book is American Psychiatric Association: Diagnostic and Statisti­ cal Manual of Mental Disorders, Fifth Edition. Arlington, VA, American Psychiatric Associa­ tion, 2013. Library of Congress Cataloging-in-Publication Data Diagnostic and statistical manual of mental disorders : DSM-5. — 5th ed. p. ; cm. DSM-5 DSM-V Includes index. ISBN 978-0-89042-554-1 (hardcover : alk. paper) — ISBN 978-0-89042-555-8 (pbk. : alk. paper) I. American Psychiatric Association. II. American Psychiatric Association. DSM-5 Task Force, m. Title: DSM-5. IV. Title: DSM-V. [DNLM: 1. Diagnostic and statistical manual of mental disorders. 5th ed. 2. Mental Disorders— classification. 3. Mental Disorders—diagnosis. WM 15] RC455.2.C4 616.89Ό75—dc23 2013011061 British Library Cataloguing in Publication Data ^ n A CIP record is available from the British Library. ^ Text Design—Tammy J. Cordova Manufacturing—Edwards Brothers Malloy ^ cH Contents DSM-5 Classification.....CASE PRESENTATION – F   INTAKE DATE: May 2014   IDENTIFYING/DEMOGRAPHIC DATA:      This is a voluntary admission for this 32 year old Black male. This is F’s first psychiatric hospitalization. F has been married for 13 years and has been separated from his wife for the past three months. He has currently been with his sister. His family residence is in Miami, Fl., where his wife, two daughters and son reside. F has had a 12th grade education plus education to complete an LPN program. In the past, F worked for seven years as an LPN. For the past three years F has been employed at a local print shop. Religious affiliation is agnostic.   CHIEF COMPLAINT/PRESENTING PROBLEM:      I need to learn to deal with losing my wife and children.   HISTORY OF PRESENT ILLNESS:      This admission was precipitated by F’s increased depression with passive suicidal ideation in the past three months prior to admission. He identifies a major stressor of his wife and three children leaving him three months prior to admission. F has had a past history of alcohol binges and these binges are intensified when there is a need for coping mechanisms in times of stress. F was starting vacation from work just prior to admission and recognized that if he did not come to the hospital for treatment of depression and alcoholism, he would expect to have a serious alcohol binge. F reports that in the past three months since separating from his wife, he has experienced sad mood, fearfulness, and passive suicidal ideation. He denies specific suicidal plan. Wife reports that during these past three months prior to admission, F made a verbal suicidal threat.      F reports he has been increasingly withdrawn/non-communicative. His motivation has decreased and he finds himself sitting around and not interested in doing chores at home. He reports decreased concentration at work and increased distractibility. F has experienced increased irritability, decreased self esteem, and feelings of guilt/self blame. There is no change in appetite, but F reports an intentional weight loss of 20 pounds since 5 months ago with dieting. F states for many years he doesn’t sleep, having a past history of working double shifts when requested. F reports his normal sleep pattern for many years has been generally three hours of unbroken sleep. F reports past history of euphoria, although wife reports to intake worker observing periods when F’s mood is elevated, and then in the next few hours, F appears out of control with poor impulse control, increased arguing, temper tantrums and alleged shoving and pushing her and the children. He then feels tired and ends up sleeping more than his average pattern.  Wife reports he has not been violent with her since they have been separated.      F denies suicidal ideation at the present time while on the evaluation unit.        PAST PSYCHIATRIC HISTORY:      F was seen on an outpatient basis by Dr. S, for a period of two months prior to admission. He wa00:17 JOHN SOMMERS-FLANAGAN: Welcome to00:19 our clinical interviewing DVD. 00:21 In this video, we describe and demonstrate 00:25 a wide range of different clinical 00:27 interviewing responses. 00:29 Our goal is to help you further develop 00:33 your clinical interviewing repertoire. 00:37 The material in this DVD is based on our textbook, cleverly 00:42 titled clinical interviewing. 00:45 RITA SOMMERS-FLANAGAN: In our life as professors, 00:47 we really have come to believe in that old kindergarten 00:51 activity called show and tell. 00:53 So in this video, were obviously 00:55 going to be telling you about clinical interviewing skills, 00:59 but we also will be showing you video clips that 01:02 illustrate these. 01:03 And we really hope that together theyll 01:06 combine to help you become excellent clinical 01:10 interviewers. 01:12 JOHN SOMMERS-FLANAGAN: And we begin 01:13 with a focus on very basic interviewing and listening 01:17 skills, skills that everyone needs 01:21 to do a really good clinical interview. 01:24 These skills include attending behavior, 01:27 non-directive listening, directive listening, and action 01:32 responses, as well as the skill the use of questions. 01:36 Later, we move to demonstrating more complex assessment 01:40 interviews, including intake, mental status, and suicide 01:44 assessment interviewing. 01:47 RITA SOMMERS-FLANAGAN: You know, our overall goal in this DVD 01:51 is to help you become aware of how to do the skills 01:56 and when to do the skills. 01:58 Awareness isnt under-girding. 02:01 Thats very important in conducting 02:04 professional clinical interviews and in being a mental health 02:07 professional. 02:09 JOHN SOMMERS-FLANAGAN: You know, just a few years ago, Rita, 02:11 although I might be underestimating 02:13 that, we had a clinical supervisor who 02:16 used to always say, dont fly by the seat of your pants. 02:19 You need to know what youre doing and why youre doing it. 02:22 You need to know where youre going, basically. 02:25 And I think what he also was saying 02:27 is that as clinical interviewers, 02:29 we need to become more intentional. 02:32 And so thats another goal that we have for this video. 02:35 And that is we hope that it can move you in that direction 02:38 so you become a little bit more intentional in your clinical 02:41 interviewing activities. 02:52 In the next four parts of this interviewing DVD, 02:56 we focus on what we call the continuum 02:59 of listening responses, beginning with the less 03:03 directive, almost non-directive listening approaches 03:07 and extending to the more complex and directive 03:10 interviewing or even action skills. 03:13 RITA SOMMERS-FLANAGAN: I think its important 03:15 before we actually talk about the techniques 03:17 that we take a minute to think about a couple 03:21 of things that are across techniques in interviewing. 03:25 One is that because theres a power 03:29 differential in the relationship, 03:31 and we can ne