Fluent Essays

Assignment: Conducting a Diagnostic Interview With a Mental Status Exam Please see attachments   Please view the video link- https://www.youtube.com/watch?v=RdmG739KFF8  mental status exam video, the DSM-5 Morrison, J. (2014). Diagnosis made easier: Principles and techniques for mental health clinicians (2nd ed.). New York, NY: Guilford Press  and an example of a diagnostic summary write-up and two required readings.  Video link of Carls Scenario: https://www.youtube.com/watch?v=RdmG739KFF8  the case example of F is example how it should be written  Diagnosis made easier: Principles and techniques for mental health clinicians (2nd ed.). New York, NY: Guilford Press  and an example of a diagnostic summary write-up and two required readings.    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. https://youtu.be/RdmG739KFF8 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. Watch the “Mental Status Examination” segment starting at 01:22:23. This is the case of Carl, which will be used for the Application. Submit a 2- to 3-page case presentation paper in which you complete both parts outlined below:     Part I: Diagnostic Summary and MSE Provide a diagnostic summary of the client, Carl. Within this summary include:  Watch the “Mental Status Examination” segment starting at 01:22:23. This is the case of Carl, which will be used for the Application. Identifying Data/Client demographics Chief complaint/Presenting Problem Present illness Past psychiatric illness Substance use history Past medical history Family history Mental Status Exam (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? Support Part II with citations/references. The DSM 5 and case study do not need to be cited.  Utilize the other course readings to support your response Morrison, J. (2014). Diagnosis made easier: Principles and techniques for mental health clinicians (2nd ed.). New York, NY: Guilford Press. Chapter 10, “Diagnosis and the Mental Status Exam” (pp. 119–126) Chapter 17, “Beyond Diagnosis: Compliance, Suicide, Violence” (pp. 271–280) ( I attached the book as a link)Also from James Morrison Diagnosis Made Easier: Principles and Techniques for Mental Health Clinicians, Second Edition The First Interview, Fourth Edition When Psychological Problems Mask Medical Disorders: A Guide for Psychotherapists For more information, see www.guilford.com/morrison 2 http://www.guilford.com/morrison DSM-5® Made Easy The Clinician’s Guide to Diagnosis James Morrison THE GUILFORD PRESS New York London 3 Epub Edition ISBN: 9781462515448; Kindle Edition ISBN: 9781462515455 © 2014 The Guilford Press A Division of Guilford Publications, Inc. 72 Spring Street, New York, NY 10012 www.guilford.com All rights reserved No part of this book may be reproduced, translated, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, microfilming, recording, or otherwise, without written permission from the publisher. Last digit is print number: 9 8 7 6 5 4 3 2 1 The author has checked with sources believed to be reliable in his effort to provide information that is complete and generally in accord with the standards of practice that are accepted at the time of publication. However, in view of the possibility of human error or changes in behavioral, mental health, or medical sciences, neither the author, nor the editor and publisher, nor any other party who has been involved in the preparation or publication of this work warrants that the information contained herein is in every respect accurate or complete, and they are not responsible for any errors or omissions or the results obtained from the use of such information. Readers are encouraged to confirm the information contained in this book with other sources. Library of Congress Cataloging-in-Publication Data Morrison, James R., author. DSM-5 made easy : the clinician’s guide to diagnosis / James Morrison. p.; cm. Includes bibliographical references and index. ISBN 978-1-4625-1442-7 (hardcover : alk. paper) I. Title. [DNLM: 1. Diagnostic and statistical manual of mental disorders. 5th ed 2. Mental Disorders— diagnosis—Case Reports. 3. Mental Disorders—classification—Case Reports. WM 141] RC469 616.89075—dc23 2014001109 DSM-5 is a registered trademark of the American Psychiatric Association. The APA has not participated in the preparation of this book. 4 http://www.guilford.com For Mary, still my sine qua non 5 About the Author James Morrison, MD, is Affiliate Professor of Psychiatry at Oregon Health and Science University in Portland. He has extensive experience in both the private and public sectors. With his acclaimed practical books—including, most recently, Diagnosis Made Easier, Second Edition, and The First Interview, Fourth Edition— Dr. Morrison has guided hundreds of thousands of mental health professionals and students through the complexities of clinical evaluation and diagnosis. HiA Tool for the Culturally Competent Assessment of Suicide: The Cultural Assessment of Risk for Suicide (CARS) Measure Joyce Chu, Rebecca Floyd, and Hy Diep Palo Alto University Seth Pardo Alliant International University Peter Goldblum Palo Alto University Bruce Bongar Palo Alto University and Stanford University School of Medicine Despite important differences in suicide presentation and risk among ethnic and sexual minority groups, cultural variations have typically been left out of systematic risk assessment paradigms. A new self-report instrument for the culturally competent assessment of suicide, the Cultural Assessment of Risk for Suicide (CARS) measure, was administered to a diverse sample of 950 adults from the general population. Exploratory factor analysis yielded a 39-item, 8-factor structure subsumed under and consistent with the Cultural Theory and Model of Suicide (Chu, Goldblum, Floyd, & Bongar, 2010), which characterizes the vast majority of cultural variation in suicide risk among ethnic and sexual minority groups. Psychometric properties showed that the CARS total and subscale scores demonstrated good internal consistency, convergent validity with scores on other suicide-related measures (the Suicide Ideation Scale, the Beck Depression Inventory suicide item, and the Beck Hopelessness Scale), and an ability to discriminate between participants with versus without history of suicide attempts. Regression analyses indicated that the CARS measure can be used with a general population, providing information predictive of suicidal behavior beyond that of minority status alone. Minorities, however, reported experiencing the CARS cultural risk factors to a greater extent than nonminorities, though effect sizes were small. Overall, results show that the CARS items are reliable, and the instrument identifies cultural suicide risk factors not previously attended to in suicide assessment. The CARS is the first to opera- tionalize a systematic model that accounts for cultural competency across multiple cultural identities in suicide risk assessment efforts. Keywords: culture, diversity, suicide, assessment, measurement Recently, investigators have illuminated a lack of systematic incorporation of cultural variation into standard suicide risk as- sessment practice (Chu, Goldblum, Floyd, & Bongar, 2010; Leach, 2006; Leong & Leach, 2008). Even though cultural literature has shown that suicide rates, expression, experience, risk factors, and protective factors vary across gender, ethnic, age, sexual orienta- tion, and other cultural groups (see Chu et al., 2010, for a review), standard risk assessment protocol does not systematically account for these differences. Without particular attention to cultural vari- ation in suicide risk expression, suicide risk may be underde- tected and managed improperly (e.g., Joe & Kaplan, 2001; Langhinrichsen-Rohling, Friend, & Powell, 2009; Morrison & Downey, 2000; Rockett, Samora, & Coben, 2006; WendlCASE 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 waJournal of Social Work Education, 50: 349-364, 2014 Copyright ® Council on Social Work Education ISSN: 1043-7797 print/2163-58II online DOI: 10.1080/10437797.2014.885272 ¡ J Routledge g ^ ^ Taylor & Francis Group Suicide Prevention in Social Work Education: How Prepared Are Social Work Students? Philip J, Osteen, Jodi M, Jacobson, and Tanya L. Sharpe The prevalence of suicide suggests social workers will encounter clients at risk for suicide, but research shows social workers receive little to no training on suicide and suicide prevention and feel unprepared to work effectively with clients at risk. Baseline results from a randomized intervention study of the Question, Persuade, and Refer suicide prevention gatekeeper training with 73 advanced masters of social work student interns show suicide knowledge was average, attitudes about suicide prevention were generally neutral, and use of suicide prevention practice skills was low. These results indicate an opportunity for enhancing student outcomes through training and inform social work edu- cation regarding necessary preparation for student interns and new graduates to identify and respond effectively to client suicide risk. Every 15.2 minutes, a person dies by suicide in the United States, making suicide the 11th lead- ing cause of death (Centers for Disease Control [CDC], 2008). Suicide does not discriminate; it affects persons of all ages, racial groups, religious beliefs, genders, and educational levels (CDC, 2008). Due to its prevalence in todays society, the U.S. Surgeon General David Satcher declared suicide to be a major risk to public health (U.S. Public Health Service, 1999), and in 2001, the U.S. Department of Health and Human Services (U.S. DHHS) noted suicide prevention train- ing, for social workers and other human service professionals, as a key strategic initiative in its national strategy for suicide prevention. The majority of persons who contemplate suicide seek help from a mental health professional within several months prior to their attempt (Goldsmith, Pellmar, Kleinman, & Bunney, 2002; Luoma, Martin, & Pearson, 2002), suggesting that when accurate assessment and appropriate intervention by a professional is provided, suicides can be prevented. Unfortunately, chronic risk factors and acute warning signs of suicide are often missed by mental health professionals, includ- ing but not limited to social workers, based, in part, on the fact that professionals rarely receive formal training and education on the assessment of and response to client suicide risk (Dickinson, Sumner, & Frederick, 1992; Feldman & Freedenthal, 2006; Jacobson, Osteen, Jones, & Berman, 2012; Jacobson, Ting, Sanders, & Harrington, 2004; Schmitz et a l , 2012). Despite this lack of preparation, the likelihood that social workers and other mental health professionals will come Accepted: November 2012 Philip J. Osteen is assistant professor, Jodi M. Jacobson is associate professor, and Tanya L. Shar