Transcript Chapter 13 Assessment and Diagnosis

Chapter 13
Using Assessment in Counseling
Facts
Making a treatment decision is a form of
diagnosis
 Formal Diagnosis expected by:
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Employers
 Licensing boards
 Insurance companies
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Informal diagnosis
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Referral
Examples of Diagnosis
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Community counselor
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School Counselor
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When determine issue is developmental not
pathological equals a diagnosis
Recommend student be tested by
psychologist equals a diagnosis
Career Counselors
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Determines client is “vocationally immature”
equals a diagnosis
Instruments Designed to Provide Diagnosis
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Interview
Composite International Diagnostic Interview
Schedule: Authorized Core Version 1.0 (CIDI-Core)
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Assesses Axis I disorders and is approproate for those 18 and
older
Takes between ½ hour and 1½ to complete
Can be administered by clinicians or trained lay interviewers
Diagnositic Interview Schedule (DIS)
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Designed to diagnosis on all axes
Does not require clinical judgment
Must be administered exactly as given
Trainer must have participated in training program
Takes one hour to complete
Both of these instruments have good interrater reliability
Semi-Structured Interview
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Psychiatric Research Interview for Substance
and Mental Disorders (PRISM)
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Assesses Axis I disorders, borderline, antisocial
disorders
Trained clinicians
Amount of time varies with psychopathology
Structured Clinical Interviews for Axix I DSM-IV
Disorders (SCID-I)
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Assesses Axis I disorders
Only administered by clinicians
Takes about 1½ hours to administer
Good to excellent interrater reliability
Interviews for Children
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Diagnostic Interview for Children (DISCIV)
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Assesses Axis I disorders
Diagnostic Interview for Children and
Adolescents (DICA)
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Assesses wide range of child and
adolescent psychopathology
Both can be adminstered by clinician and
lay technician
Treatment Planning
Client Characteristics
Client demographics
 Functional impairment – work, love, play,
spirit
 Subjective distress – work, love, play, spirit
 Coping Style - strengths
 Resistance – blind spots
 Problem Complexity – theory
 Social Support – work, love, play, spirit
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Treatment Planning
Problems – Goals
1. What are the goals
2. How to recognize when accomplished
3. How to conceptualize getting there
4. Alternative conceptualizations
5. How to focus on all aspects
6. How to evaluate effectiveness