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COUN—640 FINAL EXAM. QUESTIONS AND ANSWERS.
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COUN—640 FINAL EXAM. QUESTIONS AND ANSWERS.
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COUN—640 FINAL EXAM. QUESTIONSAND ANSWERS
What eis ea ediagnosable ebehavior? e- eCorrect eAnswer e- ea. eP. e34: e"Every eDSM-5
ediagnosis eincludes ea erequirement ethat ethe eclient's eexperiences eof edistress, eimpaired
efunctioning, eor erisk eof eharm eare eclinically esignificant-meaning ethat ethey eare ehaving ea
esubstantial enegative eeffect eon ethe eperson's elife eor ethe elife eof eother epeople. eIn eaddition,
ethese eclinically esignificant esymptoms emust ebe eunusual efor etheir econtext..."
What eis enot ea ediagnosable ebehavior? e- eCorrect eAnswer e- ea. ePg. e35 eThese einclude
enormally eexpected, eculturally eappropriate, eand elife-phase e(developmentally)
eappropriate eor eexpectable eexperiences, eand ea efew eother etypes eof enondiagnosable
ebehavior.
b. e*Other enondiagnosable ebehavior: ebehavior ethat eis econsidered eby eNon eclinicians eto
ebe e"deviant.", econflicts ebetween ean eindividual eand esociety—such eas epolitical, ereligious,
eor esexual edeviations efrom esocietal enorms—unless ethese eare ethe eresult eof ea
ediagnosable emental edisorder.
Describe ethe epurpose eand elimits eof ethe ediagnostic esystem e- eCorrect eAnswer e- eP. e35 eTo
eassist eclinicians ein edescribing eclient econcerns ein eorder eto ecommunicate etheir eview eof
ethe eclient's eneeds. eDiagnosis eis ea edescriptive etool. eIt eprovides ean eagreed-upon
elanguage efor echaracterizing ea eclient's ebehavior, ethoughts, efeelings, eand eother easpects
eof edistress, eimpairment, eor erisk.
List ethe ereservations eof ecounselors eabout ediagnosis. e- eCorrect eAnswer e- eP. e37-40
eReservations eabout ediagnosis eare ebased eon ethe elimited escope eof eDSM eVTR, ethe
emisperception ethat esystem edetermines ethe etheoretical eor edisciplinary eapproach eof ethe
ecase econceptualization eand etreatment eplan, eand esocio-cultural ecautions.
b. eThe esocio-cultural econsiderations einclude epotential efor ediagnostic ebias e(routinely eover
ediagnose, eunderdiagnose, eor emisdiagnose especific edemographic egroups esuch
eethnicity, egender, eage, eor esocioeconomic estatus), epotential efor estigmatization eand
elabeling e(providing ea eclient ewith ea e"label" ethat eaffects ehow ethey ethemselves eand eothers
ethink eof ethem), eunder eresponsiveness eto esocial echange e(diagnosis eis etoo eunresponsive
eto esocial echange. eHowever, ethe eauthors eof ethe eDSM eattempt eto eaddress ethis ethrough
ethe erigor eof ethe erevision eprocess eused eto eupdate ethe esystem), eand eover
eresponsiveness eto epayment epressures econcern ethat erevisions, eadditions, eand
eexpansions eto ethe eDSM eclassification esystem esometimes emay eoccur efor ereasons eof
epayment epressure erather ethan eclinical eevidence eor ein eresponse eto eprofessional
eadvances.
What eare ethe emain eelements eof ea efully eprepared ediagnosis? e- eCorrect eAnswer e- eP. e42
eThe emain eelements eof ea efully eprepared ediagnosis eprovide ea eholistic edescription eof ethe
, eclient's epresentation eincluding e*Clinical eDisorder, eGeneral eMedical eConditions,
ePsychosocial eand eEnvironmental eProblems, eand eAssessment eof eFunctioning*. eThe
eClinical eDisorder eelement eincludes eall epast eand epresent ediagnoses efrom ethe eDSM
ethroughout ethe eclient's elifespan. eGeneral eMedical eConditions eincludes eany emedical eand
ephysical eproblems ethat emay ebe erelated eto ea eclient's eclinical edisorder(s). ePsychosocial
eand eEnvironment eProblems einclude eany esociocultural estressors ethat emay ealso ebe
eassociated ewith eclient's epresenting econcerns. eThe eAssessment eof eFunctioning eprovides
ea equalitative eassessment eof ethe eclient's elevel eof estress eregarding ethe epresenting
eproblems. eIn eaddition eto ethe eAssessment eof eFunctioning eis ea ePsychometric escale eused
eto eassess elevel eof efunctioning.
What edoes eit emean eto e"rule eout" ean ediagnosis? e- eCorrect eAnswer e- ePg. e70 eInitially,
ebased eon edimensions eour eclient eis enot eexperiencing. eThen erule eout ethe epresence eof
edisorders ewith erelatively eclear ebiological eetiologies eor ethose edue eto esubstance euse. eWe
eshould ealso ecarefully erule eout enormally eexpectable ereactions, ecultural einfluences, eand
eage-appropriate edevelopmental ebehaviors, eas ewell eas eother econditions ethat emight ebe
ecausing epsychological eproblems ebut eare enot ediagnosable emental edisorders.
What eis ea edifferential ediagnosis? e- eCorrect eAnswer e- ePg. e70 eDifferential ediagnosis
erefers eto edifferentiating eone ediagnosis efrom eother edisorders ethat ehave esome esimilar
epresenting echaracteristic. eOnce ewe ehave eidentified ethe elikely eclasses eof edisorders, ewe
ethen elook einside ethe erelevant eDSM-5 echapter eand euse eour eruling-out eprocess eand
edifferentiation eto emake ea ecloser edecision eabout ewhich especific edisorder, eif eany, ewithin
ethe ediagnostic eclass ebest ematches ethe eclient's eexact esymptoms.
How eshould eyou erecord ewhen ea eperson ehas emore ethan eone ediagnosis e- eCorrect eAnswer
e- eP. e71 eAll ediagnoses eshould ebe erecorded ewith ethe emost eprominent ediagnosis erecorded
efirst. eThe eprinciple eof eparsimony eshould ebe eapplied eby eusing ethe eleast enumber eof
ediagnoses eto erepresent ethe egreatest enumber eof esymptoms. eThe ediagnoses eshould ealso
ebe edescribed ein ea ehierarchal eorder eby ewriting eclinical edisorders ewritten efrom emost eto
eleast eprominent.
How eshould eyou erecord ea ediagnosis ethat eyou eare euncertain eabout? e- eCorrect eAnswer e-
eP. e71: eThere eare eseveral eoptions:
i. e1. eRecord eour ebest eestimated ediagnosis, efollowed eby ethe eindicator e"provisional
ediagnosis." eThis eindicates ethat ewe ehave ea ediagnosis ein emind ebut ebelieve ewe eneed
emore einformation eto emake ea edefinite edecision. e(ex. e298.8 eBrief ePsychotic eDisorder eWith
eMarked eStressors e(Provisional eDiagnosis)
ii. e2. eThe esecond eoption eis eto edefer erecording ea ediagnosis euntil ea elater etime. e(ex. e799.9
eDiagnosis eor eCondition eDeferred).
iii. e3. eThe ethird ecommon estrategy eis eto euse ethe ecategory e"unspecified." eThis eindicates
ewe ehave eenough eclient einformation eto enarrow edown ethe eclass eof ethe edisorder ewe
ebelieve ethe eperson eis eexperiencing ebut einsufficient edata eto emake ea especific ediagnosis
ebecause ethe eclient's epresentation edoes enot emeet ethe ecriteria efor eany eof ethe eexact
ediagnoses ewithin ethe eclasses eof ediagnoses. e(ex. e301.9 eUnspecified ePersonality
eDisorder.
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