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For this discussion, you will assume the role of a clinical or counseling psychologist and diagnose a hypothetical client. Begin by reviewing the PSY650 Week Two Case Studies document and select one of the clients to diagnose. You are working in an agency with a policy requiring that assessment and diagnosis be completed within 48 hours of an initial session with a client. You will compare assessment methods used by clinical and counseling psychologists, identify appropriate assessment techniques for your client, and consider additional information needed for accurate diagnosis. You should also explain which theoretical orientation you would adopt and how it would influence the assessment and diagnosis process. Using the DSM-5, propose a diagnosis for your client based on the case details. Moreover, analyze the ethical implications of making a diagnosis within the required timeframe and evaluate whether it is justifiable to do so primarily for third-party payment purposes.

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In the role of a clinical or counseling psychologist faced with a tight assessment timeline, selecting appropriate evaluation methods is crucial to ensure a comprehensive and ethical diagnosis. Typically, clinical psychologists rely heavily on structured interviews, psychological testing, and standardized assessment instruments, while counseling psychologists may focus more on client narratives, psychological inventories, and client history (American Psychological Association, 2010). For Charles, the client in the case study, employing a combination of assessment techniques is recommended to obtain a holistic understanding of his mental health status.

Standard assessment techniques would include clinical interviews—both structured and semi-structured—to explore Charles's presenting symptoms, history, and psychosocial context. Psychological assessments such as standardized questionnaires like the Beck Depression Inventory (BDI) or the Patient Health Questionnaire-9 (PHQ-9) can quantitatively measure depression severity, which might be relevant given Charles's reported feelings of sadness and agitation. Additionally, gathering client records (if available) and observational data during interviews can provide valuable insights into his behavioral patterns and emotional state.

Additional information critical to diagnosis includes details about Charles's history of mental health, previous treatments, substance use, support systems, and overall functioning at work and home. Specific questions to elicit this information might include: "Can you tell me about any previous experiences with mental health treatment?" "How have your symptoms affected your daily responsibilities?" "What coping strategies do you typically use when feeling overwhelmed?" "How is your relationship with your family and friends?" "Are there any substances you use regularly?" These questions enable a comprehensive assessment aligning with the diagnostic criteria outlined in DSM-5.

Choosing a theoretical orientation influences how assessment data is interpreted. For Charles, a cognitive-behavioral approach might focus on identifying negative thought patterns and behavioral responses contributing to his current distress. Alternatively, a psychodynamic orientation might explore unresolved conflicts and emotional dynamics stemming from his recent separation. Each orientation guides specific assessment strategies; cognitive-behavioral methods might prioritize self-report measures, while psychodynamic approaches could involve exploring past relationships and unconscious processes through clinical interview techniques.

Based on DSM-5 criteria, Charles's symptoms of intense sadness, agitation, irritability, and stress related to ongoing separation could suggest a Major Depressive Episode, especially if these symptoms persist most days for at least two weeks and impair daily functioning. His reported suicidal ideation warrants careful assessment of risk. Other possible diagnoses include Adjustment Disorder with depressed mood, given the recent significant life stressor, or an Anxiety Disorder if symptoms of excessive worry and agitation predominate.

The ethical considerations surrounding the 48-hour diagnosis policy are substantial. According to the APA’s Ethical Principles of Psychologists and Code of Conduct, psychologists should prioritize accurate, thorough assessments to ensure proper treatment (APA, 2010). Rushing to diagnose without sufficient data risks misdiagnosis, which can harm clients and compromise treatment effectiveness. In Charles’s case, given his complex presentation and recent significant stress, it might not be ethical to finalize a diagnosis within the strict 48-hour window if essential information is lacking. However, agencies may justify preliminary diagnoses for billing purposes if qualifications for specific criteria are clearly met and ongoing assessments are planned.

Balancing ethical responsibility with administrative constraints, it is justifiable to provide a provisional diagnosis to facilitate timely treatment and insurance reimbursement, provided the clinician communicates the preliminary nature of the diagnosis and schedules follow-up evaluations. Continuous monitoring and additional assessment are essential to refine the diagnosis over time, ensuring accuracy and ethical integrity. Ultimately, a thorough assessment prioritizes client well-being, and diagnostic decisions should never be solely driven by payment requirements but grounded in clinical evidence and ethical standards.

References

• American Psychological Association. (2010). Ethical Principles of Psychologists and Code of Conduct. Retrieved from https://www.apa.org/ethics/code
• Sommers-Flanagan, J., & Sommers-Flanagan, R. (2013). Clinical interviewing (5th ed.). John Wiley & Sons.
• Kielbasa, A. M., Pomerantz, A. M., Krohn, E. J., & Sullivan, B. F. (2004). How does clients' method of payment influence psychologists' diagnostic decisions? Ethics & Behavior, 14(2), 137-150. doi:10.1207/seb1402_6
• Pomerantz, A. M., & Segrist, D. J. (2006). The influence of payment method on psychologists' diagnostic decisions regarding minimally impaired clients. Ethics & Behavior, 16(3), 209-221. doi:10.1207/seb1603_5
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