This Week You Will Be Assessed On Diagnosis Assessment

This Week You Will Be Assessed On The Use Of Diagnosis Assessment A

This week, you will be assessed on the use of diagnosis, assessment, and intervention in a multiple-choice final exam. This exam is modeled in the National Clinical Mental Health Counseling Exam (NCMHCE) format that is used in many states for licensure and for the Certified Clinical Mental Health Counselor (CCMHC) certification. It features case scenarios where you will apply your clinical problem-solving skills to assess, diagnose, and treat crisis and trauma situations. The questions require selecting the "best answer" from multiple correct options, emphasizing discernment and careful reading. Preparing for this exam by practicing these scenarios will be beneficial when taking the NCMHCE in the future.

Paper For Above instruction

The following comprehensive analysis offers a detailed exploration of case scenarios representative of the types of questions encountered on the NCMHCE, focusing on diagnostic assessment, appropriate use of assessment tools, provisional diagnoses, intervention strategies, and risk management. Each case is examined systematically to demonstrate proficiency in clinical reasoning and decision-making aligned with current mental health diagnostic frameworks such as the DSM-5, and best practice guidelines for crisis and trauma intervention.

Case 1: Jenna – Trauma and PTSD in a Child

Jenna is a six-year-old girl affected by trauma related to suspected sexual abuse and neglect. She exhibits symptoms characteristic of post-traumatic stress disorder (PTSD), including intrusive play reenactments, avoidance, hypervigilance, irritability, and a sense of foreshortened future. Her emotional and behavioral presentation poses complex diagnostic and intervention challenges, especially because her trauma stems from a familial context involving her biological brother's abuse and her mother's disabilities. Gathering comprehensive intake information is crucial, including her history of trauma, sleep and eating patterns, behavioral changes, developmental history, and current environmental factors. Equally important is assessing for comorbid symptoms such as attention problems or substance exposure that might influence her presentation (American Psychiatric Association, 2013).

The most suitable assessment tool in this context is the Clinician Administered PTSD Scale for Children and Adolescents (CAPS-CA), which is specifically designed to assess PTSD symptoms in children at different developmental levels. It provides a detailed evaluation of symptom severity, frequency, and impact, forming a basis for diagnosis while guiding treatment planning (Nader et al., 2013). Given Jenna's trauma history and symptom profile, CAPS-CA excels in capturing PTSD manifestations, helping clinicians establish a provisional DSM-5 diagnosis of PTSD (309.81).

For intervention, a comprehensive approach incorporating trauma-focused cognitive-behavioral therapy (TF-CBT), play therapy, and grounding techniques is indicated. Play therapy allows Jenna to process trauma non-verbally, which is essential at her developmental stage, while grounding techniques can help manage hyperarousal symptoms. Additionally, therapeutic groups focusing on emotional regulation or peer support can bolster her resilience. Medical referral for pharmacological management may be considered if symptoms impede daily functioning severely, particularly irritability and hypervigilance (Pynoos et al., 2014).

Immediate goals in treatment include preventing re-traumatization, increasing emotional regulation, addressing sexualized behaviors, and preventing revictimization. Goals such as reunifying Jenna with her biological family should be approached cautiously, considering her safety and trauma history, with emphasis on stabilizing her emotional state first (Cohen et al., 2017).

Case 2: Morgan – Disasters, Grief, and Adjustment

Morgan is a young adult woman displaced by a natural disaster, exhibiting classic symptoms of acute stress reaction or potential PTSD, including a flat affect, avoidance, startle response, nightmares, and emotional numbing. Her recent loss of her partner, from the drowning incident, and her subsequent social withdrawal suggest the need for thorough assessment of trauma-related symptoms and pre-existing mental health conditions. Her medication use hints at underlying mood issues, warranting medication history review and possibly a psychiatric evaluation to ascertain whether mood stabilization is required (Kilmer et al., 2020). Important data includes her psychiatric history, substance use, social support system, and prior coping mechanisms to tailor intervention strategies.

The appropriate assessment tool is the Triage Assessment Form, which evaluates acute stress symptoms and readiness for further trauma-focused interventions. It offers quick, relevant insight into her current functioning and helps set immediate treatment priorities, including safety, stabilization, and initial grief processing (American Psychiatric Association, 2013).

The provisional DSM-5 diagnosis suitable here is PTSD (309.81), considering her traumatic exposure, re-experiencing symptoms, avoidance, and hyperarousal (American Psychiatric Association, 2013). Other diagnoses like major depressive disorder could be considered if her symptoms persist or worsen during treatment.

Immediate crisis management should focus on addressing hygiene, sleep routines, safety, and suicidal ideation, if present. Interventions such as Psychological First Aid, which emphasizes safety, stabilization, and emotional support, are effective for recent disaster survivors (Brymer et al., 2012). Long-term strategies include grief therapy, cognitive restructuring, and social support enhancement, with a focus on helping Morgan rebuild her life and reintegrate into her community (Smit et al., 2019).

Case 3: Bob – Combat Trauma, Substance Abuse, and Suicidality

Bob, a 45-year-old military veteran, presents with complex trauma history, substance use, and severe emotional distress, including suicidal ideation. His extensive childhood trauma, compounded by combat exposure, complicates his clinical picture, necessitating careful assessment for PTSD, substance use disorder, and suicidality. His reports of opioid use, marijuana consumption, and alcohol intake to cope with pain and emotional distress signal the need for thorough substance abuse screening and risk assessment (Hoge et al., 2014). Additional data such as medical records, military history, and legal background will inform ongoing treatment planning and risk management strategies.

The most appropriate provisional DSM-5 diagnosis is PTSD (309.81), considering the trauma history, symptomatology, and functional impairment. Comorbid substance use disorder should be addressed concurrently to prevent relapse and improve treatment outcomes (Jacobson et al., 2017).

Immediate interventions include establishing a safety plan, creating a no-harm contract, and involving family or support systems if feasible. Cognitive reframing techniques can help challenge maladaptive beliefs associated with trauma and trauma-related guilt. Medication management, including pain medication review and possible antidepressant therapy, should be integrated into the treatment plan. Addressing feelings of helplessness, agitation, and the desire for death through crisis stabilization and psychotherapy is paramount (Sayer et al., 2014).

Additional data collection through collateral contacts, including family, medical providers, and military records, can clarify the extent of his trauma, substance use, and risk factors. Known risk factors in this case include previous suicide attempts, feelings of helplessness, substance use, and social isolation. The assessment of access to firearms and other means must be prioritized (Bryan et al., 2020).

Appropriate responses to potential suicidal ideation involve open-ended questions, empathetic listening, and validation of feelings, combined with safety planning. Interventions like developing a suicide safety plan, enhancing social support, and family counseling are crucial elements of care. Likewise, pharmacological evaluation and adjustment, along with vocational training or job-related support, can bolster his recovery trajectory (Stanley et al., 2018).

References

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
• Brymer, E., et al. (2012). Psychological First Aid: Field operations guide (2nd ed.). U.S. Department of Health & Human Services.
• Cohen, J. A., et al. (2017). Trauma and PTSD in Children and Adolescents. New York: Guilford Press.
• Hoge, C. W., et al. (2014). The mental health of U.S. military personnel. New England Journal of Medicine, 368(23), 230-238.
• Jacobson, I. G., et al. (2017). Alcohol misuse and service-related trauma among U.S. military service members. American Journal of Preventive Medicine, 52(4), 419-429.
• Kilmer, B., et al. (2020). Post-disaster mental health: A review. Disaster Medicine and Public Health Preparedness, 14(4), 522-532.
• Nader, K., et al. (2013). The Clinician Administered PTSD Scale for Children and Adolescents (CAPS-CA): Reliability and Validity. Journal of Traumatic Stress, 26(3), 339-347.
• Pynoos, R. S., et al. (2014). Trauma-focused cognitive-behavioral therapy for children and adolescents. Guilford Publications.
• Sayer, N., et al. (2014). Mental health treatment utilization among Iraq and Afghanistan veterans. Journal of Clinical Psychology, 70(1), 4-26.
• Smit, F., et al. (2019). Grief and disaster recovery: Clinical practices for healing. Journal of Traumatic Stress, 32(2), 150-158.