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Saturday, April 20, 2019

The Comprehensive Diagnostic Assessment and Evaluation


By: SOPHIA F. DZIEGIELEWSKI

Mental health practitioners must know how best to proceed with completing a comprehensive diagnostic assessment and evaluation. In mental health, all practitioners are expected to do so for all their clients.

For many professionals, the role of assessment leading to diagnosis in mental health counseling can be a complicated one; it can be particularly problematic for practitioners in solo practice who do not have access to collaborative teams or referral sources (Dziegielewski, 2013). Regardless of the practice setting, all mental health practitioners are being called on to be more knowledgeable and interactive and to utilize evidence-based diagnostic tests to support practice strategy (Dudley, 2014).

The role of the practitioner in linking the client to environmental considerations is an essential one. As well, all mental health practitioners need to be keenly aware of updates in diagnostic criteria and act as advocates for the client throughout the diagnostic assessment and intervention process.

Equipped with a basic knowledge of the use and misuse of the DSM-5 in the creation of a diagnostic impression, the mental health practitioner can more constructively participate in the consultation process. Knowledge of diagnostic impressions and criteria can assist the practitioner in enhancing the clients overall functioning level.

Because mental health practitioners often have regular and subsequent contacts with their clients, they can be essential in helping the interdisciplinary team to reexamine or reformulate previous diagnostic impressions and the relationship these original impressions can have on the clients future treatment potential.

As a team member, the mental health practitioner is aware of the environment and the importance of building and maintaining therapeutic rapport with the client. This makes the practitioners input in understanding the mental disorder an essential contribution to intervention effectiveness. The mental health practitioner remains in a key position to allay the clients and his or her familys fears and to elicit their help and support (Dziegielewski, 2013).

Moreover, coordinated care continues to increase the emphasis on behavior-based care with limited time frames for treatment (Dziegielewski, 2008, 2013). Use of the two supplemental chapters (21 and 22) of the DSM-5  is essential for documenting supportive information and conditions not attributable to a mental disorder.

These circumstances and conditions are not attributable to a mental disorder yet remain the focus of clinical treatment. Because they historically have not been considered reimbursable, some practitioners have avoided their use. Nevertheless, the current practice emphasis on brief time-limited treatment (Dziegielewski, 2008) makes understanding these conditions essential.

Information gathered must always extend beyond the client. Special consideration should be given to the needs of family, significant others, and the clients identified support system. Family members not uncommonly have limited information about mental health diagnosis and treatment. Information gathered from outside sources such as the Internet can be misleading and biased, and family members may feel uncomfortable telling health care professionals that they believe another mode of treatment might be better.

The well-informed practitioner can correct distortions and foster cooperation in the treatment plan (Dziegielewski, 2013). When practitioners are knowledgeable about different mental health conditions, they can better serve their clients and make the most appropriate treatment decisions and system linkages. With an updated knowledge of mental health diagnosis and subsequent intervention, they can help prepare, as well as educate, clients and family members about the responsible use and expectations for psychiatric care.

Professional schools that train mental health practitioners need to include course work on how to complete a comprehensive diagnostic assessment that focuses on identifying the principal diagnosis and any supportive information that can affect the diagnosis. Because practitioners are held accountable for their own practice actions, they must strive to achieve the highest standards of their profession (Reamer, 2009).

References

SOPHIA F. DZIEGIELEWSK, 2015, DSM-5TM in Action, by John Wiley & Sons, Inc.

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