Diagnosis and Treatment Planning - Research Paper Example

Diagnosis and Treatment Planning In DSM-IV-TR, the classification of various disorders and illnesses uses a diagnostic system that has five levels. The levels are also known as axes. The five axes offer a complete diagnosis to the treatment provider which is crucial for an effective treatment planning. In axis I, clinical, developmental and learning disorders are dealt with. Disorders in axis I include: Panic Disorder, social phobia, Generalized Anxiety Disorder, posttraumatic stress disorder, Obsessive-Compulsive Disorder, and Specific Phobia. Axis II deals with mental retardation and personality disorders. Axis III on the other hand focuses on physical and/or medical disorders. Axis IV deals with the factors that contribute to or affect the present psychiatric disorder and treatment outcomes. Finally, axis V dwells on global assessment functioning in which mental health professionals use in the assessment of their patients progress (APA, 2000). This project will focus on bipolar disorder which is a disorder in axis I. My client who will fall under the bipolar disorder category will be a 55 year old adult with major depression disorder. Major depression disorder is a mental disorder that can seriously affect a person’s quality of life. It is a condition that is characterized by depressed mood that is long lasting or total lack of interest in participating in most activities. The disorder leads to a long period of hopelessness and gloom. There is an indication that substantial depression disorder is triggered by a stimulus or it may take place without a triggering event. Major depression disorder may lead to a chronic condition of a number of episodes of depression. There are a number of approaches that can be used in the diagnosis of significant depression disorder. The diagnosis of the disorder may take place when the patient has paid his/her family doctor a visit with concerns about changes in sleeping patterns or appetite, mood and similar symptoms. Family doctors are preferred to carry out the diagnosis to other medical doctors. The first approach in the diagnosis of serious depression disorder involves the constellation of symptoms of the disorder apart from the depressed mood. The doctor carries out an interview with the patient regarding the patient’s history on sleeping patterns, sex drive, appetite and mood patterns. After conducting this kind of interview, the doctor is then expected to carry out a physical examination on the patient to ensure that other possible causes of the disorder are ruled out. This should take place because certain disorders may have same symptoms as serious depression disorder such as cognitive dysfunction, various medical conditions such as stroke and other mental disorders. Some nasty life events such as bereavement of a loved one may pose symptoms that are similar to serious depression disorder therefore unless the symptoms are prolonged one is not supposed to be diagnosed. Apart from the approach of interviewing the patient, the doctor may also administer the patient with a brief screening questionnaire. This type of questionnaire is known as Beck Depression Inventory, and when the patient fills it, the doctor will be able to get a better picture of the patient’s symptoms. The main disadvantage of this kind of approach is that the patient may be shy to answer some of the questions touching his personal life hence the doctor will not be able to get a better picture of the symptoms affecting the whole process of diagnosis. The only advantage is that the patient is given his own time to answer the questions (Friedson, 1972).. Another approach that can be used in diagnosing major depression disorder is interviewing the family members of the patient. This is advantageous as the family members might be able to give the doctor information that the patient has not provided. The patient might have forgotten to give out the information, may have denied the information or may consider the information not relevant for the diagnosis process. This approach though is not sufficient as the family members may lack crucial information about the health of the patient. The best approach to be used in the diagnosis of major depression disorder in a 55 year old adult will be interviewing him and undertaking physical examination on his health. The approach of interviewing his family members can also be included as it will provide the whole process with sufficient information. This is based on the advantages of the approaches. The DSM-IV-TR is a format that has been designed for use in cross settings. In the case of an adult with considerable depression disorder professionals such as psychiatrists, psychologists, counselors and even social workers can use it in the diagnosis process apart from mental health workers. Use of DSM-IV-TR in diagnosis normally requires that the symptoms have been present for one month and above (APA, 2000). In diagnosing my client, a multi axial approach of DSM will be used as this will impact the mental health of the client. In using DSM-IV-TR multi axial approach in diagnosing my client, five dimensions will be assessed. The first dimension will be Axis I which will evaluate the clinical syndrome of the client such as depression. The second dimension will be Axis II which will focus on evaluating the personality disorders and developmental disorders of the client. Developmental disorder may include mental retardation while personal disorders may include antisocial disorders. The third dimension which is Axis III will dwell in evaluating my client’s physical conditions such as brain injury which takes part in the development and continuance of the disorder. The fourth dimension which is the Axis IV will evaluate how severe psychosocial stressors are on my client. Some of the stressors are the happenings in his daily life such as death of a loved one or starting a new job. The final dimension is Axis V which dwells on evaluation of present and past highest functioning level of my client. This final dimension will help me understand how the previous axes affect my client and what types of changes are expected. The use of DSM-IV-TR format in the diagnosis of my client has its own advantages and disadvantages. One of the disadvantages of utilizing DSM-IV-TR in diagnosis is that the counselor will feel uncomfortable. Promoting a mechanistic approach in assessing mental disorder is also another disadvantage of using DSM-IV. This mechanistic approach creates a false impression that the understanding of a mental disorder is more advanced. Another disadvantage of using DSM-IV-TR is that for those counselors who have limited clinical expertise, it will be difficult for them to interpret the DSM system. Development of a common language for the discussion of diagnoses is one of the advantages of using DSM-IV-TR format in diagnosis. This knowledge of diagnoses is tremendously famous among psychiatrists and counselors. Another advantage of DSM-IV-TR diagnosis is that it helps both the client and the psychiatrist or counselor with being accountable in every thing they do as health records will be kept and treatment plan will be developed (Friedson, 1972). Before developing a treatment plan for my client, I will need to establish the exact symptoms of my client during the diagnosis and assessment process. This is important as some of symptoms such as depression may be similar to some disorders and the treatment plan may end up not being effective. Another thing that I need to establish before developing a treatment plan for my client is the cause of the disorder. This is noteworthy because treatment of this kind of disorder may depend on what caused it. In the treatment plan for my client, I will incorporate psychotherapy as current research and diagnostic resources that counseling professionals use to develop a treatment plan that will effectively address my client’s symptoms. My choice of therapy is effective for this client because when combined with drug therapy for treating major depressions, the outcome is always excellent. The psychotherapy I will tend to use on my client is in three basic types that is cognitive-behavioral therapy, interpersonal therapy and couple/family therapy (Horwitz, 2002). The focus of therapy in my treatment plan will be to enable my client change his negative behavior and thoughts and embrace positive thoughts about life, and this will be through cognitive-behavioral therapy. The goal of my client in the treatment plan will be to change his negative perception about the cause of his major depression and the end of the treatment process. Specific intervention in the treatment plan that can used to help my client achieve his goal is full attendance of his therapy sessions. Another intervention that can be used for my client to achieve his goal is to encourage him to avoid lonely places which might increase the level of depression and rather spend most of his time social places with his loved ones (Horwitz, 2002). When diagnosing and formulating a treatment plan for my client, a number of social systems need to be considered. This is because the social systems might be the rude cause for the major depression disorder for my client. Among the social systems to be considered include work place, recreation place, home/marriage, church and may be hospital. Managed care companies, the health care system, school systems, the policies within my own agency, or other social, political, or economic systems might impact the diagnosis and treatment planning process with my client either in a positive or negative way. Managed Care Company and health care systems might offer positive impacts in a way that my client will receive the right diagnosis and might undergo sessions of psychotherapy in his treatment plan. Economic systems might have negative impacts on my client as the diagnosis process and treatment plan might be frightfully expensive for him to afford. On the other hand, policies within my agency may either be in favor of my client or not hence offering both positive and negative impacts for the diagnosis process. References American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders. 4th ed., text revision. Washington, DC: American Psychiatric Association. Friedson, E. (1972). Profession of Medicine: A Study of the Sociology of Applied Knowledge. New York: Dodd, Mead. Grob, G. N. and A. V. Horwitz. (2010. Diagnosis, Therapy, and Evidence: Conundrums in Modern American Medicine. Healy, D. (1997). The Antidepressant Era. Cambridge, MA: Harvard University Press. Hirshbein, L. D. (2009). American Melancholy. New Brunswick, NJ: Rutgers University Press. Horwitz, A. V. (2002). Creating Mental Illness. Chicago: University of Chicago Press. Read More