20190526223732weekly_one x
Please read the attached document and provide a brief detailed response to each reviews. The response to each comment is provided in the attachment.
Re: Topic 4 DQ 1 (Obj. 4.3)
The process of assessing, diagnosing, and developing a treatment plan is important. By using a systematic pathway to follow in an order that lays out first the client’s appropriateness for treatment, their presenting problem, a thorough history, observable patterns of behavior or speech, and collecting collateral information is a methodical approach to determining a diagnosis and the appropriate treatment(s). Following the screening, if a client determined to be appropriate for treatment, it is necessary to inform the client of their rights through the process of informed consent. Then the biopsychosocial interview follows and is used to gather needed information to make an informed assessment. This interview should include, according to Sequences (n.d.), social history; family dynamics; mental health history; academic/intellectual history; medical history (slide 4), to name just a few of the important pieces of information to gather during the assessment. On determining a possible diagnosis, a process should also be implemented including using provisional and rule out diagnoses and if necessary, staffing the case with a colleague or a supervisor before making a final determination.
It is vital to include the client in the creation of the treatment plan in order to ensure buy-in from the client. If the goals are not their own but some creation of the therapist, where is their motivation to adhere and follow through? The therapist supports the client through this process by frequent monitoring of the objectives which must be measurable and have a built-in way of measuring progress or lack of progress. For example, administering a PHQ9 Depression Scale at the onset of treatment, and then re-administering the test at specific times throughout the treatment episode to determine any changes in reported symptomology.
Sequences. (n.d.). Retrieved from https://lc.gcumedia.com/mediaElements/gcu-sequence-application/v3.1/#/showcase/sequence/39/view
My response:
Good morning Victoria,
This student believes the most important step to effective treatment planning is involving your clients. Without their feedback, the treatment plan is useless. The treatment plan is the road map that a patient will follow on his or her journey through treatment. The documentation serves you and the client, not the other way around!
Re: Topic 4 DQ 1 (Obj. 4.3)
Study the “Case Formulation and the Diagnostic Process” media piece. Now, summarize the process of assessment, diagnosing, and treatment in your own words.
How does the therapist support the client for beneficial behaviors to progress towards treatment goals? To diagnosis is to identify a problem that becomes the focal point of counseling as intervention. The treatment plan draws out the path for the counseling process to take place. Assessing the issue is collecting data in a specific pattern to calculate distresses and questions that arise through out the process of treatment. What are some implications for not including the client in the creation of an effective treatment plan? In David’s case, he might need to go see his PCP and his deteriorating conditions might just be to his uncomfortable physical body. Then mental heath treatment plan is needed depending on what his doctor said. I would wait for those results and see what comes of it then maybe his treatment plan could be based off David’s physical healing. Then if his mental health does not change then we could work up a more in-depth treatment plan together. How does the therapist support the client for beneficial behaviors to progress towards treatment goals? Such measures could be administered frequently with a minimal burden on clients or clinicians. Additionally, using the same measure of treatment progress would allow clinicians to better gauge the effectiveness of treatment elements for each client in time to make changes before therapyprogresses too far in any particular direction (Hayes et. al. 2008).
Reference
: Hayes, S. A., Miller, N. A., Hope, D. A., Heimberg, R. G., & Juster, H. R. (2008). Assessing Client Progress Session by Session in the Treatment of Social Anxiety Disorder: The Social Anxiety Session Change Index. Cognitive and behavioral
practice, 15(2), 203–2011. doi:10.1016/j.cbpra.2007.02.010
My response:
Good morning Anakalia
Re: Topic 4 DQ 1 (Obj. 4.3)
When looking through the media piece, I loved that it stated that treatment begins the moment the client makes contact. It is not when there is a plan in action or when the first payment is made, it is when they decide to take that leap of faith and call or walk into the office to set up an appointment or ask preliminary questions. What does the screening, assessment, diagnosing and treatment journey look like?
Screening is ensuring that the client is in a place of openness and acceptance for treatment and can afford the services provided or as insurance that can cover their costs.
Assessment is the use of psychological tools, such as, tests that can give insight to what disorders and problems the client is currently facing. These assessments are not a diagnosis but are a gateway to diagnosing the problems at hand.
Consider rule outs, provisional, and determined diagnoses made using the DSM-5 (American Psychiatric Association, 2013). The DSM-V is an amazing resource for when diagnosing. The clinician is able to search out the disorders that the client could fit and narrow it down from that point until there is a more definite diagnosis.
Once a diagnosis or diagnoses has been established, it is time for treatment. The client could potentially have multiple problems so, working alongside the clinician and creating a list of the problems and figuring out which ones are the most threatening could be very beneficial in deciding on the best route for the restoration to begin.
If a clinician were not to include the client in their treatment plan, it could cause some hostility or a wall to be built. The client has come to the clinician for guidance, not for someone to tell them what to do as they see fit. The client needs their coping skills to be strengthened and renewed so that they can begin to process and cope on their own later down the road when other problems arise. The clinician’s main goal is to encourage the client, while giving them the necessary resources to succeed in the therapeutic journey.
Reference
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
My response:
Good morning Kristen
Re: Topic 4 DQ 1 (Obj. 4.3)
The assessment is an initial step to treatment. Counselors use this step to gather information about the client’s history and challenges that have brought them to seek help. Assessments can include interview style questions as well as standardized tests, or it can include observations (Hohenshil, & Getz). After this information is gathered, the professional will make a diagnosis that is based off the assessment data and resources such as the DSM. Tools like the DSM will help to evaluate what symptoms and diagnosis is accurate based on criteria met per disorder. Some individuals may find themself dealing with multiple disorders. These co-occurring disorders can be common, and as a clinician it is important to determine what disorder is primary and which is secondary. Treatment will treat the primary diagnosis first, and will be determined based on information from the assessment and diagnosis (DSM) (Hohenshil, & Getz). Treatment planning will assist in the client being able to manage their symptoms. Because treatment planning is so invasive to the client’s overall well-being of change, it is important to have them participate. When clients are not involved in their treatment they tend to have a lack of motivation, become resistant to change, and can become defiant toward professionals (Hohenshil, & Getz). Clients must have a sense of control and support; thus, making rapport and collaboration a key element to the therapeutic process. While clients must take some command in their treatment, counselors must hold firm to boundaries and remember that they are the clinician and the individual is the client. Crossing boundaries can be detrimental to treatment just like not having the client involved in treatment.
Hohenshil, T. & Getz, H. (n.d.) Chapter seventeen: Assessment Diagnosis and Treatment Planning in Counseling The Handbook of Counseling
My response:
Good morning Sydnee
DQ#2: How are treatment goals/objectives influenced by a therapist’s theory of choice? Cite two examples of how the counseling theory being utilized in therapy could dramatically alter treatment goals. Give an example or describe a reason that would prompt you to make a referral.
As a counselor one must know how to respond to various complex individual and family issues, behaviors and emotions. Having a theory of counseling and psychotherapy allows counselors to be effective I their jobs by being able to conceptualize a problem ad form a solution. As a counselor it is important that a counselor set expectations/goals with their clients. There are many different perceptions of what a counselor can do and what someone can expect from the experience of counseling. Just showing empathy for a client isn’t enough. (Lieberman & Lester, 2004) Empathy is only one component of successful counseling. Gaining insight does not always guarantee change. A therapist often knows what is best for the client, especially after assessment etc. Setting goals influenced by a therapist helps by setting realistic, obtainable goals. Often clients are not sure of what obtainable goals are.
Counseling theory being utilized in therapy could dramatically alter treatment goals simply because of the input. For example, Michalak, Klappheck, and Kosfelder (2004) sampled outpatients receiving CBT regarding motivation and found that patients with greater autonomy for treatment reported better outcomes. Another example is the motivation. As Frank and Frank’s (1991) classic definition suggests, counseling and psychotherapy involve mobilizing forces or energy within the client in the direction of healing or change. A reason that would prompt me to make a referral is if it is affecting the person as a whole with the possibility of harm. Religion or therapy approach is also another reason I would make a referral.
Reference:
Frank, J. D., & Frank, J. B. (1991). Persuasion and healing. New York: Basic Books.
Michalak, J., Klappheck, M. A., & Kosfelder, J. (2004). Personal goals of psychotherapy patients: The intensity and the “why” of goal motivated behavior and their implications for the therapeutic process. Psychotherapy Research, 14, 193-209
My response:
Good afternoon Kim,