Chapter 17-Teaching the Diagnosis and Treatment Planning Course

Question 1

What are reasons counselors do need diagnostic capacities?

Answer 1

1. Third-party payers
2. Diagnoses enable research on particular types of psychopathology
3. Means of communicating with other mental health professionals
4. May need for referral to different type of professional

Question 2

Describe TRADITIONAL MODELS OF TEACHING DIAGNOSIS AND TREATMENT PLANNING

Answer 2

1. Illness-and-cure tradition, clients are “diagnosed” with “mental disorder” and “treated” to “cure” their “illness.”
2. Traditional texts of abnormal psychology textbook and DSM
3. Objectivist Model

Question 3

Describe the structure of TRADITIONAL MODELS OF TEACHING DIAGNOSIS AND TREATMENT PLANNING

Answer 3

1. Memorize and then apply diagnostic categories

2. Established by “experts”

Question 4

Postmodern and constructivist philosophies propose at least two principles:

Answer 4

1. one related to language
2. other related to who makes meanings and how
   * Meanings are historically situated and constructed and reconstructed through the medium of language

Question 5

What terms does constructivist use replace the traditional term treatment planning the word diagnosis?

Answer 5

1. Collaborative counseling planning

2. Assessment

Question 6

As described previously, what are three postmodern concepts on about knowledge?

Answer 6

1. social constructionism
2. contextualism
3. deconstruction
   * * illustrate how meaning is represented rather than found

Question 7

What concepts are good to review before the diagnosis and treatment course?

Answer 7

Social constructionism, emphasizes two primary ideas:

(1) knowledge is constructed rather than discovered
(2) knowledge is constructed within, and therefore affected by, its social context
* * Knowledge cannot be separated from contexts: ethnicity, social class, gender, or time in history.

Question 8

Give 2 examples of questions of how positivist and constructivist questions about assessment differ.

Answer 8

1. “What are the facts?” Vs. What are the assumptions?”

2. “What are the answers?” Vs. “What are the questions, and how were they decided?”

Question 9

Three illustrations of positivist assessment in history:

Answer 9

1. Women incapable of serious intellectual endeavors, risked sterility if pursued higher education
2. Women victims of partner abuse diagnosed instead of addressing abuse
3. Perspective on eye contact

Question 10

Why teach the DSM at all?

Answer 10

1. Communicating among professionals
2. Way of organizing client behaviors.
3. When used flexibly, may provide clues to explore further
4. Identifying situations/life contexts that intersect with specific diagnoses
5. Clients have a name for what was once a nameless set of experiences

Question 11

What are goals of teaching diagnosis course with a postmodern perspective?

Answer 11

(1) to help students understand clients’ psychological distress from multiple perspectives and in collaboration with clients and their communities
(2) to help students work together with clients and their communities to build meaningful counseling plans

Question 12

How does constructivist version of the diagnosis course teach students to use the DSM?

Answer 12

1. Develop multi-axial diagnoses.

2. Emphasize how Axis 4 psychosocial stressors interact with the other Axes.

Question 13

How do counselor educators use CONSTRUCTIVISM TO TEACHING THE DIAGNOSTIC COURSE?

Answer 13

Use reflexive, inclusive, context-sensitive classroom strategies as well as challenging traditional notions of diagnosis and treatment planning.

Question 14

What are diverse materials that could be used in the diagnostic course?

Answer 14

1. Eriksen and Kress’s (2005) Beyond the DSM Story
2. Parker et al. (1995), in Deconstructing Psychopathology (existence of diagnostic categories actually creates diagnoses)

Question 15

How does a constructivist diagnosis course address so-called treatment plans?

Answer 15

1. Renamed collaborative counseling plans
2. Use traditional treatment planning book that addresses both concrete cognitive-behavioral and insight-oriented interventions AND narrative or solution-oriented interventions

Question 16

What activity assists students in owning the diagnostic course?

Answer 16

“Card-sort” activity

Students brainstorm list of needs and desires for the course

Question 17

What is another activity that can help students learn about diagnoses?

Answer 17

1. Invite friends/family members to class who have had a diagnosis
2. Develop questions that will help students better understand the visitors’ “disorders.”

Question 18

What are some challenges in having guest visitors?

Answer 18

1. Logistical-trying to schedule, have a backup plan for no shows
2. Ethical considerations of:
   A. Confidentiality
   B. Do no harm
   C. Not to use clients for our own personal benefit

Question 19

How can instructor mitigate ethical concerns for guest visitors?

Answer 19

1. Rely on mental health professionals for sound guest visitor referrals
2. Send ideas visitors about specific questions they might address
3. Inform visitors it is up to them what they share and how much
4. If they become uncomfortable, they may end presentation at any time

Question 20

How can role play be used in the diagnosis course?

Answer 20

1. Students role play a presenting problem with class members
2. The “counselor” can then tries to identify the DSM category
3. “counselors” develop a collaborative counseling plan with the “client.”

Question 21

Describe Dr. S. Weir Mitchell’s treatment of females as an historical illustration that can be shared in the diagnosis course.

Answer 21

1. Treatment of female neurasthenia patients (i.e., those with fatigue, loss of energy and memory, and feelings of inadequacy), 2. Involved overfeeding the women and depriving them of intellectual and social stimulation.

Question 22

Describe Dr. Isaac Baker Brown’s treatment of females as an historical illustration that can be shared in the diagnosis course.

Answer 22

1. Advocated and practiced clitoridectomy as a cure for female masturbation.
2. Women of upper class could not survive masturbation and would succumb to idiocy and eventually death if they practiced it.
3. Many of these women were considering divorce.

Question 23

How can debate help students in the diagnosis course?

Answer 23

1. Encourage multiple perspectives
2. Directs students who are more multiplistic or subjectivist (in between dualistic and constructivist to evaluate usefulness of particular methods in different situations.
3. Can reduce dualistic thinking.

Question 24

Define Deconstruction in terms of the diagnosis course.

Answer 24

Process of examining the foundations of meanings by exploring their context

Question 25

Deconstructive listening requires counselors to:

Answer 25

1. believe that people’s stories can have many possible meanings 2. The meaning the listener makes may not be what the speaker intended
2. Students need “not knowing” attitude to encourage discussion of multiple possible interpretations

Question 26

How can videos help in the diagnostic course?

Answer 26

1. Encourage metacognition by asking students to use Interpersonal Process Recall (Kagan, 1980) to discuss what they are thinking at various points in the video.
2. EX questions:
   “Why were you thinking that?” “Where does such thinking come from?” “What does such thinking tell you about yourself?”

Question 27

How can recordings of role-played counseling sessions help students in the diagnosis course?

Answer 27

1. Stopping the recording and quickly having students write down their thoughts helps them be more aware of automatic thoughts.
2. Helps get their own issues out in the open, reduces judgmentalism and automatic concrete or inherited beliefs