CSL 569

Psychopathology,
Diagnosis and
Treatment
JANE SIMMONS, PH.D.
COUNSELING HEALTH AND WELLNESS
Choose one Word to Describe….

• Where are you joining from

today?
• Which emoji describes your
current state of mind? (Right
click in answer box)
• First name of one favorite
person or furry friend
• Where would you rather be
tonight instead of this class?
• Something you are good at
or Something very few
people know about you
Introduction - Agenda 3

 Introductions
 Syllabus Review: Textbooks, Course Resources, Links,
Expectations, Assignments, Discussions
 Canvas (Re)Orientation: Modules
 Tevera

Department Of Counseling
Introductions 4

 Jane Simmons, Ph.D., LMHC.

 Assistant professor of Counseling at Barry U. since 2023
 Counselor Educator and Supervisor
 Licensed Mental Health Counselor (private practice since
2012)
 Qualified Supervisor MHC and MFT
 5

Who are we?

How do we work together?

Class Culture
and
What would you like to learn
Expectations and take away from this
course?

What are your thoughts about

Diagnosis?
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Posted on Canvas

Assignments
• Quizzes
• In class assignments
• Class Discussions
• Clinical Assessment of a Movie
Syllabus Character
• Professional Presentation

Attendance

Grades

Questions?
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 Course Information

Canvas
 Modules for each class section
 Class Lecture (Powerpoint)
 Video
 Required Readings
 Quiz
 Class Exercises
 Assessment Materials
 Intervention Materials
 Supporting Materials
 Additional Readings
 Links to additional materials
 Training Links
Class Learning Map 8

Interviewing Documentati
Assessment Diagnosis Treatment
Skills on
Clinical Interview Main diagnosis Case Case Notes
Mental Status Diagnostic Conceptualization Clinical reports
Exam criteria Treatment Plan
Assessment
Measures
Cultural
Formulation
9
Choosing the Right Diagnosis 1
0

 Categories for diagnoses:

 Principal diagnosis (meets all criteria for the disorder)
 Provisional diagnosis (BPS, Intake, missing information)
 Additional diagnosis (co-morbidity)
 Medical Problems
 Psychosocial and environmental problems (V, Z-Codes)
 International Classification of Diseases (ICD-10)
 1
How to Use the DSM-5-TR 1

DSM is a medical Dimensional Developmental Cultural

classification of approach to and lifespan Issues/Gender
disorders diagnosis considerations differences

Definition of a mental Elements of a diagnosis

disorder • Diagnostic criteria and
• Clinical significant descriptors
disturbance in • Disorder subtypes and
cognition, emotion or specifiers
or behavior
• Associated with
significant distress
or disability
 1
How to Use the DSM-5-TR 2

To use the DSM-5-TR, a mental health professional would:

 Complete a BPS and refer to the presenting problem
(symptoms, duration, frequency, intensity)
 Navigate to the relevant disorder section based on the
patient's presenting symptoms
 Carefully review the diagnostic criteria listed for that
disorder
 Determine if the patient meets the criteria for a diagnosis
by considering the severity and duration of symptoms,
while also ruling out other potential diagnoses through
differential diagnosis;
 All while utilizing their clinical judgment and considering
the patient's cultural context and individual circumstances
Differential Diagnosis of Psychotic 1
3
Disorders

 Create a safety hierarchy (least to most severe)

 Family history as a guide
 Consider:
 Physical disorders
 Somatic symptoms
 Substance use causes
 Mood disorders
 1
current appearance (bipolar, MDD – cycles)4
History may indicate something other than

Recent history beats ancient history

Differenti
Collateral information sometimes beats the
al client’s information

Signs and symptoms (observation, non-

Diagnosi verbals)

Be wary when evaluating crisis-generated

s of data (single episode, environment changes)

Pay attention to contradictions from the

Psychotic client

Objective findings beat subjective

Disorders judgement

Choose the simplest explanation

Refer to the more frequently encountered

diagnosis
Differential Diagnosis of Psychotic 1
5
Disorders

 Consider past behavior when trying to predict future

behavior (previous diagnoses, reports and records,
treatment outcomes and recommendations)
 More symptoms of a disorder increase its likelihood of the
correct diagnosis (Look at the criteria for number of
symptoms)
 Typical features of a disorder increase its likelihood of the
correct diagnosis
 Use the words undiagnosed, unspecified, or not otherwise
specified (NOS) whenever you cannot be sure of a
diagnosis
 Consider the possibility that the client should not be
diagnosed at all (personality, learned behaviors, choices…)
The Clusters 1
6
DSM-5-TR uses clusters to categorize Personality Disorders,
dividing them into three groups:

Cluster A (odd or eccentric) Includes Paranoid, Schizoid,

and Schizotypal personality disorders.
Cluster B (dramatic or erratic), Includes Antisocial,
Borderline, Histrionic, and Narcissistic personality
disorders.
Cluster C (anxious or fearful), Includes Avoidant,
Dependent, and Obsessive-Compulsive personality
disorders.

With each cluster containing several specific personality

disorders with shared characteristics
Multiple Diagnoses (Co-morbidity) 1
7

 “The disturbance is not attributable to the physiological

effects of a substance or another medical condition and is
not better explained by another mental disorder.”
(Diagnostic Criteria)
 Symptoms cannot be explained by a single disorder (ex.
ADHD, Social Anxiety, Bipolar Disorder, Generalized
Anxiety Disorder, Major Depressive Disorder often go
together)
 Avoid personality disorders when client is acutely ill with
a severe mental disorder
 When listing multiple diagnoses, list first as the most
urgent, treatable, or specific
 When possible, list chronologically