What diagnosis would you give Charles?

For this discussion, you will assume the role of a clinical or counseling psychologist and diagnose a hypothetical client. Begin by reviewing the PSY650 Week Two Case Studies document and select one of the clients to diagnose. I WILL PLAY THE ROLE OF A CLINICAL PSYCHOLOGIST (The Case of Charles) CHOSEN CASE Charles is a 33-year-old African-American male seeking treatment due to suicidal ideation. He is currently going through divorce proceedings and reports feeling agitated, angry, sad, and stressed most days. He is concerned that his relationship issues have begun to impact his responsibilities at work and fears losing his job. Charles is open to seeking treatment, but his insurance provider is out-of-network. His insurance company is willing to reimburse him for up to 8 sessions if an acceptable diagnosis is submitted. What diagnosis would you give Charles? In your initial post, compare the assessments typically used by clinical and counseling psychologists, and explain which assessment techniques (e.g., tests, surveys, interviews, client records, observational data) you might use to aid in your diagnosis of your selected client. Describe any additional information you would need to help formulate your diagnosis, and propose specific questions you might ask the client in order to obtain this information from him or her. Identify which theoretical orientation you would use with this client and explain how this orientation might influence the assessment and/or diagnostic process. Using the DSM-5 manual, propose a diagnosis for the client in the chosen case study. Analyze the case and your agency’s required timeline for diagnosing from an ethical perspective. Considering the amount of information you currently have for your client, explain whether or not it is ethical to render a diagnosis within the required timeframe. Evaluate the case and describe whether or not it is justifiable in this situation to render a diagnosis in order to obtain a third party payment.

ANSWER

As a clinical psychologist, I would approach the case of Charles, a 33-year-old African-American male presenting with suicidal ideation and significant distress due to his divorce and work-related concerns, with a thorough assessment and diagnosis. Based on the information provided, here is my analysis and proposed course of action:

**Diagnosis:**
I would consider diagnosing Charles with **Major Depressive Disorder (MDD)** based on the following criteria from the DSM-5:
– Presence of five or more of the following symptoms during the same 2-week period: depressed mood most of the day, nearly every day; diminished interest or pleasure in all, or almost all, activities; significant weight loss or gain; insomnia or hypersomnia; psychomotor agitation or retardation; fatigue or loss of energy; feelings of worthlessness or excessive guilt; diminished ability to think or concentrate; recurrent thoughts of death, suicidal ideation, or a suicide attempt.
– Symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

**Assessment Techniques:**
To aid in my diagnosis of Charles, I would use a combination of assessment techniques commonly employed by clinical and counseling psychologists:
1. **Clinical Interviews**: I would conduct a thorough clinical interview with Charles to gather information about his symptoms, history, and current life stressors. Specific questions would focus on the duration, intensity, and impact of his depressive symptoms and suicidal ideation.

2. **Self-Report Measures**: I would administer validated self-report scales such as the Beck Depression Inventory (BDI) to assess the severity of his depressive symptoms and the Columbia-Suicide Severity Rating Scale (C-SSRS) to assess suicidal ideation and behaviors.

3. **Observational Data**: If possible, I would gather observational data to assess Charles’s behavior, affect, and psychomotor agitation or retardation.

4. **Client Records**: With Charles’s consent, I would review any relevant client records, including medical history, previous treatment, and information from the divorce proceedings.

**Additional Information Needed:**
To formulate a comprehensive diagnosis and treatment plan, I would need more information on Charles’s:
– Family history of mental health issues.
– Previous treatment history, if any.
– Current stressors and coping mechanisms.
– Social support system and relationships.
– History of substance abuse or other comorbid conditions.

**Theoretical Orientation:**
I would adopt a cognitive-behavioral theoretical orientation with Charles. This approach would involve identifying and challenging negative thought patterns contributing to his depression and suicidal ideation. Cognitive-behavioral therapy (CBT) is evidence-based and effective for addressing depression and suicidality.

**Ethical Perspective:**
From an ethical standpoint, it is crucial to consider the agency’s required timeline for diagnosing and the potential implications of providing a diagnosis within that timeframe. While the agency’s timeline may be driven by administrative or reimbursement considerations, ethical practice prioritizes the welfare and accuracy of the client’s diagnosis.

**Justifiability of Diagnosis for Third-Party Payment:**
In this situation, it is justifiable to provide a provisional diagnosis for the purpose of obtaining third-party payment, as long as the diagnosis is based on a comprehensive assessment that includes clinical interviews, validated assessment tools, and consideration of relevant client history and context. However, it is essential to emphasize that the diagnosis is preliminary, and ongoing assessment and treatment planning will be necessary to refine and adjust the diagnosis as needed.

In summary, the case of Charles warrants a thorough assessment and provisional diagnosis of Major Depressive Disorder, which can facilitate access to treatment and reimbursement from his insurance provider. Ethical considerations should guide the diagnostic process, with a focus on the client’s well-being and the ongoing refinement of the diagnosis as more information becomes available through treatment.