BOISE STATE UNIVERSITY

COUNSELING PROGRAM

COUN 550 – DIAGNOSIS, ASSESSMENT, AND TREATMENT PLANNING

FALL 2016

Course and Instructor

Course Number: COUN 550

Course Title:Diagnosis, Assessment, and Treatment Planning

Course Time:Thursday, 6:00-8:45 p.m.

Course Location:Edu 416

Semester: Fall 2016

Credits:3 credits

Instructor: Raissa Miller, PhD, LPC

Office E612

(208) 426-1307

Office Hours: Tuesday 1:00-3:00; Wednesday 9:00-12:00

Course Objectives and Accreditation
CACREP Standards Addressed in the Course
II. G. 3 / Human Growth and Development
g. / Theories and etiology of addictions and addictive behaviors, including strategies for … intervention, and treatment.

Course Description

[Graduate Course Catalog Description]

The course examines concepts of “mental disorders,” DSM classification systems, and the diagnostic benefits and diagnostic problems inherent in such systems. An introduction and overview of the major psychopathological syndromes of adolescent and adults (especially in the area of co-morbidity of substance abuse/dependence and other DSM diagnoses) to facilitate appropriate use of assessment-diagnostic-treatment links (including treatment planning). May be taken for COUN or MHLTHSCI credit, but not both. PREREQ: PREM/INST.

Methods of Instruction

Instructional methods will include lecture, case analysis, group discussion, written and oral feedback on learning exercises, and multi-media presentations (e.g., power-point, videos, etc.).

Successful implementation of these instructional methods relies on active student engagement inside and outside the classroom. Methods and evidence of active engagement include:

  • Reading and reflecting on assigned chapters and articles prior to class – including taking notes while reading.
  • Reviewing readings from DSM-5 with attention to bigger-picture themes and patterns.
  • Formulating questions or requests for feedback prior to class.
  • Completing optional practice exercises and review formative feedback.
  • Attending office hours as needed.
  • Engaging in self-directed learning (e.g., reading optional articles, exploring on-line resources, etc.)
  • Accessing the BSU Writing Center for assistance with writing style when needed.

Course Objectives

In this course students will have the opportunity to explore three overarching questions:

  1. How do counselors classify mental disorders?
  2. How do counselors assess for mental disorders?
  3. How do counselors organize treatment?

Assessment includes models and approaches to clinical evaluation such as screening and assessment, diagnostic interviews, mental status exams, inventories, and assessment tools, bio-psycho-social history, indications/contraindications for medication. Diagnosis includes the diagnostic process and use of the current DSM, co-occurring disorders, criteria for common disorders, and cultural issues in diagnosis. Diagnosis also includes emerging systems for conceptualizing mental health and un-health. Treatment planning includes the importance of family and social/community networks, evidence-based treatment strategies,and professional issues related to practice. Students will develop proficiency in being able to accurately communicate the symptoms and clinical presentation of clients with disorders through reliable use of the DSM-5 system of classification, the proper use of diagnostic terms, assessment tools in a comprehensive plan of treatment including referrals/coordination of treatment with other providers, support groups, etc.

Upon completion of this course, students will also exploretheories and etiology of addictions and addictive behaviors, including strategies for intervention, and treatment (II. G. 3.g).

Within each question, students will have the opportunity to develop related reasoning skills, comprehend complex issues and problems, and learn to collect and use evidence to solve problems. Course readings, learning exercises, lectures, and application practices were carefully selected to help you explore these questions and develop foundational assessment, diagnosis, and treatment planning skills.

Technology Skills Addressed in the Course
Instructor Application / Student Application
Utilize Blackboard technology / X / X
Word process, including APA formatting / X / X
Use a spreadsheet and a statistical package
Acquire graphics from the web, digital camera, scanner, or Microsoft media and insert them into a poster or presentation
Create and deliver a power point presentation / X
Find material on the Web and review Web sites / X / X
Be able to use e-mail, including document attachments / X / X
Be able to sign in and participate in listservs
Be familiar with computerized testing
Be able to use digital recording equipment / X
COURE READINGS

Course readings will provide students with important information that they can use to explore the major questions of the course and develop the essential clinical skills this course is intended to foster. Readings are intended to help students prepare for the intellectual challenges they will face in class and in completing learning exercises, as well as serve as resources for future clinical practice.

TEXTBOOKS

Necessary:

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders

(5thEd.).Washington, DC: Author. **You can purchase pre-made tabs at

American Psychological Association. (2009). Publication manual of the American Psychological

Association (6th ed.) Washington, DC: American Psychological Association.

Kress, V. E., & Paylo, M. J. (2015). Treating those with mental disorders: A comprehensive

approach to case conceptualization and treatment. Upper Saddle River, NJ: Pearson.

Suggested (many are available to you online through BSU library):

First, M. B. (2013). DSM-5 handbook of differential diagnosis. Washington, DC: American Psychiatric Association.

Jongsma, A. E., Peterson, L. M., & Bruce, T. J. (2014). The complete adult psychotherapy treatment planner. Hoboken, NJ: John Wiley and Sons, Inc.

Jongsma, A. E., Peterson, L. M., McInnis, W. P., & Bruce, T. J. (2014). The child psychotherapy treatment planner. Hoboken, NJ: John Wiley and Sons, Inc.

Seligman, L., & Reichenberg, L. W. (2014). Selecting effective treatments: A comprehensive systematic guide to treating mental disorders. Hoboken, NJ: Wiley

Sommers-Flanagan, J. & Sommers-Flanagan, R. (2013). Clinical Interviewing. Hoboken, NJ: Wiley

ARTICES

Balch, J. W., & Ray, D. C. (2015). Emotional assets of children with autism spectrum disorder: A sigle-case therapeutic outcome experiment. Journal of Counseling & Development, 93, 429-439.

Berg, K. C., Peterson, C. B., & Frazier, P. (2012). Assessment and diagnosis of eating disorders: A guide for professional counselors. Journal of Counseling & Development, 90, 262-269.

Eriksen, K., & Kress, V. E. (2008). Gender and diagnosis: Struggles and suggestions for counselors. Journal of Counseling & Development, 86, 152-162.

Jones, K. D. (2010). The unstructured clinical interview. Journal of Counseling & Development,

88, 220-226.

Kaut, K. P. (2011). Psychopharmacology and mental health practice: An important alliance.

Journal of Mental Health Counseling, 33(3), 196-222.

Kress, V. E., Hoffman, R. M., & Eriksen, K. (2010). Ethical dimensions of diagnosing:

Considerations for clinical mental health counselors. Counseling & Values, 55, 101-112.

Kress, V. E., Hoffman, R. M., Adamson, N., & Eriksen, K. (2013). Informed consent,

confidentiality, and diagnosing: Ethical guidelines for counselor practice. Journal of

Mental Health Counseling, 35(1), 15-28.

Kress, V. E., Kelly, B. L., & McCormick, L. J. (2004). Trichotillomania: Assessment, diagnosis, and treatment. Journal of Counseling & Development, 82, 185-190.

Kress, V. E., Stargell, N. A., Zoldan, C. A., & Paylo, M. J. (2016). Hoarding disorder: Diagnosis, assessment and treatment. Journal of Counseling & Development, 94, 83-90.

Milner, C. E., & Belicki, K. (2010). Assessment and treatment of insomnia in adults: A guide for clinicians. Journal of Counseling & Development, 88, 236-244.

Murray, T. L. (2011). The role of psychoharmacoloy in mental health: A response to Kaut

(2011). Journal of Mental Health Counseling, 33(4), 283-294.

Perry, B. D. (2007). Stress, trauma, and post-traumatic stress disorders in children. Retrieved from:

Polanski, P. J., & Hinkle, J. S. (2000). The mental status examination: Its use by professional

counselors. Journal of Counseling & Development, 78, 357-364.

Schottelkorb, A. A., & Ray, D. C. (2009). ADHD symptom reduction in elementary studnets: A signle-case effectiveness design. Professional School Counseling, 13, 11-22.

Seligman, L. (2004). Intake interviews and their role in diagnosis and treatment planning. In

Diagnosis and treatment planning in counseling (3rd ed.) (pp. 138-159). New York: Klewer.

Seligman, l. & Hardenbury, S. A. (2000). Assessment and treatment of paraphilias. Journal of Counseling & Development, 78, 107-113.

Wadsworth, J. S., & Harper, D. C. (2007). Adults with attention-deficit/hyperactivity disorder: Assessment and treatment strategies. Journal of Counseling & Development, 85, 101-108.

Additional On-line Resources

DSM-5 Official Webpage:

DSM-5 Resource Guide:

ACA Podcasts and Webinars:

DSM-5 Critical Perspective:

Albertson’s Library Video Resource:

Mental Health Medications:

Methods of Assessing Learning Progress

The objectives described in a prior section reflect promises of the course. The learning exercises detailed below reflect what students will be doing to realize these promises.

Attendance, participation, & professionalism: Detailed below under important policies.

Peer biopsychosocial history: [RM1]Conduct biopsychosocial and CFI interviews with a peer. Develop assessment and clinical writing skills by integrating information into a biopsychosocial history.

Assessment, Diagnosis, and Treatment Planning Basics[RM2]: Students will take a multiple-choice test based on information covered in readings, lectures, and Power Points.

Treatment planning practice: Write a basic treatment plan in response to presenting concerns identified in peer client through the biospychosocial history. Please focus on Z code concerns – do not “diagnose” specific mental disorders.

Midterm case studies: Complete two complex diagnostic cases and one evidence-based treatment plan.[RM3]

Final case study: Select a character from a book, television program, or film to serve as the basis for a comprehensive case study. The case study will include a biopsychosocial history, mental status report, DSM-5 diagnosis and justification, and treatment plan with expanded evidence-based justification. This learning exercise will serve as evidence of learning achieved in the course and inform students’ letter grades (100 point scale). [RM4]

*Note: Additional learning exercise details and rubrics will be provided in class.

Grading Scale

Grading is a way of communicating to students and to academic and professional communities the amount of learning students have achieved in the course. Students’ progress in learning will be informally assessed throughout the semester through learning exercises. Written and verbal feedback will be provided to guide students in their learning. Formal learning will be assessed in the final case study (as noted above) and through observation of professional characteristics and behaviors (including attendance, participation, and professionalism).

Letter Grade / Points
A+ / 97-100
A / 94-96
A- / 90-93
B+ / 87-89
B / 84-86
B- / 80-83
C+ / 77-79
C / 74-76
C- / 70-73
D+ / 67-69
D / 64-66
D- / 60-63
F / 59
Important Policies

Due Dates

Timely completion of readings and learning exercises demonstrates respect for peers and the instructor in the learning community and allows for adequate assessment of learning progress. If students are unable to adhere to due dates, reading schedules, and other deadlines, they should email the instructor to schedule a meeting. The instructor and student will discuss reasons for delays in completing readings and learning exercises and brainstorm solutions for moving forward.

Attendance, Participation, & Professionalism

It is students’ decisions to obtain a master’s degree in counseling and COUN 550 is part of that decision. Once students make the choice to enroll in COUN 550, they take on responsibilities to everyone in the learning community and to future clients. Students are expected to demonstrate personal characteristics consistent with the characteristics of professional counselors, engage in ethical behavior as defined in the American Counseling Association Code of Ethics, and adhere to BSU’s Academic Integrity Policy. As professionals, students also are responsible for coming to class prepared to discuss readings, make productive contributions to class discussions/activities, and attend respectfully to others.

Missed classes, lack of participation, and lack of professionalism may result in a grade reduction, competency concern report, and/or request for other remediation per Counseling Program policies. The following chart serves as a guide regarding expectations for professional behavior and potential outcomes for those who do not meet these expectations. Note that one only meets professional expectations if ALL indicators are met. However, one need only have ONE area in which s/he is below expectations to necessitate remediation

Meets professional expectations / Below professional expectations / Significantly below expectations
  • 0 – 1 absences
  • Rarely tardy or late from break
  • Contributes more days than not
  • Contributions reflect routine, careful preparation for class
  • Timely completion of learning exercises
  • Attentive and respectful toward others when not contributing directly
  • No concerns regarding personal characteristics
  • Shows ethical integrity and adheres to ACA Code of Ethics
  • No concerns regarding academic integrity
/
  • 1-2 absences* (see below)
  • Frequent, minor tardiness
  • Rarely contributes to class
  • Contributions reflect occasional preparation for class
  • Periodic tardiness in completing learning exercises
  • Sometimes distracted or disrespectful nonverbally when not contributing directly (e.g., texting, surfing, sidebars)
  • Occasional or minor personal characteristic concerns
  • If ethical violation present, concern is minor and student takes action to remedy
  • Minor, uninformed violations of academic integrity
/
  • 2+ absences
  • Persistent, minor tardiness
  • Recurrent, major tardiness
  • Contributions are rare or not productive
  • Contributions reflect lack of preparation for class
  • Consistent tardiness in completing learning exercises
  • Behaviors detract from safe, scholarly learning environment
  • Serious concerns regarding personal characteristics
  • Major ethical violation OR inability to understand ethical concerns
  • Major, intentional violations of Academic Integrity Policy

Indicators show potential for continued success in graduate school and beyond. / Final grade adjustment of ½ - 1 letters, conference with instructor, and/or competency concern report filed with Counseling Program. / Final grade adjustment of 1-2 letters, conference with instructor, and/or competency concern filed with Counseling Program. Serious violations may require repeating course (e.g., 3+ absences), assignment of F in course (e.g., ethical or integrity concerns), or other remediation per competency concern report.

Format Guidelines

Instructions for formatting will be provided for each learning exercise. Please note, treatment plan justifications should be written in accordance withAPA style (APA Manual, 6th ed.). Regardless of paper formatting, ALL sources used for ALL learning exercises must be cited in APA format.

Disability statement

Students with disabilities needing accommodations to fully participate in this class should contact the Educational AccessCenter (EAC). All accommodations must be approved through the EAC prior to being implemented. To learn more about the accommodation process, visit the EAC’s website at

Academic integrity statement

Academic misconduct or dishonesty such as cheating and plagiarism is unacceptable and appropriate penalties will be imposed. This includes referencing material that has not been read by you, such as secondary references.

COURSE PLAN
Week / Topic / Readings / Learning Exercise Due
8/25 / Introductions
Thinking about learning
Defining mental health and un-health
9/1 / Clinical Assessment
  • Biopsychosocial histories
  • Mental Status Exam (MSE)
  • DSM-5 assessment tools
/
  • Jones (2010)
  • Polanski & Hinkle (2000)
  • Seligman (2004)
  • Kress & Paylo: Appendix 1.3 (pgs.31-38)
  • Watch Mental Status Exam Training videos (1-8) – Dr. Thom Field
Browse DSM-5 Online Assessment Measures
9/8 / Mini Mental Status Exam (MMSE)
Treatment Planning
  • Format Review
  • Practice
/
  • Kress & Paylo: Ch.1-2
/ Bio-psycho-social
9/15 / Diagnosis Overview
  • Evolution of the DSM
  • Structure and organization of the DSM
  • Differential diagnosis
  • Roles, risks, benefits of diagnosis
  • Ethical Considerations
  • Z-codes
/
  • DSM: Preface, Section I (pp. xli-25) and Other Conditions (pp. 715-732).
  • Kress et al. (2010;2013)
  • Erickson & Kress (2008)
/ Treatment Plan
9/22 / Bipolar and Related Disorders
Depressive Disorders /
  • DSM: pp. `123-188
  • Kress & Paylo: Ch. 4
  • Optional Video: Living Well with Bipolar Disorder: A New Look

9/29 / Neurodevelopmental Disorders
(Guest Lecturer: Amy Curry) /
  • DSM: pp. 31-86
  • Kress & Paylo: Ch.13 (Neurodev. Section)
  • Wadsworth & Harper (2007)
  • Balch & Ray (2015)
  • Schottelkorb & Ray (2009)

10/6 / Anxiety Disorders
Obsessive- Compulsive and Related Disorders /
  • DSM: pp. 189-264
  • Kress & Paylo: Ch. 5-6
  • Kress et al. (2016)
  • Kress et al. (2004)
  • Optional Video:
Evidenced-Based Treatment Planning for Panic Disorder and/or Social Anxiety
10/13 / Trauma-and-Stressor Related Disorders
APA Style /
  • DSM: 265-290
  • Kress & Paylo: Ch. 7
  • Perry (2007)
  • Optional Audio:
In 'The Evil Hours,' A Journalist Shares His Struggle With PTSD – NPR Fresh Air Jan. 20, 2015
10/20 / Substance-Related and Addictive Disorders /
  • DSM: pp. 481-590
  • Kress & Paylo: Ch. 8
/ Mid-Term Case Studies[RM5]
10/27 / Schizophrenia Spectrum & Other Psychotic
Dissociative Disorders
Somatic Symptom and Related Disorders /
  • DSM: 87-122; 291-328
  • Kress & Paylo: Ch. 10 and 14
  • Optional Video: Living with Schizophrenia

11/3 / Feeding and Eating Disorders
Elimination Disorders /
  • DSM: pp. 329-360; 461-480; 355-360
  • Kress & Paylo: Ch. 11 and 12
  • Berg et al. (2012)

11/10 / Disruptive, Impulse-Control, and Conduct d/o
Gender Dysphoria /
  • DSM: pp. 461-480; 451-459; 361-422
  • Kress & Paylo: Ch. 12 and 15
  • Milner & Belicki (2010)

11/17 / Personality Disorders[RM6] /
  • DSM: pp. 645-706; 423-450
  • Kress & Paylo: Ch. 9
  • Seligman & Hardenburg (2000) [RM7]

11/24 / THANKSGIVING HOLDIAY
(No Class Mtg.)
12/1 / Sleep-Wake Disorders
Paraphilic Disorders
Sexual Dysfunctions [RM8]
Neurocognitive Disorders /
  • DSM: pp. 591-644

12/8 / Psychopharmacology (Guest Speaker) Nancy Nadolski
Alternative Diagnostic Symptoms /
  • Kaut (2011)
  • Murray (2011)
  • NIMH Mental Health Medications website
/ Final Case Study Due
12/5 / FINALS WEEK
(NO Class Mtg.)

*Note: The syllabus is subject to change.

COUN 550: Diagnosis, Assessment, and Treatment Planning – Fall 2016

Raissa Miller, Ph.D., LPC 1

[RM1]10 pts.

[RM2]Quiz worth 20 points

[RM3]Grade treatment plan (10 pts.)

[RM4]Change to pre-set cases (like mid-term). Case: similar to mom, phobia w/ panic attacks, nicotine do. Include one child, one adolescent, and one adult case. Make final worth 70 pts. Focus on trauma, anxiety, and depression.

[RM5]Next year, have the week students turn in mid-terms be just the mid-term review (no lecture). Move lecture to next week.

[RM6]Consider inviting Stephen Hill as a guest speaker --

[RM7]Double check to make sure all the topics/readings align – some topics were moved around and might not match.

[RM8](consider guest speaker Laura Brotherson)