Clinicians often have to employ multiple skills simultaneously while engaging with clients. Not least among them are reflective listening, information gathering and sensitive questioning, recording key responses, observing for signs of syndromes, and identifying the chief complaints. This week you address the complex process for identifying and distinguishing among similar diagnostic syndromes.
This process begins in the diagnostic interview. Research of skilled clinicians shows that forming diagnostic impressions too quickly increases the risk of errors in diagnosis. Every clinician should be evaluating differential diagnoses at the diagnostic interview and beyond. While social workers want to resolve their own uncertainty, using the formal steps of a decision tree ensures accuracy. A decision tree is especially important when all available data is not pointing in the same direction.
This week, you walk through the steps of a differential diagnostic decision tree using a case within the neurodevelopmental disorders. At the same time, you begin to meet with your colleague in case consultation about your individual case assignment.
Required ReadingsFirst, M. B. (2014). Handbook of differential diagnosis. Washington, DC: American Psychiatric AssociationNote:You will access this e-book from the Walden Library databases.Chapter 1, “Differential Diagnosis Step by Step” (pp. 14–24)Morrison, J. (2014). Diagnosis made easier (2nd ed.). New York, NY: Guilford Press.Part 1, “The Basics of Diagnosis” (pp. 3–56)American Psychiatric Association. (2013f). Disruptive, impulse-control, and conduct disorders. In Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author. doi:10.1176/appi.books.9780890425596.dsm15American Psychiatric Association. (2013k). Neurodevelopmental disorders. In Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author. doi:10.1176/appi.books.9780890425596.dsm01American Psychiatric Association. (2013m). Other conditions that may be a focus of clinical attention. In Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author. doi:10.1176/appi.books.9780890425596.VandZcodesWalsh, J. (2016). The utility of the DSM-5 Z-codes for clinical social work diagnosis. Journal of Human Behavior in the Social Environment, 26(2), 149–153. doi:10.1080/10911359.2015.1052913Blackboard. (2018). Collaborate Ultra help for moderators. Retrieved from https://help.blackboard.com/Collaborate/Ultra/ModeratorNote: Beginning this week, you use a feature in your online classroom called Collaborate Ultra. Your Instructor will assign you a partner and then give you moderator access to a Collaborate Ultra meeting room. This link provides an overview and help features for use in the moderator role.Document: Case Collaboration Meeting Guidelines (Word document)Note: Download these guidelines and consult the Assignment instructions. You are encouraged to orient yourself to these instructions and take action as early in the week as possible.Document: How to Write a Diagnosis According to the DSM-5 (PDF)
Required MediaLaureate Education (Producer). (2018f). Steps in differential diagnosis [Video files]. Baltimore, MD: Author Retrieved from https://mym.cdn.laureate-media.com/2dett4d/Walden/SOCW/6090/04/DD/index.html.
Optional ResourcesAmerican Psychiatric Association. (2013b). Assessment measures. In Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: Author. doi:10.1176/appi.books.9780890425596.AssessmentMeasuresCoker, T. R., Elliott, M. N., Toomey, S. L., Schwebel, D. C., Cuccaro, P., Emery, S. T., … Schuster, M. A. (2017). Racial and ethnic disparities in ADHD diagnosis and treatment. Pediatrics, 138(3), 1–11. Retrieved from http://pediatrics.aappublications.org/content/138/3/e20160407Document: Suggested Further Reading for SOCW 6090 (PDF)Note: This is the same document introduced in Week 1.
Optional MediaUniversity at Buffalo School of Social Work (Producer). (2017). Episode 221—Dr. Jennifer Cullen and Dr. Jolynn Haney: Understanding and treating autism in women: Using lived experiences to shape practice [Audio podcast]. Retrieved from http://www.insocialwork.org/episode.asp?ep=221
Discussion: Applying Differential Diagnosis to Neurodevelopmental Disorders
Social work clinicians keep a wide focus on several potential syndromes, analyzing patterns of symptoms, risks, and environmental factors. Narrowing down from that wider focus happens naturally as they match the individual symptoms, behaviors, and risk factors against criteria A–E and other baseline information in the DSM-5.
Over time, as you continue your social work education, this process will become more automatic and integrated. In this Discussion, you practice differential diagnosis by examining a case that falls on the neurodevelopmental spectrum.
By Day 3
Post a 300- to 500-word response in which you address the following:
By Day 6
Respond to at least two colleagues in the following ways:
Note: You do not need to include an APA reference to the DSM-5 in your response. However, your response should clearly be informed by the DSM-5. You do need to include an APA reference for any other resources you use to support your response.Note:You are required to create a thread for your initial Discussion post before you will be able to view other colleagues’ postings in this forum.If you have not yet visited the weekly resources and assignments, you should visit that area now to access the complete set of directions and guidelines for this discussion.
Submission and Grading Information
Grading CriteriaTo access your rubric:Week 4 Discussion Rubric
Post by Day 3 and Respond by Day 6To participate in this Discussion:Week 4 Discussion
Assignment: Case Collaboration Meeting
Collaboration is a key part of social work practice. Most MSW professionals engage in these processes during the postgraduate practice years that each state requires before their licensing moves from supervised to independent status. Even beyond those requirements, peer consultation and collaboration are key aspects of most social work practice settings.
For this Assignment, Imagine that you are working with the client featured in the case study your Instructor assigned. Your task is to provide a diagnosis and present your findings in the Week 7 Discussion.
Your diagnosis can come from any part of the DSM-5, so frequent communication and research with your colleague may be needed.
The collaboration that begins in this Assignment is intended to provide a safe venue for developing your differential diagnosis and case discussion skills with your colleague. This week you meet with your assigned partner at least once via Collaborate Ultra and begin considering the assigned case. In this Assignment, you describe that meeting and any initial analysis of the case.
Note: In the Week 7 Discussion, you make your final findings presentation as an individual, not with your partner.
By Day 7
Submit a 1- to 2-page paper in which you describe your team meeting. In your write-up, make sure to address the following: