Full Course Description


Mastering Differential Diagnosis with the DSM-5: A Symptom-Based Approach

Program Information

Objectives

  1. Apply a four-step diagnostic process to accurately identify and code a client’s diagnosis.
  2. Specify key symptoms and diagnostic criteria for frequently diagnosed mental disorders.
  3. Determine important differential diagnoses for anxiety, depressive, trauma-related, substance-related, and neurodevelopmental disorders.
  4. Analyze differential diagnoses for children who present with disruptive behavior.
  5. Differentiate between overlapping symptoms and comorbid conditions in order to provide the correct diagnosis.
  6. Utilize the DSM-5® severity tables, assessment tools, and coding notes to improve the accuracy of diagnosis and ICD-10 coding.

Outline

Quick Review of Using the DSM-5 and ICD-10

  • Diagnosis of mental disorders in the U.S.A.
    • Use of two models DSM-5 and ICD-10
    • Use of Specifiers
    • DSM-5 and ICD Coding and Recording 
  • Web-based DSM-5 Resources
    • Digital Updates
    • DSM-5 Cross-Cutting Symptom Measures and Screening Tools

Four Step Diagnostic Method

  • Case 1: Michelle 
  • Goals of the Clinical Interview
  • Steps to a DSM-5 Diagnosis
  • Step 1: Gathering Client Information and Behavior Sample
    • Interview Phases I, II, and III
    • Using Client Observation Sheet in Step 1
    • Using assessment tools to supplement data
    • Sources of Error to avoid in the clinical interview
  • Step 2: Identifying Key DSM-5 Symptom Clusters
  • Step 3: Differential Diagnosis List
    • Considering medical and substance causes of symptoms
    • Assessments for Alcohol, Drug and Tobacco use
    • Differential Diagnosis Guides in DSM-5 Manual
  • Step 4: Initial DSM-5 Diagnosis
    • Comorbidity considerations

Differential Diagnosis of Specific DSM-5 Mental Disorders
Clients with Symptoms of Depression 

  • Key symptoms of Depression and Dysphoria
  • Substance-Related and Medical conditions with Depressive Symptoms
  • Mental Disorders with Symptoms of Depression
  • Diagnosis Challenge: Case 2: Marilyn Wilson
  • Differentiating Disorders with Symptoms of Depression 
  • Frequent Comorbid Disorders

Clients with Fear and Anxiety 

  • Key Symptom Patterns of Anxiety
  • Substance-Related and Medical conditions with Anxiety Symptoms
  • Mental Disorders with Symptoms of Anxiety
  • Differentiating by Patterns of Anxiety symptoms
  • Diagnosis Challenge: Case 3: Hunter
  • Specific Differential Diagnoses
    • Generalized Anxiety Disorder 
    • Panic Disorder 
    • Frequent Comorbid Disorders

Clients with Abnormal or Impaired Cognition

  • Diagnostic Challenge: Case 4: Christa 
  • Sorting Patterns of Psychosis
  • Substance-Related and Medical conditions with Psychosis symptoms
  • DSM-5 mental disorders with psychosis symptoms
  • Sorting Patterns of Cognitive Deficit: Case 5: Bob Gray
  • Substance-Related and Medical conditions that produce cognitive deficits
  • Differential Diagnosis when Cognitive Deficits as a Key Symptom​
    • Neurodevelopmental Disorders 
    • Neurocognitive Disorders

Clients with Repetitive Thoughts and Behaviors

  • Diagnostic Challenge: Case 6: Devin
  • Mental Disorders with Symptoms of Repetitive Thoughts and Behaviors
  • Substance-Related and Medical conditions associated with Repetitive Thoughts and Behaviors
  • Frequent Comorbid Disorders

Clients with Disruptive Behaviors

  • Disruptive Behavior Symptoms
  • Diagnostic Challenge: Case 7: Natalia is a Problem
  • Substance-Related and Medical conditions associated with Disruptive Behaviors
  • Differential Diagnosis by Patterns of Disruptive Behavior 
    • Defiant, Angry and Vindictive
    • Impulsive and/or Antisocial
  • Comorbidity in DSM-5 Disruptive, Impulse Control, and Conduct Disorders

Copyright : 09/28/2018

Mastery in Mental Health Documentation & Medical Necessity: Comprehensive Clinical Documentation for Psychotherapists

Program Information

Objectives

  1. Complete proper documentation to inform clinical decision-making.
  2. Evaluate the role of the clinical diagnosis in justifying medical necessity and providing more effective services to clients.
  3. Determine how to use the behavioral language required by insurance companies to facilitate delivery of services to clients.
  4. Demonstrate understanding of how to document what really happens in a clinical session without violating privacy or confidentiality.
  5. Assess medical necessity by employing the “golden thread” for improved treatment outcomes.
  6. Determine potential red flags in documentation and the proper corrective measures for them.

Outline

Why is Documentation the Topic Clinicians Love to Hate?

  • How do you feel about documentation?
  • Why is documentation so daunting?
  • Why is documentation the topic clinicians love to hate?
  • Why document?
Medical Necessity
  • Definition of Medical Necessity
  • What is “The Golden Thread” and how does it relate to medical necessity?
  • What is the role of the diagnosis in justifying medical necessity?
How to Write a Treatment Plan
  • Definition of a treatment plan
  • Everything that’s needed in a treatment plan and why
  • How to write a treatment plan that justifies medical necessity using behavioral language and the “golden thread” with examples
  • Practice writing a treatment plan
How to Write a Session Note
  • Definition of a session note and how it relates to the treatment plan
  • Everything that’s needed in a session note and why
  • How to write a session note that justifies medical necessity using behavioral language and the “golden thread” with examples
  • Practice writing a session note
How to Write an Intake Summary
  • Definition of an intake summary and how it relates to all other documentation
  • Everything that’s needed in an intake summary and why
  • How to write an intake summary that lays the ground for medical necessity
How to Write Case/Collateral Contact Notes
  • Definition of a case/collateral contact note and how it relates to the treatment plan
  • Everything that’s needed in a case/collateral contact note and why
  • How to write a case/collateral Contact Note that justifies medical necessity using behavioral language and the “golden thread” with examples
How to Write a Discharge Summary
  • Definition of a discharge summary and how it relates to the treatment plan
  • Everything that’s needed in a discharge summary and why
  • How to write a discharge summary that completes the “golden thread” with examples

Copyright : 12/05/2018

Differential Diagnosis Challenges: Clients with Trauma, Self-Injury, Impulsivity and Other Complex Behaviors

Program Information

Objectives

1. Evaluate client syndromes of poor impulse control, suicidal ideation, suicidal capability, intentional self-injury and symptoms following traumatic experiences.

2. Apply a four-step differential diagnostic method to diagnose the underlying mental disorders of clients with dysfunctional behavioral patterns and/or a history of trauma.

3. Collect the specific information required for an accurate differential DSM-5 diagnosis of clients with a history of trauma.

4. Conduct a differential diagnosis for clients with impulsive, suicidal and self-injurious behaviors.

Outline

  1. Clients with Impulsive Behaviors and Weak Impulse Control
  1. Symptoms of impulsivity/diminished impulse-control
  1. Child
  2. Adolescent and Adult
  1. Diagnostic Challenge: Case 8 Wyatt
  2. Substance-related and medical conditions associated with impulse-control problems
  3. Mental Disorders with impulsivity as one of the criteria symptom clusters
  4. Frequent Comorbid Disorders
  1. Clients with Experiences of Trauma or Psychosocial Stress
  1. Definition of Trauma in DSM-5
  2. Case Study 9: Annemarie
  3. Necessary information about the trauma event(s)
  4. The role of Substance-Related and Medical conditions and Trauma
  5. Differential Diagnosis: Trauma-Related?

a. Mental Disorders that follow traumatic event

b. Mental Disorders that follow severe neglect before age of 5

  1. Differential Diagnosis: Does not meet diagnostic criteria set for PTSD
  1. Adjustment Disorder or Other Mental Disorder
  2. Other Specified Trauma Related Disorder
  1. Frequent Comorbid Disorders

 

  1. Clients with Suicidal Ideation or Behaviors
  1. Clusters of Suicidal Symptoms
  2. Differential Diagnosis of the Underlying Mental Disorder
  1. Mental Disorders associated with Suicidal Capability
  2. Mental Disorders associated with Suicidal Ideation
  1. Medications that enhance suicidal risk
  2. Diagnostic Challenge: Case 10 Marty

 

  1. Clients with Self-Injury Behaviors
  1. Understanding self-injury, non-suicidal behaviors
  2. Substance Use Disorders that induce self-injury behaviors
  3. Mental Disorders associated with self-injury
  1. Client states motivation for the self-injurious behavior
  2. No apparent reason for the self-injurious behavior

 

  1. Wrap Up Diagnosis Challege: Case Study 11 Joe Jensen
  1. Working the Differential Diagnosis Process
  2. What About Personality Disorder?
  3. Joe’s initial DSM-5 diagnosis

Copyright : 05/02/2019