NSU PYCL584 2022 April Complete Course Latest (Full)

PYCL584 Diag/Tx of Adult Psych

Week 1 Discussion

What behaviors have you, your family or acquaintances ever displayed that could have been viewed as “abnormal” by an outside observer? What were the possible negative consequences?

 

PYCL584 Diag/Tx of Adult Psych

Week 2 Discussion

What model of psychopathology (or personality in general) do you feel would help you in understanding and dealing with your own emotional difficulties if you were to develop them? Why?

 

PYCL584 Diag/Tx of Adult Psych

Week 3 Discussion

What do you feel are the pros and cons of making an official diagnosis and labeling your client? Give examples.

 

PYCL584 Diag/Tx of Adult Psych

Week 4 Discussion

What do you believe are the ways in which you can assist the caretakers of patients with severe dementia?

 

PYCL584 Diag/Tx of Adult Psych

Week 5 Discussion

Discuss the problem of elder abuse and how can mental health counselors assist in prevention efforts?

 

PYCL584 Diag/Tx of Adult Psych

Week 6 Discussion

Discuss the relationship between Schizophrenia and violent behavior. Address incidence, prevalence, risk factors and prevention efforts.

 

PYCL584 Diag/Tx of Adult Psych

Week 8 Discussion

How do you feel about physician assisted suicide?  Under what conditions would you see suicide as a rational choice rather than a product of depression?

PYCL584 Diag/Tx of Adult Psych

Week 9 Discussion

Discuss any phobias you feel you struggle with and share how you cope with them.

 

PYCL584 Diag/Tx of Adult Psych

Week 10 Discussion

Discuss examples of obsessive-compulsive behavior that occur in everyday life and that are not considered abnormal.  How does superstitious behavior relate to OCD?

 

PYCL584 Diag/Tx of Adult Psych

Week 11 Discussion

Give examples of people you have known who have complained of symptoms or illnesses for which no medical explanation could be found.  What do you feel may have given rise to those symptoms or in what way did the person seem to benefit from their complaints or “illness?”

 

PYCL584 Diag/Tx of Adult Psych

Week 12 Discussion

Discuss how an individual might develops the defense mechanism of dissociation.  Relate this to early childhood experience and list everyday occurrences of dissociation that are not considered abnormal.

 

PYCL584 Diag/Tx of Adult Psych

Week 13 Discussion

 

PYCL584 Diag/Tx of Adult Psych

Week 14 Discussion

 

PYCL584 Diag/Tx of Adult Psych

Week 15 Discussion

 

PYCL584 Diag/Tx of Adult Psych

Week 1 Critical Thinking

WEEK ONE

Abnormal Behavior:  Definitions and Historical Perspectives

It is important to appreciate how our understanding of abnormality or psychopathology has evolved over the centuries.  Such an understanding will enable us to critically evaluate how we understand mental disorders today and perhaps appreciate that 100 years from now what we accept as truth today will seem primitive and unscientific in 2100.

As you explore the history and roots of our understanding of mental illness, take particular note of the fact that no matter how primitive, inhumane or bizarre the conceptualization of aberrant behavior seems to be, the recommended treatment for the behavior is entirely consistent and sensible with that notion.  For instance, if the primitive cave dwellers believed that animistic spirits entered the body as a result of a person disobeying the gods, then it makes perfect sense that “trephining,” or drilling holes in one’s head to release them, is a proper treatment.  Notice also how the history of mental illness has progressed through at least three traditions including the supernatural, biological and psychological conceptualizations.

Defining abnormal behavior may seem at first glance to be a straightforward endeavor.  However, it is a truly complex process that must take into consideration many factors.  A list of symptoms is not an adequate determinant of abnormality alone since any single symptom can be quite normal in the right context.  Furthermore, being “statistically” average does not necessarily mean one is “normal.”  Failure to conform to what most people do is not a good criterion of abnormality.  Abnormality involves an interplay of defective psychological functioning (i.e. cognitive impairment), defective social functioning (i.e. inability to conform to rules), loss of control, society’s evaluation (i.e. what professionals say) and a person’s own personal distress (i.e. anxiety or guilt).

READ:  Chapter 1 (B & D)

Critical Thinking Exercise:  What do you feel are the most salient and valid criteria of abnormality?  Why?  Write a one page, single-spaced (12 point font ONLY) response and submit it by Assignment Drop Box (ADB).

 

PYCL584 Diag/Tx of Adult Psych

Week 2 Critical Thinking

Models of Abnormal Behavior: From Biology to Humanism

Each theoretical model offers its own explanation of the etiology, assessment and treatment of psychopathology.  Each approach has its value in understanding the complexity of human behavior and each professional will choose that approach which is most helpful in understanding and treating the disorder in question.

The biophysical or medical model considers psychopathology to be the result of diseases, trauma, toxins or heredity that disrupts normal processes.  The intrapsychic model exemplified by psychoanalytic approaches, substitutes psychological factors for biological diseases as underlying causes of pathology and stresses the importance of the “unconscious” as well as early childhood experiences that influence future adjustment.  The humanistic and existential schools emphasize man’s phenomenological view of the world and assert that how we perceive events in the world will determine our behavior.  Disorder or pathology develops when the person experiences incongruence between what he or she experiences and perceives and what others tell them is real or what they “should” feel.  This incongruence leads to anxiety and loss of meaning in one’s life.  Finally, the behavioral or learning theory model rejects that which cannot be scientifically observed and manipulated like “the unconscious” and emphasizes that psychopathology is learned according to the same principles as “normal” behavior.

READ:  Chapters 1 & 2 (B & D)

Critical Thinking Exercise:  What do you feel are the problems associated with using a medical/biological model to understand the etiology of most psychological problems?  What model do you believe is more relevant?  Why?  Submit a one page response via the Assignment Drop Box (ADB).

 

PYCL584 Diag/Tx of Adult Psych

Week 4 Critical Thinking

Neurocognitive Disorders

As we begin to discuss the actual psychiatric disorders, it is important to differentiate those with known and verifiable organic or physiological etiology from those disorders with psychological bases or more controversial and complex etiologies.  You must keep in mind that most psychiatric symptoms CAN have a physical basis.  Symptoms like depression, anxiety, mania, confusion, memory loss, delusions and hallucinations are often caused by medical conditions or substances including illicit drugs and prescription medications.  It is wrong to immediately assume that your patient has generalized anxiety due to poor coping skills or early childhood trauma when a more thorough evaluation by a physician would reveal that the patient suffered from hyperthyroidism.  The rule, therefore, is to approach each of your patients with this index of suspicion and insure that any possible medical condition has been ruled out before making your diagnosis.  You will notice as you read the DSM-5 that most chapters include a series of diagnoses that I refer to as “diagnoses of exclusion” as well as two other types.  These include diagnoses like “Depressive Disorder due to Another Medical Condition” and “Substance/Medication-induced Anxiety Disorder.”  It is only when medical and substance induced causes have been eliminated that the remaining diagnoses can be validly made.  Hence, the remaining diagnoses are called “diagnoses of exclusion.”  For instance, Schizophrenia, Major Depression and Panic Disorder are all diagnoses of exclusion.  This distinction becomes most relevant when we consider appropriate treatment for your patient.  It would be very inappropriate to treat a 50 year old depressed woman with psychotherapy aimed at dealing with her presumed low self esteem or feelings of loss when , in fact, she suffers from depression due to estrogen deficiency.  In that case her depression would be more successfully treated with estrogen replacement therapy.  Be aware that diagnoses like Major Depression and Schizophrenia that I have termed “diagnoses of exclusion” are not necessary entirely psychologically caused.  We recognized that most disorders have some physical basis and many professional refer to both Depression and Schizophrenia as “brain disorders.”  However, this is a controversial area and the nature of the causation, as you will see in your reading, is not as clear cut as other clearly “organic” illnesses like those that we now consider.

The first group of psychiatric disorders we will address are all based on organic etiologies that can be verified with laboratory and/or radiological evaluation and testing.  They have in common a disruption of our cognitive and intellective functions and include primarily dementias of various etiologies and delirium., all of which are caused by CNS impairments and medical/ substance toxicity of some sort.

READ:  Chapter 15 (B & D)   (Cognitive Disorders)

CRITICAL THINKING EXERCISE:  Discuss the differences between dementia, delirium and amnestic disorder.  How are they similar? Submit a one page, single-spaced response via the Assignment Dropbox (ADB).

 

 

PYCL584 Diag/Tx of Adult Psych

Week 5 Critical Thinking

WEEK FIVE

Neurocognitive Disorders (continued)

READ:  Chapter 15 (D & B)

CASE STUDY:  Read and answer questions on the following case study.  Submit via ADB

Mr. Science

Mr. Science is a 61 year old science teacher who became very fearful during the first semester of the new academic year.  Over the next few months he lost interest in his hobbies, stopped reading and had difficulty doing computations or taking care of his finances.  He even got lost driving to his school one morning.  He began writing notes to himself to avoid forgetting things.  Abruptly he retired from work and did not even consult his wife.  He became stubborn and irritable and needed help in shaving and dressing.

When he was examined 6 years after the first symptoms developed, he was alert, cooperative, but disoriented to time.  He could not recall the names of 4 or 5 objects after 5 minutes and was unable to remember his college, his major and thought that Kennedy was president in 1978.  His speech was fluent, but he had word finding problems.  He called a cup a vase and the rims of glasses as “holders.”  He did math poorly and could not copy a cube or draw a house.  His interpretations of proverbs were concrete and had no insight into his problems.  Lab tests were all negative.  CAT scan showed cortical atrophy.

Questions:

What is his diagnosis?

What are the symptoms that helped you make this diagnosis?  What diagnostic criteria do they relate to?

What are two other possible diagnoses and why did you not choose them?

What kinds of psychological interventions would be appropriate in this case?

What is his prognosis?

 

PYCL584 Diag/Tx of Adult Psych

Week 7 Critical Thinking

CASE STUDY:  Read and answer questions on the following case study.  Submit via ADB.

Ms. Neighbors

Ms. Neighbors is a 25 year old, single, unemployed African American woman who was evaluated in the crisis center after her sister observed that her behavior had become increasingly bizarre and her work habits erratic.  She had no prior psychiatric history.

Ms. Neighbors lost her job 3 months ago and had become increasingly preoccupied with her neighbors who she felt were harassing her by “accessing” her thoughts and then repeating them to her.  She admitted to feeling “stressed” since she lost her job.

The patient was medicated and her beliefs about thought broadcasting remitted.  Within 2 months she was employed and feeling well.

Questions:

What is her diagnosis?

What are the symptoms that helped you make this diagnosis?  What diagnostic criteria do they relate to?

What are two other possible diagnoses and why did you not choose them?

Discuss the role of genetics in this case.

What is her prognosis?

 

PYCL584 Diag/Tx of Adult Psych

Week 8 Critical Thinking

CASE STUDY:  Read and answer questions on the following case study.  Submit via ADB.

Mr. Jock

Mr. Jock is a 24 year old Caucasian man who was brought to the ER mute and rigid.  Friends who brought him reported that he was playing basketball when he suddenly put his head down on the floor, made sounds as if he were praying and became “frozen.”  When interviewed an hour later he said “I am communicating directly with God.”

Mr. Jock’s friends said that he had been getting “hyper” lately, but stated he did not use drugs or alcohol.  They reported that he had been doing well up to one week before admission, working and going to school.  One week before admission he began saying “odd” things usually religious in nature, stopped sleeping and became sexually demanding on his girlfriend.  He began working out more at the gym to “burn off extra energy.”  His friends remembered that he had similar symptoms a year before, was hospitalized, but left AMA and later became increasingly depressed for 3 months.  He withdrew from socializing and slept all the time.  He spontaneously returned to his normal self and reinvested himself in his daily activities.

Lab and medical tests were all negative and his physical status was fine.  During his hospital stay Mr. Jock alternated between “rigid posturing” and “mild hyperactivity.”  He would become “unstuck” and begin pacing around the unit talking about his newfound faith in religion to anyone who would listen.

Questions:

 What is his diagnosis?

What are the symptoms that helped you make this diagnosis?  What diagnostic criteria do they relate to?

What are two other possible diagnoses and why did you not choose them?

What kind of treatment approaches would be effective in this case?

What is his prognosis?

 

PYCL584 Diag/Tx of Adult Psych

Week 10 Critical Thinking

Diagnostic/Case Conceptualization Paper:  Read and address the dimensions listed in your syllabus regarding the following case study.  It must be a minimum of 8 double spaced pages.  Submit via ADB.

Mr. Fife

Mr. Fife is a 25 year old, Asian single man living with his mother and working at the post office where he has been employed since he dropped out of college after 2 years.  He complains of “nervousness” and says he is “just going through the motions” and “wants to lead a normal life and return to college.” His father abandoned him soon after his birth and divorced his mother.  During his adolescence and young adulthood he had no close friends, but formed several close relationships in college.  However, he states he became “super self conscious” when speaking to strangers and classmates, feel nervous and had difficulty speaking.  He had a “buzzing” in his head, felt like he was “outside his body,” had hot flashes and perspired.  He called these experiences “panic attacks” that came on suddenly when he was with people.  He became increasingly uncomfortable in social situations and was “afraid of doing something stupid.”  He finally dropped out of school. To deal with his discomfort he tried various drugs to medicate his symptoms and enjoyed some relief.  His physician discovered he had mitral valve prolapse and treated him with medication, but it provided no change in his anxiety.

Mr. Fife feels that at the post office he does not have to deal with people.  He avoids public restrooms and uses a stall rather than a urinal.  He has 2 best friends but does not date and avoids group settings.  He has no problems with authority figures.

The purpose of this assignment is for you to practice applying what you are learning about mental health diagnoses, the diagnostic process, and infusing counseling principles into diagnosis.

Analyze thiscase in an 8-page (minimum) paper. You do not need a cover page or references, and strict adherence to APA style is not necessary. You can also use first person language as needed. Your paper should have sections that address the following topics (minimum 1 double-spaced page per section):

Relevant symptoms: What psychological, emotional, social, or biological/physiological symptoms do you observe while listening to the case? In this section, don’t just list symptoms; you need to cluster symptoms according to DSM-5 disorder criteria (think criterion A for various disorders). Also make sure to be specific; for example, “anxiety” and “feeling anxious” are not symptoms, but feeling on edge, worrying, shaking, etc. might be. Finally, discuss any relevant cultural considerations/issues that could be impacting the case.

Substance/medical etiology: Discuss any relevant substances, medications, or medical conditions that could explain the symptoms from the previous section. If possible, rule out any substance/medication-related or medical diagnoses and clearly explain why you would rule them out. If these diagnoses cannot be ruled out, justify why this is the case.

Stressors/Clinical History: Identify any potential stressors that occurred in relation to symptomology; if there are any, do they explain the symptoms and why/why not? Discuss the timeline of symptoms to the extent possible, including when the symptoms began, how long they last, and the frequency at which they come and go. Note that timelines may vary for different sets of symptoms. If there are gaps in the clinical history, note them as well.

Diagnostic impression: Offer a DSM-5 diagnosis (you can offer more than 1), including DSM-5 code numbers, relevant subtypes and/or specifiers. Also include the ICD code numbers and the impact of utilizing the DSM version compared to the ICD version on billing and epidemiological disease monitoring. Clearly justify your diagnoses by linking the symptoms to the DSM-5 criteria and to the clinical history. Make sure to address clinically significant distress and/or functional impairment caused by symptoms for each diagnosis offered.

Rule Outs and Differential Diagnosis: What are potential competing mental health diagnoses for this client that you can definitely rule out based on what you observed? What are potential mental health diagnoses for this client that you cannot yet rule out, but would need to rule out if you continued working with this client? Make sure to justify both in the context of the symptoms you listed and what remains missing from the clinical picture.

Case conceptualization: How is it that this person came to have these particular problems? What prevention efforts might have mitigated these problems? Where are these problems stemming from (e.g., intrapsychic issues, early relationships, learned behaviors, faulty cognitions)? What are this person’s strengths? You are encouraged to utilize counseling theory to inform this section.

Treatment recommendations: What type of intervention/treatment would you implement with the client? What crisis intervention models might be helpful and when? If you were working with this client, what would be your treatment goals be? Which counseling theories would you draw upon to help this client? Why? Would the person benefit from psychotropic medications? Why or why not? What ethical and legal considerations specific to clinical mental health counseling might be at play here?

 

PYCL584 Diag/Tx of Adult Psych

Week 12 Critical Thinking

CASE STUDY:  Read and answer questions on the following case study.  Submit via ADB

Mrs. Spinner

Mrs. Spinner is a 46 year old woman who was referred by her husband who described “attacks” of dizziness that his wife experienced that left her incapacitated.  She described being overcome with dizziness and nausea 4-5 times a week, when the room would begin to “shimmer” and she had the feeling that she was “ floating” and could not maintain her balance.  The attacks almost always occurred at about 4PM, after which she had to lie down until 7 or 8PM.  After feeling better she would spend the rest of the night watching TV, would fall asleep on the couch and go to the bedroom at around 3AM.

The patient was evaluated medically and all tests were negative.  She was in fine physical condition.  When asked about her marriage she stated that her husband was abusive verbally and demanding of her and her children.  She admitted that she dreaded his arrival home from work each day.  When she was unable to make dinner, her husband and children would have to go out to eat.  He came home, watched TV and had no conversation with his wife.

Questions:

What is her diagnosis?

What are the symptoms that helped you make this diagnosis?  What diagnostic criteria do they relate to?

What are two other possible diagnoses and why did you not choose them?

How would Mrs. Spinner respond to psychotherapy designed to address her “emotional” problems?

What therapeutic approach would you consider and why?

What is her prognosis?