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Case Conceptualization

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Submitted By rlcooper1966
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Case conceptualization as defined by Erford (2010) refers to “How professional counselors understand the nature of clients’ concerns, how and why the problems have developed, and the types of counseling interventions that might be helpful.” Additionally, “A good case conceptualization should effectively link a client’s presenting problem to a treatment plan as well as provide the basis for tailoring treatment to client need and expectations” (Sperry, 2005). Sperry continues by stating that “The purpose of a well-articulated case conceptualization is to better understate and more effectively treat a client or client-system, that is, a couple or family.” Assessment is the preliminary process of case conceptualization, which according to Barlow & Durand (2003) and Nystul (2006) includes “intake interviews, test and inventories, behavioral observations, and relevant information gather from other source.” A thorough assessment is important in collecting sufficient information in order to understand the underlining issue of the client. Erford (2010) argues that “a good treatment plan requires an assessment appropriate to the client’s presenting concerns and a case conceptualization that includes an understanding of what the problem is, how it developed, and how to deal with it”. Who, what, when, where, why, and how should be addressed in the assessment process and are pivotal in formulating a comprehensive case conceptualization. An accurate comprehensive assessment is essential in obtaining a clear conceptualization of each case; thereby, resulting in a treatment plan specifically designed to meet the need of the individual client. Diagnosis “is the identification of a disease, disorder, or syndrome based on some form of systematic assessment” (Erford, 2010) and is essential in developing a treatment plan. “The case conceptualization integrates the information gathered during the assessment with counseling and developmental theory, as well as diversity and social justice issues, and leads to a diagnosis and effective treatment planning” (Erford, 2010). Erford further argues that a good treatment plan requires an assessment that is appropriate for addressing the client’s concerns, understanding the problem, how it developed, and how to fix it. The treatment plan should be mutually agreed upon by parties; the client as well as the counselor. Mead, Hohenshil, & Singh (1997) states that the Diagnostic and Statistical Manuals of Mental Disorders (DSM) are among the most essential diagnostic tool in the mental health counseling profession, which includes clinical counseling, psychology, psychiatry, and social work. Proper use of DSM system provides a common language amongst collaborating professionals, assures accurate payment from third-party insurance companies and other agencies, enhance the selection of effective treatment plans, and provides the counselor with a foundation to evaluation the effectiveness of the treatment plan (Mead, Hohenshil, & Singh, 1997). To assure the treatment of their client, especially when treatment is unaffordable, and to assure third-party reimbursement for services provided, there are cases where the counselor deliberately falsified a client’s diagnosis (Mead, Hohenshil, & Singh, 1997). Whether intentional or unintentional, misdiagnoses can result in serious repercussions for the clients as well as legal and ethical ramifications for the counselor. For example, in the case of women who are misdiagnosed as bipolar, when in fact, they are suffering from PMS, risk being classified as mentally unstable. Misdiagnoses can sky rocket or cancel clients’ insurance policy, contribute to discrimination on the job, and become a permanent part of the clients’ medical record (Braun & Cox, 2005). Counselors who are found in violation of state and federal law by intentionally or neglectful misdiagnosis of a client are in jeopardy of legal actions being taken against them as well as their license to practice being revoked. References
Barlow, D. H., & Durand, V. M. (2003) Essentials of abnormal psychology (3rd ed.). Pacific Grove, CV: Wadsworth-Thomson Learning.
Braun, S. A., & Cox, J. A. (2005). Managed mental health care: Intentional misdiagnosis of mental disorders. Journal of Counseling & Development, 83(4), 425-433. Retrieved April 11, 2012 from http://ezp.waldenulibrary.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=18867636&site=ehost-live&scope=site
Erford, B. T. (2010). Orientation to the counseling profession: Advocacy, ethics, and essential professional foundations. Upper Saddle River, NJ: Pearson Education, Inc.
Mead, M. A., Hohenshil, T. H., & Singh, K. (1997). How the DSM system is used by clinical counselors: A national study. Journal of Mental Health Counseling, 19(4), 383-401. Retrieved April 11, 2012 from http://web.ebscohost.com.ezp.waldenulibrary.org/ehost/detail?sid=65a7c337-8309-4b10-ac44-f5dbcde37b47%40sessionmgr13&vid=1&hid=10&bdata=JnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl#db=a9h&AN=226909
Nystul, M. S. (2006). Introduction to counseling: An art and science perspective (3rd ed.). Boston: Allyn & Bacon.
Sperry, L. (2005). Case conceptualizations: The missing link between theory and practice. The Family Journal, 13(1), 71-76. doi: 10.1177/1066480704270104 Retrieved April 11, 2012 from http://tfj.sagepub.com/content/13/1/71.abstract

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