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Assessment and Diagnosis in Action

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Critical Thinking in Clinical Assessment and Diagnosis

Part of the book series: Essential Clinical Social Work Series ((ECSWS))

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Abstract

The book’s final chapter reiterates the key point that all knowledge is partial, provisional, and subject to review as new evidence comes to light. Thus, to guard against tunnel vision and premature closure, clinicians need to avail themselves of many forms of knowledge, from many domains, that can complement psychiatric categories and offer essential insight for understanding a client’s suffering and illuminating pathways for recovery. A discussion of the role and use of the DSM in real-world practice draws on both research and theory to highlight its benefits and limitations, including the challenges of distinguishing primary and secondary conditions, and of responding to subthreshold presentations. The chapter then provides a comprehensive overview of multiple ways of collecting, organizing, and interpreting information—biological, social, psychological, and spiritual—within a framework of therapist–client collaboration. Emergent integrative directions in clinical assessment are reviewed (epigenetics, diathesis–stress theory, the transdiagnostic model, etc.) that consider people in flexible relationship to elements of their environment and suggest how specific aspects of environment can contribute to mental disorder, a connection that has been lacking in previous theoretical models. The chapter concludes with a call for social workers to face the challenge of insuring that culture, spirituality, and the impact of poverty and oppression are not forgotten and that the idea of internal flaw, failure, and deficit does not overwhelm and obscure our commitment to social justice. Our ability to respond to this challenge rests on how well the next generation is taught to think critically, compassionately, and holistically—the very aim of this book.

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References

  • Belsky, J. (2014). The downside of resilience. The New York Times, November 28, 2014. http://www.nytimes.com/2014/11/30/opinion/sunday/the-downside-of-resilience.html?mabReward=RI%3A8&action=click&pgtype=Homepage&region=CColumn&module=Recommendation&src=rechp&WT.nav=RecEngine&_r=0.

  • Benard, B. (2004). Resiliency: What we have learned. San Francisco CA: WestEd.

    Google Scholar 

  • Berganza, C. E., Mezzich, J. E., & Pouncey, C. (2005). Concepts of disease: Their relevance for psychiatric diagnosis and classification. Psychopathology, 38(4), 166–170.

    Google Scholar 

  • Berzoff, J. (2011). Why we need a biopsychosocial perspective with vulnerable, oppressed, and at-risk clients. Smith College Studies in Social Work, 81(2–3), 132–166.

    Article  Google Scholar 

  • Dewees, M. (2002). Contested landscape: The role of critical dialogue for social workers in mental health practice. Journal of Progressive Human Services, 13(1), 73–91.

    Article  Google Scholar 

  • Epple, D. M. (2007). Inter and intra professional social work differences: Social work’s challenge. Clinical Social Work Journal, 35, 267–276.

    Google Scholar 

  • Frazer, P., Westhuis, D., Daley, J. G., & Phillips, I. (2009). How clinical social workers are using the DSM-IV: A national study. Social Work in Mental Health, 7(4), 325–339.

    Article  Google Scholar 

  • Garland, E. L., & Howard, M. O. (2014). A transdiagnostic perspective on cognitive, affective, and neurobiological processes underlying human suffering. Research on Social Work Practice, 24(1), 142–151.

    Article  Google Scholar 

  • Haslam, N., & Giosan, C. (2002). The lay concept of “mental disorder” among American undergraduates. Journal of Clinical Psychology, 58(4), 479–485.

    Article  Google Scholar 

  • Hodge, D. R. (2001). Spiritual assessment: A review of major qualitative methods and a new framework for assessing spirituality. Social Work, 46(3), 203–214.

    Article  Google Scholar 

  • Hodge, D. R. (2005). Developing a spiritual assessment toolbox: A discussion of the strengths and limitations of five different assessment methods. Health and Social Work, 30(4), 314–323.

    Article  Google Scholar 

  • Hodge, D. F. & Bushfield, S. (2006). Developing spiritual competence in practice. Journal of Ethnic and Cultural Diversity in Social Work, 15(3/4), 101–127.

    Google Scholar 

  • Hyman, S. E. (2010). Slipping the ‘cognitive straitjacket’ of psychiatric diagnosis. Scientific American (December 28, 2010). http://www.scientificamerican.com/article.cfm?id=dsm-psychiatric-genetics&page=3.

  • Kirk, S. A.; Siporin, M., & Kutchins, H. (1989). The prognosis for social work diagnosis. Social Casework: The Journal of Contemporary Social Work, 295–304.

    Google Scholar 

  • Kutchins, H., & Kirk, S. A. (1988). The business of diagnosis: DSM-III and clinical social work. Social Work, 215–220.

    Google Scholar 

  • Kutchins, H., & Kirk, S. A. (1995). Should DSM be the basis for teaching social work practice in mental health? No! Journal of Social Work Education, 31(2), 159–165.

    Google Scholar 

  • Lebowitz, M. S., & Ahn, W. (2014). Effects of biological explanations for mental disorders on clinicians’ empathy. In Proceedings of the National Academy of Sciences. doi:10.1073/pnas.1414058111.

  • Mattaini, M. A., & Kirk, S. A. (1991). Assessing assessment in social work. Social Work, 36(3), 260–266.

    Google Scholar 

  • McCutcheon, V. V. (2006). Toward an integration of social and biological research. Social Service Review, 80(1), 159–178.

    Article  Google Scholar 

  • McQuaide, S. (1999). A social worker’s use of the diagnostic and statistical manual. Families in Society, 80(4), 410–417.

    Article  Google Scholar 

  • 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).

    Google Scholar 

  • Oldham, J. M., & Morris, L. B. (1995). The new personality self-portrait: Why you think, work, love, and act the way you do. New York: Bantam.

    Google Scholar 

  • Probst, B. (2012). Not quite colleagues: Issues of power and purview between social work and psychiatry. Social Work in Mental Health, 10, 367–383.

    Article  Google Scholar 

  • Probst, B. (2013). Walking the tightrope: Clinical social workers’ use of diagnostic and environmental perspectives. Clinical Social Work Journal, 41(2), 184–191.

    Article  Google Scholar 

  • Probst, B. (2014). The life and death of axis IV: Caught in the quest for a theory of mental disorder. Research on Social Work Practice, 24(1), 123–131.

    Article  Google Scholar 

  • Probst, B., Balletto, C., & Wofford, N. What they bring: How MSW students think about mental disorder. Clinical Social Work Journal (doi:10.1007/s10615-015-0517-6).

  • Schoen, D. A. (1984). The reflective practitioner: How professionals think in action. New York: Basic Books.

    Google Scholar 

  • Schoen, D. A. (1992). The crisis of professional knowledge and the pursuit of an epistemology of practice. Journal of Interprofessional Care, 6, 49–63.

    Article  Google Scholar 

  • Wakefield, J.C. (1996). Does social work need the eco-systems perspective? Social Service Review (March 1996). 1–30.

    Google Scholar 

  • Wakefield, J. C. (2005). Disorders versus problems of living in DSM: Rethinking social work’s relationship to psychiatry. In S. A. Kirk (Ed.), Mental disorders in the social environment: Critical perspectives (pp. 83–95). New York City: Columbia University Press.

    Google Scholar 

  • Wakefield, J. C. (2013). DSM-5 and clinical social work: Mental disorder and psychological justice as goals of clinical intervention. Clinical Social Work Journal, 41(2), 131–138.

    Article  Google Scholar 

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Correspondence to Barbara Probst .

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Probst, B. (2015). Assessment and Diagnosis in Action. In: Probst, B. (eds) Critical Thinking in Clinical Assessment and Diagnosis. Essential Clinical Social Work Series. Springer, Cham. https://doi.org/10.1007/978-3-319-17774-8_13

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