In need of a 250 word response/discussion to each of the following forum posts. Agreement/disagreement/and/or continuing the discussion.

Original forum discussion/topic post is as follows:

This week we will examine Post-traumatic Stress Disorder. The United States Government Accountability Office reviewed Department of Defense (DOD) data on service members separated for misconduct. The study found that over 60% of those service members had been diagnosed with a mental illness within two years prior to separation.

A brief video about the report:

https://www.usatoday.com/videos/news/nation/2017/0…

The report can be found here:

United States Government Accountability Office. (2017, May 26). Actions needed to ensure post-traumatic stress disorder and traumatic brain injury are considered in misconduct Separations. Retrieved from http://www.gao.gov/products/GAO-17-260

In this forum, please address the following:

• What is the main purpose of diagnosis?
• What are some potential ethical issues associated with the process of diagnosis?
• What does differential diagnosis mean and how does it affect the diagnostic process?
• If you worked in an agency that required you to formulate a diagnosis and treatment plan based upon your impressions at the initial session, how would this influence your practice?
• What are the challenges of diagnosis in the military?

Forum post response #1

What is the main purpose of diagnosis? Therapists use information gathered from interviews, tests, and observations to create a picture of the factors that may be causing and/or maintaining a client’s mental issues (Comer, 2014, p. 84). This clinical picture, including assessment data, can then be used in making a diagnosis. The main purpose of a diagnosis is the determination of whether or not a person’s psychological problems can be ascribed to a particular disorder. Diagnosis helps a therapist to form ideas about possible disorders (Comer, 2014, p. 84).

Ethical issues in diagnosis include possible labeling, label stigmatization, errant conclusions or diagnoses, possible inaccuracy of client/family symptom self-report, and any biases the clinician may hold which could affect accuracy of diagnosis (Comer, 2014, p. 88-89). Because the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (American Psychiatric Association, 2013) lists approximately 400 disorders, accuracy is vital to the diagnostic process.

Differential diagnosis is a term for listing all possible disorders a client may have (Morrison, 2014, p. 5). Morrison (2014, p. 14) cites a 23-year-old male with hallucinations. A few of the possible diagnoses include psychotic depression, medication toxicity, mania, schizophrenia, alcohol misuse, and relevant medical conditions, such as epilepsy and brain tumor or injury (Morrison, 2014, p. 14). Morrison (2014, p. 16) suggests using a diagnostic safety hierarchy in which the top level contains conditions which need urgent treatment, the lower level contains conditions which are unlikely to be affected by treatment, and all other conditions in the center.

If an agency required an immediate diagnosis, I probably would not work there to begin with. If I discovered this policy after I joined the agency, I would move my practice elsewhere, after ensuring my clients’ welfare. The ethical concerns listed above should always be a part of the diagnostic process. Inaccurately labeling a client can cause harm, and initial impressions may incorrectly inform a diagnosis.

Diagnostic challenges in the military are most heavily seen in the separation process. The information in the United States Government Accountability Office (USGAO) (2017) class reading highlighted the ways that military branch policy may differ from those of the Department of Defense (DOD). When the appropriate assessment measures are not used to test for Post-traumatic Stress Disorder (PTSD) (Comer, 2014, 144-145), a military member may be subject to misconduct charges or dishonorable discharge (USGAO, 2017). This is notable because PTSD prevalence is higher in military members than in the general public (10-20% for the former compared to 8% for the latter) and assessing members for possible PTSD prior to separation allows for government mental health support and effective treatment methods (USGAO, 2017). PTSD has been around for centuries. It was referred to as shell shock during WWI and combat fatigue during WWII. Many military members experience serious psychological symptoms post-combat. Approximately 29% of male and female participants in Vietnam experienced acute or post-traumatic symptoms (Comer, 2014, p. 144). Another 22% experienced some stress symptoms and currently 10% of Vietnam veterans still experience PTSD symptoms, including flashbacks, night terrors, and nightmares (Comer, 2014, p. 145). There is a similar pattern for 20% of returning Afghanistan and Iraq war veterans. The most disheartening fact I discovered was that multiple deployments increase the possibility of severe PTSD by 50% (Comer, 2014, p. 145).

Diagnostic accuracy is important. Test and assess everything. Use differential diagnoses. Leave nothing to chance. This is a person who needs help. Find the safest most appropriate solution and do no harm in the process.

Forum post response #2

• What is the main purpose of diagnosis?

The main purpose of the diagnosis is so that the individual would feel better of course. People who has PTSD does not feel okay. With its side effects, it is important that cure is recommended. PTSD side effects include detachment, anxiety, depression, nightmares, agitation, hostility, not wanting to sleep due to fear, self-destruction behavior, mistrust, guilt, loss of interest and unwanted memories that lead to the trauma.

• What are some potential ethical issues associated with the process of diagnosis?

Ethical issue includes having trust and believe that one would recover from the shock or trauma is a concern. Another ethical issue is being able to keep a promise that one would stop being potentially in a shock due to a resultant situation of war or so. Having concern for others is another one; knowing that the diagnosis will boost the social life with others is a good idea.

• What does differential diagnosis mean and how does it affect the diagnostic process?

Differential diagnosis refers to the act of differentiating between two or more conditions which was found to have similar signs and symptoms. With this fact, it is hard to differentiate during curing procedure because of the fact that most PTSD sicknesses symptoms comes with similar traumas. For example, if the procedure was to cure reoccurring symptoms of hostility, it could be that there were also depression problems that was not noticed due to differentiation in diagnosis. This requires attention as well.

• If you worked in an agency that required you to formulate a diagnosis and treatment plan based upon your impressions at the initial session, how would this influence your practice?

Initially, I would do a check up introduction and overview of the signs and symptoms in other to decide on what treatment options to give. Then, I would formulate a treatment plan accordingly by asking these questions: how do you feel after you the accidental trauma? With this question, I expect lots of answers such as: I feel depressed and anxious, I feel sleepless and scared, I have fear that someone will get me bad, etc. I would formulate the treatment plan as followed:

1. Take your medications on time, your medications for anxiety and depression and anxiety.
2. Put on a soft music before going to bed so that you would feel relaxed.
3. Lock up your doors and feel safe or you could buy surveillance cameras and put by the door of your house.

• What are the challenges of diagnosis in the military?

The one challenge I know is that what if the military personal would get deployed again, maybe their symptoms would get back to them. The most symptom is the feeling of fear about dying. It is therefore important to pay attention to the military personnel’s who are having combat fear.

Forum post response #3

• The main purpose of diagnosis is very essential aspect which helps professionals in determination, identification, and labeling of a client’s specific disease. Other purpose of diagnosis is to guide professionals towards treatment planning. This also enable professionals to examine the prognosis, monitoring, and screening in order to make accurate judgement and appropriate choice of treatment. It is also very vital in order to help implement appropriate treatment and communication for the diagnosed disease of such abnormality.
• Some potential ethical issues associated with the process of diagnosis is either under-diagnosing or over-diagnosing of clients mental health symptoms. This often posed as a major issues that raise a serious ethical concern especially when clients have been treated on a specific signs and symptoms in the past instead of appropriate diagnosing they just believe based on assumptions and continue treatment based on previous diagnosis. This might pose an ethical concern among professionals which might result to either under-diagnosing or over-diagnosing of a client’s mental health issues towards accurate judgement and appropriate choice of treatment. Also, some other ethical issues associated with the process of diagnosis can be raised especially with individuals who has been diagnosed with mental health abnormalities as a result of self-perceptions, others perceptions, and negative feelings of stigmatization based on how their mental health disorder has been labelled by others.
• Differential diagnosis is a list of possible disease that could or may be the major cause of a specific signs and symptoms as a result of some initial information gathered. These may include medical information from current symptoms, medical history, and as a result of a clinician physical examination of such symptoms and abnormalities. This can affect the diagnostic process especially when there is inadequate capture of a client’s medical history or when a client’s previous medical visitation with other professionals is not documented.
• I believe if I have an opportunity to work in an agency that required me to formulate a diagnosis and a treatment plan based upon my impression at the initial session is to first ask the client about the root cause of the problem in order to have a detail understanding of the problem because the more a professional know and understand the signs and symptoms of a client mental health disorder, the better chances of understanding either there is a progression or a regression. Secondly, knowing about the signs and symptoms based on the current diagnosis is also very important to know about as well and also asking for the client’s medical history will help to determine if such abnormalities is genetic or hereditary in nature. This will help to re-evaluate the clients current symptoms and mental health condition to see if there is a development of other signs and symptoms that is different from what is on his/her initial personal medical records. I absolutely believe this will help to influence my practice in different ways because the more information I am able to gather about my client’s condition the better chances for me to apply a therapeutic intervention measure towards treatment. If it is something that required a professional cultural competency that is above and beyond my capability then a referral will be recommended as a last resort. But if it is something that required family involvement, then I will apply a family therapeutic intervention process whereby every member of the family will be treated as a client and not just the family member affected with such abnormality but will be a group effort towards the well-being of the family member with such abnormality. This will make me ensure that every member of the family is invited during sessions in order to get them involved and see the family member with such abnormality problem as a general problem and also to make him/her feel accepted as well.
• There are different challenges of diagnosis in the military which is associated with adjustment disorder, anxiety disorder, Post-traumatic Stress Disorder (PTSD), problems with alcohol, guilt, feeling on edge especially an hyper-vigilant behavior which is very common as a result of traumatic, frightening, and life-threatening experience in a combat area. These are some major challenges and others which include relationships problems and other stressful events of life which might result to having a negative thoughts and feelings of suicide behaviors and fear of death especially during time of crises.

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