Review Question
January 20, 2020
Critical Assignment Case Study 4
January 20, 2020
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dq1 res to gail 2050

MAIN POST
Discussion 1: More information about self~ Initial Post Due 1/19/20

Please briefly introduce yourself.  For the RC, please be sure to trigger your attendance in the course shell by taking the attendance quiz. Be sure to order your text books ASAP if you haven’t already.
1) Mention if you are or hope to be a clinician and the population you would like to serve. (If you are already diagnosing, please share a bit about how you experience it.)
2) Briefly define psychopathology in a way your grandmother could understand.
3) Please discuss any early thoughts, ideas or hopes you have concerning identifying, conceptualizing and treating psychopathology. What do you know and think about diagnosing in general?And, what about the new diagnostic manual, the DSM-5? Any thoughts about it at this point of the course?
Your initial post should always be due by the Sunday night. Your responses (at least two) should be posted by Wednesday night.  You will not have discussion posts due on the weeks where you have a paper due.  Those will generally be due on Wednesdays.  You are responsible for your level of engagement with your peers. My hope is that you will want to engage in the discourse that arises from these topics.

Gails RESPOND TO MAIN POST

Manage Discussion Entry

Hi Class! My name is Gail Lewis. I have been an Licensed Clinical Professional Counselor (LCPC or LPCC) for 22 years. I have a Masters Degree in Clinical Counseling. I am licensed in Colorado and California and see clients in my private practice. I am interested in seeing elders, who have Medicare insurance and to perform psychological assessments, both cognitive and projective.
I enjoy diagnosing and have been licensed to diagnose since earning my Masters in Clinical Counseling. However, there is always something new to learn about the practice of diagnosis. The DSM is always changing, and clinicians do need to diagnosis both to help inform themselves about treatment options or suggestions for referral to psychiatry for medication and to bill insurance.
In diagnosing, I am concerned about how my client will react to the diagnosis I have given, especially when the client has a major mental illness such as borderline personality disorder (BPD), schizophrenia, bi-polar, dissociative identity disorder, autistic spectrum disorder, and obsessive-compulsive disorder (OCD), among others.  BPD still has a high amount of stigma in the world of psychological treatment, and although there is DBT (Dialetical Behavior Therapy) and other approaches which have improved the lives of people with BPD, there are those with profound symptomology that defy therapy and medical management. I do take people with BPD, and this population is still quite a challenge to work with. The stigma remains surrounding this diagnosis. Some people are diagnosed with bi-polar disorder instead because there is less stigma attached.
In diagnosis, there is often comordity and co-occurring disorders, so diagnosis can be very complicated. I still know its necessary. It is important that we remember that these are foremost people, not the diagnoses they have been labelled with.
I do not like the newest DSM-5 as much as previous versions, like DSM-4. There were changes in how autism is diagnosed and labelled, grouping  people whose diagnosis was Aspergers Syndrome to the broad spectrum of Autistic Spectrum Disorder (ASD). I personally know clients and friends who prefer to refer to themselves or their associates as having Aspergers Syndrome and continue to use that terminology, although it no longer exists in the new DSM. Another change in the DSM-5 was to rearrange the personality disorders so that there are no longer clusters of personality disorders with similar or related symptoms, such as Clusters A, B or C. I found that organization to be useful in my conception for treatment modalities for my clients.
Psychopathology includes any mental illness diagnosis that exists. It may be depression, anxiety, personality disorders, dissociative disorders, developmental disorders like autism, eating disorders, schizophrenia and more.  How I would explain psychopathology to my grandmother would be to ask her to remember what she called her nervous breakdown.  There was even more stigma attached to even depression or anxiety in her middle adulthood. My grandmother took to her bed, over-sleeping and eating very little, with many tears and no motivation to get up for anything, including personal hygiene or housework or for a leisurely walk around the house or outdoors.  Because of the stigma, I believe medical doctors blamed mental illness on the nervous system, thereby averting attention to a physical illness. My grandfather was told to ignore my grandmother and her symptoms. He was told to ignore her tears and sadness! Over time she recovered, but she would openly refer to her nervous breakdown to family members whenever a friend of hers would die (as my grandmother far outlived her friends and family as she lived to age 96). My grandmother obviously knew her nervous breakdown was due to psychic distress and profound sadness, an emotional illness.  Psychopathology was referred to a nervous breakdown by laypeople far into the late part of the twentieth century, and took many different forms. There was scant medication for mental illness in the early part of last century. Psyche means the mind and pathology means illness.

Craighead, E. W., Miklowitz, D. J., & Craighead, L. W. (2013). Psychopathology: History, diagnosis and empirical foundations (2nd ed.). Hoboken, NJ: Wiley.

Diagnostic and statistical manual of mental disorders: DSM-5. (2013). Washington, DC: American Psychiatric Association. (Saybrook University library: PsychiatryOnline database.

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