Diagnostic Assessment 1

Purpose:

This assignment helps you practice diagnostic reasoning by applying DSM-5-TR criteria to real client presentations. You will watch pre-recorded interviews, identify a diagnosis, connect symptoms to each criterion, consider differentials, highlight client strengths, and propose treatment goals.

Link to Diagnostic Assessment 1: https://youtu.be/d6E8CiApCzQ

Instructions:

You will be given access to four recorded client interviews. Each recording presents a different client scenario. For each case, write a diagnostic assessment paper (12 single-space pages) that includes the following sections:

1. Identifying Information and Diagnosis

• Situate the clients intersectional identity and summarize their history.
• Identify the most accurate DSM-5-TR diagnosis for the client.
• Clearly connect the clients reported symptoms to each diagnostic criterion.
• Example: The client meets Criterion A because she reports a depressed mood nearly every day for four months and has experienced a loss of appetite and hypersomnia nearly every day. She meets Criterion B because she has missed the last week of work and canceled appointments with friends.

1. Client Strengths

• Identify at least five specific strengths (e.g., coping skills, supports, values, resilience factors).

1. Differential Diagnosis

• Identify at least one differential diagnosis.
• Describe which criteria fit the clients presentation, which did not, and why you ruled this diagnosis out.

1. Treatment Goals

• Identify at least one broad treatment goal for the client.
• Write at least two SMART objectives (Specific, Measurable, Achievable, Relevant, Time-bound).

Format:

• 1-2 pages, single-spaced.
• Write in clear, professional prose (not bullet points only).
• APA format is not required.
• Use the Diagnostic Assessment Example provided as a model.
• Please submit as a Word file (.doc or .docx). Other file types will not be accepted.

Diagnostic Assessment Example

Primary Psychiatric Disorder(s): F50.01 Anorexia nervosa, restricting type, severe

Rationale (what did you see that supports the diagnosis?)

Client is a 54 17-year-old heterosexual cisgender White female who reports that she weighed 115 pounds two years ago when she was on a competitive gymnastics team and was pressured by her coach to lose weight. She then decided to go on a diet that got a little out of control. She has steadily lost weight over the past two years, and now she is at her lowest weight at 87 lbs. She is currently not participating in sports and is on medical homeschooling due to her frailty and low body weight. She was hospitalized last month for medical re-feeding and gained eight pounds in the hospital, but has since lost six pounds. Although markedly underweight, she says that she feels fatter than ever and perceives herself to be obese. She confided during the interview that her parents give her high-calorie supplemental nutrition shakes when she does not eat at family meals, and she pretends to drink them but secretly pours them out whenever she can. She also reports that she exercises frantically by running around her room and doing jumping jacks. She reports that she must exercise secretly because her doctor forbade her to exercise.

She meets criteria A for anorexia nervosa, restricting type, because she reports restrictive food intake and dangerously low body weight. She meets criteria B because she reports intense fear of gaining weight, being fat, and behavior that interferes with weight gain, such as pouring out her nutritional shakes. She meets criteria C because she lacks insight into her underweight condition, reporting herself to be fatter than ever despite her awareness of her current weight. She meets the criteria for restricting type because she denies any purging behavior. Her weight loss is accomplished through fasting and excessive exercise.

Client Strengths:

1. Client is a bright young woman who aspires to be a doctor.
2. Client is fearful of gaining weight but reports a high degree of motivation for treatment.
3. Clients parents are supportive, and the home/family environment is stable.
4. Client has health insurance, so she has good access to care.
5. Client reports having some strong friendships.
6. Client denies any complicating legal history that might interfere with treatment.
7. Although her physical condition is fragile, the client is alert and responsive and can engage in change-focused psychotherapy.
8. Other than her eating disorder, cthe lient has no complicating psychiatric illnesses.
9. Client is not suicidal or homicidal.

Differential Diagnosis

I considered a diagnosis of bulimia nervosa (BN) because she reported that she secretly binges at least twice a week. However, on further questioning, she reported that her typical binge includes exactly 25 Cheerios and an eighth of a cup of skim milk. Although this seems like binge behavior to her, given her distorted thoughts about food intake, this does not meet criteria for a BN binge, described in the DSM as an amount of food definitely larger than what most individuals would eat in a similar period of time.

Treatment Goal:

• Challenge and reduce distorted beliefs about food intake and body size to support healthier self-perceptions.

SMART Objectives:

1. Cognitive Reframing: Within the next 4 therapy sessions, client will identify at least 3 distorted thoughts related to body size or food (e.g., I am fat even though I am underweight) and practice reframing each thought into a more balanced statement, as documented in session notes.
2. Behavioral Experiment: By the end of 6 weeks, client will participate in at least 2 therapist-guided exposure exercises (e.g., eating a forbidden food item in session or challenging mirror-checking behavior) and record her emotional response, demonstrating reduced distress over time.