Respond to at least two colleagues who had a different position than your own in the following way: Explain why you agree or disagree with whether the client meets diagnostic criteria and should be told about a “tentative” diagnosis, approach to diagnosis, or impact of diagnosis.Explain how the social worker could have worked with a supervisor to make an initial diagnosis. DB1 Christina, Diagnosis is not something that should be taken lightly. It is not a checklist of symptoms or a stack of standardized mental health surveys. A detailed assessment that outlines the bio-psycho-social-economical-cultural background of the client must be conducted to gather information. Then the use of diagnostic tools can be used by the social worker to evaluate symptoms or presenting problems of the client. This is when the social worker can begin to understand if a diagnosis is necessary. Looking at the client’s mood, cognition, behavior, and physiology the social worker can determine what the reporting issues are affecting, the time period that the presenting problem has been occurring. The social worker will put together all information collected to determine the diagnosis and treatment plan using clinical-based evidence. The DSM-5 provides a section called “Assessment Measures”, which is a multi-dimensional approach that depends on a client’s ability to self-report symptoms and the clinician’s interpretation of reports (Cooper, 2018). Identify the symptoms or “red flags” in the case study that may be evaluated for a possible mental health disorder. In the case study of Ms. Evans, the possible red flags to consider for evaluation include colleagues reports of not taking care of herself for several months, reports of being fearful, delusional, and hearing voices, decline in job performance the same amount of time, history of military service in Iraq, tox screen results showing THC, biological history of maternal mental illness. Additionally, she is awaiting an honorable discharge from service, this alone can be an extremely difficult change to deal with. Should the social worker have shared this suspected diagnosis based on the limited assessment with Ms. Evans at this time? The social worker had limited assessment information and went with what her gut told her instead of getting the necessary detailed assessment and the use of diagnostic tools necessary to come to a diagnostic conclusion of schizophrenia. The social worker professional obligation is to not only to make a clinical diagnosis but in doing so looking at the client’s general medical health, psychosocial and environmental concerns, and to assess the client’s level of functioning with the presenting problem (Cooper, 2018). I believe this was poor judgment on the social worker's behalf. Explain the potential impact of this diagnosis immediately and overtime if the “tentative” diagnosis is a misdiagnosis. The impact of giving a tentative misdiagnoses can not only have immediate effects but also have long term effects. Schizophrenia is a type of psychotic disorder however other things can cause psychosis such as drugs and medical conditions. Schizophrenia is also treated with pharmacological medications such as anti-psychotics that can have serious side effects. A diagnosis in the client’s medical records can have profound effects on all aspects of life. The military discharges individuals for mental health diagnosis, and with this diagnosis, she would lose all military retirement benefits as well. Giving the wrong diagnosis is irresponsible and unethical. When may it be appropriate to use a provisional diagnosis? A provisional diagnosis is given when the social worker does not have enough information to make a diagnosis. The specifier provisional is only used when the social worker feels strongly that the full criteria of the diagnosis will be met once more information is obtained (American Psychiatric Association, 2013). Such as when a diagnosis has a specifier of a specific time length requirement. When would diagnosis as other specified and unspecified disorders? The social worker can use the other specified disorder when the presenting problem’s presentation does not meet the criteria for any one specific category within the diagnostic class and must state specific reasons (American Psychiatric Association, 2013). The unspecified disorder is used when the social worker chooses to not specify the specific reasons the criteria are not met (American Psychiatric Association, 2013). According to the DSM-5 (2013), the difference is entirely clinical judgment and left up to the social worker. References American Psychiatric Association. (2013). Introduction and Use of Manual. In Diagnostic and statistical manual of mental disorders (pp. 5–24). introduction, American Psychiatric Publishing. Cooper, R. (2018, March). Understanding the DSM-5: stasis and change. https://www.ncbi.nlm.nih.gov/pubmed/29183162. DB 2 Brandy, As we are aware, traumatic experiences can have a long-lasting affect on a person’s mental state especially if the person does not seek treatment. In the case study, Ms. Evans was serving in the military on tour in Iraq and she began to experience, and express specific issues that caused concern for her mental state. Some of the “red flags” identified in the case study that could be viewed as a possible symptoms of a mental health disorder include: thinking and expressing her fear of the world ending in 2020 due to the voices in her head, self-diagnosis of depression and appearing fearful by those close to her. According to Roberts and Trockel (2015), there were other concerns, such as changes in her behavior, for example there was a decline in her job performance and her ADLs or self-care have decreased. It was noted that Ms. Evans was positive for THC (tetrahydrocannabinol), which may be problematic due to certain symptoms displayed could be enhanced by the substances she is consuming. One must consider several things when dealing with substance use, which include frequency and self-medication likelihood. These should be considered when there is trauma involved along with the severity of symptoms being exhibited. The more information gathered during the assessment portion, the higher probability of having an accurate and effective treatment plan (Neukrug & Fawcett, 2015). A misdiagnosis due to lack of information can be detrimental to a client, especially when medications are involved, because it can cause adverse effects with the client in turn possibly worsening the symptoms or situation. According to Paris (2015), “When a tentative diagnosis is a misdiagnosis and that diagnosis is then communicated with the patient it can interfere with treatment and pigeonhole them into categories that they do not belong in, resulting in self-stigma.” In my professional opinion it was premature to share the tentative diagnosis with the client based off the information gathered, because there are several diagnoses that have similar symptoms. I believe further assessment needs to be completed, with the assistance of a psychologist and/or psychiatrist. Provisional diagnosis may be appropriate to use when the clinician is certain the full criteria of a diagnosis will be met once enough information is obtained (American Psychiatry Association, 2013).Clinicians can used other specified with a diagnosis if a client does not meet the full criteria and documenting the criteria(s) not met. Clinicians may use unspecified in the same manner with a diagnosis; however, they are not required to document the criteria not met. According to American Psychiatry Association (2013), there is no requirement placed on the clinician on which of the two they can use. References: Neukrug, E. S., & Fawcett, R. C. (2015). Diagnosis in the assessment process. In E. S. Neukrug & R. C. Fawcett, Essentials of testing and assessment: A practical guide for counselors, social workers, and psychologists (3rd ed., pp. 43–58). Stamford, CT: Cengage Learning Paris, J. (2015). The Intelligent Clinician’s Guide to the DSM-5 (Vol. Second edition). Oxford: Oxford University Press. Roberts, L. W., & Trockel, M. (2015). Case example: Importance of refining a diagnostic hypothesis. In L. W. Roberts & A. K. Louie (Eds.), Study guide to DSM-5 (pp. 6–7). Arlington, VA: American Psychiatric Publishing.