CNL-610: Topic 3 Reading: Utilizing the Assessment Instruments Introduction One of the critical parts of the DSM-5 assessment process is the use of the free assessment instruments that are provided with the DSM (American Psychiatric Association, 2013). The following link provides 80 free downloadable assessments that provide additional diagnostic information about the client: http://www.psychiatry.org/practice/dsm/dsm5/online-assessment-measures (American Psychiatric Association, 2014) Level 1 Cross-Cutting Symptom Measure There are several different categories of assessments. The Level 1 Cross-Cutting Symptom Measure is a 23-item assessment instrument that screens for the following: • depression • anger • mania • anxiety • somatic symptoms • suicidal ideation • psychosis • sleep problems • memory • repetitive thoughts and behaviors (OCD) • dissociation • personality functioning • substance use in adults (American Psychiatric Association, 2013). There is an adult version, a version for children 11-17, and a version for parents to fill out for children 6-17. This instrument is a good initial intake instrument to screen for a variety of mental health disorders (American Psychiatric Association, 2013). The scores on the Level 1 instrument can lead the clinician to follow-up instruments to further screen for particular mental health disorders. One of the valuable aspects of the assessments is that they are all very short (5-10 items) so they can be administered quickly. They can be used for initial assessment and for following progress of therapy (American Psychiatric Association, 2013). For example, the depression inventory could be used every few sessions to follow progress of therapy. Level 2 Assessments Level 2 Assessment for Adults For adults, there are Level 2 assessments for: • depression • anger • mania • anxiety • somatic symptoms • sleep disturbance • repetitive thoughts and behaviors • substance use. (American Psychiatric Association, 2013). Level 2 Assessments for Parents of Children Ages 6-17 The Level 2 assessments for parents of children 6-17 screen for: • somatic symptoms • sleep disturbance • inattention • depression • anger • irritability • mania • anxiety • substance use (American Psychiatric Association, 2013). Level 2 Assessments for Children Ages 11-17 The Level 2 instruments for children from 11-17 measure: • somatic symptoms • sleep disturbance • depression • anger • irritability • mania • anxiety • repetitive thoughts and behavior • substance use (American Psychiatric Association, 2013). Severity Measures There are also a series of severity measures for adults and children. Severity measures are specific to a disorder and measure how severe the disorder is. Some assessments can be completed by the client, while others must be administered by the counselor (American Psychiatric Association, 2013). Severity Measures for Adults For adults, there are severity measures for: • depression • separation anxiety • specific phobias • social anxiety disorder • panic disorder • agoraphobia • generalized anxiety disorder • posttraumatic stress symptoms • acute stress symptoms • dissociative symptoms (American Psychiatric Association, 2013). Severity Measures for Children Ages 11-17 For children 11-17, there are severity measures for: • depression • separation anxiety disorder • specific phobia • social anxiety disorder • panic disorder • agoraphobia • generalized anxiety disorder • posttraumatic stress disorder • acute stress symptoms • dissociative symptoms (American Psychiatric Association, 2013). Other Severity Measures Additionally, there are some clinician-rated severity measures for autism spectrum disorder, psychosis severity, somatic symptom disorder, oppositional defiant disorder, conduct disorder, and nonsuicidal self-injury. One of the most important assessments for measuring the severity of a disorder is the WHODAS (World Health Organization Disability Assessment Schedule). This, in combination with the other severity measures, will give clinicians a way to assess how severely the disorder is impacting the client’s functioning. This can substitute for the GAF score (Axis 5) on the DSMIV-TR, the previous version of the DSM (American Psychiatric Association, 2013). There is also an early development and home background assessment for parents or clinicians to complete. All of these assessments help clinicians screen for a variety of disorders. They can also help to provide a more depth assessment of disorders that they suspect from the initial intake. Other Assessments There are several other assessments that may be very useful in initial screening. It is very important to assess for substance use disorders. There are a number of common assessments that are very helpful for this kind of screening. One source of instruments such as the Michigan Alcoholism Screening Test (MAST), Alcohol Use Disorder Identification Test (AUDIT), Drug Abuse Screening Test (DAST), and Cut/Annoyed/Guilty/Eye opener (CAGE) is Project Cork, at http://www.projectcork.org/clinical_tools/ (Project Cork, 2010). It is also very important to screen for a client’s trauma exposure. One of the valuable instruments for completing a quick trauma screening is the Life Events Scale (LEC), which can be found at: http://www.ptsd.va.gov/professional/assessment/te-measures/life_events_checklist.asp (National Center for PTSD, n.d.) These instruments are not only valuable in the initial assessment process but are also short enough to use as frequent measures of therapeutic progress. For example, the Level 2 Depression Scale is eight questions (National Center for PTSD, n.d.). It could be administered at the beginning of every session to see if the client’s depression level is improving. References American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing American Psychiatric Association. (2014). Online assessment measures. Retrieved from http://www.psychiatry.org/practice/dsm/dsm5/online-assessment-measures National Center for PTSD. (n.d.). Life events checklist for DSM-5 (LEC-5) -. Retrieved from http://www.ptsd.va.gov/professional/assessment/te-measures/life_events_checklist.asp Project CORK. (2010). Clinical tools. Retrieved from http://www.projectcork.org/clinical_tools/ © 2019. Grand Canyon University. All Rights Reserved. 1. Diagnosis and Treatment Planning Skills Read Chapter 3 in Diagnosis and Treatment Planning Skills. URL: http://gcumedia.com/digital-resources/sage/2014/diagnosis-and-treatment-planningskills_ebook_2e.php 2. SAMHSA Explore the SAMHSA website to learn about the importance of coordination and collaboration with mental health services. URL: https://www.samhsa.gov/ 3. ACA Code of Ethics Explore the ACA Code of Ethics website. URL: http://www.counseling.org/knowledge-center/ethics 4. Cognitive Case Conceptualization and Treatment Planning Read “Cognitive Case Conceptualization and Treatment Planning,” by Wenzel, from American Psychological Association (2013). URL: https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com.lopes.idm.oclc.org/login.aspx ?direct=true&db=pzh&AN=2013-02671-002&site=ehost-live&scope=site 5. ICD, DSM, and the Tower of Babel Read “ICD, DSM, and the Tower of Babel,” by Frances, from the Australian and New Zealand Journal of Psychiatry (2014). URL: http://journals.sagepub.com.lopes.idm.oclc.org/doi/abs/10.1177/0004867414526792 6. Utilizing the Assessment Instruments Read "Utilizing the Assessment Instruments." 7. Psychiatric Presentations/Manifestations of Medical Illnesses Read “Psychiatric Presentations/Manifestations of Medical Illnesses," by Castro & Billick, from Psychiatric Quarterly (2013). URL:https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true& db=cmedm&AN=23456449&site=eds-live&scope=site
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