1. What are some of the challenges in diagnosing an individual with persistent depressive disorder or cyclothymic disorder versus their more severe counterparts? Explain with examples.

2. Read the case study of “Jack” located in the Topic 4 materials and provide the appropriate DSM-5 diagnoses in descending order, from the dominant, to the least dominant. For each diagnosis you assign, provide an explanation of the diagnostic criteria you assessed to be compelling, as found in the DSM-5 diagnostic criteria monograph for each disorder.

3. Review the vignettes located in the topic five materials and then diagnose Robin and Becky with a psychotic disorder. What are the justifications for your diagnosis? Include differential diagnoses that were considered and discarded.

4. Review the vignette of Brett located in the topic five materials, and then provide a DSM diagnosis. Based on your cultural background/worldview, what is your perspective on the nature of psychotic disorders?

Briefly review the biblical narrative in Mark 5: 1-20. How would you help a psychotic individual who presents to your treatment center and insists that the etiology of his disorder is spiritual in nature and not biochemical?

Review Mercer’s article and identify two or three recommendations/practices you find relevant in this source as pertaining to a clinician that considers treating Brett.

5. Obsessive-compulsive and related disorders (e.g., hoarding disorder) have gained popularity in the media in recent years. How do portrayals of these disorders in popular culture differ from the descriptions of them in the DSM? How might the media popularity affect a person’s likelihood to seek treatment?

6. In what ways do people treat their own symptoms of anxiety disorders, and trauma and stress disorders? Review the case study of Rebecca, located under the Topic 6 topic materials. Provide and justify a diagnostic impression for Rebecca.

7. It can be difficult to distinguish between symptoms of personality disorders and other psychological disorders. What are some key differences between these disorders that can assist a counselor in making an accurate diagnosis?

8. Borderline personality disorder is often viewed as a diagnosis largely given to women, whereas antisocial personality disorder is considered a man’s diagnosis. Given your understanding of gender roles in society, why do you think this dichotomy exists?

9. In the DSM-5, Gambling Disorder was moved from the “Impulse Control Disorders” category to the “Substance-Related and Addictive Disorders” category. Do you think that this was a good decision? Why or why not?

10. What are some of the popular myths about addiction with which you are familiar? Use examples.

Each answer must have 150-200 words and a cite in the answer. Should look like this

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Discussion 1

Sheila came to your office about 8 months ago seeking counseling. She stated that she, “hoped to save her marriage.” After a few sessions with Sheila, you suggested that couples counseling might be helpful, but her husband, Roy, refused to participate. Three months ago, Sheila and Roy went through a very nasty breakup of their marriage, and now you have been subpoenaed to produce all of your records pertaining to Sheila’s treatment. Sheila has told you not to comply with the subpoena.

What should you do? Why?

Describe the specific steps you would take in responding to the subpoena.

This discussion question meets the following NASAC Standards:

20) Understand the addiction professional’s obligation to adhere to generally accepted ethical and behavioral standards of conduct in the helping relationship.

21) Understand the importance of ongoing supervision and continuing education in the delivery of client services.

35) Seek appropriate supervision and consultation.

47) Inform the client of his/her confidentiality rights, program procedures that safeguard them, and the exceptions imposed by statute.

65) Apply confidentiality-related legal restrictions appropriately.

66) Demonstrate respect and nonjudgmental attitudes toward the client in all contacts with other professionals or agencies.

110) Protect client rights to privacy and confidentiality in the preparation and handling of records, especially in relation to the communication of client information with third parties.

112) Prepare and record treatment and continuing care plans that are consistent with agency standards and comply with applicable administrative rules.

116) Demonstrate ethical behaviors by adhering to established professional codes of ethics that define the professional context within which the counselor works, in order to maintain professional standards and safeguard the client.

118) Adhere to federal and state laws, and agency regulations, regarding addictions treatment.

120) Utilize a range of supervisory options to process personal feelings and concerns about clients.

122) Obtain appropriate continuing professional education.

123) Assess and participate in regular supervision and consultation sessions.

Discussion 2

Marcie is a new client and a 22-year-old female who works as a receptionist in a doctor’s office. She has just revealed to you during the intake session that she has recently lost interest in most activities, has been sleeping a great deal yet feels tired all the time, and sometimes wishes she could cease to exist. She mentioned feeling as though she has been “on an emotional roller coaster” during the past year, throughout her on-again/off-again relationship with a 35-year-old married man. The last breakup with him seemed final, and Marcie has felt herself sinking deeper and deeper into depression ever since. When probed further about suicidal ideations, Marcie admitted that she has considered killing herself, although she is uncertain whether or not she would actually do it. She said that she is currently in possession of a gun that her friend allowed her to keep in her home following a rash of burglaries in the neighborhood, but she does not know whether she would actually use it.

You have consulted with your supervisor, who has agreed that Marcie should be referred immediately for a psychiatric evaluation and has instructed you to arrange for Marcie to go directly from your office to a nearby hospital. Marcie told you that her mother accompanied her and is in the waiting room, but she has emphatically stated that she does not want her mother to know what is going on with her. How should this delicate situation be handled? Why? What are three ethical and/or legal concerns about this case?

This discussion question meets the following NASAC Standards:

20) Understand the addiction professional’s obligation to adhere to generally accepted ethical and behavioral standards of conduct in the helping relationship.

35) Seek appropriate supervision and consultation.

47) Inform the client of his/her confidentiality rights, program procedures that safeguard them, and the exceptions imposed by statute.

65) Apply confidentiality-related legal restrictions appropriately.

66) Demonstrate respect and nonjudgmental attitudes toward the client in all contacts with other professionals or agencies.

110) Protect client rights to privacy and confidentiality in the preparation and handling of records, especially in relation to the communication of client information with third parties.

112) Prepare and record treatment and continuing care plans that are consistent with agency standards and comply with applicable administrative rules.

116) Demonstrate ethical behaviors by adhering to established professional codes of ethics that define the professional context within which the counselor works, in order to maintain professional standards and safeguard the client.

118) Adhere to federal and state laws, and agency regulations, regarding addictions treatment.