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22/08/2022
Review the diagnostic criteria on pages 99-100; 160-161; 561-562
of the DSM-5.
A counselor’s own perception of psychopathology is extremely important in the diagnostic process.
Using the case study of “Tina”, write a 500-750 word essay in which you examine your thought process about her presenting issues. Include the following in your paper:
Discuss the historic and cross-cultural perspectives of psychopathology that could potential impact the diagnosis and treatment of Tina.
After reviewing the several diagnoses that could pertain to Tina from the latest version of the DSM, what is your diagnostic impression?
Substantiate your diagnostic impression with appropriate criteria from the current version of the DSM.
Discuss how historic misconceptions of psychopathology could potentially impact the treatment of this client. As part of this discussion, you may include a diagnosis, any referrals that you would make, and a general course of treatment.
Case Study: Tina
Tina is a 17-year-old Navajo female who is brought into a counselor’s office for symptoms of depression; her family has noticed that she is more withdrawn than usual and she is often observed crying and talking to herself. Through the intake interview, the counselor learns that Tina hears voices daily that command her to perform certain acts of hygiene (showering, combing her hair, etc.). She further reveals that she believes these voices to be the result of witchcraft that her boyfriend is using to control her. Tina also states that she has used methamphetamines heavily for the past several months. She and her mother ask the counselor to work with Tina for the depression, but claim that they wish to see a medicine man for hearing voices.
Where does the counselor begin with this client? Tina is clearly demonstrating symptoms of psychoses, yet it is difficult to determine what has caused them. Is she experiencing a severe depressive episode with psychotic features? Have the voices been induced by excessive drug use? Alternatively, should the counselor take into account the cultural acceptance of witchcraft and let the medicine man exclusively treat Tina? This case study is but one example of the way different cultures deviate in concept of mental illness as it presents itself in the counselor’s office.
Viewing clients as devoid of their cultural backgrounds because notions of health and wellness differ greatly by who is defining them are unethical and unwise. In order to be as receptive as possible to a client’s position, counselors must constantly deconstruct and be aware of their own beliefs regarding psychopathology. This process of exploring a belief system has been given many names, one of which is social constructionism (Lemma, 2011).
Social constructionism is the concept that reality is formed and defined by the individual experience of it; the perceptions of any given society are constantly in flux as trends and knowledge shifts. As such, the concept of psychology changes to meet the needs of each given culture. Ruder & Guterman (2007) state that “social constructionism is, itself, a social construction that is always changing and subject to reconstruction” (p. 387).
Rudes, J. & Guterman, J. (2007). The value of social constructionism for the counseling profession: A reply to Hansen. Journal of Counseling & Development,85(4), 387-392
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