Applications of Behavior Analysis in Healthcare and Beyond by Unknown

Author:Unknown
Language: eng
Format: epub
ISBN: 9783030579692
Publisher: Springer International Publishing

Assessment, Treatment, and Therapist Repertoires in Clinical Behavior Analysis

Diagnostic Assessment

Currently, mental health services are mostly organized according to a diagnostic framework; understanding this system is a basic skill necessary for therapists who wish to work in an outpatient mental health setting. Disorders are classified based on symptom counts, and the goal of treatment is to decrease these symptoms. In the USA, the Diagnostic and Statistical Manual of Mental Disorders (DSM; American Psychiatric Association 2013) is the main framework that guides diagnostic assessment; international work uses the International Statistical Classification of Diseases and Related Disorders (ICD) classification system (World Health Organization 2004), and the current versions of these systems are quite similar. The DSM is currently in its fifth edition, and each revision has been controversial (e.g., see Follette and Houts 1996; Greenberg 2013; Whitaker and Cosgrove 2015). A common diagnosis is major depressive disorder, which requires that five of nine of the following symptoms to occur in a two-week period: depressed mood, diminished interest or pleasure, significant weight loss or gain, insomnia or hypersomnia, fatigue or loss of energy, feelings of worthlessness or inappropriate guilt, diminished ability to concentrate or indecisiveness, and recurrent thoughts of death. Importantly, these symptoms must also cause the individual “clinically significant distress or impairment in social, occupational, or other important areas of functioning” (p. 161).

The gold standard method for categorizing the problems of a particular individual is to conduct a semi-structure diagnostic interview (e.g., the Structured Clinical Interview for DSM-5 Disorders (SCID-5; First et al. 2016), Kiddie-Schedule for Affective Disorders and Schizophrenia Screen Interview (KSADS; Kaufman et al. 1997)). These instruments guide the assessor through a decision tree to determine which diagnoses best match an individual’s description of their problem and concurrent behavioral observations.

Knowledge of latent constructs and self-report measures that assess symptoms is also important. An example of a common self-report measure is the Beck Depression Inventory (BDI), which asks individuals to report on the severity of each depression symptom in the past 2 weeks (Beck et al. 1996). Measures such as the BDI are commonly used to screen individuals for further assessment and intervention as well as to track treatment progress.

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