clinical assessment and diagnosis

clinical assessment and diagnosis essay assignment

.4.1 What are the basic elements in assessment?

· 4.2 What is involved in the assessment of the physical organism?

· 4.3 What is psychosocial assessment?

· 4.4 How do practitioners integrate assessment data?

· 4.5 What is the process for classifying abnormal behavior?

The assessment of the personality and motivation of others has been of interest to people since antiquity. Early records show that some individuals used assessment methods to evaluate potential personality problems or behaviors. There are documented attempts at understanding personality characteristics in ancient civilizations. Hathaway ( 1965 ) points out that one of the earliest descriptions of using behavioral observation in assessing personality can be found in the Old Testament. Gideon relied upon observations of his men who trembled with fear to consider them fit for duty; Gideon also observed how soldiers chose to drink water from a stream as a means of selecting effective soldiers for battle. In ancient Rome, Tacitus provided examples in which the appraisal of a person’s personality entered into their leader’s judgments about them. Tacitus (translated by Grant, 1956 , p. 36) points out that Emperor Tiberius evaluated his subordinates in his meetings by often pretending to be hesitant in order to detect what the leading men were thinking.

Online nursing papers clinical assessment and diagnosis Essay assignment paper

Psychological assessment is one of the oldest and most widely developed branches of contemporary psychology, dating back to the work of Galton ( 1879 ) in the nineteenth century (Butcher, 2010 ; Weiner & Greene, 2008 ). We will focus in this chapter on the initial clinical assessment and on arriving at a clinical diagnosis according to DSM-5. Psychological assessment refers to a procedure by which clinicians, using psychological tests, observation, and interviews, develop a summary of the client’s symptoms and problems. Clinical diagnosis is the process through which a clinician arrives at a general “summary classification” of the patient’s symptoms by following a clearly defined system such as DSM-5 or ICD-10 (International Classification of Diseases), the latter published by the World Health Organization.

Assessment is an ongoing process and may be important at various points during treatment, not just at the beginning—for example, to examine the client’s progress in treatment or to evaluate outcome. In the initial clinical assessment, an attempt is usually made to identify the main dimensions of a client’s problem and to predict the probable course of events under various conditions. It is at this initial stage that crucial decisions have to be made—such as what (if any) treatment approach is to be offered, whether the problem will require hospitalization, to what extent family members will need to be included as coclients, and so on. Sometimes these decisions must be made quickly, as in emergency conditions, and without critical information. As will be seen, various psychological measurement instruments are employed to maximize assessment efficiency in this type of pretreatment examination process (Harwood & Beutler, 2009 ).

A less obvious, but equally important, function of pretreatment assessment is establishing baselines for various psychological functions so that the effects of treatment can be measured. Criteria based on these measurements may be established as part of the treatment plan such that the therapy is considered successful and is terminated only when the client’s behavior meets these predetermined criteria. Also, as we will see in later chapters, comparison of posttreatment with pretreatment assessment results is an essential feature of many research projects designed to evaluate the effectiveness of various therapies.

In this chapter, we will review some of the more commonly used assessment procedures and show how the data obtained can be integrated into a coherent clinical picture for making decisions about referral and treatment. Our survey will include a discussion of physical, neurological, and neuropsychological assessment; the clinical interview; behavioral observation; and personality assessment through the use of projective and objective psychological tests. Later in this chapter we will examine the process of arriving at a clinical diagnosis using DSM-5.

Let us look first at what, exactly, a clinician is trying to learn during the psychological assessment of a client.

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clinical assessment and diagnosis