Ecpy 621 class 3
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ECPY 621 – Class 3. CPT, Case Conceptualization, and Treatment Planning. Overview. Review last week Activity CPT coding Case Conceptualization Activity. Most Valid Diagnoses by Freq. in General Population – Common. Major Depressive Disorder, Single Episode Alcohol Dependence

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ECPY 621 – Class 3

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Ecpy 621 class 3

ECPY 621 – Class 3

CPT, Case Conceptualization, and Treatment Planning


Overview

Overview

  • Review last week

  • Activity

  • CPT coding

  • Case Conceptualization

  • Activity


Most valid diagnoses by freq in general population common

Most Valid Diagnoses by Freq. in General Population – Common

  • Major Depressive Disorder, Single Episode

  • Alcohol Dependence

  • Bipolar I Disorder

  • Schizophrenia

  • Major Depressive Disorder

  • Somatization Disorder

  • Borderline Personality Disorder


Most valid diagnoses by freq in general population less common

Most Valid Diagnoses by Freq. in General Population – Less Common

  • Panic Disorder with or w/o agoraphobia

  • Dementias – Including Alzheimer’s, Vascular, Due to HIV Infection

  • Antisocial Personality Disorder

  • Obsessive-Compulsive Disorder

  • Mental Retardation

  • Anorexia Nervosa


Most valid diagnoses by freq in general population rare

Most Valid Diagnoses by Freq. in General Population – Rare

  • Learning disorders

  • Gender Identity Disorder

  • Tourette’s Disorder

  • Autistic Disorder

  • Delusional Disorder


Hierarchy of conservative diagnoses

Hierarchy of Conservative Diagnoses

  • Most Favorable

    • Major Depressive Disorder

    • Bipolar I Disorder

  • Middle Ground

    • Alcohol Dependence

    • Panic Disorder

    • Specific or Social Phobia


Hierarchy of conservative diagnoses1

Hierarchy of Conservative Diagnoses

  • Middle Ground – cont’

    • Obsessive- Compulsive Disorder

    • Anorexia Nervosa

    • Substance Dependence – other than alcohol

    • Borderline Personality Disorder


Hierarchy of conservative diagnoses2

Hierarchy of Conservative Diagnoses

  • Least Favorable

    • Schizophrenia

    • Antisocial Personality Disorder

    • Dementia Due to HIV Disease

    • Dementia of the Alzheimer’s Type


Cpt coding

90804

Individual psychotherapy, insight oriented, behavior modifying and/or supportive, in an office or outpatient facility, approximately 20 to 30 minutes face-to-face with the patient:

90805

with medical evaluation and management services

CPT coding


Cpt coding cont

90808

Individual psychotherapy, insight oriented, behavior modifying and/or supportive, in an office or outpatient facility, approximately 75 to 80 minutes face-to-face with the patient;

90809

with medical evaluation and management services

CPT coding cont’


Seligman chapter one

Seligman – Chapter one

  • Determinants of Tx outcome

    • Therapist related

    • Client related

    • Therapeutic alliance

    • Treatment Variables


Do a client map

Do a Client Map

  • Diagnosis

  • Objectives of Tx

  • Assessments

  • Clinician characteristics

  • Location of Tx

  • Interventions to be used*

  • Emphasis of Tx*


Do a client map1

Do a Client Map

  • Number

  • Timing

  • Mediations needed

  • Adjunct services

  • Prognosis


Interventions elements of

Interventions – Elements of

  • Maintaining positive therapeutic alliance

  • Providing support

  • Providing information/education

  • Reducing painful feelings

  • Decreasing specific maladaptive behaviors

  • Modifying specific misperceptions

  • Helping put concerns in context


Emphasis

Emphasis

  • Insight vs. action

  • Directive vs. vocative

  • Systemic vs. client centered

  • Group vs. individual

  • Short vs. long term

  • Planned vs. spontaneous

  • With vs. without homework


Psychotherapeutic approaches

Psychotherapeutic Approaches

  • Psychoanalysis

  • Psychodynamic

  • Behavior Therapy

  • Cognitive Therapy

  • No Treatment


Other approaches berman

Other approaches – Berman

  • Styles

    • Assumption based

    • Symptom based

    • Interpersonally based

    • Developmentally based

    • Diagnosis based


Case conceptualization

Case Conceptualization

1. Identifying data: age, sex, race, marital/family status, school and/or job status, living situation, etc.

2. Presenting problem: client's words and from counselor's point of view; prioritize problems

3. History of presenting problem: duration of presenting problem; precipitating events for seeking counseling, (sudden or insidious), previous problem solving and resources used


Case conceptualization1

Case Conceptualization

4. Previous counseling or help seeking: attitudes about that, results

5. Medical concerns: illnesses/ problems; medications

6. Alcohol and drug use

7. Social history physical, social, emotional, spiritual; support systems

8. Family history: past and present relationship with family, problems an strengths of family


Case conceptualization2

Case Conceptualization

9. Mental status:

  • affect: appropriate, blunted, constricted

  • judgment: intact, impaired

  • oriented or disoriented

  • thought process: intact, flight of ideas

  • mood: anxious, depressed

  • memory: intact, impaired

  • speech‑ normal, loud, soft, pressured

  • suicidal or homicidal ideation

  • attitude: cooperative, angry


Case conceptualization3

Case Conceptualization

10. Symptomatology: frequency, duration, intensity of symptoms:

Depression as evidenced by _________________

Anxiety as evidenced by ___________________

Stress as evidenced by _____________________

11. a) Impairment in functioning: school, social relations, family, job

b) Current functioning as compared to past year


Case conceptualization4

Case Conceptualization

12. Strengths, assets:

13. Counseling goals: Long and Short Term (Measurable)

14. Counseling techniques, strategies, interventions


Activity

Activity

  • TWISTED SISTER


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