What might you do in these situations? What are the pros and cons to
the various options, and what do you see as being the best approach to take? Are there any negative
consequences to your chosen actions? What might you do to minimize and/or
counteract those? Is there any way you could
have prevented these situations from arising in the first place?
1. Although you’ve only worked with Ms. Brown for a few sessions,
you readily developed a diagnosis for her of Borderline Personality Disorder.
Today she began the session asking what Borderline Personality Disorder
is, and how you know that’s what’s wrong with her. When you ask where
she heard that term, she says that she saw the code on her insurance forms,
and looked it up in the library.
1a. Same scenario as above, but she already has looked up what
Borderline Personality Disorder means and tells you she disagrees with
the diagnosis. She also tells you that she read that therapists hate
having clients with BPD, and that she doesn’t want that to go on her record.
2. Mr. and Mrs. White have requested a learning disabilities evaluation for their son. He is not doing well in school, and seems to have many difficulties with his schoolwork and homework. If he receives a learning disability diagnosis, it will be a part of his permanent record, and he will be eligible for special education services and accommodations. Your evaluations shows that although he is performing below his abilities, he does not meet criteria for an LD. Mr. and Mrs. White are not pleased with this outcome, and say that if you do not certify that he has an LD, they will find someone who does.
2a. What if he DID meet criteria for an LD, but that outcome displeased his parents who want to ensure that their son is not stigmatized so early in life?
2b. What if the person being evaluated was a college junior who
was about to take the LSATs, and requested the evaluation because although
she’s struggled successfully through high school and college despite her
difficulties in reading, she wants to give herself every advantage to do
well on the LSATs and knows she can use the extra time allotted for people
with LDs?
3. You’ve completed an assessment that you felt fully addressed your client’s presenting complaints. You plan to use this assessment to present to your faculty for your required case study exam. Shortly before the exam, you discover that one or more faculty members require types of tests or measures you had not included, as you did not feel them necessary. It is too late for you to begin putting together a different assessment case to present, and you believe the client, who you are now treating, would be amenable to completing these additional tests.
3a. Same scenario as above, but the specific test you have heard is required is one that has little psychometric data to support its use. In addition, it takes a fairly long amount of time to administer, score, and interpret.