The Importance of Differential Diagnosis

Plus Earn 1 Free CE Hour on DSM-5® Differential Diagnosis for Clients with a History of Trauma

PESI Team, Margaret L. Bloom, Ph.D.

When clients have a history of trauma, it can be difficult to determine whether the anxiety, isolation, and mood changes are due to trauma, other related diagnoses, or something completely different.

In fact, according to the National Academics of Science, Engineering and Medicine, “it is estimated that 5 percent of U.S. adults who seek outpatient care each year experience a diagnostic error.”

This error rate is speculated to jump up to at least 10 percent when diagnosing mental disorders—due to the multiplicity of signs and symptoms—although this rate is not well documented.

Making differential diagnosis a part of your process

One of the key ways mental health professionals can reduce errors in mental health diagnosis is by always including a differential diagnosis as part of the diagnosis process.

Differential diagnosis is an important step in any diagnosis, but can be even more critical when a client has a history of trauma. This is because the symptoms of trauma regularly overlap with other diagnoses.

For example, when clients don’t reveal their history with trauma, their symptoms of mood swings and sleep problems could be misdiagnosed as depression or anxiety. On the other hand, if clinicians are aware of a client’s traumatic history, it can be easy to default to a diagnosis of PTSD and miss other possible disorders.

How to start differential diagnosis

Once you have conducted the initial interview and identified the client's key symptom patterns, the next step in accurate diagnosis is generating a differential diagnosis. To correctly execute differential diagnosis, you must complete two phases:

Phase One: Generate a list of all POSSIBLE diagnoses
Phase Two: Narrow the list to most PROBABLE diagnoses

Phase one requires practitioners to go broad and think of anything that could be possible given the syndromes a client has. That list is then narrowed in Phase Two, detailing the more probable diagnoses.

Learn some helpful tips on how to generate you first, broad list of all possible diagnoses in this short video clip:
Note: This clip is taken from a FREE, one-hour CE video on DSM-5® Differential Diagnosis for Clients with a History of Trauma, which discusses a case study about a man named Roger. Roger was diagnosed with Post Traumatic Stress Disorder four years ago, but is now exhibiting new changes in behavior.

Learn more about Roger, how to narrow your differential diagnosis list, and how to make the most accurate diagnosis possible in the full, FREE one-hour CE video.

DSM-5 Course Image
If you’re interested in learning even more about improving your confidence in advanced diagnosis, check out our new online course, Mastering DSM-5® Differential Diagnosis, Mental Health Documentation & Medical Necessity.

Meet the Course Expert:
Margaret (Peggy) L. Bloom, Ph.D., a licensed psychologist and NCC, is a Professor Emerita of Counselor Education and Counseling Psychology at Marquette University in Milwaukee, Wisconsin where she taught psychopathology, diagnosis and assessment and foundations of clinical mental health counseling. Previously she served on the faculties of Loyola University, Chicago, University of Memphis, Boston University, Overseas, and the University of Florida. Peggy is nationally recognized for her knowledge and expertise in assessment, DSM diagnosis and in counselor education. She is an appointed member of the Board of the Center for Credentialing & Education (National Board for Certified Counselors), an elected fellow of the American Psychological Association and a past-president of the Association for Counselor Education and Supervision. Peggy has published numerous journal articles and made professional presentations across the world.

Beginning with the introduction of the DSM-III-R, then the DSM-IV, and now the DSM-5®, Dr. Bloom has conducted DSM seminars across the United States for hundreds of psychologists, professional counselors, social workers and other mental health professionals. Peggy brings a unique interdisciplinary perspective to each DSM seminar. She began her career as a psychiatric nurse and earned graduate degrees in nursing, counseling, and counseling psychology. For a number of years she maintained a private therapy practice in addition to her university positions.

Bloom received her bachelor of science in nursing (with distinction) from the State University of New York at Buffalo, a master of science in psychiatric nursing from the University of California at San Francisco and a master’s in counseling and guidance from the University of Hawaii. She earned her Ph.D. in counseling psychology (education) from Arizona State University in Tempe. She also holds certificates in management and leadership in education from Harvard University.

Topic: DSM | Trauma

Tags: Challenging Clients | Therapy Tools | Tools | Trauma | Trauma Treatment

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