339 Session 2

Diagnostic labels may lead to the loss of:

custody, employment, health insurance, right to make decisions about legal/health affairs, freedom

fundamental attribution error (in general psychology)

tendency to over-emphasize dispositional or personality-based explanations for behaviors observed in others while under-emphasizing situational explanations

fundamental attribution error (in assessment)

when a therapist fails to consider effects of social factors on individual’s behaviors? attitudes (e.g. poverty, marginalization, etc)

Formulation approach to diagnosis

working out the most likely explanations as one can tell of the causes or perpetuating factors of a person’s behavior

who is behind the formulation approach?

Caplan and Cosgrove

how clinicians address bias in diagnosis? Consider the ___ of their ___ on client’s ___ outside of ___

1. effects, diagnoses, treatment

how clinicians address bias in diagnosis? Consider treatment implications of giving a client

one diagnosis over another

how clinicians address bias in diagnosis? Record __s and other __ considered

rule outs, diagnoses

how clinicians address bias in diagnosis? Be willing to write ___, make ___ to minimize __________ in various areas of client’s life

write letters, statements, deleterious effects of diagnosis

how clinicians address bias in diagnosis? Follow ___ of the profession

ethical standees,

how clinicians address bias in diagnosis? Seek___ when indicated to protect __ and _

legal advice, self, client

how clinicians address bias in diagnosis? Fully inform clients of the
__,
__,
__,
_,
what clinician can do to _ the client

diagnosis, rationale, benefits, risks, protect

how clinicians address bias in diagnosis? Stay __ about the various potential & active _ and _ _ of diagnoses

informed, positive, negative consequences

how clinicians address bias in diagnosis? Keep __ informed

public

Social Constructionist Viewpoint

looks at how BPD was developed as a diagnostic category and how it gets used present day

Social Causation Viewpoint

explains the prevalence of women in BPD category as products
of power, resources, coping styles & risk for sexual abuse & violence

Main Points to Shaw and Proctor

• women’s deviancy (witchcraft to hysteria to BPD)

• psychiatric concepts/expectations = gendered & dichotomous (woman associated w irrationality, silence, nature, men associated w reason, culture, logic)

• denial and/or minimization in field of etiological importance of abuse, trauma, oppression for distress (Freud’s ‘false memory syndrome’)

Acculturation

process of cultural and psychological change that
results following meeting between cultures; occurs in levels

Acculturation (example)

me vs Izzie

Individual racism

overt acts of discrimination by individuals on the
basis of skin color that cause death, injury, destruction of property, or
denial of services or opportunity.

Cultural racism

societal beliefs and customs that promote the
assumption that the products of a given dominant culture, including the
language and traditions of that culture are superior to those of other
cultures.(Assumption White is the norm & is superior)

Institutional racism

polices, practices, and procedures of institutions
that have a disproportionately negative effect on racial minorities’
access to and quality of goods, services, and opportunities.

Cultural Identity

extent to which an individual endorses and
manifests the cultural traditions and practices of a particular group
(Marsela & Yamada)

Healthy Paranoia or Health cultural paranoid

cultural response style based on experiences of racism and oppression in White-
dominant society; a reasonable and adaptive cultural mistrust exhibited
by members of minority cultures

Prejudice and racial discrimination are in themselves __
situations that could lead to difficulties &
issues

stressful, emotional, identity

Color blindness is a form of !

racism

Culturally related V codes

• R , S problem

• A problem

• Target of D.

• I issues (Partner distress; parent-child; sibling)

• E. or O. difficulties

• I. problem

• L. issues

• Problems with H.

• Issues of A. or N. (partner abuse; child abuse)

1. Religious, Spiritual
2. Acculturation
3. discrimination
4. Interpersonal
5. Education, occupational
6. Identity
7. Legal
8. housing
9. Issues of abuse or neglect

3 general guidelines when using V codes

• client has a disorder and it is R. to a given V code

  • example:

• Client has a mental disorder that is U. to a V code but is still I

  • example:

• Client does N have a mental disorder but the particular V code appears to be focus of clinical attention

  • Just a V___
    
    

1. related, homeless BPD
2. unrelated, NPD sibling rivalry
3. NOT, V-code