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106 Cards in this Set

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Generic Social Work
Addresses common principles of social work that cover over sectoral boundaries and reflect core social work practices and values.
Generic Social Work
Harriet Bartlett
Help people identify and resolve or reduce problems arisiing out of disequilibrium between individuals, groups and the environment; and to seek out and strengthen maximum potential of individuals.
Generic Social Worki - Major Theorists
Eda Goldstein
Help people find the means and opportunity by which they can work out, find alternatives for and deal with internal, interpersonal and environmental conditions.
Generic Social Worki - Major Theorists
William E Gordon
Match coping capacities of the individual and qualities of the environment to enhance individual potential and relieve environmental problems.
Generic Social Worki - Major Theorists
Gordon Hamilton
Release resources in the immediate environment and capacities of the individual that allow for a fuller life.
Generic Social Worki - Major Theorists
Helen Perlman
Help individuals effectively cope wth social functioning problems.
Generic Social Worki - Major Theorists
Mary Woods and Florence Hollis
Help people cope with intrapsychic, interpersonal, and environmental problems that cause personal suffering.
Generic Social Worki - Major Theorists
Goals
Generic Social Work
Central pruposes are to help people resolve problems, improve social functioning, achieve desired change, and fulfill self defined aspirations.
Common Elements among Social Work Theorists
Focus
Generic Social Work
Centrality of person-in-situation
Common Elements among Social Work Theorists
Problems
Generic Social Work
Stress internal psychological processes, external social and environmental conditions and the interplay between them.
Common Elements among Social Work Theorists
Social Functioning
Generic Social Work
Focus on social functioning and role expectations, emphasizing the right of individuals to define their roles and meet their requirements in unique, self-determined ways.
Common Elements among Social Work Theorists
Values
Generic Social Work
Worth of the individual; right of individuals to have access to services and opportunity to fulfill potential without regard to race, class. gender, sexual orientation, ;p self determination and confidentiality.
Common Elements among Social Work Theorists
DSM-IV Axis
I Clinical disorders/other disorders that are the focus of clinical attention.

II Personality Disorders/Mental Retardation

III Medical Conditions

IV Psychosocial/Environmental Problems

V Global Assessment of Functioning
DSM-IV - Disorders Usually Diagnosed in Infancy, Childhood or Adolescence
Mental Retardation
1. Significantly sub-average intellectual functioning. 70 IQ or below.

2. Significant Limitations in 2 (communication, self-care, home living, social/interpersonal skills, use of community resources, self-direction, functional academic skills, work, leisure, health and safety. )

3. Onset must occur before 18 years of age.
DSM-IV - Disorders Usually Diagnosed in Infancy, Childhood or Adolescence
Degrees of Mental Retardation
1. Mild Mental Retardation - 50/55 -70 IQ (85%, educable)

2. Moderate Retardation - 35/40 -50/55 IQ (10%, trainable)

3. Severe Mental Retardation (20/25-35/40 IQ, 4% supervision)

4. Profound Mental Retardation (Below 20/25 IQ, 2%)

5. Mental Retardation, Severity Unspecified, scales wont work.
DSM-IV - Disorders Usually Diagnosed in Infancy, Childhood or Adolescence
Learning Disorders
An individual's achievement on individually administered, standardized tests in reading, mathematics, or written expression is substantially below (2 standard deviations between achievement and iq - can use 1 deviation if there is other interference) that expected for age, schooling and level of intelligence.

The learning problems significantly interfere with academic achievement or activities of daily living that require math, reading or writing skills.
DSM-IV - Disorders Usually Diagnosed in Infancy, Childhood or Adolescence
315.00 Reading Disorder
A. Reading achievement as measured by individually administered standardized tests of reading accuracy or comprehension, is substantially below that expected given the person's chronological age, measured intelligence and age-appropriate education.

B. The disturbance in Criterion A significantly interferes with academic achievement of activities of daily living that require reading skills.

C. If a sensory deficit is present, the reading difficulties are in excess of those usually associated with it.
DSM-IV - Disorders Usually Diagnosed in Infancy, Childhood or Adolescence
315.1 Mathematics Disorder
A. Mathematical ability as measured by individually administered standardized tests, is substantially below that expected given the person's chronological age, measured intelligence and age-appropriate education.

B. The disturbance in Criterion A significantly interferes with academic achievement of activities of daily living that require mathematical ability.

C. If a sensory deficit is present, the reading difficulties are in excess of those usually associated with it.
DSM-IV - Disorders Usually Diagnosed in Infancy, Childhood or Adolescence
315.2 Disorder of Written Expression
A. Writing skills as measured by individually administered standardized tests or functional assessments of writing skills is substantially below that expected given the person's chronological age, measured intelligence and age-appropriate education.

B. The disturbance in Criterion A significantly interferes with academic achievement of activities of daily living that require the composition of written texts.

C. If a sensory deficit is present, the writing difficulties are in excess of those usually associated with it.
DSM-IV - Disorders Usually Diagnosed in Infancy, Childhood or Adolescence
315.9 Learning Disorder, NOS
Do not meet the criteria for a specific learning disorder. Might include problems in all three areas that together significantly interfere with academic achievemnt even though performance on tests measuring each individual skill is not substantially below that expected given the person's age, intelligence or education.
DSM-IV - Disorders Usually Diagnosed in Infancy, Childhood or Adolescence
Motor Skills Disorder
315.4 Developmental Coordination Disorder
A. Performance in daily activities that require motor coordination is substantially below that expected given the person's age and iq. May have marked delays in achieving motor milestones.

B. Disturbance in A significantly interferes with academic achievement or activities of daily living.

C. The disturbance is not due to a general medical condition and does not meet the criteria for pervasive developmental disorder.

D. If mental retardation is present, the motor difficulties are in excess of those usually associated with it.
DSM-IV - Disorders Usually Diagnosed in Infancy, Childhood or Adolescence
Communication Disorders
315.31 Expressive Language Disorder
A. Scores obtained from standardized individually administered tests are substantially below those obtained from standardized measures of both nonverbal intellectual capacity and receptive language development.

B. Difficulties with expressive language (limited vocab, errors in tense, recalling words, sentence complexity) interfere with academic or occupational achievement or with social communication.

C. Criteria are not met for mixed receptive expressive language disorder or pervasive developmental disorder

D If mental retardation, a speech-motor or sensory deficit, or environmental deprivation is present, the language difficulties are in excess of those usually associated with these problems.
DSM-IV - Disorders Usually Diagnosed in Infancy, Childhood or Adolescence
Language Disorder
315.32 Mixed Expressive Receptive Language Disorder
A. The scores obtained from a battery of standardized individually administered measures of both receptive and expressive language development are substantially below those obtained from standardized measures of nonverbal intellectual capacity.

B. The difficulties with receptive and expressive language significantly interferes with academic or occupational achievement or with social communication.

C. Criteria are not met for a Pervasive Developmental Disorder

D. If mental retardation, as speech-motor or sensory deficit, or environmental deprivation is present, the language difficulties are in excess of those usually associated with these problems.
Disorders Usually First Diagnosed in Infancy, Childhood or Adolescence
Language Disorder
315.9 Phonological Disorder
A. Failure to use developmentally expected speech sounds that are appropriate for age and dialect (ex. switching sounds).

B. The difficulties in speech sound production interfere with academic or occupational achievement or with social communication.

C. If mental retardation, a speech-motor or sensory deficit, or environmental deprivation is present, the speech difficulties are in excess of those usually associated with these problems.
Disorders Usually First Diagnosed in Infancy, Childhood or Adolescence
Language Disorder
307.0 Stuttering
A. Disturbance in the normal fluency and time patterning of speech, characterized by frequent occurrences of one or more of the following:

1. Sound and syllable repetitions
2. Sound prolongations
3. Interjections
4. Broken words
5. Audible or silent blocking
6. Circumlocutions (word substitutions to avoid problematic words).
7. words produced with an excess of physical tension.
8. Monosyllabic whole word repetitions.

B. The disturbance in fluency interferes with academic or occupational achievement or with social communication.

C. IF a speech-motor or sensory deficit is present, the speech difficulties are in excess of those usually associated with these problems.
Disorders Usually First Diagnosed in Infancy, Childhood or Adolescence
Language Disorder
307.9 Communication Disorder, NOS
Abnormality of vocal pitch, loudness, quality, tone, etc not meeting the criteria for any specific communication disorder.
Disorders Usually First Diagnosed in Infancy, Childhood or Adolescence
Pervasive Developmental Disorders
1. Severe and pervasive impairment in:
a. reciprocal social interaction skills
b. communication skills
c. the presence of stereotyped behavior, interests and activities.
Disorders Usually First Diagnosed in Infancy, Childhood or Adolescence
Pervasive Developmental Disorders
299.0 Autism
A. At least 6 items from 1,2 and 3, with at least two from 1 and one from each 2 and 3:

1. Qualitative impairment in the use of multiple nonverbal behaviors such as eye to eye gaze, facial expression, body postures and gestures to regulate social interaction.

b. failure to develop peer relationships appropriate to developmental level

c. a lack of spontaneous seeking to share enjoyment, interests, or achievements with other people

d. lack of social or emotional reciprocity.

2. Qualitative impairments in communication as manifested by at least one of the following:
a. delay in, or total lack of, the development of spoken language
b. in individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others.
c. stereotyped and repetitive use of language or idiosyncratic language
d. lack of varied, spontaneous make-believe play or social imitative play appropriate to developmental level.

3. Restricted repetitive and stereotyped patterns of behavior, interests and activities, as manifested by at least one of the following:
a. encompassing preoccupation with one or more stereotyped and restricted patterns of interest that abnormal either in intensity or focus.
b. apparently inflexible adherence to specific, nonfunctional routines or rituals
c. stereotyped and repetitive motor mannerisms
d. persistent preoccupation with parts of objects.

B. Delays or abnormal functioning in at least one of the following areas, with onset prior to 3 years of age: 1. social interaction 2. language as used in social communication 3. symbolic or imaginative play.

C. The disturbance is not better accounted for by Rett's Disorder or Childhood Disintegrative Disorder.
Disorders Usually First Diagnosed in Infancy, Childhood or Adolescence
Pervasive Developmental Disorders
299.80 Rett's Disorder
A. All of the following:
1. Apparently normal prenatal and perinatal development
2. Apparently normal psychomotor development through the first five months after birth.
3. Normal head circumference at birth.

B. Onset of all of the following after a period of normal development:
1. Deceleration of head growth between ages 5 and 48 months.
2. Loss of previously acquired purposeful hand skills between ages 5 and 30 months with subsequent development of sterotyped hand movements .
3. loss of social engagement early in the course (social interaction may develop later)
4. Appearance of poorly coordinated gait or trunk movements.
5. Severely impaired expressive and receptive language development with severe psycho-motor retardation.
Disorders Usually First Diagnosed in Infancy, Childhood or Adolescence
Pervasive Developmental Disorders
299.10 Childhood Disintegrative Disorder
A. Apparently normal development for at least the first two years after birth as manifested by the presence of age appropriate verbal and nonverbal communication, social relationships, play and adaptive behavior.

B. Clinically significant loss of previously acquired skills (before age 10) in at least two of the following areas:
1. expressive/receptive language
2. social skills or adaptive behavior
3. bowel or bladder control
4. play
5. motor skills

C. Abnormalities of functioning in at least two of the following areas:
1. Qualitative impairment in social interaction
2. Qualitative impairment in communication
3. Restricted, repetitive, and stereotyped patterns of behavior, interests, and activities, including motor stereotypies and mannerisms

D. The disturbance is not better accounted for by another specific Pervasive Developmental Disorder or by Schizophrenia.
Disorders Usually First Diagnosed in Infancy, Childhood or Adolescence
Pervasive Developmental Disorders
299.80 Asperger's Disorder
A. Qualitative Impairment in Social interaction, as manifested by at least two of the following:
1. Marked impairment in the use of multiple nonverbal behaviors.
2. Failure to develop peer relationships.
3. Lack of spontaneous seeking to share enjoyment, interests, or achievements with other people
4. lack of social or emotional reciprocity.

B. Restricted repetitive and stereotyped patterns of behavior, interests, activities as manifested by at least one of the following:
1. Encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus.
2. Apparently inflexible adherence to specific, nonfunctional routines or rituals
3. Stereotyped and repetitive motor mannerisms.
4. persistent preoccupation with parts of objects.

C. The disturbance causes clinically significant impairment in social, occupational, or other important area of functioning.

D. There is no clinically significant delay in language.

E. There is no clinically significant delay in cognitive development or self help skills, adaptive behavior and curiosity about the environment.

F. Criteria are not met for PDD or Schizophrenia.
Disorders Usually First Diagnosed in Infancy, Childhood or Adolescence
Pervasive Developmental Disorders
299.80 PDD, NOS
Severe and pervasive impairment in either the development of reciprocal social interaction associated with impairment in either verbal or nonverbal communication skills or with the presence of stereotyped behavior, interests and activities, but the criteria are not met for a specific PDD, Schizophrenia, Schizotypal Personality Disorder, or Avoidant Personality Disorder.
Disorders Usually First Diagnosed in Infancy, Childhood or Adolescence
Attention Deficit/Hyperactivity Disorder
A. Six of more of the following symptoms of inattention have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level:

inattention
a. often fails to give close attention to details or makes careless mistakes in schoolwork, work or other activities
b. often has difficulty sustaining attention in tasks or play activities
c. often does not seem to listen when spoken to directly
d. often does not follow through on instructions and fails to finish school work chores or duties in the workplace
e. often has difficulty organizing tasks and activities
f. often avoids, dislikes or is reluctant to engage in tasks that require sustained mental effort
g. often loses things necessary for tasks or activities
h. is often easily distracted by extraneous stimuli
i. is often forgetful in daily activities.

2. six or more of the following symptoms of hyperactivity-impulsivity have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level.

hyperactivity
a. often fidgets with hands or feet or squirms in seat
b. often leaves seat in classroom or other situations in which it is inappropriate
c. often runs about or climbs excessively in situations in which it is inappropriate
d. often has difficulty playing or engaging in leisure activities quietly
e. is often on the go or acts if driven by a motor.
f. often talks excessively

impulsivity
g. often blurts out answers before questions have been completed.
h. often has difficulty awaiting a turn
i. often interrupts or intrudes on others.

B. Some symptoms were present before 7 years of age.

C. Some impairment from the symptoms is present in two or more settings.
Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence
ADHD Subtypes
314.01 ADHD, Combined type
314.00 ADHD, Predominately Inattentive Type
314.01 ADHD, Predominately Hyperactive/Impulsive Type
Disorders Usually First Diagnosed in Infancy, Childhood or Adolescence.
Conduct Disorder
A. A repetitive and Persistent Pattern of behavior in which the basic rights of others or societal norms or rules are violated, as manifested by 3 or more of the following within 12 months (1 present in last 6 months):
Aggression to People and Animals
1. often bullies, threatens, or intimidates others.
2. often initiates physical fights
3. has used a weapon that can cause serious physical harm to others
4. has been physically cruel to people
5. has been physically cruel to animals
6.. has stolen while confronting a victim
7. has forced someone into sexual activity

Destruction of property
8. has deliberated in engaged in fire sighting with the intention of causing serious damage
9. has deliberately destroyed others' property

Deceitfulness or theft
10. has broken into a house, building or car
11. often lies to obtain goods/favors, or to avoid obligations
12. has stolen items of nontrivial value without confronting victim

Serious violation of rules
13. often stays out at night against parental prohibitions, beginning before age 13
14. has run away from home overnight at least twice while living in a parental home (or once without returning for a lengthy period)
15. Is often truant from school, beginning before 13.

B. The disturbance in behavior causes clinically significant impairment in social, academic or occupational functioning.

C. If older than 18, criteria are not met for antisocial personality disorder
Disorders Usually First Diagnosed in Infancy, Childhood or Adolescence.
Conduct Disorder Types
312.81 Conduct Disorder, Childhood Onset = Onset of at least one criterion of Conduct Disorder prior to age 10.

312.82 Conduct Disorder, Adolescent Onset Type = Absence of any criteria prior to age 10

312.89 Conduct Disorder, Unspecified Onset = age of onset is not known.
Disorders Usually First Diagnosed in Infancy, Childhood or Adolescence
Conduct Disorder = Must specify severity
Mild = Few if any problems in excess of those necessary to diagnosis and problems cause only minor harm to others.

Moderate = Number of conduct problems and effect on others are between mild and severe

Severe = Many conduct problems in excess of those required to make the diagnosis or conduct problems cause considerable harm to others.
Disorders Usually First Diagnosed in Infancy, Childhood or Adolescence
313.81 Oppositional Defiant Disorder
A pattern of negativistic, hostile and defiant behavior lasting at least 6 months, during which 4 or more of the following are present:

1. often loses temper
2. often argues with adults
3. often actively defies or refuses to comply with adult requests or rules
4. often deliberately annoys people
5. often blames others for his or her mistakes or behaviors
6. is often touchy or easily annoyed
7. is often angry and resentful
8. is often spiteful and vindictive

B. Disturbance in behavior causes clinically significant impairment in social, academic or occupational functioning.

C. Behaviors do not occur exclusively during the course of a psychotic or mood disorder.

D. Criteria are not met for Conduct Disorder or (if 18+ year) antisocial personality disorder.
Disorders Usually First Diagnosed in Infancy, Childhood or Adolescence
312.9 Disruptive Behavior Disorder, nos
Clinically significant impairment without meeting all criteria
Disorders Usually First Diagnosed in Infancy, Childhood or Adolescence
Feeding and Eating Disorders of Infancy or Early Childhood

307.52 Pica
A. Persistent Eating of nonnutritive substances for a period of at least one month.

B. The eating of nonnutritive substances is inappropriate to developmental level.

C. the eating behavior is not part of a culturally sanctioned practice.

D. If the eating is comorbid with another disorder it is sufficiently severe to warrant independent clinical attention.
Disorders Usually First Diagnosed in Infancy, Childhood or Adolescence
Feeding and Eating Disorders of Infancy and Early Childhood

307.53 Rumination Disorder
A. Repeated regurgitation and rechewing of food for a period of at least 1 month following a period of normal functioning.

B. The behavior is not due to an associated gastrointestinal or other general medical condition.

C. The behavior is not related to Anorexia or Bullemia and if the symptoms occur in comorbidity with another disorder they are severe enough to warrant independent clinical attention.
Disorders Usually First Diagnosed in Infancy, Childhood or Adolescence
Feeding and Eating Disorders of Infancy and Early Childhood

307.59 Feeding Disorder of Infancy or Early Childhood
A. feeding disturbance as manifested by persistent failure to eat adequately with significant failure to gain weight or loss of weight over at least one month.

B. The disturbance is not due to an associated gastrointestinal or other general medical condition.

C. The disturbance is not better accounted for by another disorder or lack of food.

D. The onset is before age 6.
Disorders Usually First Diagnosed in Infancy, Childhood or Adolescence
Tic Disorder
307.23 Tourette's Disorder
A. Both multiple motor and one or more vocal tics have been present at some time during the illness, not necessarily concurrently.

B. The tics occur many ties a day nearly every day or intermittently throughout a period of more than 1 year, and during this epriod there was never a tic free preiod of more than 3 consecutive months.

C. the onset is before 18 years.

D. Not due to a substance or general medical condition.

*Tic = sudden, rapid, recurrent, nonrhythmic, stereotyped motor movement or vocalization.
Disorders Usually First Diagnosed in Infancy, Childhood or Adolescence
Tic Disorder
307.22 Chronic Motor or Vocal Tic Disorder
A. Single or multiple motor or vocal tics but not both.

B. Tics occur many times a day nearly every day or intermittently throughout a period of more than 1 year, and during this period there was never a tic free period of more than 3 consecutive months.

C. Onset before 18 years of age.

D. Disturbance is not due to a substance or medical condition.

E. Criteria not met for Tourette's.
Disorders Usually First Diagnosed in Infancy, Childhood or Adolescence
Tic Disorder
307.21 Transient Tic Disorder
A. Single or multiple motor and/or verbal tics.

B. The tics occur many times a day, nearly every day for at least four weeks, but for no longer than 12 consecutive months.

C. Onset before age 18.

D. Not due to a substance or a medical condition.

E. Criteria not met for other tic disorders.
Disorders Usually First Diagnosed in Infancy, Childhood or Adolescence
Tic Disorder
307.20 Tic Disorder, NOS
Do not meet criteria such as tics lasting less than four weeks or with an onset after 18 years.
Disorders Usually First Diagnosed in Infancy, Childhood or Adolescence
Elimination Disorders
Encopresis
787.6 With Constipation and Overflow Incontinence
307.7 Without Constipation and Overflow Incontinence
A. Repeated passage of feces into inappropriate places whether voluntary or involuntary.

B. At least one such event a month for at least 3 months.

C. Chronological age is at least 4 years.

D. Behavior is not due to a substance or medical condition.
Disorders Usually First Diagnosed in Infancy, Childhood or Adolescence
Elimination Disorder
307.6 Enuresis
A. Repeated voiding of urine into bed or clothes (whether voluntary or involuntary).

B. Behavior is clinically significant as manifested by either frequency of twice a week for at least 3 consecutive months or the presence of clinically significant distress or impairment in social academic (occupational) or other areas of life functioning.

C. At least 5 years old.

D. Behavior is not due to substance or general medical condition.
Disorders Usually First Diagnosed in Infancy, Childhood or Adolescence
The Fire Code requires that, at all times during “occupancy” (even if there is no detected emergency), occupants of a building must be allowed an unimpeded means of _____________ to the exterior of the building, or other designated safe area.
egress
309.21 Separation and Anxiety Disorder
A. Developmentally inappropriate and excessive anxiety concerning separation from home or from those to whom the individual is attached, as evidenced by three or more of the following:

1. Recurrent excessive distress when separation from home or major attachment figures occurs or is anticipated.

2. Persistant and excessive worry about losing or about possible harm befalling, major attachment figures.
3. Persistent and excessive worry that an untoward event will lead to separation from a major attachment figure.
4. Persistent reluctance or refusal to go to school or elsewhere because of fear of separation
5. Persistently and excessively fearful or reluctant to be alone ow without major attachment figures at home or without significant adults in other settings.
6. Persistent reluctance or refusal to go to sleep without being near a major attachment figure or to sleep away from home.
7. Repeated nightmares involving the theme of separation.
8. Repeated somatization when separation from major attachment figure occurs or is anticipated.

B. The duration of the disturbance is at least 4 weeks.

C. The onset is before age 18.

D. The disturbance causes clinically significant distress or impairment in social, academic, or other important areas of functioning.

E. The disturbance does not occur exclusively during the course of a PDD, Schizophrenia or other psychotic disorder and in adolescents and adults is not accounted for by panic disorder with agoraphobia.

* Early onset if occuring before 6 years of age.
Disorders Usually First Diagnosed in Infancy, Childhood or Adolescence
313.23 Selective Mutism
A. Consistent failure to speak in specific social situations, despite speaking in other situations.

B. The disturbance interferes with educational or occupational achievement or with social communication.

C. The duration of the disturbance is at least 1 month (not limited to the first month of school).

D.The failure to speak is not due to a lack of knowledge of , or comfort with, the spoken language required in the social situation.

E. The disturbance is not better accounted for by a Communication Disorder and does not occur exclusively during the course of a PDD, Schizophrenia or other Psychotic Disorder.
Disorders Usually First Diagnosed in Infancy, Childhood or Adolescence
313.89 Reactive Attachment Disorder of Infancy or Early Childhood
A. Markedly disturbed and developmentally inappropriate social relatedness in most contexts, beginning before age 5 years, as evidenced by either (1) or (2).

(1) Persistent failure to initiate or respond in a developmentally appropriate fashion to most social interactions, as manifest by excessively inhibited, hypervigilant, or highly ambivalent and contradictory responses.

(2) diffuse attachments as manifest by indiscriminate sociability with marked inability to exhibit appropriate selective attachments (ex. overly affectionate with strangers).

B. The disturbance in Criterion A is not accounted for solely by developmental delay and does not meet criteria for a PDD.

C. Pathogenic care as evidenced by at least one of the following:
1. Persistent disregard of the child's basic physical needs
2. Persistent disregard of the child's basic emotional needs for comfort, stimulation and affection.
3. Repeated changes of primary caregiver that prevent formation of stable attachments.

D. There is a presumption that the care in Criterion C is responsible for the disturbed behavior in criterion A.
Disorders Usually First Diagnosed in Infancy, Childhood or Adolescence
313.89 Reactive Attachment Disorder of Infancy or Early Childhood - specify type
Inhibited type = If criterion A1 predominates in the clinical presentation

Disinhibited Type: If Criterion A2 predominates in the clinical presentation.
Disorders Usually First Diagnosed in Infancy, Childhood or Adolescence
307.3 Stereotypic Movement Disorder
A. Repetitive, seemingly driven, and nonfunctional motor behavior (hand shaking, body rocking, head banging, self biting).

B. The behavior markedly interferes with normal activities or results in self inflicted bodily injury that requires medical treatment.

C. If mental retardation is present, the stereotypic or self-injurious behavior is of sufficient severity to become a focus of treatment.

D. The behavior is not better accounted fro by a compulsion, a tic, a steotypy that is part of a PDD or hair pulling (trichotillomania).

E. The behavior is not due to direct physiological effects of a substance or a medical condition.

F. The behavior persists for 4 weeks or longer.
Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence.
313.9 Disorder of Infancy, Childhood, or Adolescence, NOS
Disorder that does not meet criteria for any specific order in the classification.
Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence.
Delirium
Characterized by a disturbance of consciousness and a change in cognition that develop over a short period of time.
Delirium, Dementia, and Amnestic and Other Cognitive Disorders
Dementia
Characterized by multiple cognitive deficits that include impairment in memory.
Delirium, Dementia, and Amnestic and Other Cognitive Disorders
Amnestic Disorder
Characterized by memory impairment in the absence of other significant accompanying cognitive impairments.
Delirium, Dementia, and Amnestic and Other Cognitive Disorders
293.0 Delirium due to a general medical condition
A. Disturbance of consciousness (reduced awareness of environment with reduced ability to focus, sustain, or shift attention).

B. A change in cognition or the development of a perceptual disturbance that is not better accounted for by a preexisting, established or evolving dementia.

C. The disturbance develops over a short period of time and tends to fluctuate during the course of a day.

D. There is evidence from the history, physical examinationq, or laboratory findings that the disturbance is caused by the direct physiological consequences of a general medical condition.
Delirium, Dementia, and Amnestic and other Cognitive Disorders
Substance Intoxication Delirium

291.0 Alcohol
292.81 Amphetamine
292.81 Cannabis
292.81 Cocaine
292.81 Hallucinogen
292.81 Inhalant
292.81 Opioid
292.81 Phencyclidine
292.81 Sedative, hypnotic, or anxiolytic
292.81 Unknown substance
A. Disturbance of consiousness

B. A change in cognition or the development of a perceptual disturbance that is not better accounted for by a preexisting, established, or evolving dementia.

C. The disturbance develops over a short period of time (usually hours to days) and tends to fluctuate throughout the course of the day.

D. There is evidence from the history, medical exam, lab findings of symptoms developing during substance intoxication or medication use is etiologically related to the disturbance.
Delirium, Dementia, and Amnestic and other Cognitive Disorders
293.0 Delirium due to a general medical condition
A. Disturbance of consciousness (reduced awareness of environment with reduced ability to focus, sustain, or shift attention).

B. A change in cognition or the development of a perceptual disturbance that is not better accounted for by a preexisting, established or evolving dementia.

C. The disturbance develops over a short period of time and tends to fluctuate during the course of a day.

D. There is evidence from the history, physical examinationq, or laboratory findings that the disturbance is caused by the direct physiological consequences of a general medical condition.
Delirium, Dementia, and Amnestic and other Cognitive Disorders
Substance Intoxication Delirium

291.0 Alcohol
292.81 Amphetamine
292.81 Cannabis
292.81 Cocaine
292.81 Hallucinogen
292.81 Inhalant
292.81 Opioid
292.81 Phencyclidine
292.81 Sedative, hypnotic, or anxiolytic
292.81 Unknown substance
A. Disturbance of consiousness

B. A change in cognition or the development of a perceptual disturbance that is not better accounted for by a preexisting, established, or evolving dementia.

C. The disturbance develops over a short period of time (usually hours to days) and tends to fluctuate throughout the course of the day.

D. There is evidence from the history, medical exam, lab findings of symptoms developing during substance intoxication or medication use is etiologically related to the disturbance.
Delirium, Dementia, and Amnestic and other Cognitive Disorders
Psychosocial
Intrapsychic and interpersonal change. Based on psychoanalytic theory, ego psychology, role and systems theory.
Theoretcial Approaches in Clinical Practice
Problem Solving
Solve discrete problems. Based on psychosocial and functional approaches.
Theoretcial Approaches in Clinical Practice
Behavior Modification
Symptom reductiopn of problem behaviors and learning alternative behaviors.
Theoretcial Approaches in Clinical Practice
Cognitive Therapy
Symptom reduction of negative thoughts, distorted thinking, and dysfunctional beliefs.
Theoretcial Approaches in Clinical Practice
Crisis Intervention
Brief treatment of reactions to crisis situation to reestablish the client's equlibrium.
Theoretcial Approaches in Clinical Practice
Family Therapy
Treats the whole family system and sees the individual symtom bearer as indicative of a problem in the family as a whole.
Theoretcial Approaches in Clinical Practice
Group Therapy
Group members help and be helped by others with similar problems, get validation for their own experiences and test new social identities and roles.
Theoretcial Approaches in Clinical Practice
Narrative Therapy
Uses the stories that people tell about their lives to reveal how they structure perceptions opf their experiences. Therapist co-construcs alternative, more affirmingm stories with the client.
Theoretcial Approaches in Clinical Practice
Ecological or Life Model
Focuses on life transitions, environmental pressures and maladaptive fit between individual and family or the larger environment. Focuses on the interaction and interdependence of people and enviornments.
Theoretcial Approaches in Clinical Practice
Task-Centered
Accomplishing tasks to reinforce self esteem and reestablish usual capacity for coping.
Theoretcial Approaches in Clinical Practice
Substance Related Disorders
May be caused by abusing a drug, by side effects of a medication or by toxin exposure.
DSM-IV
Substance Dependence
Maladaptive pattern of drug use with increased tolerance, withdrawal symptoms, compulsive use or behavioral problems.
DSM-IV
Substance Abuse
Social role, legal or medical problems due to drug use.
DSM-IV
Substance Intoxication or Withdrawal:
Behavioral, psychological and physiological symptoms due to effects of the substance; will vary depending on type of substance (hallucinations, insomnia, stupor, agitation, etc).
DSM-IV
Substance Related Disorders Misc.
The client may also have substance induced delirium, dementia, psychosis, mood disorders, anxiety disorder, or sexual or sleep dysfunction. Treatment must first focus on the substance. **Treatment = outpationt, inpatient; residential or day care; group, individual and/or family counseling; methadone maintenance (opiates); detoxification; self help groups; or a combination or therapies and medication.
DSM-IV
Schizophrenic and other Psychotic disorders
*Psychotic symptoms during an active phase: delusions, hallucinations, disorganized speech, thought disorder and/or negative symptoms (flat affect, alogia or avolition)

*deterioration from a previous level of functioning

*Continuous cycle for at least 6 months with least one month of active phase of psychotic symptoms.

*Onset is often in adolescence or early adulthood.
DSM-IV
Schizophrenic and other Psychotic disorders
Schizophrenia
Catatonic Type = Stupor, negatvisim, rigidity

Disorganized Type=incoherence, flat or grossly innapropriate affect)

Paranoid Type=Delusions or frequent auditory hallucinations often persecutory or grandiose.

Undifferentiated Type = Prominent delusions, hallucinations, incoherence, or grossly disorganized behavior.

Residual Type=Absence of prominent psychotic features.

Treatment = medication and ego supportive therapy aimed at containing psychotic symptoms and maintaining the person's highest level of functioning.
Disorganized Type
DSM-IV
Schizophrenic and other Psychotic disorders
Schizophreniform Disorder
*Less than 6 months

*Greater liklihood of an acute onset preceded by turmoil/high stress.

*Range of prognoses and characterized by absence of blunted or flat affect.
DSM-IV
Schizophrenic and other Psychotic disorders
Schizoaffective Disorder
*Psychotic sycmptoms of schizophrenia concurrent with the presence of either a major or depressive episode, a manic episode or a mixed episode.
DSM-IV
Schizophrenic and other Psychotic disorders
Delusional Disorders
*Presence of a persistent delusion

*Hallucinations are either absent or not prominent.

*May be persecutory type, jealous type, erotomainc type, somatic type, or grandiosse type.
DSM-IV
Schizophrenic and other Psychotic disorders
Brief Psychotic Disorder
Usually sudden onset and duration of less than one month.
DSM-IV
Schizophrenic and other Psychotic disorders
Shared Psychotic Disorder
A delusion is held with another person in a close relationship.
DSM-IV
Schizophrenic and Psychotic Disorders
Treatment of Schizophrenic and other Psychotic Disorders
1. Anti-Psychotic Medication

2. Individual Psychotherapy - Facilitate coping and self acceptance.

3. Family Therapy

4. Group Therapy

5. Milieu Therapy - combining staff, program, social structure, respite and expectations of reasonable behavior.

6. Social Network Intervention/Case Management.

7. Self-Help Groups.
DSM-IV
Schizophrenic and Psychotic Disorders
Mood Disorders
Persistent abnormal mood - depressed/euphoric. Symptoms may be somatic, affective, cognitive, and/or behavioral. Psychological distress and role functioning.
DSM-IV
Mood Disorders
Major Depressive Disorder
Vegetative or Classic symptoms: weight loss or gain, insomnia or sleeping too much, motor agitation or low energy. Feeling sad, empty or worthless; difficulty concentrating or making decisions; and or general loss of pleasure or interest. Recurrent thoughts of death or suicide. AT LEAST 2 WEEKS DURATION.
DSM-IV
Mood Disorders
Dysthymic Disorder
Similar symptoms to major depressive disorder but less severe and more chronic, AT LEAST 2 YEARS.
DSM-IV
Mood Disorders
Bipolar I Disorder
Formerly called Manic-Depression. One or more manic episodes characterized by persistent abnormally elevated or irritable mood; pressured speech; grandiosity; sleeplessness; and/or excessive pleasurable high risk activity.
DSM-IV
Mood Disorders
Bipolar II Disorder
Major depressive episodes with at least one hypomanic episode (manic symptoms at a less severe intensity).
DSM-IV
Mood Disorders
Cyclothymic Disorder
Chronic, fluctuating mood with hypomanic and many depressive symptoms, but not as severe as bipoloar 1 or 2.
DSM-IV
Mood Disorders
Treatment of Mood Disorders
1. Antidepressants, antipsychotics, mood stabilizers.

2. Interpersonal/Psychodynamic Theory.

Behavioral Therapy

Cognitive Therapy

Group Psychotherapy

Self Help Groups
DSM-IV
Mood Disorders
Anxiety Disorders
Excessive worry, fear and/or avoidance rituals or repetitive thoughts.
DSM-IV
Anxiety Disorders
Anxiety Disorders
Panic Disorder
Brief recurrent intense fear in the form of panic attacks with physiological or psychological symptoms. May include agoraphobia, anxiety about being in places or situations from which one cannot escape or where one might have a panic attack and not be able to get help.
DSM-IV
Anxiety Disorders
Anxiety Disorders
Phobia
Fear of a specific object or situations.
DSM-IV
Anxiety Disorders
Anxiety Disorders
Social Phobia
Social Anxiety Disorder. Unreasonable fear of embarrassment or humiliation in social settings.
DSM-IV
Anxiety Disorders
Anxiety Disorders
Obsessive-Compulsive Disorder
Intrusive recurrent thoughts or compulsive behaviors distressing to the person and which are time consuming.
DSM-IV
Anxiety Disorders
Anxiety Disorders
Post-Traumatic Stress Disorder
More than ONE MONTH of persistently re-experiencing a severe trauma; avoidance of things associated with the trauma or numbness. Person has arousal/anxiety symptoms.
DSM-IV
Anxiety Disorders
Anxiety Disorders
Acute Stress Disorder
WITHIN ONE MONTH of experiencing a trauma, anxiety and dissociative symptoms develop.
DSM-IV
Anxiety Disorders
Anxiety Disorders
Generalized Anxiety Disorder
Excessive worry, cognitive and physiological symptoms of distress. CHRONIC, AT LEAST 6 MONTHS DURATION.
DSM-IV
Anxiety Disorders
Somatoform Disorders
Characterized by multiple physical/somatic symptoms with no organic findings.
DSM-IV
Somatoform Disorders
Somatoform Disorders
Body Dysmorphic Disorder
Preoccupation with some imagined defect in appearance.
DSM-IV
Somatoform Disorders
Somatoform Disorders
Conversion Disorder
Motor or perceptual symptoms suggesting physical disorder, but which reflect emotional conflicts.
DSM-IV
Somatoform Disorders
Somatoform Disorders
Hypochodriasis
Unrealistic interpretation of physical signs as abnormal and preoccupation with a fear or belief of serious illness.
DSM-IV
Somatoform Disorders
Somatoform Disorder
Somatization Disorder:
Recurrent and multiple somatic complaints of SEVERAL YEARS.
DSM-IV
Somatoform Disorders
Somatoform Disorders
Pain Disorder
Preoccupation with pain that causes impaired functioning and which is caused by psychological factors.
DSM-IV Somatoform Disorders