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What gives you the feeling of exercising?

Assessment is one of the most vital and complicated processes that psychologists undertake before they provide a diagnosis. The reason is that assessment needs to be accurate so as the right diagnosis is given to a person or their health status is adequately known. However, assessment and diagnosis techniques vary on whether a person is a clinical psychologist or counseling psychologist. After a careful review of the case of Amanda, the best assessments to help her are the ones that relate to the counseling psychology field. The reason is that counseling psychologist knows issues relating to food consumption, economic, social, and psychological factors and how they relate to health and mental wellbeing of individuals. A counseling psychologist will provide adequate and right assessment techniques that will help formulate the best diagnosis plan for Amanda and raise questions that will be helpful in getting more information regarding her problem.

As a counseling psychologist to provide effective diagnosis plans and measures for Amanda, one will need first to analyze and understand the case. The parents believe that Amanda has an eating disorder, but Amanda is in denial. It is important to start by considering that Amanda eats less than the way she exercises, has troubles at night while sleeping, anxiety, and low self-esteem. Also, it is important to keep in mind that even though she accepts medical treatment, she has no confidence in the privacy of the sessions. There is a possibility that she might not reveal all information which can be critical in deciding the best diagnosis.

The common assessment that is used to gather information in cases of eating disorders. The two main assessment techniques are semi-structured interviews and a self-report questionnaire. They help retrieve information relating to body imagery and dietary consumption. Clinical Psychologists mostly use assessments like the questionnaires which only provide the symptoms and risks behaviors of eating disorders. Counseling psychologist prefers semi-structured interviews that require a lot of experience and skills because they provide additional information regarding diagnosis recommendations.

In the assessment process of Amanda, I will use interviews and tests. The interviews are important in the retrieval of information that will reveal the symptoms and risk factors of Amanda’s situation as well as recommendations. The will be to conduct the medical assessment, mental health assessment, and nutritional assessment. The first step is to take tests to evaluate the health conditions of Amanda in relationship to normal body functioning. The test will provide information regarding the physical status of Amanda. The second process is an interview that considers the sensitivity of personal information. The best interview that will ensure the most important information is obtained is eating disorder Inventory interview assessment that accesses the cognitive and behavioral trends of a person. The information will be helpful in determining the psychological and social aspects of Amanda.

There is additional information that I will get from the assessments which will be helpful in the formulation of the diagnosis. It is important to know if Amanda has been abused physically, emotionally, or even sexually which has a big impact on the self-esteem of many adolescents. Other important information that will be helpful is the total time Amanda takes each day to exercise, how much she eats, and the type of foods that she eats. Finally, another information will be academic progress, parent relationship, and special relationships. I will need to know the events that make her do exercises and the ones that make her lose appetite for eating. The specific questions that I will ask include:
 What gives you the feeling of exercising?
 How many times do you exercise per day?
 What meals do you take and how many times do you take them per day?
 How is academic progress?
 How is your relationship with your parents?
 How can you describe your relationship with your friends?
 Have you ever experienced weakness and nausea when you run?
 What made you decide to start dieting and doing exercises?

After obtaining the required information, it is important to consider the theoretical orientation that might influence making a diagnosis of the case. In the case of Amanda, the best theoretical orientation is cognitive behavioral therapy. The approach is effective in the situation of Amanda because it focuses on providing a remedy of extreme beliefs, distorted thoughts, and polarized thinking. It gives a psychologist a chance to analyze the beliefs of a patient and help them realize the errors in the beliefs. The orientation will help focus on identifying the behaviors and actions of Amanda relating to her beliefs and line of thought only. The next step is providing a diagnosis of Amanda according to DSM-5 manual. After analyzing the information, the most likely diagnosis for Amanda is anorexia nervosa. The reason is that she has a massive body weight which has been caused by excessive exercises, and a distorted body image.

According to the time one has been given to provide a diagnosis for Amanda, I think 48 hours is not sufficient to provide a diagnosis and conduct assessment that do not break any ethical issues. The reason is that a psychologist will need enough time of setting up interview questions that will not make Amanda uncomfortable. Since Amanda is not confident in the psychological session and is in denial, there is a high chance of her giving wrong information in the first days that might lead to inaccurate results. One needs at least three days to get Amanda to open up and reveal all information that is vital to determining the exact diagnosis. It will be even unethical to provide a diagnosis to obtain a third party payment. There is a high chance of collecting insufficient information which can worsen the condition of Amanda due to making wrong diagnosis decision.

American Psychiatric Association. (2013). DSM-5: The diagnostic and statistical manual of mental disorders (5th ed.) [E-book]. Washington, D.C.: American Psychiatric Publishing.
American Psychological Association. (2010). Standard 9: Assessment (Links to an external site.)Links to an external site..Retrieved from http://www.apa.org/ethics/code/index.aspx?item=12
Kielbasa, A. M., Pomerantz, A. M., Krohn, E. J., & Sullivan, B. F. (2004). How does clients’ method of payment influence psychologists’ diagnostic decisions? Ethics & Behavior, 14(2), 187-195. doi:10.1207/s15327019eb1402_6
Pomerantz, A. M., & Segrist, D. J. (2006). The influence of payment method on psychologists’ diagnostic decisions regarding minimally impaired clients. Ethics & Behavior, 16(3), 253-263. doi:10.1207/s15327019eb1603_5
Sommers-Flanagan, J., & Sommers-Flanagan, R. (2015). Clinical interviewing. Retrieved from https://ebookcentral-proquest-com.proxy-library.ashford.edu


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