For the Final Vignette Assignment, you will construct a well-developed vignette

For the Final Vignette Assignment, you will construct a well-developed vignette case assessment that includes all the following: 1) primary and secondary
diagnosis; 2) differential diagnoses, 3) cultural and diversity considerations, 4) risk assessment, and 5) ethical considerations. Your submission should be 6
pages of written content in length, not including title page and references page. The paper must include a minimum of five (5) credible, peer-reviewed
references, such as published journal articles and/or edited textbooks (i.e. DSM-5-TR). All sources should have been published within the last 10 years.
ABSTRACT-
An abstract provides a summary of what is included in the paper. Information that is not in the paper should not be included in the abstract. Approximately 150-250 words in length.
SECTION 1- Primary and Secondary Diagnosis
● After thoroughly reviewing the vignette (presenting problem and biopsychosocial history), provide a descriiption of the specific diagnosis you would
select as the primary diagnosis (e.g. Major Depressive Disorder). The primary diagnosis is the diagnosis that is causing the most functional impairment
for the client at the time of evaluation. Include all of the following element in your descriiption:
○ Name of the primary diagnosis using correct DSM language (code and name). Include all specifiers and modifiers.
○ List all relevant criteria that client meets for the diagnosis you chose and discuss what symptoms the client has that meet these criteria. For
example: if discussing Schizophrenia (Criterion A), an appropriate linkage of the diagnostic criteria to the client might look like this: “for the
last six months, the client presents with delusions and hallucinations as evidenced by beliefs that the FBI has installed GPS on their vehicle in
order to track their every move. The client also reports seeing FBI agents outside of their home, despite the client’s spouse indicating that no
one has been in the home.”
● Name and list the symptoms for all other relevant diagnoses (secondary diagnoses). For example, if my client has primary diagnosis of schizophrenia,
they may also have a secondary diagnosis of an anxiety disorder, a depressive disorder, substance use disorder, a personality disorder, etc. Be mindful
that the client must fully meet criteria for that disorder and be impaired by the symptom associated with that disorder in order to have a second
diagnosis.
● Describe and discuss the client’s potential areas of functional impairment in one or more relevant domains of living (occupational, academic, legal,
social, family, activities of daily living, etc.).
● Describe and discuss areas where more information may be needed to clarify the primary and secondary diagnosis, if needed. Explain your rationale
for needing this information and how the information gathered would be relevant to your overall assessment and/or to diagnostic decision-making
This can include information about diagnoses that you would like to rule-out to make a proper diagnosis. Minimum of two (2) full pages of written content.
SECTION 2: Differential Diagnosis
● Consider differential diagnosis. This is the process of differentiating between two or more conditions which share similar signs or symptoms. Describe
and discuss other diagnoses that you considered when making your diagnosis and describe the criteria in the DSM-5-TR as well as the details in the
vignette that led you to consider these diagnoses. For example, for a client with a primary diagnosis of schizophrenia, I may have also considered (but
rejected) diagnoses of bipolar I disorder, paranoid personality disorder, etc.
● Discuss why you did not select these diagnoses as your primary or secondary diagnoses. For example, if I have a client who has acute symptoms, I may
want to consider a medical condition or substance use/intoxication as the cause of the symptoms and then explain how those have been ruled out.
Minimum of one (1) full page of written content.
SECTION 3: Diversity and Cultural Conceptualization
In this section, students will focus on how different cultures and communities exhibit or explain symptoms in various ways. Because of cultural experiences, it is
important for clinicians to be aware of relevant contextual information stemming from an individual’s culture, ethnicity, religion, geographical origin,
socioeconomic or financial status, language, migrant status, etc. Having a lack of understanding of cultural context can lead to inherent bias in diagnosis as well
as misdiagnosis. This section should demonstrate the following:
● Students will examine the dimensions of culture and issues pertaining to diagnosis, but not limited to, differences in age, sex, gender, ethnicity, and
socio-economic status when it comes to symptom presentation, the role of culture and mental illness (sigma) in diagnosis and treatment, etc. For
example: delayed help-seeking response for the appearance of acute psychotic symptoms in self or a family member due to cultural beliefs, client
unwillingness to work with a clinician of a different cultural background, clinician bias, etc. Describe at least two (2) cultural or diversity considerations
that are relevant to the client in the vignette.
● Using information gained from the DSM-5-TR (Culture and Psychiatric Diagnosis; pp. 860-880) and/or other credible peer-reviewed sources, discuss the
impact of the client’s culture on both the presentation of symptoms and diagnosis. Feel free to also expand on culture-bound syndromes, if applicable
to this vignette.
● Elaborate on what value the cultural formulation interview (CFI) from the DSM-5-TR has when considering the impact of culture and diversity on client
symptoms and diagnosis. Minimum of one (1) full page of written content
SECTION 4: Risk Assessment
● Describe and discuss the need for assessment of potential crises and/or risks for this client.
● Identify if the client is a risk to self or others and provide your rationale for why you think he is or is not. If you were seeing this client, describe what
you would do to further determine if he is a risk to himself or others?
● Describe how you would evaluate for at least two (2) other types of crises/risks that may apply to this client’s situation (substance abuse, recidivism,
need for medical assistance, homelessness/unhoused, legal issues, occupational issues, relationship issues, potential for violence, etc.) and provide
your rationale for why this client may be at increased risk for crises.
● Discuss relevant referrals and the rationale for making those referrals related to any potential crises and/or identified risks.
Minimum of one (1) full page of written content
SECTION 5: Ethical Considerations
● Discuss at least 2 ethical considerations and issues pertaining to the diagnosis and risk assessment of mental health disorders and the role of the
clinician in mitigating those issues. Specifically cite the code of ethics (AAMFT, ACA, or APA) when needed to expand on ethical considerations and
issues you discuss in this section.
Minimum of one (1) full page of written content.
TEXTBOOK
Diagnostic and Statistical Manual of Mental Disorders
DSM-5-TR
978-0890425763