Have you ever worked with a patient who you felt was previously misdiagnosed? If so, how did you handle the situation?

"(Situation) A few months ago, I encountered a client who had a recent mood disorder diagnosis. (Task) As their newly appointed Mental Health Counselor, I wanted to take great care in reading their files to ensure that all of the dots connected before I added onto their treatment roster. (Action) I read through their files with a fine-toothed comb and noticed that they experienced drug-induced psychotic episodes from time to time. However, these episodes happened like clockwork around major holidays like Christmas and Thanksgiving. After a few group and talk therapy sessions, I began to suspect that this client was abusing methamphetamines around these holidays as these events triggered traumatic family-related memories. I concluded that when this patient was clean, they did not have manic episodes. I felt that we needed to address the addiction and trauma issues before claiming a mood disorder, which would be a life long care issue. The social worker on the team disagreed with me and felt that her mania had persisted for years and should be part of her long term diagnostic plan. (Result) I worked closely with this client's multidisciplinary healthcare team, and we came up with a more inclusive treatment plan that included addiction therapy and hypnosis for deep trauma. In the end, we did not all entirely agree on a diagnosis. Still, we worked well together to ensure that the patient was properly taken care of and not just handed heavy prescriptions that may have been unnecessary."

"Mental health issues can be tricky, and misdiagnosis can certainly happen. (Situation) When I was completing my internship, the clinic had a client diagnosed with depression. (Task) As the intern, it was up to me to be astute in my observations, take notes, and then speak up if I had anything new to contribute. (Action) After observing a few counseling sessions, I saw that this client showed underlying symptoms that aligned with bipolar disorder. These signs included episodes of elatedness, where he rambled verbally and could not seem to get his thoughts together. He also had a history of impulsiveness, which I felt did not align as well with a typical depression diagnosis. So I kept an eye out for additional signs and asked my supervisor about them. (Result) We had the client see the psychiatrist in our clinic, and we concluded that his diagnosis should be updated to reflect mixed episode bipolar disorder. The benefit of completing my internship with a multidisciplinary team is that I could consult with the other healthcare professionals working with the client and discuss the situation around a 360 view of patient wellness. I was happy to be able to bring my notes to the table and encourage a patient re-assessment. This situation was certainly a highlight of my internship."

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