Medication and Diagnosis

Actions
(this is for your personal information, you do not need to discuss your scores).
• Consider the following questions and post your response and a reflection on one peer response to the discussion board:
o What does it mean to problematize conventional thinking about assessment? What might be an example of a problematic assessment process or tool?
o What are some of the concerns raised about a medicalized approach to assessment? How might it affect approaches to action and outcomes?

EXAMPLES of assignment

CA
Chelsea
Manage Discussion by Chelsea
Reply from Chelsea
• What does it mean to problematize conventional thinking about assessment? What might be an example of a problematic assessment process or tool?
o Problematizing a tool means criticizing and raising questions regarding normalized tools that have been used to assess diagnoses or conditions. I think it’s beneficial to question what measures are being used to assess an individual to ensure that they are appropriately being diagnosed and to always strive towards improvement of these tools. Assessment tools have been primarily been constructed off of norms set forth by white researchers which has furthered systemic inequalities, filtered knowledge, and impacted what we believe is abnormal behavior. One example of an assessment tool that is rightfully problematized is the DSM. The DSM has evolved as we’re in our 5th edition but still is very misaligned with neuroscience and genetic findings. The DSM is politicized and does not take into account how different a diagnosis can be for individuals in different cultures or environments.
• What are some of the concerns raised about a medicalized approach to assessment? How might it affect approaches to action and outcomes?
o I believe medicalizing assessment goes against what we are taught as social workers. By listing out criteria to focus on when assessing, we are not looking at individual’s holistically and taking into account the systems they are in or what factors might be leading to their symptoms. If this approach is taken, there is a heightened risk of misdiagnosis or overdiagnosis. The label of a diagnosis can be stigmatizing, however, a wrong diagnosis can inhibit a person from receiving the actual treatment or help that they need. By focusing on what boxes to check and what to label a person, we are not investigating what social determinants might be causing this person’s anguish and not looking to see how we can advocate for them on a greater scale. The outcomes include a disregard of individuality and the voice of our clients, misdiagnosing, overdiagnosing, and further deterring a resolution.
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JL
Janette
Sep 8 6:54pmLast reply Sep 9 1:29pm
Manage Discussion by Janette
Reply from Janette
• What does it mean to problematize conventional thinking about assessment? What might be an example of a problematic assessment process or tool?
Problematizing conventional thinking about assessments serves to challenge precedent or prior tools that may have been deemed the “gold standard” for measuring certain variables. I think it is critical to re-assess and re-structure the scales and assessment tools we are using as clinicians and researchers in order to stay in line with current treatments and overall trends within societal diagnoses and interventions. Anything that may be regarded as overly subjective would be an example of a problematic assessment tool (i.e. not having a numbered scale to relay qualitative data). For example, having a homeroom teacher anecdotally describe a child’s performance in his/her classroom based on their personal relationship to said student would be a problematic assessment tool, since these ratings rely heavily on collateral variables (i.e. how the teacher is feeling that day regarding the student’s behavior, prior incidents that teacher may have had with the student, overall relationship with said student etc.).
• What are some of the concerns raised about a medicalized approach to assessment? How might it affect approaches to action and outcomes?
Using a primarily medicalized approach to assessment, especially regarding behavior and early onset behaviors can be dangerous for many reasons, the first being that there is often a plethora of variables and moving pieces that can affect a human’s behavior. This was heavily covered during the HBSE (Human Behavior and Social Environment) courses. Aspects as small as what someone had for breakfast or as large as their socio-economic status can have immense ramifications regarding the outcome of an assessment. Therefore, controlling for these variables is key in order to produce reliable and accurate data. Medicalizing may rely more heavily on quantitative instruments as opposed to qualitative or be more willing to slap on a diagnoses title without necessarily considering all of the external/environmental factors that may contribute to certain behaviors or symptoms. When used in the wrong context or replied on as a consistent first step, a medicalized approach may lead to overdiagnoses or misdiagnoses within certain demographics (i.e. ADHD in young boys, who often experience a generalized higher activation level than young girls due to hormones and/or genetics at certain developmental stages).