Managed Mental Health Care: Intentional Misdiagnosis of Mental Disorders

Braun, Sharon A.; Cox, Jane A.

doi:10.1002/j.1556-6678.2005.tb00364.x

Cited by 24 publications

(19 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There is much written about similar issues in other countries, including the impact of managed care, the role of insurance companies which only pay for treatment following DSM medical diagnosis (e.g., AFTA, ; Braun & Cox, ; Cushman & Gilford, ; Moses, ; Wylie, ) and the linking of diagnoses to eligibility for disability payments and/or school support funding (e.g., Angell, ).…”

Section: An Outline Of Controversies Relating To Dsm‐5mentioning

confidence: 99%

“…For example, if a biomedical/diagnostic paradigm is seen as being incompatible with a practitioner's preferred frame, the practitioner may feel forced to utilise the former approach for funding or other purposes, despite the lack of fit with his/her own ideology and whilst continuing to use another frame in clinical work. This raises ethical issues, particularly where funding depends on diagnosis and practitioners could be accused of fraudulent practice (Braun & Cox, ; Crews & Hill, ; Denton, ; Moses, ). Furthermore, there may be concern that the use of incompatible frames may be counterproductive or unhelpful for the client.…”

Section: An Outline Of Controversies Relating To Dsm‐5mentioning

confidence: 99%

See 1 more Smart Citation

Dialogues from the ‘Coalface’:DSM‐5 and Emotional Process in a Clinical Setting

Chambers¹,

MacDonald²,

Mikes‐Liu³

2013

ANZ J of Family Therapy

View full text Add to dashboard Cite

In this article, we propose that emotional reactivity can influence dialogue around the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and the wider issues included in the debate. We explore this emotional process and the impact that it has on our clinical practice, our clients' experiences, our experience of ourselves as clinicians and the ways we work with other professionals. We begin by presenting clinical scenarios, then briefly summarise key ideas from the DSM-5 debate, and draw on Bowen Family Systems Theory to explore a number of ways that emotional reactivity to these ideas can manifest itself in multidisciplinary and collegial relationships. We conclude that it is helpful to increase awareness of our own emotional processes to best avoid becoming reactive to, or dismissive of, alternative paradigms or knowledge bases that may be of use to our clients. We describe a number of principles and ideas that we have found useful in this context and identify ongoing dilemmas in our practice.1 The advent of DSM-5 brings back into focus dilemmas within therapy and mental health around the complexity of different paradigms being used in the best interests of the client and family. 2 The debate is substantial because of far-reaching implications for the whole counselling and mental health field. 3 At the coalface, these dilemmas are not purely theoretical and frequently raise strong feelings around intensely held personal and professional values for the clinician. 4 Emotional reactivity can affect how we see our clients and the options available to them, and the way we collaborate with colleagues in providing care. 5 Applying a theoretical understanding of emotional processes can be useful for reflecting on personal and professional functioning and can provide options for working within a multi-paradigm workplace.The imminent release of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has evoked an increased focus on diagnosis, the medical model and the struggle to describe complex human situations adequately. As members of multidisciplinary teams in a publicly funded child and adolescent mental health setting whose overarching frame is systemic 1 , we have watched this discussion with interest. Over time, we have become increasingly aware of the role of emotional responses in this process, both in terms of the impact on the broader debate, in our daily workplace, and within ourselves. This article seeks to explore this issue as it relates to our day-to-day work: with clients and their families/carers; alongside other clinicians in our teams; with the referrers of our clients and other services to which we refer. We have approached this

show abstract

Section: An Outline Of Controversies Relating To Dsm‐5mentioning

confidence: 99%

Section: An Outline Of Controversies Relating To Dsm‐5mentioning

confidence: 99%

Dialogues from the ‘Coalface’:DSM‐5 and Emotional Process in a Clinical Setting

Chambers¹,

MacDonald²,

Mikes‐Liu³

2013

ANZ J of Family Therapy

View full text Add to dashboard Cite

show abstract

“…A diagnosis allows for reimbursement by third-party payers (i.e., health insurance companies or agency grant funders; Braun & Cox, 2005). Insurance companies require a medical diagnosis for reimbursements.…”

Section: Informed Consent Considerations and Diagnosismentioning

confidence: 99%

“…Clients who are not aware that not all DSM diagnoses are reimbursable may agree to incur the risks of receiving a diagnosis but not receive the financial benefit (Braun & Cox, 2005). Although the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (the Federal Mental Health Parity Act; U.S. Department of Health and Human Services, 2008) prohibits providing discrepant benefits for mental health and substance abuse treatment, thirdparty payers are not required to reimburse for mental disorders that are not biologically based (U.S. Department of Health and Human Services, 2008).…”

Section: Informed Consent Considerations and Diagnosismentioning

confidence: 99%

Informed Consent, Confidentiality, and Diagnosing: Ethical Guidelines for Counselor Practice

Kress

Hoffman²,

Adamson

et al. 2013

Journal of Mental Health Counseling

View full text Add to dashboard Cite

show abstract

“…In other words, counselors may be tempted to "upcode" (Cooper & Gottlieb, 2000, p. 199), giving an acute problem a more severe diagnosis than presenting symptoms warrant for a presenting problem, or to "downcode" (p. 199) to an Axis I diagnosis when the client presents with just an unreimbursable diagnosis (e.g., an Axis II diagnosis; APA, 2000). In the process, such counselors misrepresent their work to third parties (Braun & Cox, 2005;Danzinger & Welfel, 2001;Kanapaux, 2003). Danzinger and Welfel (2001) found that 44% of counselors responding to a survey "indicated that they had changed or would change a client's diagnosis in order to receive additional managed care reimbursement" (p. 146).…”

Section: Accuracy Versus Misrepresentationmentioning

confidence: 99%

Ethical Dimensions of Diagnosing: Considerations for Clinical Mental Health Counselors

Kress

Hoffman

Eriksen

2010

Counseling and Values

View full text Add to dashboard Cite

There are numerous ethical considerations inherent within the process of assigning a Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM‐IV‐TR; American Psychiatric Association, 2000) diagnosis. In this article, general ethics considerations such as informed consent and confidentiality, accuracy of diagnosis, and multiple relationships are examined as they relate to clinical mental health counselors' use of the DSM‐IV‐TR. The article concludes with the authors' suggestions for ethically sensitive diagnostic practices.

show abstract

Managed Mental Health Care: Intentional Misdiagnosis of Mental Disorders

Cited by 24 publications

References 41 publications

Dialogues from the ‘Coalface’:DSM‐5 and Emotional Process in a Clinical Setting

Dialogues from the ‘Coalface’:DSM‐5 and Emotional Process in a Clinical Setting

Informed Consent, Confidentiality, and Diagnosing: Ethical Guidelines for Counselor Practice

Ethical Dimensions of Diagnosing: Considerations for Clinical Mental Health Counselors

Contact Info

Product

Resources

About