NCE Group Session DSM 20220820 185609 Meeting Recording

[00:00:02]why the group works is I open it up for questions there we go I opened it up for questions questions in general something you've seen on a practice test something you've seen that you don't have any issue that you have a concern with anybody quickly have anything I have a bit of a quest well it is a question I'm used to um seeing uh information about Carl Rogers and kirkoff for empathy but I am not familiar with Alan Ivy and you don't need to be okay okay okay I only teach to the test if I have not mentioned him he is not going to be the under one of the important people okay okay so you should always I'm teaching you enough to know what it can't be okay okay so they give you an allen Ivy test the other three answers belong to a different theorist and you should know who the other three okay okay so and like a word if there's a word you don't know if you know the other stuff can't be true then that one has to be true okay that word ipsitively that's a research question absentively means that I'm only comparing myself medium this myself local Norms I live in I live in Tennessee local Norms say that you know this is how I'm tall I'm five nine and this is how much I should weigh those are the local Norms right National Norms give me a different number Pam you're five nine you should weigh between like 140 and 160. all I really care about is do I weigh less today than I did yesterday okay that's iFly and that's verbiage that you just need to know okay so if you don't know it don't shy away from it look at the other questions and you should know enough to know what it can't be okay okay other questions guys there are not a lot of DSM questions on the test um so but and and I never know which ones are going to be so I really try to cover um the gamut well the big parts of the DSM one of the things that you'll always see is brief psychotic schizophrenia form and schizophrenia anybody want to Brave and tell me what the difference is is it due to the duration of the episode right be specific um schizophrenia form um what's first what's first Bakery yes pretty psychotic yes how long is that 30 days three days to 30 days absolutely absolutely okay then I have schizophrenia form which is a form of schizophrenia right the goal is once we and let me clarify I only teach to the test in the real world is someone presents at your office or an emergency room and they're having a psychotic break you're going to diagnose it with schizophrenia because that's what insurance pays for okay but that's not that's not right for the test for the test it's gonna ask how long this has been going on right and what we know is schizophrenia happens uh or a psychotic disorder happens in the age of 15 and 25. if you make it to 40 and you've never had a psychotic break then you're good if you have one past 40 it's less likely to reoccur we don't know what cause schizophrenia we have looked at some genetic pieces but we really don't know what causes it so most often what we see is this this kid who goes to college or someone who gets married and in the early fifth to the early teen late teens or you know early 20s and they have psychotic break so we do not want to diagnose with schizophrenia because there's no cure so very psychotic is three days to 30 days one month to six months is schizophrenia form a form of schizophrenia and after six months it's full-blown schizophrenia cool go with that [Music] I'm sorry one more time uh schizophrenia form is somebody answer her nobody answer her come on you know this great psychotic is three days to 30 days and then schizophrenia form is one month to six to six minutes thank you guys and that's the best way to learn I say to you you know a topic when you can teach somebody else okay when you can watch TV and you say oh my god look he's he's borderline right so that's when you know it when you can apply this stuff to your everyday life you do this every day I am not teaching your foreign language I'm not teaching you anything that you don't know I'm just giving it a verbiage that's going to be right for the test okay I remember this test has nothing to do with whether it counts or not I know you got people in your office and they licensed and they'll be like oh Lisa can you help me out I'm like girl you got a license I have but you out no we don't do that right we help them out but so there are people that are better test takers and what I really try to do is make sure that you learn test taking skills okay because that's what we really need to know to pass this test okay we'll have some questions we're going to go straight to questions I'm I don't always do that uh this is because the shortage of time today we're going to go straight to questions uh and you guys know if you've been with me for half a second I like a social work question um I I think they're closer to the actual tests social work has had and the others too like the El the um uh my drug and alcohol test um my lmfts they've always been the way that the now the test is written um so I do like the things much better so if it's a social worker just put in therapists okay I'm gonna ask you not to answer until I say so I want everyone to have a chance to get there and I'm gonna call on you for the answer it doesn't matter if your camera's on and off it don't matter okay so a therapist but don't answer please and you does that write that where the chat box is yes you should see a thing that says chat it's uh like like the like the like the voice thing if you were thinking like in okay so without an answer do not put answer in your chat box until I say it's okay we don't group group think group think is where we go with what everybody else says so that's not okay it won't let me insert and the chat it says chat in Channel meetings is only available to team members did you sign in or come in as a guest probably as a guest oh okay but I'll call on you don't worry Jessica okay I'll make sure you get an answer a therapist on an inpatient unit conducts an intake with a 40 year old man who was transported to the hospital by the police after an altercation in the park he's unable to provide a medical or social history and reports having no memory of how he arrived in the hospital a police check reveals that he is an executive a large company in a nearby City he was laid off a few days ago at the end of his week-long stay he's recovered his memory the most likely diagnosis and please don't answer yet I want you to really understand the question it's I always say it's like the Bible when when God you know mentions the woman with the issue of blood or the alabaster box when it's in the question it means something okay oh he's 48 okay hit altercation in the park and he has he doesn't remember he doesn't remember what happened police check reveals he's the executively large company and he was laid off a few days ago at the end of the house the week-long stay he recovers his memory he knows who he is okay so go ahead Jessica since I know that you can't answer in my chat box I'm just gonna go ahead and let you answer the first one ah okay what what can it not be first let's rule out always what it cannot be I think at postmatic stress disorder ding ding ding that's out okay and I will give you a hint it can't be huge either acute is the precursor for PTSD because three days to 30 days is acute okay so seeing deer out okay so I would say hey because I know Amnesia is losing your memory there we go there we go what's fictitious disorder I don't know and I don't know the second part of the Amnesia but that was disgusting disassociative Fugue when it's when I dissociate that it means that that's what used to be called MPD okay but I don't want to go there because it's not usually I'd answer a question on your test just know that it's going to be amnesia okay fictitious disorder I think Lisa did you know that one yeah my uh my chat box not working either so um fictitious is lying okay well we would say pretending okay we don't call our client's life but yes they lying okay they're not telling the truth or the tests they're pretending to have an illness there's nothing wrong with them oh there's nothing wrong and they're pretending malingering is they're pretending but they have a goal malingering is I I want to get out of I I don't want to go back to work I want to stay on um I want to get workman's comp I want to uh I'm applying for Social Security disability from a language the question will give you they have a purpose of the reason fictitious is Faking It and Amnesia that's that's the best answer so a is my best answer for this question okay okay number two a school therapist receives a referral for a 13 year old boy for inattended and poor grades during the observation interaction with the student the therapist experiences the boy as intelligent and highly verbal but knows his difficulty following instructions and reports that he avoids reading and writing activities his most likely diagnosis would be okay all I know is within this question it is a reading test volunteers go ahead Lisa um I I eliminated a because conduct is um you'd be stealing something right yeah being mean is that the cat's tail on fire untreated conducts are anti-socials as that Persona disorder as they grow up right anti-social is not a social anti-social means that anti-society rules and our nice student I'll smile on you and then I'll kill you okay so a is out and then attention deficit hyperactivity disorder I eliminated that because it's not talking about him paying attention I mean right um autism spectrum was I left in in learning disorder now what got me was to avoid reading and writing activities so I went with learning disorder yeah yes you did so most often that's the only time you're going to refer to a psychologist okay because that's an assessment piece because that's who it diagnosed that but those absolutely at least what words in the question let me know that they was the right answer he avoided reading and writing back up he highly he's intelligent and highly ding ding ding he's intelligent he's intelligent so kids that are really smart they can't get their work turned in I'm concerned they're really great in English but struggling math that's a learning difference okay so we don't want to stick if the question doesn't talk about their learning style then ADHD or add would be the right answer right but if it discusses their learning then that's a learning disability or learning disorder ask me questions guys you're good can you repeat that again if um can you repeat that again Dr Pam I can't I can't I can okay so in this question I the reason that I know is that learning disorder is because the therapist's experiences the boy as intelligent he's highly verbal but he can't follow instructions and he rep and he avoids reading and writing okay if I'm really really intelligent but I'm I'm failing like basic English that's a learning difference there's something going on that I can't take what I have and transfer that to the test question so that whatever the teacher is asking me if the question just says that he is uh let me back up so ADHD any of those mental health disorders have to be diagnosed in two settings so if adz or ADHD is the right answer they're going to say he's that way at home and that way it's cool okay in this question all I know is that he is uh inattentive at school and there's not enough information for me to diagnose with uh B he's not autistic there's nothing about him having poor social skills and another question that says he's stealing anything because I'm gonna say I don't get mad at me I may like call you out and stuff but you call me out too well t-a-t-a adult to adult right adult to adult no because you always tell me not to use work um situations I do the reason I was saying um because we had a 13 year old boy who was hospitalized because he wasn't able to self-regulate but when he got out of the hospital they gave a major depressive disorder but he was very smart but he didn't know how to read or write so he wouldn't go to school so we kept on thinking he had AJ's ADHD but the psychiatrist could say no there's it might be trauma related but then two days ago his mom stated that when he was eight years old he had ADHD but I was trying hard to get a psychological to distinguish a learning disorder you know what I mean but I guess I didn't know how to communicate I didn't know how to communicate that basically okay so um uh unless it says according to Priscilla and her job right that's not the right answer but okay so I teach to the test but in the real world if he's struggling with school and he's smart I definitely request a psychological exam a psychological testing so we can see where he is okay assessments the waste w-a-i-s 16 and above whisk six hit and below whipsy wppsi I always say those the kids are still pee-pee on themselves not really but that's three to five the wixie that's an assessment question a therapist evaluates a six-year-old girl everybody read this because I might call on you just saying it okay a six-year-old girl with morally severe cerebral palsy among other symptoms that parents report that their daughter is observed attempting to chew and to eat non-food items including sand and house plants sometimes you're able to intervene where she is chewing on the item but she is hospitalized on one or more occasion for ingesting leaves from a potentially harmful plant what most likely is the diagnosis uh lyanna are you there Liliana [Music] yes I'm listening only because I'm in the street oh oh you're out partying while I'm teaching no yes you are it's okay it's because it's my brother wedding oh yeah yeah yeah yeah oh my goodness are you are you drinking lots of wine no no no you should you really should okay so I never did before you don't know what you're missing Okay so let's see here Paige are you there yes I'm here damn she called on me oh okay I was hoping Lily okay so what do you think this is so I ruled out autism because he doesn't seem to be artistic um and I ruled out D because it isn't Dia um no wait I thought it was like a pic when they picked their face it's not ah ah okay so what you're what you're talking about is excoriation that's when I pick my face is when I eat anything that's not food so that was my right answer got it Pika because in its most common with children or adults who have a lower IQ who suffer from some neurodevelopmental disorders they're more likely to eat things that are not food and I know there's a TV show once that people that ain't like detergent and ice and blah blah blah but for the test anything that's not food including ice is going to be considered pica okay okay okay are you got the hook yeah that easy in co-presis um isn't it isn't it related to your like your bowel and bladder or no so no poop really and if your races is pee and co-presis is poop okay okay so if a uh so it can be a a kid who's past the age of five and they're still pooping on themselves it also can be into my work in a prison here when they take their their fecal materials yes that is still called in Caprices yes can you say the other name in your recess is p and ureces and co-presis is poop yeah they definitely with it okay that's what that means that's that's that's that's the word so it could be I can't control my bladder or it can be that I can control my bladder and I poop in inappropriate places or I uh share my poop with others that is in co-presis and I know we're diagnosed after five okay yeah so a four-year-old who's having difficulty you know not pooping or wedding itself still we don't diagnose that yet so three for the test is that human behavior when kids should be potty trained I don't care what your mom and him said two is not the right answer for the test it is three okay so between three and four that's when kids definitely body drink so if they're past four then we're concerned because they don't they're not able to control their bowels or they they put it in the wrong place this is poop okay so I always say take the test into work so the next time you go to work my jail people my prison people say oh my gosh she's got in Capri says he threw [ __ ] at me fecal material at me that's what I said yes this is Cecilia actually they do more than just throw it at you they sometimes if I see you do I see you no because uh girl if you if I can't see her you can't talk to me okay oh there we go there we go okay so well usually I'll experienced them put it all they put it all over their whole body in the prison too they um a lot of my severe psychotic people that I work with yeah I put it all over their body so that is in Caprices so when I when I when I poop in appropriate places and I use my poop Professor okay rumination disorder you probably won't see that on the task but I'm going to tell you anyway rumination disorder is when people have difficulties with the texture in their mouth so they will chew and chew and chew and then they will swallow and regurgitate or they'll put it in their hand and put it back in their mouth it is so gross okay so we used to only think it was in children now we know it's in adults as well so rumination disorder and um a couple of well about two years ago one of my NC clients said to me that because the cows have four stomachs they keep sending it through their stomachs that's the rumination so what happens is I take the food in and my body cannot ingest it so I'm either going to regurgitate it throw off my hand or I'm going to try to gag it and then re-swallow I know I'm not going to show you a video but if you put in YouTube you will definitely go ahead and pick that up okay so this one is Pika a couple of Clues cerebral palsy and then eating things that are non-food items because it's a reading test right ah personality disorders ego syntonic or egodist tonic ego syntonic Ding Dang they don't have a problem they've been ingrained they've been that way their whole life they're not coming for treatment a couple interest rate with a therapist due to increasing conflict and distance after two years of marriage the man reports feelings as his as is his wife needs approval for everything and he's exhausted with her constant worries and questions about what she should do the woman endorsed his frequent worries about her husband leaving her or dying young and said that she only asks his opinion because she trusts him more than I trust myself the man says he feels more like a parent than a husband and this can't continue what is the woman's diagnosis if you don't have a clue it is a reading test is an absolute reading test Wanda are you there yo yo Wanda Davis come on down yes ma'am yes ma'am I'm here do I see you can you hear me I can hear you and see you girl you're a cutie pie look at you okay thank you what's my answer um Let me let me read it one more time I was trying to read with you but let me no okay take your time take your time foreign I would say dependent personality disorder because it looks like she's depending on him for everything exactly sure would absolutely absolutely and you may never have seen that before but you can read right yes okay yes ma'am if you're still on you're not on the target yet Wanda what is a no we didn't personalize disorder what do they do um um guess what they say avoid try not to um so they avoid because they're afraid of ridicule so avoidant personality disorders really do like people they really do but they're afraid that you're going to make fun of them so they're not going to say anything but they'll come to a party they're like hoping you'll say something but they're going to avoid people because they're afraid of their own they're afraid you'll judge them okay histrionics are always my girls always my girls I always say Jessica Rabbit if you're not sure if you're not old enough to know who she was Who Framed Roger Rabbit I know is old um but most of us have a friend in our friend group that does this okay so Jessica Rabbit when she talked to oh come on she was very seductive and she was like oh Roger do I go to McDonald's okay drama queens drama queens drama queens not permissive my Border Lines are more permissive but my my histrionics for the tests are going to be women narcissists are men okay histrionics it's attention on me attention on me attention on me um I my my my boss would not accept my Facebook request okay drama drama drama that's what you're looking for in the question okay so that is going to be so I trust him more than I trust me that is dependent Dad how do I diagnose that how long is God anybody foreign who said that I said that six months yes six months free floating not tied to anything it's an overall feeling of restlessness always on edge okay I'm sure that nobody in this room but me suffers from God but that's what that means six months of free floating anxiety I can't tie it to anything specific it's just what it is foreign guys as I go along please feel free to ask oh let's go with this one on top of any races a minute ago so a diagnosis of in your recess is an appropriate when when do I diagnose a unuresis the patient avoids feces intentionally or unintentionally at least twice a week that's out because that would be in co-presis right feces in co-presis medication may be causing the problem nope A and B are out now we're down to C or D uh uh Jackie you always like this one sure I made it easy I got you down to Sandy okay I'm gonna go with C you are that has to be at least five okay in the real world this is not something I would ever remember because I can just Google it on my phone I can pull up DSM right so I I wouldn't necessarily spend time learning that I hate that on the test oh where's my bill yes you have you have been possibly conditioned okay number nine my mother brings her five-year-old daughter to therapy she's referred by the school the mother cheerfully reports that the teacher says that her daughter seems autistic but doesn't talk or interact with peers the mother reports that the daughter plays with other siblings and cousins and talks at home a lot with her extended family what differential diagnosis should we considered differential diagnosis just means I'm not sure which of these would fit but so which one of these would I consider Catherine um it's a reading test Catherine don't think I wouldn't go with generalized anxiety disorder because that's six months right foreign do you see anything about when she's separated from her mother that she freaks out she doesn't talk or interact with her peers ah but it doesn't say she freaks out okay so it's not separation anxiety and it's not Gad so now I'm down to b or d I would say probably selective mutants it is yes selective mutism are are adults and kids who refuse to talk at school or refuse to talk in certain situations okay absolutely absolutely bye oh let's see here Rhodesia where are you girl are you still in your car sorry I'm back are you driving no I'm back I'm back okay okay number ten is yours okay an 11 year old boy is referred to a school therapist her excessive truancy an assessment with the boy reveals several incarcerations at the Juvenile Detention Center for selling drugs and the parents report a long-standing inability to enforce limits as a consequence with him the teacher describes him as a bully and disinterested in school although the although the therapist knows the boy has a reputation as a boy what did would we diagnose him with um so I will rule out see guy bipolar one is my mood disorder right I would see something like they always got this like hype the full-blown manic attack so see us out yes I will rule out be because we diagnose that until you're an adult at least 16 for anti-social and he's 11. so now you're down to A and D foreign okay hold on let me read it again so Honda disorder kids are violate the law okay well I'm gonna go with conduct disorder and what words in the question prove it to me um well it says that when you just said that he violate the law but he's had silver incarceration at the Juvenile Detention Center for selling drugs um so that he is a law breaker I mean a law got it got it okay so when you see the difference between opposition defiant those kids are bad let's not pretend they're bad they challenge authority they're they're not the greatest kids ever however if I'm breaking a law okay if I'm bullying if I'm setting fires if I'm setting the cats tell on fire I'm trying to poke the dog's eyes out I am going to be conduct okay but a question tells you go ahead oh no nothing it's a reading test and the answer not even it doesn't even part of the answer foreign so untreated conduct disorders then at 18 we can just we can we can uh diagnose his anti-social those are my serial killers remember a social means I don't like people anti-social I like people I invite you to my house that I'll kill you and eat you okay they're anti-society rules aid social that's not a DSM diagnosis that's people that just don't like people I see a hand up Liliana is that from before or do you have a question no uh I was uh interest to answer the previous question about somebody answered ah okay you want the next one it depends on right okay Liliana come on up just be brave okay number 11 a client is referred to a therapist after being discharged from a psychiatric hospital the records indicate he has been hearing voices for the past four months when the question tells me that there's a reason four months and he believes he's being followed according to the DSM of five criteria the most likely diagnosis for the client is what four months Brave psychotic schizophrenia just schizoaffective disorder or schizophrenia form foreign it is not three days to 30 days is a it's been four months that is going to be schizophrenia form D is my answer schizophrenia form because it's not quite schizophrenia because schizophrenia takes six months okay uh schizoaffective disorder oh let's see here uh Fisher Joy is that your last name fish fishy fish toy what's your first name yeah Joy is my first name oh God I got it got it hi Joy how are you good good were you trying to hide in my group thinking I wouldn't call on you no yes you are it's okay so schizoaffective disorders you know what that means okay I studied this today I should remember this um is this like no let's see okay okay so I'm gonna give you a cat I'm gonna give you some hints a faster disorder a f f e c t i v e is mood that's another word for mood the affect the look on my face describes my mood okay so anytime you see that word AFF ECT so if I have schizophrenia and I have a mood disorder that's schizoaffective okay so what it looks like is bipolar one right five full days of that whole like manic episode and when my mood when I don't sleep that I have hallucinations or I have uh uh delusions so schizophrenective disorder is both schizophrenia as well as a mood disorder got it okay okay uh if you've ever seen any of my videos You'll I will always tell you I've never ever ever seen this diagnosed outside of an institution so prison or hospital or some places like that so because if your skits are effective I can give you both an antipsychotic as well as a lithium and you're kind of like a walking zombie so if I've I've never seen it diagnosed outside an institution uh so you might have one but the original diagnosis came from the institution and most often okay I see a question uh Clement or Priscilla what's your what's your question I was going to ask you does it have a time frame or no just because it does not in there it does okay actually I'll take it back two weeks two weeks of both symptoms but I haven't seen it on the test so I don't usually teach that because that's that's not using the test for two weeks okay thank you so much let me I had an inmate I work in a person and I had an inmate um who was diagnosed with get your effective disorder and it's like his mood swing is like it's like a pendulum and one day he will be no one minute he will be fine and then the next minute he would be very irritated and then he will turn to me what is your name and everybody will be calling my name and he still wouldn't remember and then sometimes he gets so mellow it's like he freaks me out and I feel very uncomfortable around him do you know what medications he's on guess about everything he's on lithium I'm sorry for bipolar yes and I always say take advantage of your work if you have the opportunity to talk to the psychiatrist to read the charts take advantage of that because that really lets you see what it looks like in real life okay so definitely so um so it sounds like and this is not asked question there are people that are called rapid cyclers that means they're moving up and down up and down up and down up and down in a day up and down up and down about an hour so so he may be a rapid cycler on top of the schizophrenia foreign I have a question yes um can you diagnose conduct disorder can diagnose can conduct disorder be diagnosed in an adult no you'd be antisocial right so so there are two and you won't see this on your test you won't see this on your test so um there are two uh so all of my personality disorders are ego symptotic right they don't have a problem they're not coming for treatment there are two that I can diagnose before the age of 18 and that's anti-social and borderline okay okay that's not a test question you won't see that but just know that that's that is those are the options okay so what that means if he's 16 and he's diagnosed anti-social that we we somehow missed the conduct disorder when he was a kid yeah thank you well God take this question since you're talking to me a 35 year old woman enters treatment with a therapist during the assessment the therapist learned she's been on lithium for several years and was hospitalized after an episode in which she did not sleep for a week sold her brother's car and use the money to go to Las Vegas based on the information what is the client's most likely diagnosis I'm going to go with the what words in the question prove it to me lithium more than that this could be bipolar too so tell me what I see um time frame yeah so several years well over here she did not sleep for a week oh okay that's bipolar one five to seven days of a full-blown manic episode okay all right those were the keys in the question okay okay Stephanie you uh you got some look on your face I was just agreeing and I was just reading I was laughing because it said um sorry that she used the money to she'd sold her brother's car use the money to go to Vegas and I was just like that's just so like that's very typical of bipolar one most often you're going to end up in hot to be hospitalized or going to end up in a jail because you've done such bizarre things uh in that episode of also hypersexual I'll sleep with people that I would not have slept with I'll spend money that I don't have okay ah volunteers Diane Koch are you there cook Diane cook are you there I am here you're like please don't call with me you're ready ready let's do it okay she's 62 year old woman and she presents for treatment five weeks after the death of her beloved cat okay prior to the incident she worked full time and enjoyed Hobbies since then she stayed at home and isolated herself stating she cries all the time what initial diagnosis would she make it's been five weeks um so you want to start with what you don't think it is correct okay we got it got it okay so I don't think it's generalized anxiety disorder at six months free floating anxiety not enough time that's how and I don't think it's persistent depressive disorder because because that's two years in adults two years and adults and one year in children okay so now you're down to b or c okay um and you just a couple questions ago you said something an acute means something like real bad yeah I I want to say major depressive disorder that sounds pretty major yes yes yes there's nothing in the question that suggests that her cat and I'm sure she's upset but the test questions would say to me that this is a traumatic event it would tell me in the question all it tells me is she stayed at home and isolated herself and cries all the time so that's going to be a major depressive disorder okay and the criteria would be it's two weeks two weeks of major depression can't get out of bed uh Suicidal Thoughts don't shower can't do your normal routine that's what makes it a major depressive disorder I'm just saying it's a reading test right which isn't depressive disorders two years in adults one year in children okay and then ask you doctor is that just zero to Thirty Days right a few acute yes acute and the question would say to you because because if I'm thinking I could think if I lost my my babies my fur babies it would be traumatic for me and I it might be of that but the question doesn't say anything about trauma so I can't do it thank you I just have to read go ahead I'm sorry I just wanna because I remember you so a cute and just becomes so acute stress is before PTSD so three days to 30 days is the acute something happened I lost my house my house broke down there was a hurricane in my area we lost everything that's a cute after 30 days that it becomes PTSD for one to Thirty Days is the case three days and 30 days 3D sorry okay and then after 30 days it's PTSD it's PTSD and then major depressive order is after two weeks two weeks two weeks two weeks okay and so so if I were thinking and that's the problems we think right so if I were thinking I would have picked acute stress what I'm not that's five weeks let's pass that so no it could be a cute could it because I've been on me four weeks if it's acute so then it's not bad and it's not two years so you saw C is my only choice I'm sorry can I ask a quick question of course um you said Dad it would be diagnosed if they had an anxiety generalized it is so it's a six months of free floating anxiety that means you can't tie it to anything specific this I always I wake up and I feel anxious and I don't know why foreign six months six months um isn't there an anxiety disorder that's I can't think of the name of it that would be like historic term a panic attack is we feel like you're like you're gonna have a heart attack the the question may say the person is sitting in the hospital parking lot because they really believe they're about to die if you've ever had a panic attack it's true tachycardia your heart is beating the person next you can feel that your heart is beating you go to the emergency room not not beating but meeting really fast like your chest is popping out and and you go to the emergency room and they hook you up to all the electrodes they do all the research and they find out there's nothing organically wrong organic means biological there's nothing wrong with your heart there's nothing wrong that is just stress it's anxiety and I know I I've had a panic attack so I definitely know it I think I'm dying I swear I'm dying I've had numerous panic attacks I'm not gonna lie I painted I ain't gonna lie I feel like I'm having a heart attack yeah um lag under the in the fetal position which would be a regression right yeah yes exactly that's what it feels like oh God so a panic disorder is I've had one panic attack and I worry about having another one for the next 30 days so those are the questions that say the client is sitting in the parking lot and they're they're at the hospital they're afraid to go home they're afraid to go to sleep because they've had one panic attack and for the next 30 days they worry about having another one okay that was fun we'll go with that okie dokie okie dokie I'm gonna meet it I'll meet you okay okay 17. who wants this one guys we're going to do about three or four more questions I'm gonna wrap you up so uh Tiana are you there yep I'm here you ready let's do it okay a therapist and a community agency initiates an intake with a 19 year old immigrant from Mexico who is the whose therapist who the whose report who reports recurrent nightmares which the debt reoccurrent nightmares during which the death of her younger brother during their Journey to the US is reenacted she tells the therapist that she has started to start school when she arrived two months ago but unable to concentrate and can only see her brother's face in her mind her family does not hold her responsible for her brother's death but she reports feeling disconnected from them and doesn't know what to do right timeline timeline yeah so we just talked about like the stress disorders and the order so I would immediately what I think it's not is b or d because this and then the timeline between because of traumatic event so the death of her mother is the traumatic event okay and so let me see what the timeline is on that so see here next two down to a and c and you're going back to the question to prove to me which one's the answer based on the timeline yeah exactly so it sounds like it um by reading the question um she arrived two months ago so um so this is within two months um and so knowing that um oh you just said it but I I'm pretty positive it's a acute stress disorder three days to 30 days dang it so close so then it's PTSD because it's too much the house is too much and remember again it's a reading test so you have to know content right but they're not trying to trick you they're not they're telling you right there it's two months so you just have to know that it's not acute because it's past 30 days 30 days but the other piece be in the reading that the reoccurring nightmares would that have been like that could have been acute or PTSD because the symptoms are the same okay it was the time frame that makes the difference okay that's the only thing that makes a difference acute you know the medical term means it came on quickly it's short and sweet right not sweet but it came on quickly so acute is something just happened to me right I I my husband died my kid died I something happened and I'm in I'm in stress which we which is normal right we would expect that but after 30 days if they're still in that high stage that's going to throw PTSD okay question yes um the question I was asking when I was trying to ask about the Gad what I was I was thinking was the unspecified anxiety disorder what what time frame uh don't nope nope nope nope nope don't go there there's well because it was on the questions I was just yeah but but uh if it were important I would have told you I only teach to the tests and you don't need to know that for the test I know that's mean but that's that you don't need to know that that's not going to be the answer for the test they're not trying to see if your expert diagnosticians specified inside they will not they will not they will not they will not in the real world all you're going to do is open your DSM on your phone and that come up with a diagnosis that's the real world so the test is not trying to make you an expert diagnostician they're asking you do you know the basics so unsprecified would not they're not trying to do that to you I promise okay Lisa you look like you're dying to answer this question uh I wasn't I was Florida how was Florida Florida was hot and beautiful and Zach turned six yesterday and we came out today and he said Gigi now you can come to my birthday party [Laughter] okay you know I'm jealous because I just want a big grandma and my kids didn't want to have babies I keep telling them my my clock is ticking my clock is sticking I need a grand baby I'm 56 all my friends have grandbabies it's not fair it was hot and rainy but it didn't even matter about the rain because it was so hot okay a 22 year old client go ahead no you're right please read you know I got my glasses on Doctor what's up let me read girl girl a 22 year old client is referred by his lawyer after being accused of burglary the lawyer claims that the client is depressed when the therapist meets with the client the client states that he's not that he is depressed but he cannot identify any specific feelings so like you said don't say lying we'll say I was going well malingering is telling a story with a goal in mind conversion this order is the ugly icky stuff that's bad no no no no they're talking about that's a version that's a version there version therapy and you might see that as a DSM uh defense mechanism conversion is when I um I see something traumatic and then I can't see that's uh Mia Angelo my Angela she talks about when she was little that she told her her relatives that a neighbor raped her and her relatives killed the neighbor so she said she felt her voice caused someone to die so she was silent okay so that's conversion we're gonna take a traumatic event and I convert it into a physical illness but I don't see anything here about a physical illness and I was going with um he said that the client the client states that he is depressed but cannot identify any specific symptoms so it sounded like fictitious disorder but yeah so that was confusing to me because okay oh wait I'll take that back I'm sorry it's malingering because he's trying to get out of the Court that's malingering fictitious we don't know why you're lying so that's maling green got you okay I gotta let you go guys um I will send you this test this is a social work test I you know I like Social Work tests I'll send it to you um uh my understanding is you can log back in now and get this um this this recording I think Prudence has set it up that way I will put this test in the email I'll send it as an attachment but if you cannot open it then just send prints an email okay questions guys I tried to cover the major things where you'll sell the DSM they're not trying to see if you're an expert diagnostician the major ones schizophreniform brief psychotic disorder bipolar one bipolar two major depression knowing which ones are childhood disorders and which ones are adult disorders conduct and officer defiant are childhood disorders anti-social is an adult disorder yeah intermittent person Intermittent Explosive this intermittent explosive disorder that's only in children so trying to give you just some Basics so you know what to look for on the test okay excuse me Miss Pam if you log in I log in as a guest how do I log in as okay I like Miss Putin if you haven't spent any time with me I will tell you that that I love to teach that's really all I want to do I swear and I started off this business just teaching and I don't know if people paid me or not I I buy schedules all my stuff I just really I just want to teach and then I realized that you know what this isn't working very well so I hired prudence and she is uh her background is in HR so she's the billing person she's the one that says you can't see Dr Patrick you don't pay because I'd be like oh come on it's okay so now I have staff that I have to pay and I like getting paid every week so their rules uh but honestly I promise you I I I just want to teach I don't I don't know how I got here this produces me a link and she says go here Pam okay doc are you asking me a question are you just talking in general you're muted so we will be able to ask Prudence how to get back on and look at all the videos my understanding and not the all videos so we've just changed it this week so if you missed the video prior you cannot access it unless you ask her okay this one the same login should get the recording it's my understanding okay if that doesn't work for you then email Dr Pam and Prudence will take care of it okay actually my I have a weekend person now because Prudence likes to be happily married so uh Jill is our weekend person um and then Emily is our social media person she does all my social media so you might get the one of the three of those but they they know a lot more about technology than I do I just want to show up and teach which I think I'm pretty good at I think it's a gift thing from God and give things are not for you they are for others so I have to walk out um what God expects for me because at the end I have to answer to a higher power amen that's simple questions guys ask me ask me ask me I don't mind this was good thank you have you been with me when it wasn't good not good girl now okay I'm just I I hope it shows that I love what I do and to support everything I know into you everything that will help you pass this test I'm going to pour into you I'm not going to keep anything back and if I say to you you don't need to know that it's because I'm not trying to be mean it's just not a test answer okay okay and if you want to see me later after you get your license and you need some consultation or supervision all gladly but at this point I just want you to pass the test okay that's all I want for you this stupid sheet of paper should not stop you from what I believe God has called you to do okay I'm going to teach you how to pass this test and get that sheet of paper so you can hold their their big old certificate on your wall and you can make Bookoo bucks that's it it's that simple okay and I realized that but the test is not written for you and you need to make sure that you understand it is written by all the theories we study are all white men right that's face facts we might pick up a Carol Gilligan uh maybe we get like uh uh what's her name uh and let's see Anna Freud either yeah yes okay but the tests all our theorists we study are all white men this test was written for upper class white men so that means you have to know their verbiage you have to get out of yourself because this test is not written for you facts facts facts facts it's not written for you it's a very high vocabulary level the assumption is that you have a master's degree so you have should have a high vocabulary level I always suggest that you I say read that increases your vocabulary but I hate to read I'm not gonna lie uh what we do in my house though is the closed caption is always on on all the TVs always always always um because you can see the words and you can hear them at the same time because most often it's not the the clinical terms you know the clinical terms it's the everyday vocabulary that we struggle with and and missing a term will definitely you know that'll that'll mess up the test if you don't understand what they're asking you it's a reading test it's it's really I know it's not that simple but it is okay okay thank you for not having a life and hanging out with me on Saturday nights so one day I'll have a date I'm just saying one day you won't get me bye guys thank you stop curtain