Dr Reid, I agree about the dangers of assigning labels that follow a person ever afterward. Of course I meant that one should diagnose Adjustment Disorder only if the clinical symptoms are present (greater anxiety, depression or problematic conduct than would normally be expected that results in significant impariment of functioning). The DSM allows for coding presenting concerns that do not meet the criteria for a mental disorder but are nevertheless appropriate for clinical visits (the so-called V-codes, such as Academic Problem, Occupational Problem, Paren-Child Relational Problem). Most people going through divorce do not need treatment at all, and among those who do most are more appropriately given a V-code instead of a mental disorder diagnosis (even a somewhat benign one like Adjustment Disorder). I would never put a label on anyone lightly. Nor would i fail to make a warranted diagnosis. And that is sometimes a matter of clinical judgment. Another reason the treating clinician needs to be unbiased. Hey, I prefer not to use clinical labels unless clearly warranted (I prefer functional assessments and use a family systems therapy approach). Many mental disorders are outside my scope of praqctice, so I would refer a client who presented with severe symptoms to another clinician. I do not accept third-party payemths; all of my clients pay for their own counseling. Third-party payments come with more strings attached than they are worth, in my opinion. So in my earlier post I was merely pointing out that the therapist may have had sufficient reason to assign the Adjustment Disorder diagnosis. There may not have been any intent to downcode to defraud insurance companies. If the therapist was downcoding, I would like to see him/her reported to appropriate state licensrue oversight bodies and professional organization ethics committees. This is a serious violation of professional duties (Dr. Reid discussed the reasons why this is true very cogently in an earlier post). I would never condone downcoding a diagnosis or knowingly engage in it myself. Hope I was clearer this time. Don H. Morris, Ed.D.
Licensed Professional Counselor
Little Rock, Arkansas
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