TPC-Journal-V4-Issue3

The Professional Counselor \Volume 4, Issue 3 175 previously have been indicated in the multiaxial system, counselors will need to work closely with associated parties to identify revised reporting requirements (Dailey et al., 2014). Counselors also can use the WHODAS 2.0, found in Section III of the DSM-5 or at www.psychiatry.org/dsm5 , to more clearly indicate an individual’s level of functioning (APA, 2013). The APA initially predicted that the insurance industry would transition to DSM-5 by December 31, 2013. This estimate was overly optimistic, however, as most third-party billing systems and government agencies have been slow to switch over to the DSM- 5 and likely will not do so until the nationwide mandate for the use of ICD-10 codes goes into effect on October 1, 2015. Counselors can check with their employers and third-party payers to ensure a smooth transition to the DSM-5 in a manner consistent with local administrative procedures. The APA also is making implementation and transition updates available via their website. Emerging Assessment Measures As discussed previously, the DSM-5 includes a variety of cross-cutting assessment measures, disorder- specific severity measures and interview tools for clinicians. The APA (2013) qualified all print and online assessments, including the WHODAS 2.0 and Personality Inventories, as “emerging measures” intended for further research and exploration in clinical practice. Counselors may do well to integrate attention to screening of cross-cutting symptoms and monitoring of diagnostic severity in practice. In most cases, the tools provided by the APA are clear, direct and ready to use; however, these online assessments vary widely in format, quality and rigor of psychometric validation (Jones, 2012b). For example, the severity measure for depression is the Patient Health Questionnaire–9 (APA, 2014b; Kroenke, Spitzer, & Williams, 2001). This well-developed instrument is in the public domain, and psychometric data are easy to access and indicate a strong degree of psychometric integrity. On the other hand, the Severity Measure for Panic Disorder–Adult (Shear et al., 2001) has limited validation and few publicly available references regarding development procedures and psychometric considerations (Keough et al., 2012). From an ethical perspective, counselors who use these measures are responsible for ensuring that they do so in a manner that is within their scope of practice and includes appropriate attention to instrument validity and administration procedures. Professional counselors must adhere to ethical standards (American Counseling Association [ACA], 2014; National Board for Certified Counselors [NBCC], 2012) and best practice guidelines (Association for Assessment in Counseling, 2003) when administering and interpreting diagnostic assessments. A potentially useful tool to enhance clinical understanding of a client’s cultural worldview, the cultural formulation interview (CFI) is the APA’s attempt to address critics’ claims that the DSM has not historically included culture as part of diagnostic assessment (Dailey et al., 2014). Whereas the DSM-IV-TR (2000) included some cultural characteristics within its diagnostic classifications, it was clear that consumers needed more attention to psychosocial and environmental factors (Smart & Smart, 1997). The DSM-5 has continued this trend by updating diagnostic classification to include culture-related diagnostic issues for most disorders, supplemental information about cultural concepts and inclusion of the CFI. The CFI is a 15–20 minute semi-structured interview consisting of 16 key questions (APA, 2013). With its coverage of numerous topics related to cultural perceptions of the presenting problem, the CFI helps counselors facilitate conversations about domains such as etiological origin, specific circumstances, interpersonal support systems, and coping and help-seeking behavior. Twelve additional modules, to be used as supplements to the CFI or independent of the CFI, are provided by the APA. These modules address topics or specific populations, such as immigrants and refugees; coping and help seeking; and spiritual, religious, or moral traditions. These modules can provide a firm foundation for culturally sensitive counselors to build competence and better