In the pages that follow, you will be introduced to the diagnostic assessment, with its obvious strengths as well as its limitations. This book is designed to support the practitioner with the current application principles relating psycho-pathology to clinical mental health practice. In addition, the application chapters of the book extend beyond the traditional diagnostic assessment supporting efforts to enhance behaviorally based biopsychosocial practice strategy. Although the concept of the diagnosis and assessment is rich in tradition, the connection between diagnostic procedures and behaviorally based outcomes is embedded in linking the mind with body or person in environment. This makes it paramount to continually assess and reassess how to best address context changes reflecting emotional, physical, and situational factors related to client wellbeing.

Mental health practitioners believe strongly in allowing ethical principles and a respect for cultural diversity to guide all practice decisions. In the diagnostic assessment, individuals are acknowledged while individual dignity, worth, respect, and nonjudgmental attitudes provide the cornerstones from which all intervention stems. Many times these concepts remain subjective and require professional acknowledgment, interpretation, and application extending beyond the diagnostic assessment to efficient and effective practice strategy. To accomplish this, the practitioner needs to understand this information and how to incorporate it into the use of diagnostic tools such as the DSM-IV-TR. Furthermore, this handbook encourages anenvironment for health and mental health practitioners that extends beyond the diagnostic assessment and allowing the best service possible acknowledging the needs of the client and his or her system.

The first section of the book is dedicated to the concept and application of the diagnostic assessment found in today's behaviorally based biopsychosocial field of practice. The first four chapters introduce the reader to the major diagnostic assessment schemes utilized in the profession, along with support and resistance issues. In Chapter 1, diagnosis and assessment are exemplified in relation to how these terms are applied in current health and mental health practice. A historical perspective is explored and the type of diagnostic assessment most utilized today is outlined. In Chapter 2, as exemplified in the multidisciplinary or interdisciplinary teams, client information is examined and applied to completion of a comprehensive diagnostic assessment to ensure quality care. In Chapter 3, the multiaxial diagnostic assessment is defined along with current practice concerns such as accurate record keeping, time-limited services, managed care requirements, and quality assurance and improvement procedures. Information in regard to the DSM-IV-TR is provided and each axis is described allowing practitioners to clearly identify and apply each step of the diagnostic system. In Chapter 4, the linkage is made between the diagnostic assessment and how it provides the foundation for the treatment planning and practice strategy that will follow.

The second section of the book follows with an overview of practice strategy and direct application to several common mental health conditions designed to apply and refine practitioner skills. Practice strategy is highlighted and considerations for future exploration and refinement are noted.

This section of the book takes the information provided in the first four chapters and applies diagnostic and psychotherapeutic considerations directly to practice. Selected mental health conditions include reactive attachment disorder, conduct disorder, substance disorders, eating disorders such as anorexia nervosa, schizophrenia and the psychotic disorders, obsessive compulsive disorder, mood disorders such as the bipolar disorders, and borderline personality disorder.

Two appendixes feature a glossary of general medical terms and sample treatment plans.

This book challenges the practitioner to synthesize information into a complete diagnostic assessment that includes practice strategy. Each chapter, along with the Quick Reference Boxes, are designed to give the health and mental health practitioner a sense of "hands-on" learning and participation. This book is not all-inclusive of the many aspects of a mental disorder. This book provides a quick reference for application of the mental health diagnostic assessment along with chapters on specific applications designed to show how to best apply the diagnostic framework toward current practice strategy.

Creating a practice handbook of this nature is never easy--nor should it be. Practice wisdom must be grounded in evidenced-based practice. The actual drafting of chapters from the first proposal to the end product covered a span of well over two years with numerous rewrites and edits. This book represents over 20 years of professional practice and teaching experience. In addition, the contributing authors of the application chapters--all fellow practitioners--spent countless hours working on how best to transcribe practice experience into the written word.

All the contributors of this text feel strongly about their passion for the health and mental health professions and that much needs to be learned from the clients served. Case examples are used throughout this book to help define the interface between what is written in the text and how it applies to practice. Many of the struggles that other professionals have noted are highlighted and the case examples present information in a practical and informative way that is sensitive to the client's best interests, while taking into account the reality of the practice environment.

There is a subjective nature to diagnosis and assessment, just as there is a subjective nature to individuals and the best intervention strategy to be employed. This handbook is intended to take the practitioner beyond the diagnostic assessment and ignite a creative fire for practice strategy and implementation, similar to what it has done for the authors of this manuscript.

SOPHIA F. D ZIEGIELEWSKI