Required Texts:

• Desk Reference to the Diagnostic Criteria from DSM-5, American Psychiatric Association (2013), paperback
• The Pocket Guide to the DSM-5 Diagnostic Exam, American Psychiatric Association
• DSM-5® and Family Systems, Russo, Coker, King

1. Critical Thinking – Analyze and integrate systemic and biopsychosocial frameworks when assessing and diagnosing presenting problems.
2. Communication – Effectively articulate clinical assessments, treatment plans, and case analyses in written and oral formats.
3. Information Literacy – Access, evaluate, and apply current clinical research and DSM-5 resources to support assessment and treatment decisions.
4. Quantitative/Analytical Reasoning – Apply structured diagnostic criteria and clinical reasoning to develop evidence-based formulations.
5. Ethical Reasoning / Professional Responsibility – Demonstrate ethical and culturally responsive clinical practice in all assessments and interventions.

1. The use of the DSM-5 in the diagnosis of presenting problems, and the integrating of that medical model frame into coherent, systemically informed treatment strategies (SLOs 1 & 2). 
2. Assessment and management of specialized but common presenting problems, e.g., assessment and treatment of suicidality, and substance abuse (SLOs 1 & 3). 
3. A basic working knowledge of psychotropic medications, to converse with medical professionals and clients who are on medication or those who may benefit from a medication evaluation referral (SLOs 1 & 2).  
4. Understanding the larger systemic context and utilizing the larger system in formulation and treatment when and to whom to turn for consultation or referral for specialized treatment needs (SLOs 2 & 4). 
5. The assessment and treatment of individuals in the context of a systemic therapy (SLOs 1 & 2); 
6. Awareness of issues in class, culture, gender, and diversity in clinical practice (SLOs 4 & 5); 
7. Practicing the development of coherent frames for treatment that are clinically sound, ethically appropriate, and respectful of both the system and the individual (SLOs 2 & 4). 
8. Understanding some of the essential pragmatic issues involved in establishing a professional career in the field of MFT (SLO 4). 

1. Attendance, Reading & Participation — 36 points

• Read all assigned materials prior to class and come with written reflections or questions
• Contribute to discussion in ways that connect content to clinical reasoning — not just personal reaction
• Provide examples that ground abstract diagnostic concepts in relational or contextual realities
• Demonstrate attention to the impact of your contributions on peers, particularly around diagnostic labeling and clinical bias
• Engage respectfully and with clinical curiosity in all group work
  
  

2. Weekly Reflections — 24 points

• What does a systemic or relational lens add to — or complicate — that concept?
• What is one question you are still sitting with?

3. In-Class Assignments — 50 points

• Biopsychosocial formulation in triads
• Relational and contextual critique of a given diagnosis
• Cross-cutting symptom measure practice (DSM-5-TR Levels 1 & 2)
• Systemic case conceptualization mapped to the proposed 4-domain diagnostic model
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4. Genogram & Relational Diagnostic Lab — 20 points

• Annotate the genogram with relational patterns relevant to the presenting concern (triangulation, enmeshment, cutoffs, intergenerational transmission, etc.)
• Attach diagnostic hypotheses to relational patterns — not just to the identified patient
• Write a brief (1-page single spaced) relational formulation identifying the systemic context shaping the symptomatic presentation
• Present findings to the class in a 10-minute group debrief
  
  

• Quality of relational pattern identification and annotation (5 pts)
• Diagnostic hypotheses grounded in systemic context, not just individual symptoms (5 pts)
• Clarity and clinical coherence of the relational formulation (5 pts)

5. Mid-Process Diagnostic Hypothesis Memo — 15 points

• Working Diagnosis: What DSM-5-TR category or categories are you considering, and what criteria does your case meet?
• Systemic Formulation Hypothesis: What relational, contextual, or developmental factors appear to be organizing or maintaining the presenting symptoms?
• What You're Still Sitting With: Name two clinical questions you have not yet resolved. What information would change or refine your formulation?
  
  

• Working diagnosis supported by specific DSM-5-TR criteria (5 pts)
• Systemic hypothesis demonstrates relational or contextual reasoning (5 pts)
• Clinical questions reflect genuine uncertainty and intellectual honesty (5 pts)
  
  

6. Role-Play Case Interview & Assessment Project — 60 points

• Diagnostic Interview: Conduct a role-played clinical interview using the Pocket Guide to the DSM-5-TR as a structuring tool (live or video, minimum 10 minutes)
• Mental Health Assessment Form: Complete the course assessment form (Canvas)
• Treatment Plan: Develop a clinically sound treatment plan using therapy notes format
• Clinical Paper: 3–4 pages (plus references), structured per outline below
• Mock Clinical Staffing: Following the presentation, participate in a brief facilitated staffing with peers acting as the clinical team
  
  

1. Etiology & Formulation
   Provide a clinically grounded account of the disorder's etiology as it applies to this specific client. Ground your formulation in the literature — this is not a personal opinion section.
2. Systemic Integration
   Analyze how relational, contextual, cultural, and developmental factors are shaping or maintaining the presenting symptoms. Who is in the system? What patterns are relevant? How does the family or relational context interact with the diagnosis?
3. Diagnostic Limitations & Contextual Factors
   1. Identify what the DSM-5-TR categorical diagnosis cannot fully capture about this client. 
   2. What contextual, dimensional, or relational information would meaningfully change or enrich the formulation? 
4. Treatment Recommendations
   Present your treatment plan in narrative form. Recommendations must be justified through peer-reviewed literature (minimum 2 articles). This is not your opinion — it is an evidence-based clinical argument.

• Quality and authenticity of the diagnostic interview (15 pts)
• Accuracy of DSM-5-TR diagnostic application with full specifiers (15 pts)
• Depth and coherence of systemic formulation (10 pts)
• Diagnostic limitations section demonstrates critical diagnostic reasoning (10 pts)
• Treatment recommendations grounded in literature (10 pts)

7. Movie Character Diagnosis — 50 points

• DSM-5-TR Diagnosis: Identify the primary diagnosis (and relevant comorbidities) with specific criteria citations
• Biopsychosocial Context: Situate the diagnosis in the character's relational, developmental, cultural, and environmental context
• Dimensional Analysis (new): Identify where the character falls on at least two symptom dimensions (e.g., severity, chronicity, functional impairment, relational impact). How does a dimensional lens add to or change the categorical diagnosis?
• Media Critique: Evaluate the film's portrayal against DSM-5-TR criteria. What does the film get right? What does it distort, minimize, or sensationalize? What systemic factors does the narrative center or erase?

• Diagnostic accuracy and specificity of DSM-5-TR criteria application (8 pts)
• Quality of biopsychosocial and systemic contextualization (8 pts)
• Dimensional analysis — depth and clinical relevance (7 pts)
• Media critique — rigor, specificity, and systemic awareness (7 pts)
  
  

8. Unit Quizzes — 20 points

9.  Final Exam — 100 points

• Distinguish categorical and dimensional approaches to diagnosis and evaluate the clinical implications of each
• Apply systemic theory to explain why a DSM-5 diagnosis may be necessary but insufficient for clinical understanding
• Critically analyze the role of culture, context, and power in the construction of diagnostic categories
  
  

• Accurate DSM-5-TR diagnosis with full specifiers and differential reasoning (8 pts)
• Biopsychosocial formulation integrating relational and contextual factors (7 pts)
• Future DSM vignette response demonstrates dimensional and contextual reasoning (10 pts)