Diagnosis & Treatment
Dr. Dikel provides consultation to attorneys, social service agencies, corrections programs, school districts, insurance companies, medical and mental health programs when there is a need to clarify the diagnosis of a client within the system. Often, these clients have already seen numerous medical and mental health professionals, have received numerous (and at times, conflicting) diagnoses, and have been treated unsuccessfully with a variety of medications. Unfortunately, due to the time and financial constraints within the mental health and insurance systems, most of these clients have never had a comprehensive diagnostic evaluation. Many, if not most, of these clients have been under-diagnosed or misdiagnosed, and most have not received appropriate treatments, despite their extensive (and expensive) history of services.
Making accurate mental health diagnoses requires the highest standard of thoroughness in medicine, because there are no diagnostic tests (blood tests, X-rays, etc.) that yield psychiatric diagnoses. When a mental health professional makes a wrong diagnosis, there are no independent objective laboratory findings that will contradict the misdiagnosis. If the patient doesn't improve, the patient may be blamed for lack of cooperation, poor motivation, etc.
A comprehensive diagnostic evaluation requires a review of all pertinent records (e.g., medical, mental health, educational, vocational, correctional, etc.), obtaining corroborative information from professionals working with the client, and a diagnostic interview with the client (and parents or caregivers if the client is a child or adolescent). The evaluation needs to include medical, mental health, social, educational, developmental and family histories, as well as a thorough review of signs and symptoms that either rule in or rule out criteria of possible psychiatric or chemical health disorders. A mental status examination is also essential, describing the client’s appearance, behavior, speech, mood, affect, thought processes and content, cognition, judgment and insight.
As most of the clients whom Dr. Dikel evaluates have complex histories of diagnosis and treatment, as well as involvement in multiple systems, they unfortunately have not received the thorough evaluation that is necessary to clarify diagnostic and treatment issues. Insurance reimbursement does not cover the amount of time necessary, for example, to conduct a thorough file review, to interview corroborative sources, etc. Unfortunately, this often results in failed treatments due to inaccurate diagnoses, with poor clinical outcomes at high expense to multiple systems. Generally, Dr. Dikel is the only professional who has actually reviewed the client’s entire historical record.
Dr. Dikel provides comprehensive and thorough diagnostic evaluations that clarify diagnostic and treatment issues. This service is available to attorneys, social service agencies, Corrections programs, school districts, insurance companies, medical and mental health programs, as well as to parents and to adult patients who are seeking definitive diagnoses. If additional testing such as a neuropsychological evaluation is indicated, Dr. Dikel will recommend appropriate referrals.
Reimbursement for these evaluations is based on an hourly rate, and varies with the complexity of the evaluations. Given the significant expenses that have usually already been incurred, with previously poor outcomes, Dr. Dikel’s evaluations and subsequent recommendations are very cost effective.
Dr. Dikel provides consultation to attorneys, social service agencies, corrections programs, school districts, insurance companies, medical and mental health programs when there is a need to clarify the diagnosis of a client within the system. Often, these clients have already seen numerous medical and mental health professionals, have received numerous (and at times, conflicting) diagnoses, and have been treated unsuccessfully with a variety of medications. Unfortunately, due to the time and financial constraints within the mental health and insurance systems, most of these clients have never had a comprehensive diagnostic evaluation. Many, if not most, of these clients have been under-diagnosed or misdiagnosed, and most have not received appropriate treatments, despite their extensive (and expensive) history of services.
Making accurate mental health diagnoses requires the highest standard of thoroughness in medicine, because there are no diagnostic tests (blood tests, X-rays, etc.) that yield psychiatric diagnoses. When a mental health professional makes a wrong diagnosis, there are no independent objective laboratory findings that will contradict the misdiagnosis. If the patient doesn't improve, the patient may be blamed for lack of cooperation, poor motivation, etc.
A comprehensive diagnostic evaluation requires a review of all pertinent records (e.g., medical, mental health, educational, vocational, correctional, etc.), obtaining corroborative information from professionals working with the client, and a diagnostic interview with the client (and parents or caregivers if the client is a child or adolescent). The evaluation needs to include medical, mental health, social, educational, developmental and family histories, as well as a thorough review of signs and symptoms that either rule in or rule out criteria of possible psychiatric or chemical health disorders. A mental status examination is also essential, describing the client’s appearance, behavior, speech, mood, affect, thought processes and content, cognition, judgment and insight.
As most of the clients whom Dr. Dikel evaluates have complex histories of diagnosis and treatment, as well as involvement in multiple systems, they unfortunately have not received the thorough evaluation that is necessary to clarify diagnostic and treatment issues. Insurance reimbursement does not cover the amount of time necessary, for example, to conduct a thorough file review, to interview corroborative sources, etc. Unfortunately, this often results in failed treatments due to inaccurate diagnoses, with poor clinical outcomes at high expense to multiple systems. Generally, Dr. Dikel is the only professional who has actually reviewed the client’s entire historical record.
Dr. Dikel provides comprehensive and thorough diagnostic evaluations that clarify diagnostic and treatment issues. This service is available to attorneys, social service agencies, Corrections programs, school districts, insurance companies, medical and mental health programs, as well as to parents and to adult patients who are seeking definitive diagnoses. If additional testing such as a neuropsychological evaluation is indicated, Dr. Dikel will recommend appropriate referrals.
Reimbursement for these evaluations is based on an hourly rate, and varies with the complexity of the evaluations. Given the significant expenses that have usually already been incurred, with previously poor outcomes, Dr. Dikel’s evaluations and subsequent recommendations are very cost effective.