Date of Award

Fall 12-2022

Document Type


Degree Name

Doctor of Philosophy (PhD)


Counseling & Human Services



Committee Director

Edward Neukrug

Committee Member

Michael Kalkbrenner

Committee Member

Alan Schwitzer

Committee Member

Shana Pribesh


This dissertation focused on the diagnostic self-efficacy of mental health counselors. The diagnosis of mental health disorders serves a wide array of functions in the counseling field including communication, treatment planning, and third-party reimbursement. Self-efficacy, or one’s belief in their own ability to accomplish a task, is considered a factor in successful task completion. The literature lacked information about which mental health disorders counselors are most confident diagnosing and an instrument which measured the self-efficacy of counselors specific to the diagnostic process. The MEASURE approach was employed to create the Diagnostic Self-Efficacy Scale and validate scores on this instrument with a sample of mental health counselors (N=450). The sample was also asked to complete a survey of perceived diagnostic competence related to specific DSM-5 diagnostic categories. Diagnostic Self-Efficacy Scale scores were analyzed using exploratory factor analysis to determine the instrument’s underlying factor structure. The results of this analysis indicated the Diagnostic Self-Efficacy Scale measured the intended construct, diagnostic self-efficacy, and items grouped together to form subscales. Three possible underlying factor solutions emerged. Mean confidence scores on the perceived diagnostic competence survey indicated this sample of mental health counselors reported higher levels of confidence diagnosing anxiety disorders, depressive disorders, trauma and stressor related disorders, substance-related and addictive disorders, bipolar and related disorders, and obsessive-compulsive and related disorders. They reported lower confidence levels when diagnosing medication-induced movement disorders and other adverse effects of medications, paraphilic disorders, elimination disorders, sleep-wake disorders, sexual dysfunctions, neurocognitive disorders. Implications for practitioners, counselor educators and supervisors, consumer stakeholders, and other professional stakeholders, along with limitations and areas for future research, are discussed.


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