Clinical Psychology full set

Advantages of Evidence-Based Practice

Standardization ensures consistency and quality, empirically supported methods increase treatment efficacy, easier to train new therapists.

Disadvantages of Evidence-Based Practice

May not address individual client needs or cultural contexts, risk of rigid application, could limit innovation.

Flexible Application of Therapy Manuals

Therapists tailor interventions to client needs while maintaining core principles of treatment for better outcomes.

Fee-for-Service Payment Method

Encourages more sessions but may lead to overtreatment.

Managed Care/Insurance Payment Method

May limit session number and restrict tools used for assessment.

Capitation Payment Method

May incentivize shorter or fewer therapy sessions.

Emerging Issues in Clinical Psychology

Online therapy ethics, confidentiality risks, AI in treatment, digital divide.

Effectiveness of Teletherapy

Comparable to in-person therapy for many disorders; increased access and flexibility.

Aspirational Principles

Broad ethical ideals like integrity and justice.

Enforceable Standards

Specific rules which, if violated, can result in sanctions.

Fisher’s Ethical Decision-Making Steps

Identify the problem, apply the APA Ethics Code, consult with colleagues, consider actions and consequences.

Four Horsemen of Ethics

Confidentiality, informed consent, conflict of interest, competence.

Interpersonal Process Group Therapy

Focuses on here-and-now interactions, exemplified by Yalom's model.

Factors that Make Group Therapy Work

Group cohesion, universality, interpersonal learning, catharsis, social skills practice.

Effectiveness of Group Therapy

Effective for various issues and can be as effective as individual therapy.

Focus of Couples/Family Therapy

Focus on relationships and communication patterns.

Key Term: Genogram

A family map used in therapy.

Behavioral Marital Therapy Success Factors

Includes communication skills, commitment, and problem-solving ability.

Polarization Process in Conflict

Escalation of conflict through blame and withdrawal.

Resilience vs. Vulnerability

Resilience is adapting to adversity, vulnerability is susceptibility to harm.

Externalizing Disorders

Outward behaviors like ADHD and ODD.

Internalizing Disorders

Inward distress such as depression and anxiety.

Play Therapy

An intervention used primarily with children to express feelings.

Russell Barkley’s Steps for ADHD

Clear instructions, immediate feedback, rewards, and structure.

MST Concepts

Fit, Do Loop, and principles of family involvement.

Prescription Privileges Pros

Continuity of care and increased access.

Health Psychology Applications

Includes weight management, smoking cessation, and pain management.

Coping Styles

Problem-focused, emotion-focused, flexible coping.

Duty to Warn vs. Duty to Protect

Tarasoff case requirement for therapists to inform or protect identifiable victims.

Forensic Psychology: NGRI

A legal defense arguing lack of understanding due to severe mental illness.

Cultural Competence in Forensic Psychology

Avoid bias and understand clients’ cultural contexts for assessments.

CBT in Sport Psychology

Involves identifying negative thoughts and goal setting.

Why psychologists should NOT have prescription privileges (4)

- Training issues

- Threats to psychotherapy

- Identity confusion

- Influence from the pharmaceutical industry

Why psychologists SHOULD have prescription privileges (8)

- Shortage of psychiatrists

- Clinical psychologists are more expert than primary care physicians

- Other non physician professionals already have prescriptions privileges

- Convenience for clients

- Professional autonomy (wider range of services)

- Professional identification

- Evolution of the profession

- Revenue for the profession.

Advantages of evidence-based practice/manualized therapy (4)

- Scientific legitimacy

- Establishing minimal levels of competence

- Training improvements

- Decreased reliance on clinical judgment

Disadvantages of evidence based practice/manualized therapy (4)

- Threats to psychology therapy relationship

- Diagnostic complications

- Restrictions on practice

- Debatable criteria for empirical evidence

What happens when therapists are flexible in their application of therapy manuals?

Flexibility while using manuals is more successful! clients are more engaged and better outcomes in therapy ultimately

Some effects of different payment methods on therapy and assessment (4)

- Different forms of payment will typically equal different forms of therapy.

- Because insurance companies require detailed info confidentiality may be breached

- Lower pay than out of pocket

- Takes time away from direct clinical work (pg 63-64)

Issues that are emerging in clinical psychology because of technology (7)

- Lack of informed consent

- Breaking of laws in different states via online psychotherapy

- Breaking of the APA ethical code

- Breaking of confidentiality

- Ignoring cultural aspects

- Practicing outside the scope of expertise

- Lack of knowledge about emergency resources (pg 68)

How well do various forms of teletherapy work compared to in-person therapy?

Supposedly works just as well as face-to-face therapy

Difference between aspirational principles in ethics compared to enforceable standards?

- Aspirational In other words, they describe an ideal level of ethical functioning or how psychologists should strive to conduct themselves. No specific definitions

- Enforceable: In contrast to aspirational, an approach to psychology ethics that emphasizes specific rules of conduct that can be violated

What are the aspirational principles that govern the ethics for psychologists? (5)

- Beneficence and nonmaleficence

- Fidelity and responsibility

- Integrity

- Justice

- Respect for people's rights and dignity (pg 103)

8 steps in ethical decision making according to Fisher

1) Prior to any ethical dilemma arising, make a commitment to do what it ethically appropriate

2) Become familiar with the American Psychological Association's ethical code

3) Consult any law or professional guidelines relevant to the situation at hand

4) Try to understand the perspectives of various parties affected by the actions you may take. CONSULT WITH COLLEAGUES (always protecting confidentiality) for additional input and discussion

5) Generate and evaluate your alternatives

6) Select and implement the course of action that seems most ethically appropriate

7) Monitor and evaluate the effectiveness of your course of action

8) Modify and continue to evaluate the ethical plan as necessary

4 horsemen of ethics

1) Confidentiality

2) Informed consent

3) Conflict of interest (multiple relationships)

4) Competence

Duty to warn

Stemming from the Tarasoff case, the obligation of clinical psychologists to alert people toward whom their clients have made credible, serious threats

Internal validity

the degree of confidence that the causal relationship being tested is trustworthy and not influenced by other factors or variables

External validity

Refers to the generalizability of the results

Efficacy

How well a form of therapy works "in the lab"

Effectiveness

How well a psychotherapy works 'in the real world'

dodo bird effect

A nickname for the common research finding that different forms of psychotherapy are roughly equally effective

What does the research say about the effectiveness of psychotherapy?

Psychotherapy works as it is commonly applied in realistic settings

Model 1 of group therapy

Usual orientation/theory , different mode of delivery (more people)

Examples of model 1 group therapy (4)

- Behavioral: Group assertiveness or social skill training

- Psychodynamic: Group dynamic therapy

- Interpersonal: Group based interpersonal therapy

- CBT: Psychoeducational groups

Model 2 of group therapy

Group therapy as an orientation of treatment in and of itself -- interpersonal group therapy (Yalom)

Factors that help make group therapy work (6)

1) Sharing information/feedback

2) Hope

3) Universality ("I'm not alone in my experiences")

4) Helping others (altruism)

5) Interpersonal learning ("working through" or "corrective emotional experiencing" with others in group)

6) Group cohesiveness (therapeutic alliance)

Practical issues related to group issues (5)

1) Group membership

2) Clientel preparation

3) Developmental stages of group therapy

4) Cotherapists

5) Socializing between clients

Ethical issues related to group therapy (1)

confidentiality

How well does group therapy seem to work?

Group therapy is superior to no treatment, and generally as effective as individual therapy, although a minority of comparative studies have found individual therapy to be slightly superior

Focus of couples and family therapy

Focus on relationships rather than on individuals, though some individual treatment may be necessary

Couples and family therapy is considered to use what kind of theoretical approach?

- systems theory: Thinking about the system rather than the individuals and try to focus on systemic interventions

Success rate of traditional behavioral marital therapy

50%

What factors are related to behavioral martial therapy success (5)

1) Commitment to each other

2) Age

3) emotional engagement

4) Traditionality

5) Shared goals

4 stairsteps in the polarization process (going downwards)

1) Incompatabilities >

2) Coercion >

3) Vilification >

4) Polarization

5 influences in the polarization process

1) Attractions

2) Behavioral repretoires

3) Level of incompatability

4) stressful events

5) Conflict resolution skills

Solution focused therapy

Focuses on solutions, not problems; Focuses on positive outcomes by asking miracle questions- how wold life be different if problem disappeared

Narrative therapy

Similar to CBT- core narrative when new things happen, we interoperate them in terms that fit our core narrative We make our interpretations of situations fit into our "narrative" that we have

constructed about our life

multisystemic family therapy

for adolescents with long-term behavioral and emotional problems that involve legal offenses.

Focuses on the multiple systems involved in a child's life

The interaction of community, school, peers, family

The "fit" = we must assess children at every level of their environment

to fix the problem

It includes 1) choosing the worst problem, 2) finding that issues

are influencing the problem, then 3) choosing 2-3 of the easiest issues to work on.

- Utilizes elements of cognitive, behavioral, parent-training, solution-focused, and other kinds of therapy

Externalizing disorders:

those in which the child 'acts out' and often becomes a disruption to parents, teachers, or other children (ADHD, OCD, conduct disorder)

Internalizing disorders

Less noticeable because they involve maladaptive thoughts and feelings more than disruptive outward behavior. >>>anxiety and depression

Resilience:

being able to adapt to adversity

Resiliency factors include...external support- I have blank friends or family, inner strengths I am brave or capable , and problem-solving skills I can I can fix this

Vulnerability

Tendency to experience psychological problems in the presence of risk factors

What special considerations are needed when assessing and treating children? (7)

Referral process - they don’t refer themselves, parents or legal systems

Confidentiality - controlled by parents

Contexts - children cannot control certain environments home or school

Be aware of all interactions- Parent-child interactions - reinforcement traps- parents unintentionally reinforcing bad behavior through neg and pos reinforcement- neg- give command child throws tantrum and parent removes command pos- child cries and parent gives them extra attention

What kinds of interventions are typically used for treating children

- CBT (more frequent)

- medicines

- Family therapy

How well does therapy work for children and adolescents?

WELL. They show improvement

Children and adolescents who undergo psychotherapy consistently demonstrate significant improvement in comparison with similar children who receive no treatment

Russell Barkley's 8 steps to better behavior

1) Learn to pay positive attention (undirected special play time 20 min per day)

2) Use your powerful attention to gain compliance (practice each day with simple, multiple tasks)

3) Give more effective commands (instruct, simple, attention, remove distractions, ask child to repeat, use cards, state deadlines)

4) Teach your child not to interrupt (Instruct what to do and tell them not to interrupt. Reinforce, practice)

5) Set up a token system (points or chips)

6) Learn to punish behavior constructively (time out or fines)

7) Expand your use of time out

8) Learn to manage your child in public places (set up rules before, set up an incentive for compliance, set up a punishment for non-compliance, assign an activity)

ABAB Design-

Adds a benefit (A) then takes it away (B) to see what changes, this process is repeated multiple times adding different ones to see what's better

Goal = determine which incentive or treatment works best

Psychoneuroimmunology

cognitive factors that contribute to your ability to resist illness

Biofeedback

helps clients achcieve control and become aware of bodily processes (such as tension or heart

rate) by showing them their physiological functioning in real time, allow [patients to see what's happening in real time hook up to machine and let them see it, do when meditating helps become aware of bodily processes

Problem focused coping:

actively confronts the problem, seeks support, and problem solves

Emotion focused coping

Emotion focused coping: distancing, self-controlling, reappraisal, avoidance, accepting responsibility

Which is the best way to cope?

Combo of both

Problem better when in control of problem

Emotional better when can't control problem

How do health psychologists increase

compliance?

Act as mediators between the doctor and patient --> communicate treatment plan in a warm, compassionate, and comprehensive tone

Educate patient on the treatment, other options, current research, and the pros and cons

Bolster the patient’s support system

Identify barriers and work through them with the patient

Slife article: naturalism

Natural laws can explain natual phenomena alone without god

Slife article: Theism

Assumes God is necessary and relevant to explain and understand the world

Slife article: Deism

God created the world but is no longer involved (except in extraordinary circumstances). He doesn't interfere, and he created natural laws that are allowed to operate autonomously

Slife article: Dualism

The world is divided into two spheres: natural and supernatural

Slife: STRONG theism

God's activity is not limited. God is not merely an add-on. God is necessary and integral.

God's activity is core and permeates

Peripheral aspects may be present but it is more. They are not sufficient by themselves

God's activity is present in all levels of theory, method, and practice. Theorists and practitioners would be upfront about God's role and activity

Slife article: Weak theism types (3)

- compartmentalized, peripheral, inconsistent

Peripheral theism

Include peripheral aspects, like prayer, but an active God is not necessary

Chronic stress

The all-too-common syndrome defined by stress levels that are consistently high and unremitting, often due to a hectic, fast-paced lifestyle

Hans Selye's General Adaptation Syndrome

alarm stage, resistance stage, exhaustion stage

What factors determine how well we cope with stress? (2)

nature, nurture

Stress has been linked to...

many different symptoms and diseases

3 components of social support

1) Social network

2) Social relationships

3) Social support

Social network

Broad scope of all social contacts one has

Social relationships

people with whom you have meaningful social relationships within your social network

Social support (as one of the 3 components)

the quality and quantity of care and assistance those relationships bring

2 hypotheses as to how social support protects our health

1) Positive feelings associated with having social support allow us to perceive our stressors in a more manageable light

2) Those who have strong social networks are more likely to confide in others which has health benefits in and of itself

What is ABCDS?

Common approach health psychologists use to treat people with excess weight, for weight loss

A in ABCDS

Activity increase