clinical psych exam 3

What is an Intervention?

Method of producing changes in behavior, thoughts or feelings in context of professional relationship

Which approach to intervention assumes that clinical problems are caused and maintained by interpersonal difficulties, which have a strong impact on mood?

Interpersonal Therapy

Which approach to intervention assumes that cognitions mediate the effect of environmental events on behaviors and emotions?

Cognitive Therapy

Which approach to intervention assumes that unconscious motives, conflits, and memories (especially from childhood) cause psychopathology?

Short-Term Psychodynamic Therapy

Which approach to intervention assumes that problem behaviors are learned and can be modified through application of learning principles?

Behavior Therapy

Which approach to intervention typically focuses on early childhood?

Short-Term Psychodynamic Therapy

Which approach to intervention aims to modify maladaptive behavioral and cognitive patterns?

Cognitive-Behavioral Therapy

Which approach to intervention aims to resolve interpersonal problems in the present?

Interpersonal Therapy

Which approach to intervention aims to make the unconscious conscious?

Short-Term Psychodynamic Therapy

Which approach to intervention focuses in part on identifying defense mechanisms that protect a person from the painful contents of the unconscious?

Short-Term Psychodynamic Therapy

What is Behavioral Activation?

Scheduling activities to counteract relative inactivity, increasing rates of previously pleasurable and meaningful activities even when feel lousy

What are the four areas/themes into which social functioninng problems are conceptualized as falling within Interpersonal Therapy?

Grief, Role Disputes, Role Transitions, Interpersonal Deficits

What is at least one approach to relaxation training?

breathing retraining, progressive muscle relaxation, or mindfulness techniques

What is transference?

When central unconscious conflicts play out in relationship with a therapist

What is exposure therapy?

Gradual exposure to feared or avoided stimuli/situations/experiences

what is relapse prevention?

Methods of dealing with recurrence of clinical symptoms

What is problem solving?

Define problem, generate solutions, select best solution, implement/evaluate solution

What is social skills training?

Rehearsal of increasingly complex behavioral skills, assertiveness training, etc

What is contingency management?

Implementation of system of reinforcements and punishments to decrease undesirable behaviors and increase desirable behaviors

What are the three cognitive techniques involved in challenging and replacing irrational cognitions in Cognitive Therapy?

Examining the accuracy of probability estimates, decatastrophizing, and developing adaptive cognitive responses

What are the four major components of most CBT programs?

Education/monitoring, Cognitive component (cognitive restructuring), Behavioral component, Relapse prevention

What component is typically present for CBT programs that target anxiety but not for CBT programs targeting other areas of psychopathology?

Relaxation skills

What are the three primary types of exposure conducted in CBT for Panic Disorder?

Exposure to physical symptoms, feared activies, and agoraphobic situations

What relaxation approach is adopted in CBT for Panic Disorder to target overbreathing (or chronic hyperventilation)?

Diaphramatic Breathing

Are thoughts assumed to mediate or moderate the effect of events on emotions within CBT for Panic disorder?

Mediate

What are the two primary cognitive errors associated with anxiety-related disorders?

Overestimation of the likelihood of a negative outcome and catastrophic thinking about the inability to cope with a negative outcome

What is habituation?

Reduction in anxiety with continued exposure to feared symptoms, activities, and situations

In which of the major three major intervention approaches do self-monitoring and homework between sessions play a significant role?

Cognitive-Behavioral Therapy

What are Common Factors?

Shared features of most therapy approaches associated with positive treatment outcome

Are problem severity, presence of personality disorder, and lower intelligence associated with more or less positive treatment outcome?

Less

Are positive treatment expectations associated with more or less positive treatment outcomes?

More

Are sex, race, ethnicity, and social class reliably related to treatment outcomes?

No

Is (mis)match of client/therapist on race/ethnicity associated with client preferences and clients' perceptions of therapists?

Yes

Is (mis)match of client/therapist on race/ethnicity associated with therapeutic outcomes?

No

Are therapist empathy, warmth and genuineness associated with more or less positive treatment outcomes?

More

Is therapist experience (years, mental-health discipline, degree) related to treatment outcomes?

No

Is therapist age, sex, and ethnicity related to treatment outcomes?

No

Are full-time front-line service providers increasingly trained to a master's or doctoral level?

Master's level

Are full-time front-line service providers increasingly trained within social-work, clinical, or counseling programs?

Social-work programs

Is therapeutic alliance associated with more or less positive treatment outcomes?

More

Do meta-analyses suggest that cultural adaptations of treatment approaches are associated with better, mixed, or worse outcomes for diverse groups?

Mixed

Do meta-analyses suggest that homework completion is a positive or negative predictor of CBT outcomes?

Positive

Are evidence-based treatment approaches associated with more positive or negative treatment outcomes?

Positive

For which major clinical disorder are a wide range of treatment approaches effective?

Depression

For which major class of clinical disorders is CBT clearly more effective than other approaches?

Anxiety disorders

True or False: Mental health care costs have leveled out over past 30 years.

False

True or False: Providers and consumers are increasingly gaining control over health-care decisions.

False

True or False: Treatment decisions are increasingly made by insurance companies b/c treatment is paid for by 3rd party payer.

True

True or False: Pharmacological treatment for mental illness is increasing more rapidly than psychosocial treatment.

True

True or False: Front-line providers of psychosocial services are now more likely to be social workers than clinical psychologists.

True

True or False: Research evidence suggests that social workers are less effective than clinical psychologists when administering the same treatment.

False

True or False: Clinical psychologists are now more likely to be working in care contexts as trainers, supervisors, program developers, program evaluators, administrators.

True

True or False: Multiple psychosocial interventions for specific psychological problems show efficacy, effectiveness, cost-effectiveness.

True

True or False: Almost everyone with mental-health problems is receiving mental-health services.

False

True or False: Most provided mental-health services are evidence-based.

False

True or False: When evidence-based psychosocial treatment is provided, the quality is often low.

True

What is the Dissemination Problem?

Effective treatments exist for many mental-health problems, but they are largely unavailable or inaccessible to the public

What is the Science-Practice Gap?

Effective treatments exist for many mental-health problems, but they are largely unavailable or inaccessible to the public

True or False: Most persons with anxiety disorders receive evidence-based psychosocial treatments.

False

True or False: The primary care physician (PCP) is the commonly the gatekeeper to provision of mental-health care services.

True

True or False: Most primary care physicians (PCP) detect anxiety/depression problems in persons they see.

False

True or False: There is increasing interest and investment in integrating mental-health care with primary care.

True

True or False: There is increasing interest and investment in training primary care physicians (PCPs) in mental-health care.

True

True or False: Practitioners who do not use empirically supported treatment often argue that the therapeutic relationship may be compromised or ineffective.

True

True or False: Practitioners who do not use empirically supported treatment often argue that their services are already effective and research is not relevant to treatment of individual clients.

True

True or False: Practitioners who do not use empirically supported treatment commonly believe that manualized treatment is not feasible.

True

True or False: Weissman et al.'s (2006) survey of training programs revealed that most training programs required both a didactic course and clinical supervision in empirically supported treatment, and most required training was empirically supported.

False

True or False: The two disciplines with largest number of students and the biggest emphasis on clinical training (PsyD & Social Work) have the largest percentage of programs that don't requiring courses and supervision in any empirically supported treatment, according to Weissman et al.'s (2006) survey of training programs.

True

True or False: Therapist self-study of treatment manuals and participation in brief workshops is sufficient to increase empirically supported treatment use.

False

True or False: Multi-component training programs for therapist are more effective at improving therapist competence and evidence-based intervention use than training approaches that rely on only one or two components.

True

True or False: The U.S. Department of Veterans Affairs has done an excellent job of disseminating and implementing empirically supported treatments in healthcare systems.

True

What is Critical Incident Stress Debriefing?

Intervention administered immediately after traumatic events that is designed to prevent development of PTSD

Does Critical Incident Stress Debriefing present the onset of PTSD?

No

What is Psychological First Aid?

An evidence-informed approach to helping those in immediate aftermath of disaster and terrorism

True or False: Critical Incident Stress Debriefing offers practical assistance and information to help survivors address their immediate needs and concerns

False

What is Eye Movement Desensitization and Reprocessing (EMDR)?

A treatment approach to PTSD with desensitization and reprocessing components.

Is the desensitization or the reprocessing component of Eye Movement Desensitization and Reprocessing (EMDR) more like exposure therapy?

Desensitization

True or False: Randomized Controlled Trials demonstrate that the reprocessing components of Eye Movement Desensitization and Reprocessing (EMDR) contributes significantly to positive treatment outcomes

False

True or False: Eye Movement Desensitization and Reprocessing (EMDR) is an empirically supported treatment

True

What are the primary goals of the Controlled Drinking Approach to alcoholism?

Establish control/moderation in drinking; avoid legal, social, and physical problems

Does the Controlled Drinking Approach to alcoholism work better for those with a higher or lower level of alcohol dependence?

Lower

What is the primary goal of Project DARE (Drug Abuse and Resistance Education)?

Prevention of substance (ab)use among school-aged youths

True or False: Project DARE (Drug Abuse and Resistance Education) not only is ineffective, but also can increase substance use

True

What is Recovered Memory Therapy?

Recovery of "repressed memories" of childhood trauma using tools such as hypnosis and guided imagery

True or False: There is compelling scientific evidence that memories are repressed in the face of trauma

False

True or False: Memory is highly susceptible to suggestion and implantation (i.e., memories can be created and distorted)

True

True or False: Randomized controlled trials provide strong support for the effectiveness of Recovered Memory Therapy when treating psychological distress

False

Does practical significance refer to the reliability or magnitude of an effect?

Magnitude

Does statistical significance refer to the reliability or magnitude of an effect?

Reliability

What are the two effect-size indices we have discussed in class?

r and d

What is the value that typically indicates statistical significance?

p-value

What p-value typically indicates that an effect is statistically significant?

p < .05

Does an analysis of potential mediators of treatment effects ask HOW treatment works or THE CONDITIONS UNDER WHICH treatment works?

How treatment works

Does an analysis of potential moderators of treatment effects ask HOW treatment works or THE CONDITIONS UNDER WHICH treatment works?

The conditions under which treatment works

What are the two primary mediators by which CBT is assumed to improve clinical problems?

Maladaptive cognitions and maladaptive behaviors

If treatment context influence the magnitude of treatment effects, is treatment context a mediator of moderator of treatment effects?

A moderator

If a variable is a mechanism by which treatment works, is the variable a mediator or a moderator?

A mediator

True or False: Therapist characteristics cannot be a moderator of treatment effects.

False

If a treatment's effectiveness is stronger when the treatment is administered in Setting A rather than Setting B, then is treatment setting a moderator or a mediator of treatment effects?

A moderator

What are the three most common control group possibilities?

Wait-list control, treatment-as-usual, and best-available treatment