PSYC 365 Midterm 01 Review

Mental Health Professions

School Psychologist

Psychiatrist

Clinical Social Worker

Marriage and Family Therapist

Psychiatrc Nurse

Licenced Professional Counsellor

Life Coach, Parenting Coach, Death Doula

Counseling Psychologist

Clinical Psychologist

School Psychologist Field Description

Works in school settings to promote the intellectual, social, and emotional well-being of student, often conducting assessments, for learning disabilities or giftedness.

School Psychologist Required Degrees

Masters or Doctorate (PhD or PsyD)

Psychiatrist Field Description

Licensed physicians who assess and treat psychological disorders using a medical model, attributing issues to biological causes and primarily using medication. Less emphasis on research.

Psychiatrist Degrees Required

Doctorate (MD or DO)

Clinical Social Worker Field Description

Provides individual and grouo psychotherapy, focusing on familial and sociocultural factors underlying psychopathology. A third of all mental health professionals are social workers.

Clinical Social Worker Degrees Required

Masters (MSW)

Doctorate (PhD or DSW)

Marriage and Family Therapist Field Description

Provides psychotherapy from a family systems perspective, focusing on relationship conflicts and involving family members in treatment.

Marriage and Family Therapist Degrees Required

Masters (MA) or Doctorate (PhD)

Psychiatrc Nurse Field Description

Assesses and treats psychological disorders, often offering primary care services. Can prescribe medication in many U.S. states.

Psychiatrc Nurse Degrees Required

Registered Nurse (RN)

Masters (MA) or Doctorate (PhD)

Licensed Professional Counselor (LPC) Field Description

Provides treatment and consultation for emotional and behavioural problems, often specializing in areas like substance use. In British Columbia, the title is "Registered Clinical Counselor (RRC)".

Licensed Professional Counselor (LPC) Degrees Required

Masters or Doctorate (PhD)

Life Coach, Parenting Coach, Death Doula (Unregulated Titles) Field Description

Titles like "Psychotherapist" and "Life Coach" are unregulated and do not require documented training licensing, or continuing education.

Life Coach, Parenting Coach, Death Doula (Unregulated Titles) Degrees Required

None

Counseling Psychologist Field Description

Assesses and treats populations with life stress and psychological disorders, typically with less emphasis on severe disorders and research compared to clinical psychology.

Counseling Psychologist Degrees Required

Doctorate (PhD or PsyD)

Clinical Psychologist Field Description

Involves assessment, prevention, treatment, researcgm and teaching related to psychological disorders. Trained scientifically and practically.

Clinical Psychologist Degrees Required

Doctorate (PhD or PsyD)

Uniform Procedures

Assessment

Diagnosis

Treatment

Ethics

Assessment Report

Contains test results, interpretations, and conclusions. It includes the reason for referral along with background information and history to set the context for the assessment, a discussion of test scores and conclusions, and recommendations for how to address the questions and concerns raised in the referral.

Diagnoses

Identify the nature of (an illness or other problem) by examination of the symptoms.

Treatment

A session of medical care or the administration of a dose of medicine.

Code of Ethics

As pertains to psychologists, enforceable rules of professional conduct identified by the American Psychological Association (APA).

Roles of Clinical Psychologists

Assessment

Psychology Treatment (therapy)

Consultation

Research

Supervision

Administration

Teaching

Intervention

Providing psychological treatments, also knows as therapy, to individuals or groups, guided by research.

Assessment/Diagnosis

Utilizing tests and other methods to diagnose problems and assess the effectiveness of treatment.

Research

Investigating the prevalence and treatment of mental disorders, the effectiveness of interventions, and the validity of assessments.

Teaching

Educating students at the undergraduate and graduate levels in colleges and universities.

Clinical Supervision

Training and overseaing the work of students and other trainees in clinical settings.

Consultation

Offering expertise to various entities, including corporations, the legal system, and other medical professionals.

Administration

Managing client records, participating in organizational goverance (e.g., university committees), and other administrative functions.

Clinical Psychology Distinctions from Other Mental Health Professions

A key characteristic of clinical psychologists is their dual training as both scientific researchers and clinical practitioners.

Requirements to become a clinical psychologist

Doctoral degree (Phd or PsyD)

Training and supervised experience in research, clinical practice, ethics, teaching, consultation

Scientific methodology including empirically based assessments and treatments

Critical thinking and understanding of statistics

Pre-doctoral supervised clinical experience with a variety of people and presenting symptoms/diagnoses

2000 hours of supervised practice in final year residency

National (Canada and USA) written licensing exam --- EPPP

Provincial ethics/legislation/clinical skills assessment --- written and/or oral

Doctorate of Philosophy (PhD)

MODEL: Scientist-Practitioner (Boulder Model)

PRIMARY FOCUS: Integration of research and clinical practice

RESEARCH REQUIREMENT: High (requires training as a researcher)

COMMON SETTING: University departments

CORE COMPETENCY: Contributing to and utilizing scientific evidence

Doctorate of Psychology (PsyD)

MODEL: Practitioner-Scholar (Vail Model)

PRIMARY FOCUS: Emphasis on clinical skills and practice

RESEARCH REQUIREMENT: Lower (de-emphasizes research competence)

COMMON SETTING: Professional schools and for-profit institutions

CORE COMPETENCY: Practical application of therapeutic techniques

An advantage of PhD programs, as compared to PsyD programs, is __________.

Tuition waivers are often offered

The two pillars of clinical psychology

Science and Ethics

The Scientist-Practitioner Model (Boulder Model)

The predominant trainign model for clinical psychologists (also know as the Boulder model). This model strives to produces professionals who integrate the roles of scientist and practitioner (i.e., who practice psychotherapy with skill and sensitivity, and conduct research on the hypotheses they have generated from their clinical observations).

The Practitioner-Scholar Model (Vail Model)

Training model developed to place a primary emphasis on practice and less emphasis on science.

The Clinical Scientist Model

A training model that encourages rigorous training in empirical research methods and the integration of scientific priniples into clinical practice.

APA Competency Standards for Accreditation of Clinical Psychology Doctoral Programs

Discipline-Specific Knowledge

Category 1: History and Systems

Category 2: Basic Content Areas

Affective Aspects of Behavior

Biological Aspects of Behavior

Cognitive Aspects of Behavior

Developmental Aspects of Behavior

Social Aspects of Behavior

Category 3: Advanced Integrative Knowledge

Category 4: Methods of Inquiry/Research

Research Methods

Statistical Analysis

Psychometrics

Profession-Wide Competencies

Research

Ethical and Legal Standards

Individual and Cultural Diversity

Professional Values/Attitudes/Behavior

Communication/Interpersonal Skills

Assessment

Intervention

Supervision

Consultation and Interdisciplinary Skills

Specialty Areas of Practice

Clinical Neuropsychology

Clinical Health Psychology

Psychoanalysis

School Psychology

Clinical Psychology

Clinical Child/Adolescent Psychology

Counselling Psychology

Industrial and Organizational Psychology

Behavioural and Cognitive Psychology

Forensic Psychology

Couple and Family Psychology

Geropsychology

Police and Public Safety Psychology

Sleep Psychology

Rehabilitation Psychology

Group Psychology and Group Psychotherapy

Serious Mental Illness Psychology

Clinical Psychopharmacology

Clinical Neuropsychology

Focuses on understanding the relationships between brain and behaviour as applied to diagnosis, assessment, and treatment.

Clinical Health Psychology

Focuses on promoting health and well-being, and preventing, treating and managing medical illness and physical disability.

Psychoanalysis

Aims to modify personality by promoting awareness of unconscious, maladaptive, and habitually recurrent patterns of emotion and behaviour.

School Psychology

Concerned with children, youth, families, and the schooling process, including developing and evaluating programs to promote positive learning.

Clinical Psychology

Provides continuing and comprehensive mental and behavioural health care for individuals and families; consultation agencies and communities; training, education, and supervision; and research-based practice.

Clinical Child/Adolescent Psychology

Provides continuing scientific knowledge to the delivery of psychological services to infants, toddlers, children, and adolescents within their social context.

Counselling Psychology

Focuses on how people both personally and in their relationships at all ages and addresses the emotional, social, work, school, and physical health concerns people may have at different stages in their lives.

Industrial and Organizational Psychology

Focuses on deriving principles of individual, group nad organizational behaviour, and applying this knowledge ot the solution of problems at work.

Behavioural and Cognitive Psychology

Uses principles of learning, development, and cognitive processing to help people overcome behavioural and emotional problems.

Forensic Psychology

Provides professional psychological expertise within the judicial and legal systems.

Couple and Family Psychology

Focuses on couples and families in relationships and in the broader environment in which they function.

Geropsychology

Applies the knowledge and methods of psychology to understanding and helping older persons and their families to maintain well-being, overcome problems, and achieve maximum potential during later life.

Police and Public Safety Psychology

Concerned with assisting law enforcement and other public safety personnel and agencies in carrying out their missions and societal functions.

Sleep Psychology

Studies sleep, and evaluates and treats sleep-related problems.

Rehabilition Psychology

The study and application of psychoogical principles on behalf of persons who have disability due to injury or illness.

Group Psychology and Group Psychotherapy

Focuses on identifying and capitalizing on developmental and healing possibilities embedded in the interpersonal/intrapersonal functioning of individuals in groups as well as collectively.

Serious Mental Illness Psychology

Applies specialized assessment and intervention to assist those who have serious mental illnesses or who are at risk of developing these problems.

Clinical Psychopharmacology

Focuses on the study and use of psychotropic medication.

CPA Ethical Code

Hierarchical application

Principle I: Respect for the Dignity of Persons and Peoples

Principle II: Responsible Caring

Principle III: Integrity in Relationships

Principle IV: Responsibility to Society

Principle I of the CPA Ethics Code

Respect for the Dignity of Persons and Peoples

Principle II of the CPA Ethics Code

Responsible Caring

Principle III of the CPA Ethics Code

Integrity in Relationships

Principle IV of the CPA Ethics Code

Responsibility to Society

Principle I: Respect for the Dignity of Persons and Peoples

This principle, with its emphasis on inherent worth, non-discrimination, moral rights, distributive, social and natural justice, generally should be given the highest weight, except in circumstances in which there is a clear and imminent danger of bodily harm to someone.

Principle II: Responsible Caring

This principle generally should be given the second highest weight. Responsible caring requires competence, maximization of benefit, and minimization of harm, and should be carried out only in ways that respect the dignity of persons and peoples.

Principle III: Integrity in Relationships

This principle generally should be given the third highest weight. Psychologists are expected to demonstrate the highest integrity in all of their relationships. However, in some circumstances, Principle III values (e.g., openness, straightforwardness) might need to be subordinated to the values contained in the Principles of Respect for the Dignity of Persons and Peoples, and Responsible Caring.

Principle IV: Responsibility to Society

This principle generally should be given the fourth highest weight of the four principles when it conflicts with one or more of them. Although it is necessary and important to consider responsibility to society in every ethical decision, adherence to this principle needs to be subject to and guided by Respect for the Dignity of Persons and Peoples, Responsible Caring, and Integrity in Relationships. WHen the welfare if an individual or group appears to conflict with benefits to society, it is often possible to find ways of working for the benefit of society that do not violate respect for dignity, responsible caring or integrity. However, if this is not possible, the dignity, well-being and best interests of persons and peoples, and integrity in relationships shouldn't be sacrificed to a vision of the greater good of society.

Protection of Privacy and Limits of Confidentiality

Confidentiality is chief to client-psychologist relationship.

Clinical psychologists can act against wishes of client:

In instances when someone may be at harm/risk

When a client has been harmed

When a client may attempt fatal harm to self

When client is a minor

Precedent set by Tarasoff Case guides clinical psychologists

The California Supreme Court ruled that psychotherapists have a duty to protect potential victims if their patients made threats or otherwise behaved as if they presented a "serious danger of violence to another".

They will break confidentiality if there is imminent harm to victim

Guidelines are fuzzy:

Legal precedents differ in various states

Unclear qualifier for "imminent" time frame

Ideations of homicide, suicide can be vague

Law requires psychologists to report client abuse

Provincial and state laws and how psychologists learn of harm vary, and may contradict ethics

Reporting becomes challenging when:

Some clients may not want to be reported

Perpetrator is present

Client may feel betrayed by psychologist

May damage psychologist-client relationship

Informed Consent

In clinical practicem th elegal requirement that researchers sufficiently inform clients about the proposed course of treatment such that the clients can make an informed decision about whether to enter treatment. In research, the requirement to inform potential participants about the genral purpose of the study; the procedures that will be used; any risks, discomforts, or limitations on confidentiality; any compensation for participation; and their freedom to withdraw from the study at any point.

Psychologists' Ethical Self-Care

Reasonable workload

Continuing education

Consultation

Supervision

Personal Psychotherapy

Healthy living

Periodic reflection on one's own practice

Duty to warn (Tarasoff case)

The California Supreme Court found that if a therapist determines, or pursuant to the standards of his profession should determine, that his patient presents a serious danger of violence to another, he incurs an obligation to use reasonable care to protect the intended victim against such danger.

The discharge of this duty may require the therapist to take one or more of various steps, depending upon the nature of the case. Thus it may call for him to warn the intended victim or others likely to apprise the victim of the danger, to notify the police, or to take whatever other steps are reasonably necessary under the circumstances.

Recently the Tarasoff rule was expanded by a California appeals court in two lawsuits stemming from a murder-suicide.

The expansion relates to a duty to warn even if the information given to the therapist comes from a third party, such as a family member.

Mental Health Act (BC)

Allows individuals at imminent risk to be held against their will for 48 hours (need a second certificate with a second evaluation/signature for a 1 month monitoring period)

This promotes safety and monitoring

Confidentiality and privacy in working with youth

Confidentiality not offered to minor clients

Parents can request all details regarding therapy

Therapists discuss benefits of confidentiality in presence of minor clients

Agree to disclose life-threatening issues

Dual Relationships

Psychologists must decline working with clients when:

A dual relationship develops with their clients (any affiliation outside therapeutic context)

Therapy no longer helps clients

Treatment is not consistent with diagnoses

Clients decide therapy is no longer required

Charging for unnecessary services violates ethical guidelines

Research Ethics in Psycholgy

Institutions must approve research beforehand

Obtain informed consent from participants

Use experimental deception as last resort

Do not coerce participation

Do not fabricate/falsify data

Inform participants of data; share data with other researchers

Erase any participant misconceptions

Treat animal subjects lawfully and humanely

Teaching Ethics in Psychology

Fundamental Principles: Students must understand the five core APA principles: Beneficence and Nonmaleficence (doing good/no harm), Fidelity and Responsibility, Integrity, Justice, and Respect for People's Rights and Dignity.

Key Ethical Standards: Training covers crucial areas like informed consent, confidentiality, privacy, and the responsible use of deception.

Professional Boundaries: Teaching includes maintaining appropriate boundaries with students and clients, including prohibiting sexual relationships and, in many cases, avoiding the solicitation of personal therapy details from students.

The Five Core APA Principles

Beneficence and Nonmaleficence (doing good/no harm)

Fidelity and Responsibility

Integrity

Justice

Respect for People's Rights and Dignity

Beneficence and Nonmaleficence

One of five general ethical principles stating that psychologists strive to benefit those they serve and to do no harm.

Fidelity and Responsibility

One of five general ethical principles stating that psychologists have professional and scientific responsibilities to society and to establish relationships characterized by trust.

Integrity

One of five general ethical principles stating that, in all their activities, psychologists strive to be accurate, honest, and truthful.

Justice

One of five general ethical principles stating that all persons are entitled to access to and benefits from the profession of psychology; psychologists should recognize their biases and boundaries of competence.

Respect for People's Rights and Dignity

One of five general ethical principles stating that psychologists respect the rights and dignity of all people and enact safeguards to ensure protection of these rights.

Ethics of Inclusion, Multi-Culturalism, Diversity

Discrimination and harassment based on age, gender, gender identity, race, ethnicity, culture, national origins, religion, sexual orientation, language, socioeconomic status is not allowed

Must work competently with diverse populations

Use valid and reliable tests

Optimize help and minimize harm to marginalized and multicultural groups

Steps in Conducting a Psychological Assessment

Reason for referral

Deciding what is being assessed and why

Choosing assessment methods

Collecting data

Analyzing data and drawing conclusions

Report results and making recommendations

Reason for Referral

A description in the psychologicla assessment of why the psychologist's services are being sought (e.g., Why is a particular child earning poor grades?).

Typical Presenting Problems from Client

I recently lost my father to cancer and I'm having trouble coping.

I'm tired all the time and my supervisor at work is telling my that my productivity is decreasing.

I'm worried that my family will disapprove of me if I tell them I'm gay. I don't know what to do.

My husband and I argue all the time and we think we need help to save our marriage.

Typical Presenting Problems from Relative

I can't get my 9-year-old son to go to school in the morning and I'm looking for help.

My mother has saved up so much stuff that she can't even get into certain rooms for her house.

My brother has relapsed and is back to using hard drugs every day. How can our family help him?

Typical Presenting Problems from Another Psychologist

I'm working with a client who recently sustained a head injury during a car accident and has been complaining of trouble concentrating. I'm wondering if this is a neurological problem or posttraumatic stress disorder, and what treatment would be necessary.

I have a client with an extreme fear of vomiting but I've never treated anyone with this phobia before. Would you be able to work with her?

Typical Presenting Problems from School

Kayden disrupts class on a daily basis. We are interested in your recommendations for how to better manage her behaviour.

We would like to have Garrison tested for a learning disability and possible accommodations.

Typical Presenting Problems from Physician

I have a client who constantly wants to be tested for leukemia even though it is clear that he's entirely healthy. Can you help?

My client who tested positive for HIV and his partner are very anxious. Can you help them?

A client of mine is having trouble remembering to take his medications. Can you find out what's wrong and help him improve his compliance?

Typical Presenting Problems from Lawyer or Court Order

Is this individual likely to harm himself or hurt others?

I am litigating a divorce and would like to have a psychologist's opinion of whether the child would be better off living with her mother or father.

Typical Presenting Problems from Employer

Is Eduardo well-suited for a job as a manager?

Is Tamira's psychological disorder severe enough that she should be missing work?

Choosing What to Assess

Goals in the referral

Understanding of the presenting problem

Professional psychologists must make accurate judgements of these

Client Characteristics to Assess

Demographics

Mental status

History (presenting problem, social, academic, occupation, family, developmental)

Intellectual and/or cognitive functioning

Hobbies, strengths, skills and interests

Sleep, nutrition, exercise

Substance use

Sexual functioning

Personality variables

Character strengths and resilience

Behavioural functioning

Emotional functioning

Relationship functioning

Psychological symptoms

Trauma history

previous mental health treatment

Past or currect legal troubles and/or violence

Demographics

Age, race, sex, gender identification, marital status, place of birth, cultural identity, religion, income/poverty, occupation

Mental status

Appearance and behaviour in the session, orientation to time and place, ability to concentrate, short-term memory, speech and language

History of the Problem

Duration and course of the problem, possible causal factors treatment history