psych review cards (use these)

3 models of training

scientist-practitioner (Boulder Model), practitioner-scholar (Vail Model), clinical scientist

Scientist practitioner

Boulder model, Emphasizes both practice and research, Graduates should be able to competently practice and conduct research

Practitioner scholar

Vail model, Emphasizes practice over research, Yields PsyD degree, Higher acceptance rates and larger classes

Clinical scientist

Strongly emphasizes research, Most current (here at Temple), Use empirically supported therapies, Tend to train researchers rather than practitioners, A subset of PhD institutions who strongly endorse empiricism and science, Came about as a result of McFall’s manifesto

McFall’s manifesto

“The future of clinical psychology hinges on our ability to integrate science and practice. Pointing to quality-control problems in the field, the author proposes that clinical psychologists adopt a Manifesto”

Cardinal Principle

Scientific Clinical Psychology is the only legitimate and acceptable form of clinical psychology

First Corollary

psychological services should not be administered to the public until they have satisfied these 4 minimal criteria - The exact nature of the service must be described clearly, The claimed benefits of the service must be stated explicitly, These claimed benefits must be validated scientifically, Possible negative side effects that might outweigh any benefits must be ruled out empirically

Second Corollary

The primary and overriding objective of doctoral training programs in clinical psychology must be to produce the most competent clinical scientists possible

PhD

Emphasize practice and research, Smaller classes, Lower acceptance rate, Typically in university departments, Offer more funding to students, Greater success in placing students in APA-accredited internships

PsyD

Emphasize practice over research, Larger classes, Greater acceptance rate, Often in free-standing professional schools, Offer less funding to students, Less success in placing students in APA-accredited internships

Pros of Evidence based therapy

Scientific legitimacy, Establishing minimal levels of competence, Training improvements, Decreased reliance on clinical judgment

Cons of evidence-based therapy

Threats to the psychotherapy relationship, Diagnostic complications (i.e.) Textbook cases vs real world cases, Restrictions on practice (i.e) Mandated manuals vs. creatively customized treatments, Debatable criteria for empirical evidence

Pros of Psychologists gaining prescription privileges

Shortage of psychiatrists (especially in rural areas, important factor in NM and LA decisions), CPs more expert than primary care docs, Other nonphysicians have privileges (dentists, podiatrists, optometrists, and some nurses, among others, Convenience for clients, Professional autonomy, Professional identification Evolution of the profession

Cons of Psychologists gaining prescription privileges

Training issues (which courses? When? Taught by whom?), Threats to psychotherapy (would medication replace therapy), Identity confusion (especially when only some CPs prescribe), Influence of pharmaceutical industry

Acculturation

Response to a new cultural environment; balance between adopting new and retaining original culture

Assimilation

(high new and low original)

Separation

(low new and high original)

Marginalization

(low new and original)

Integration

(high new and original)

Cultural adaptation

Modify treatments with empirical evidence for members of a cultural group

Etic perspective

Emphasizes similarities between all people, Assumes universality, Downplays culture-based differences

Emic perspective

Emphasizes culture-specific norms, Appreciates clients in the context of their own culture

Importance of continued training for psychologists

Courses, readings, real-world experiences, encourage cultural self-knowledge, curiosity, and humility

10 Categories of ethical standards

1. Resolving ethical issues, 2. Competence, 3. Human relations, 4. Privacy and confidentiality, 5. Advertising and other public statements, 6. Record keeping and fees, 7. Education and training, 8. Research and publication, 9. Assessment, 10. Therapy

Confidentiality- circumstances to break it, differences/similarities with youth and adults

In general psychologists are ethically obligated to maintain confidentiality, Duty to warn potential victims, child abuse requires breaking of confidentiality to protect the child, Parents are informed of some things in their childrens’ therapy

Importance of informed consent- therapy vs. research

Required for research, assessment, therapy, and other professional activities, For therapy, informed consent is an ongoing process, Informed consent for therapy must allow client the opportunity to ask questions and receive answers, Informed consent process can be an early part of a strong therapeutic relationship

Tarasoff case- describe it, the ruling (Duty to Warn) and the impact on psychologists and patients

Court case regarding a college student client who told his therapist he was going to kill his girlfriend (tatiana tarasoff). Therapist contacted campus police who detained him, but after he was released he killed her], Her family sued and won, Therapist has the duty to warn the potential victim, Sets precedent for all therapists for breaking confidentiality, (i.e.) How credible are clients’ threats? What kinds of threats merit warnings?

Competence

Sufficiently capable, skilled, experienced, and expert to complete the professional tasks they undertake, Psychologists should know their limits and seek additional training or supervision when necessary, Continued education, cultural competence, burnout can impair competence

quasi - experiments

Used in place of true experiments when practical, ethical, or other issues limit manipulations, Less scientifically sound than true experiments but common in clinical psych

Between group design

Participants in different conditions receive entirely different treatments (experimental vs control group)

Within group design

compare participants in single condition to selves at different points in time

Mixed group designs

Combination of between and within group

Difficulties defining abnormality

Who defines it?, Can behaviors be culturally typical yet also abnormal?

Harmful dysfunction

Current theory - Jerome Wakefield, Considers both scientific data (dysfunction) and social context (harmful)

Importance of definition of abnormality

Facilitate research, awareness, and treatment, Demystify difficult experience, Feel like “not the only one”, Acknowledge significance of a problem, Access treatment, Stigma damages self-image, Legal consequences

Dimensional approach

shades of gray rather than black and white, places clients’ symptoms on continuum rather than discrete diagnostic categories, 5 factor model of personality could provide the dimensions, more difficult to efficiently communicate but more thorough description of clients, may be better suited to some disorders (personality disorders)

Categorical approach

current approach of DSM, individual falls into yes or no category of having a particular disorder, black and white approach no shades of gray, corresponds well with human tendency to think categorically, facilitates communication

Clinical interviews

most frequent assessment tool

How are clinical interviews important to the field?

Assessment is closely linked with the identity of clinical psychologists, as no other mental health profession incorporates assessment into their work as clinical psychologists do

Diagnostic interviews use

To provide DSM diagnosis, Structured interviews often used, SCID is an example

Semi-structured interviews

include some structure but also some flexibility or opportunities to improvise

Intake

to determine whether to “intake” the client into the agency or refer elsewhere vary by settings (ex

Structured

Often used, Minimized subjectivity, Enhance reliability

Unstructured

allow flexibility, allows clients to direct conversation, may be more difficult to get answers to questions

Mini-mental status exam

Typically used in medical settings, To quickly assess how a client is functioning at that time

Rapport

Positive and comfortable relationship between interviewer and client, How an interviewer is with clients

Intelligence definition

Measures intellectual abilities, Ability to learn, Ability to solve problems. Ability to recognize problems,

Neuropsychological test definition

Measures cognitive functioning or impairment of the brain and its specific component or structures

Additional purposes of neuropsych tests

Make prognosis, Plan rehab, Determine eligibility for accommodations, Often used after a head injury, a brain illness, or prolonged alcohol or drug use. Focus on cognitive dysfunction from brain injuries or illnesses, Some test can be lengthy and comprehensive and other are brief and targeted

Achievement definition

Measures accomplishments in academic areas

WIAT

Ages 4-50, Administered face-to-face and one-on-one, Consist of reading, math, written language, and oral language, Yields standard scores on the same scale as most intelligence tests, Mean of 100, Standard deviation of 15

Weschler test- child and adult versions

WAIS-IV (Wechsler Adult Intelligence Scale-4th edition), Ages 16-89 & WISC-V (Wechsler Intelligence Scale for Children-5th edition), Ages 6-16. Yields full scale IQ and index scores

Bender-Gestalt II

On screen, ~6 minutes to administer, Simple copying test using 9 geometric designs, A quick “check” followed by more test as necessary, neuropsych test, Can suggest brain damage in a diffuse, but not specific way

Halstead-Reitan Neuropsychological Battery

Primary purpose is to identify people with brain damage and provide detailed information or hypotheses about any brain damage, Comprehensive battery of 8 neuropsychological tests, Some of the 8 test involve sight, hearing, touch, motor skills, and pencil and paper tasks

Luria-Nebraska Neuropsychological Battery

Wide-ranging test of neuropsychological functioning, Slightly briefer than the HRB, Consists of 12 scales, Emphasis on qualitative data in addition to quantitative data

Universal Nonverbal Intelligence Test

Entirely language-free, No speaking necessary for test administrator or test taker, All instructions are hand gestures, All responses are manual, not verbal, Consists of six subtests organized into a two-tiered model of intelligence, Memory and Reasoning

Some drawbacks of the Universal nonverbal intelligence test

only for age 5–21, limited psychometric data

Multimethod assessment

Best to use multiple methods, includes Tests, Interviews, Observations, Other sources, Convergent conclusions can be made with more confidence

Objective personality tests

Includes unambiguous test items, offer clients a limited range or responses, and are objectively scored, Typically self-report questionnaires, We don’t have great insight on our own experience, Typically a series of brief statements or questions to which clients respond in a true/false or multiple choice format

MMPI- what does it measure, has a validity scale

Most popular and most psychometerically sound objective personality test, Used worldwide, Translated into dozens of languages, Pencil and paper format original, 567 self-descriptive sentences(Marks true or false), The questions deal with Activity interests, Aesthetic preferences, Personal sensitivities

MMPI 10 clinical scales

1 - Hypochondriasis (Excessive preoccupation with the body and physical symptoms) 2 - Depression (Sadness, discomfort, and dissatisfaction with life)3 - Hysteria (Awareness of problems and vulnerabilities.)4 - Psychopathic Deviate (Amorality, social deviation, lack of acceptance of authority.) 5 - Masculinity/Femininity (Abides by stereotypical masculine and feminine values and roles.) 6 - Paranoia(Level of trusts, suspiciousness, sensitivity) 7 - Psychasthenia, (Worry, anxiety, tension, doubts, obsession), 8 - Schizophrenia, (Odd thinking and social alienation), 9 - Mania( Level of excitability) 10 - Social Introversion (Shy, insecure, timid, introverted)

-NEO Personality Inventory

Measures “normal” personality traits, Not pathologies, Based on the 5 factor model or personality - Neuroticism, Extraversion, Openness, Conscientiousness, Agreeableness, Originally created by Paul Costa and Robet McCrae, Objective personality test - Pencil and paper format, Self-report format,

Issues with NEO-PI

Lacks validity scales, Limited help with clinical diagnosis

Projective tests

The goals of the test is that the persona will project unconscious conflicts, hidden feelings into ambiguous stimuli, Purposely present ambiguous stimuli, usually present a picture or paragraph and ask the person to tell a story based on stimuli

Issues with Projective Tests

Lack objectivity in scoring and interpretation, Considered by many to be empirically inferior to objective tests, Usage has declined in recent decades

Rorschach

10 inkblots are presented, 5 - Color, 5 - Black and White, “Response” phase, Clients says what they see in each blot, “Inquiry” phase, Explain what features of the blot caused them to make their response, Very intensive training program, John Exner’s Comprehensive System is most widely used scoring system,Reliability and validity questionable, No data showing if its helpful at all

Thematic Apperception Test

Series of cards with ambiguous stimuli, Cards feature interpersonal scenes, Clients tells a story to go along with each scene, Often not formally or empirically scored, Can help begin the interview, Reliability and validity questionable, Not well documented for reliability for diagnosis purpose

Sentence completion test

Rotter Incomplete Sentence Blank (RISB), Most widely used, Beginning of sentences, Examples - I enjoy____., Not often formally or empirically scored, Reliability and validity are questionable, Not helpful for diagnosis

Stages of change

stages for changing a behavior

Precontemplation stage

No intention to change

Contemplation stage;

Aware a problem exists, considering doing something to address it, but not ready to commit

Preparation stage

Intending to take action within a short time (e.g., weeks, a month)

Action stage

Actively changing behavior and making notable efforts to overcome problems

Maintenance stage

Preventing relapse and retaining gains made during action stage

Outcomes of efficacy studies

Psychotherapy works. Benefits last and exceed placebo effect

3 important elements/common factors of psychotherapy

Therapeutic relationship/alliance, Hope, Attention

Transference

Client “transfers” the feelings, expectations, and assumptions from early relationships onto the relationship with the therapist

Countertransference

Transference by therapists toward clients

Repression

Keep impulse in unconscious

Projection

Attribute impulse to others

Reaction formation

Do opposite of impulse

Displacement

Redirect impulse towards another person or object

Sublimation

Redirect impulse in a way that benefits others

Humanistic therapy definition/principles/goals

Assumes that human nature wasn’t so bad, Problems stems from stifled self-actualization or growth, Therapist’s task is to create a climate in which the client can resume their natural growth toward psychological wellness

Primary goal of humanistic therapy

Foster self-actualization

Self-actualization

Inborn tendency to grow

Roger’s three main principles

empathy, unconditional positive regard, genuineness

Empathy

Sense the client’s emotions just as the client would, Deep, nonjudgmental, compassionate understanding of client’s experiences

Unconditional Postitve Regard (UPR)

Accepting or “prizing” the client “no matter what”

Genuiness

Honesty towards the client rather than playing a role

Congruence vs. incongruence

Clients’ real selves can match their ideal selves

Real self

The self the person actually is

Ideal self

The self the person could be if they fulfilled their own

Congruence

Real self and ideal self match, root of psychological wellness

Incongruence

mismatch between real and ideal selves, and is the root of psychopathology

Systematic desensitization

Often used for phobias and other anxiety disorders, Similar to exposure therapy, but relaxation training is included, Relaxation is incompatible with anxiety

Counterconditioning systematic desensitization

when relaxation response replaces anxiety response

Exposure therapy

Version of “facing your fears”, Often used to treat anxiety disorders, Client is repeatedly “exposed” to the feared object and the expected aversive outcome does not take place client no longer experiences the fear response, Based on classical conditioning

Definition of mindfulness

Known as “third wave” therapies, Mindfulness involves full attention to present moment without judging or wishing things were otherwise, Engage with own mental process rather than experiential avoidance, Derives from Buddhist tradition

Ellis’ Rational emotive therapy

Despite the word “behavior” in the name, it is cognitive (not behavioral) therapy, Emphasizes a connection between rationality and emotion