clinical psych eam #2

psych assessment def

collecting information to understand symptoms, classify problems and developing plans for intervention/re-evaluating

process of assessment steps (5)

clarifying referral question, plan data collection, collect data, analyze and form conclusions, communicate results

process of assessment steps: clarifying referral question

determine reasoning for referral, find importance of question, who needs the answers

process of assessment steps: plan data collection

what to assess & methods, multiple pieces of information

process of assessment steps: collect data

both subjective and objective data, using multiple methods for better quality

process of assessment steps: analyze and form conclusions

why is the interpretation important, consider multiple hypothesis

process of assessment steps: communicate results

share results with parties involved

4 goals of assessment

classification & diagnosis, description, plan & evaluate treatment, predictions & prognosis

goals of assessment: classification & diagnosis

what is going on w/ client, most common

goals of assessment: description

understand context behind problem, strengths and weaknesses

goals of assessment: plan & evaluate treatment

what is best approach, do we need to re-assess?

goals of assessment: predictions & prognosis

draw conclusions, prediction of improvement/motivation

how is process of assessment related to scientific method

trial and error, looking and one specific test question, modifying approaches

core features of test creation (4)

psychometric, standardization, breadth vs depth, professional factors

core features of test creation: psychometric properties

reliability & validity

core features of test creation: standardization

representative of target population, knowing norms

core features of test creation: breadth vs depth

more detail in exploration the less topics are addressed, more topics = less detail

core features of test creation: professional factors

theoretical oreintation of clinicain, setting, culture

reliability def

consistency of the test measuring its target

validity def

measures what its supposed to measure

types of reliability (3)

split-half/internal consistency, interrator, test-retest

types of reliability: split-half/internal consistency

able to get same result if test split in half/not finished

types of reliability: interrator

do different people come to the same conclusions with same tools

types of reliability: test-retest

client has same score over two different time

validity types (3)

content, predictive/criterion, concurrent

validity types: content

does tool/test cover full range of what it needs to cover

validity types: predictive/criterion

how well a test can predict future outcome/behavior

validity types: concurrent

how well a new test matches to a standard test

intake interview

determine services, establish key symptoms, history

mental status interview

interview + observations, quick assessment, estimates of functioning

crisis interview

unstructured, immediate focus on experience and de-escalation, short-term fixes

problem-referral interview

understanding referral question and trying to answer it

orientation interviews

acquaint client with assessments, treatments, or research procedures

debriefing interview

after a study or experience for research

termination interview

ending of services to conclude therapy or reserch

non-directive (unstructured) interviews

not structured and not reliable, conversational and open discussions, exploratory

semistructured interview

blend of both types, set of questions but can dive deeper

strutured interview

pre-determined questions with not further exploration

how therapists behavior to build rapport

body language, paying attention, eye contact, pacing of conversation/tone, use of silence

types of questions (4)

open-ended, facilitative, clarifying, direct/closed

facilitative vs clarifying questions

asking for deeper understanding vs checking for accuracy

direct/closed questions

narrow focused questions, looking for specific answers, yes or no too

active listening techniques

paraphrase, questions, reflecting emotions

paraphrase vs reflecting emotions

basic listening, getting gist of client vs showing empathy and care

Why was Cultural formulation interview (CFI) created

solve the issue of not accounting for cultural backgrounds leading to misdiagnosis or weak engagement

4 domains of CFI

cultural definition of the problem, cultural causes & explanation, cultural factors affecting coping & support, cultural factors affecting help-seeking

4 domains of CFI: cultural definition of the problem

how would u describe your problem to friends or family, how client would describe

4 domains of CFI: cultural causes & explanation

how community would describe problem

4 domains of CFI: cultural factors affecting coping & support

what helps you cope with problem

4 domains of CFI: cultural factors affecting help-seeking

what help would work best, concerns about treatment

what is the multi-method approach

looking at full functioning of person, balance strengths and weaknesses, differences and similarities

cognitive tests

brain functioning, information processing, thinking skills, intelligence tests

personality tests

way of perceiving world, behavior patterns, motivations

behavioral assessments

examine existence, functions and patterns of behavior

types of behavioral assessments

self-reports, direct observation, self-monitoring

benefits of DSM

create communication across mental health professionals, categorization, matching treatment options

factors that define disorders (4 D’s)

distress, deviance, dysfunction, dangerousness

factors that decide the cut-off of diagnosis

scientific evidence, social pressures, norms, expert opinions

criticisms of DSM

create a “normative” life, disproportionate # of disorders, cultural biases, gender bias, medicalization of disorders

factors impacting clinical decisions

theoretical orientations, stereotyped beliefs/biases, experience & training

Treatment planning is influenced and guided by

diagnosis, case conceptualization, research, collaboration

treatment planning influence: diagnosis

existing treatments, mechanism for improvement

treatment planning influence: case conceptualization

contributing factors, 4 P’s

treatment planning influence: research

empirically supported approaches

treatment planning influence: collaboration

consider client preferences, cultural and strengths

types of case conceptualization

broad understanding & disorder/problem specific model

case conceptualization: broad understanding

biopsychosocial framework, predisposing factors, vulnerabilities, precipitants

general model of understanding (biopsychosocial)

biological, psychological, social, cultural

case conceptualization: disorder/problem specific model

specific processes, thoughts, behavior and emotion impact each other

Different “p” elements of case conceptualization (7)

presentation, predisposition, precipitants, perpetuates, protective factors, plan, prognosis

‘p’ elements: presentation

Nature & severity of symptoms, disorders

‘p’ elements: predisposition

long-standing vulnerabilities, experiences, and susceptible to difficulties

‘p’ elements: precipitants

Activating or ongoing stressors linked to symptoms

‘p’ elements: perpetuates

Reinforces, what maintain’s ‘patterns’

‘p’ elements: protective factors

Factors impacting resilience

‘p’ elements: plan

Treatment recommendations and goals

‘p’ elements: prognosis

Hypothesized guess for likelihood improvement

Why case conceptualization so important to the assessment and treatment process

combines client experiences, theory and research; normalizes struggles, validates, makes multiple problems more manageable

test creation kinds (3)

analytic, empirical, sequential

test types: analytic

based on knowledge, experience and theory, high face validity, subjective

test types: empirical

data-driven, objective, collect possible items

test types: sequential

combination of other types, take numbers, refine, re-test for more accuracy/specifics