CLINICAL PSYCHOLOGY EXAM 1

What is Clinical Psychology?

Psychological specialty that provides:

• Assessment and behavioral health care

• Consultation with agencies and communities

• Training, education, supervision, research to inform of its practices

Who are Clinical Psychologists?

understand symptoms of mental health and provide treatment

Assess, diagnose, and treat those with emotional, behavioral, and/or cognitive difficulties

What are Clinical Psychologists involved in?

Therapy/Practice, Teaching, Research, Consultation, and Administration

Who are Psychiatrists?

Medical doctors who specialize in psychology in medical school ; Attribute biological causes & brain abnormalities to mental health problems

Who are Social Workers?

Focus on familial and sociocultural factors underlying psychopathology ; Involved with everyday lives of patients

True or False?
Social workers make up 1/3 of mental health professionals

True

What does a Licensed Professional Counselor do?

Work in private practice, community mental health centers, rehab facilities, correctional facilities, school, college, etc. ; Emphasize listening and decision-making skills ;

True or False?

There are more LPC’s than any other professional in the mental health workforce

True

What is an LPC in the state of California?

Licensed Professional Clinical Counselor (LPCC)

What is a Psychiatric Nurse?

Specializing in treating psychiatric patients

What is a Psychologist?

Work in counseling centers on university campuses or within communities; Address social relationships, career decisions, mild to moderate anxiety, eating disorder risks

What is a Marriage & Family Therapist (MFT)?

Attend to couples’ conflict, parent-child conflict, substance abuse, grief, dementia, depression, anxiety, etc.

What is a school counselor/psychologist?

Promote intellectual, social, emotional well-being; May conduct assessments (giftedness, intellectual/learning disabilities, or ADHD); Develop learning & behavior modification programs

Why should someone be careful when they see the title Psychotherapist or Life Coach?

These titles are unregulated, which means anyone can call themselves this.

How is clinical Psychology different from other fields?

Trained Clinicians

• Employ scientific findings to inform work with clients

Trained Researchers

• Contribute to knowledge base of their field

Skilled Critical Thinkers

• Adopt wide range of roles in diverse settings, populations, age groups, and industries

Multicultural awareness focuses on differences in

• Gender experience, sexual orientation

• Culture, identity, race

• Religion, socioeconomic status

Activities of clinical psychologists

• Intervention: providing psychological treatments; one-to-one, or to groups; guided by research

• Diagnoses/Assesment: Diagnose the problem, and assess success of treatment using tests

• Research prevalence and treatment of mental disorders, intervention effectiveness, assessments

Lightner Witmer opened first clinic in

1896

Army Alpha and Army Beta used to assess

verbal and nonverbal skills in World War I recruits

when was the scientist-practitioner (Boulder) model of graduate study (PhD) developed

1949

when was the practitioner-scholar (Vail) model (PsyD) created

1973

when was the clinical science model first introduced

1991

what perspective do clinical psychologists adopt?

holistic

What is required to become a clinical psychologist?

Doctoral degree (PhD or PsyD)

Scientific and Practitioner training

What are some critiques of the Boulder Model?

Training in practice should be prioritized overshould be prioritized over research training

Research conducted in graduate school seems trivial (less focus on diagnosis, assessment, and psychotherapy)

Clinical Psychology seen as an “art” not a science

Differences between PsyD and PhD Training paths:

Acceptance rate 41% to PsyD, 15% to PhD programs

PsyD faculty have less expertise in evidence-based psychological interventions

PsyD students

accrue more student loan debt

less likely to match to clinical internships

less likely to pass national licensing exam

Practitioner Scholar model emphasizes?

practice over science

Pros & Cons of Practitioner Scholar Model

Pros: builds clinical skills

Cons:de-emphasizes scientific basis of  clinical psychology

Clinical Scientist Model

offers rigorous training in empirical research methods

Pros & Cons of Clinical Scholar Model

Pros:integrates scientific principles into clinical practice

Cons: Changes in healthcare and education

Pros & Cons of Scientist Practitioner model

Pros: professionals integrate the roles of scientist and practitioner;

Cons: practice should be prioritized

True or False?

Clinical Psychologists DON’T require a license to practice

False

How many hours does a clinical psychologist need to take Postdoctoral fellowship

supervised clinical experience

2000

What do Clinical child/adolescent psychologists do?

Develops and applies scientific knowledge to the delivery of psychological services to infants, toddlers, children and adolescents within their social context

What does Health Psychology focus on?

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

What do Adult clinical psychologists do?

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

True or False?

Psychologists are NOT responsible for maintaining confidentiality with clients

False

What dilemmas may psychologists face when maintaining confidentiality?

• someone may be in harms way

• disclosing client’s confidentiality information to save them

What are the principles that Guide practice?

• Benefience and nonmaleficence

• Fidelity and responsibility

• Integrity

• Justice

• Respect for peoples rights and dignity

True or False?
Clinical Psychologists must:

• Practice within bounds of their competence

• Represent their training accurately

• Be sensitive to personal attributes of clients

• Not allow personal problems to interfere with treatment

• Receive clients informed consent prior to treatment

True

A clinical psychologist can act against their clients wishes when…

• someone may be at harm or risk (the client wanting to hurt someone else)

• when the client has been harmed/abused

• when a client attempts fatal harm to themselves (suicide attempts)

• when a client is a minor

Guidelines are fuzzy in breaking confidentiality because…

• legal precedents differ in various states

• unclear qualifier for “imminent” time frame

• ideations of homicide or suicide can be vague

True or False?

The law requires psychologists to report client abuse

True

how can reporting abuse become challenging?

when:

• some clients don’t want to be reported

• when perpetrator is present

A client may feel _______ by their psychologist if confidentiality was broken

betrayed

What is the Baker Act?

allows individuals at imminent risk to be held against will between 48 and 72 hours

When it comes to minors, is confidentiality offered?

No, parents are able to request all details regarding therapy

Psychologists must stop working with clients when:

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

• Therapy no longer helps the client

• Client decides they no longer want to go through therapy

• Charging for unnecessary services violates ethical guidelines

What is the process of a therapist reading the informed consent with their client?

• inform client about treatment processes

• addressing their fears and myths about treatment

• consent is read together

• psychologist reads all clauses

• answers client questions

What is a Psychological Assesment?

The process of collecting and synthesizing information to understand clients thoughts and behaviors

What are the steps in Assessment?

1. Determine the reason for referral and presenting problem

2. choose what to assess

3. select the method of assessment

4. gather the assessment data

5. consider the data and draw conclusions

6. convey the conclusions tot he appropriate parties

What does it mean when the client is providing a reason for referral to the clinician?

why psychological services are being sought

what is the goal of the presenting problem?

• what needs evaluation

• assessment instruments to use

• goals of assessment

What is the correct example of someone’s referral/presenting problem?

“I recently lost my mom to cancer and I am having trouble coping”

What needs to be assessed is guided by:

• Goals in the referral process

• Understanding of the presenting problem

• Professional psychologists must make accurate judgments about these

Define Validity

Test measures what it is intended to

assessment data is collected by:

• Interviews

• Tests

• Observations

• Historical records

why is the multimethod assessment important?

• involves multiple methods and informants

• increases reliability and validity of assessment

• provides a more complete picture of clients behavior

Clinicians rely on their _________ when making conclusions

judgement

An assessment report contains:

• Reason for referral

• Rationale for choice of assessments used

• Test scores and conclusions

• Recommendations for addressing questions in referral

• Report given to client, parents, courts, or school

What are the characteristics of a clinical interview?

• An interview is a dynamic interaction between two people

• Clinical psychologist creates opportunities for client’s comfort, safety to meet goals

How does a clinician responsibly keep the interview on track?

• Careful planning

• Deliberate and skillful execution

• Goal-orientation

• Interaction focused on client

Define rapport

Establishing Clinician-client alliance

How is rapport achieved?

Being accepting, understanding, and respecting the client

True or False

Prejudging the client is acceptable

False

How can establishing rapport be challenging?

• In family/group therapy where there are conflicting relationships

• Children of conflicting parents

The use of questions during a session is important because:

• Open-ended: begins discussions of a new topic

• Facilitative: clarify or guide clients

• Confronting and direct: forcefully guide flow of interview; may help the client if experiencing a blind spot

• Clarifying: a part of active listening 

example of open-ended question

“Would you tell me how was your childhood like?”

example of clarifying question

“that sounds difficult. Can you tell me what that was like for you?”

example of facilitative question

“Can you tell me a little bit more about that?”

why would the clinician use a confronting question during a session?

to challenge inconsistencies or contradictions

define active listening

understanding what is being said

define reflective listening

repeating what the client has said

Benefits of Silence

• Communicates focus on communication

• Allows clients to reflect on their own thoughts and feelings

• Conveys psychologist's exclusive presence for client, not rushes client

• Silence allows the client to continue talking

Psychologists should focus on _______ and ____________ of the client

feelings and perspectives

what is multi-cultural humility?

 psychologists must NEVER stop fully learning about their own filters and continually challenge themselves to question assumptions

What are the 2 purposes of an intake admission interview?

• Reason of client’s visit to clinic/agency or hospital

• Whether the agency’s facilities, policies, and services meet the needs, expectations of client

purpose of social history interview?

Details clients personal history: facts, dates, and events

social history interview covers a broad range of materials such as:

• infancy

• childhood

• adolescence

• adulthood

What is a mental status examination?

Assesses presence of in-the-moment cognitive, emotional, or behavioral problems

What is a structured diagnostic interview?

Standard set of questions and follow-up probes asked in specific order

What are some limitations of structured diagnostic interviews?

rigid, culturally insensitive; rigid, culturally insensitive; questions may be unclear, and not take cultural aspects into account

Structured Interview Advantages and Disadvantages

Advantages:

Less interviewer bias — the element of

interviewer judgment is removed, leading to

consistency in both methodology and

information gathered

Greater reliability and validity — due to the

standardized questions and scoring rubric

Disadvnatages:

No flexibility — the interviewer is restricted to

predetermined closed ended questions and

cannot explore unanticipated or interesting topics

that might surface

Less rapport — more formal with no room for the

interviewer to make small talk or delve into areas

that the participant wants to talk more about

Unstructured Interviews Advantages and Disadvantages

Advantages:

No specified script — interviewer is free to

use open-ended questions and do what’s

needed to build rapport

Flexibility — interviewer can explore what

seems important and generate ideas and

hypotheses

Disadvantages:

Less reliability and validity — each interviewer

may ask different questions to different people, so

replicability and validity are threatened

Risk of interviewer bias — interviewer’s choice

of questions and interpretation of answers are

completely based on judgment and therefore

subject to bias

Semistructured Interviews Advantages and Disadvantages

Advantages:

Compromise — interviewer is given guidance

on what topics to assess (helping reliability and

validity), and can more fully probe interesting or

important areas (maximizing rapport)

Disadvantages:

Interviewer bias — although reduced, there is

still some risk of bias because of open-ended

follow-up questions

define Personality

continuity in a person’s behavior and emotional style over time

define personality trait

stable and consistent way of perceiving the world and of behaving

Which 5 dimensions does the Five Factor Model make up personality?

• Openness to experience: Fantasy, Aesthetics, Feelings, Actions, Ideas, Values

• Consciousness: Competence, Order, Dutifulness, Achievement Striving, Self- Discipline, Deliberation

• Extraversion: Warmth, Gregariousness, Assertiveness, Activity, Excitement Seeking, Positive Emotions

• Agreeableness: Trust, Straightforwardness, Altruism, Compliance, Modesty, Tender-Mindedness

• Neuroticism: Anxiety, Hostility, Depression, Self-Consciousness, Impulsiveness, Vulnerability

what are the requirements for useful personality tests?

• Standardization: follow same scoring and administration procedures each time

• Reliability: similar results for same individual upon multiple testing

• Incremental Validity: provide information not provided by other sources; predict future behavior

Responses to _________ stimuli are assessed in Projective tests.

ambiguous

What are some characteristics of Projective Tests?

• Ambiguous test stimuli (inkblots, incomplete(inkblots, incomplete sentences to complete)

• Indirectness: respondents unaware of test purpose

• Freedom of response; open-ended test items

• Qualitative response interpretation

• Lack of standardization, as every person is unique

• Difficult to determine validity and reliability

what is an objective test?

Objective tests have standard question statements administered, with fixed-option responses

what are some advantages and disadvantages of objective tests?

advantages:

• Economical; be given to groups or individuals

• Brief Instructions; simple scoring

• Objective and reliable

disadvantages:

• Responses may not indicate actual behavior

• There can be several interpretations of the same score

• Respondents may fake responses

• Experience, culture, and content may influence question interpretation and response

what are the similarities and differences in Projective tests vs Objective tests?

Similarities:

• Undergo reliability and validity

• Used for clinical diagnoses

Differences:

• Projective tests have ambiguous test stimuli, responses can vary (open-ended), interpretation may be subjective; targets unconscious thoughts

• Objective tests are more direct, questions have standard questions with fixed-option responses, simpler scoring (can be computerized)

True or False?

Both Projective and Objective tests should be included in assessing clients

True

what is test bias?

Situation in which different decisions or predictions are made for members of two groups

Examiner of another ____ may affect performance; test materials racially biased

race

Original test standardization samples were overrepresented by :

white, middle-class, educated, cis-gendered, heterosexuals