Lecture 8: Clinical Interviews, Behavioral Observations, and Self-Monitoring

What does case formulation focus on?

Causal and maintaining factors, such as maladaptive cognitions and behaviors

What is an unstructured clinical interview?

A clinical interview that involves no standard set of questions or structured method for integrating and summarizing obtained information

What is a structured clinical interview?

A clinical interview that involves a very specific format for asking questions, determining follow-up questions, and integrating and summarizing obtained information

What is a semi-structured interview?

A client interview that blends unstructured and structured interviews, in which a script is followed but there are opportunities to diverge from the script if necessary to obtain more information.

True or False: Semi-structured interviews have substantially worse reliability and validity than unstructured interviews.

False

True or False: Structured clinical interviews show the highest levels of reliability and validity.

True

True or False: Clinical interviews ideally inform the development of a treatment plan for the client.

True

Under what conditions can a mental-health professional violate a client's confidentiality?

When the client reports engaging in ongoing harm to children or to elders, as well as when the client reports ongoing/potential harm to self or others.

True or False: Learning to conduct the SCID-5 involves fairly minimal training and supervision.

False

What is the SCID-5?

The Structured Clinical Interview for DSM-5 is a semi-structured interview guide for making major DSM-5 diagnoses

True or False: Administering the SCID-5 interview for Panic Disorder requires that the interviewer read extensively from a script.

True

True or False: Meeting DSM-5 criteria for a panic attack requires experiencing four or more symptoms that develop abruptly and reach a peak within 10 minutes.

True

True or False: Someone can receive a diagnosis of Panic Disorder if they experience only one panic attack, but it is very severe.

False

True or False: When using the SCID-5 to make almost all major diagnoses, high kappa values suggest outstanding interrater reliability.

False

True or False: To meet DSM-5 criteria for Panic Disorder, someone must experience at least one month of anticipatory anxiety about future panic attacks or their consequences.

False

What are some of the pros and cons of using a structured clinical interview versus a high-quality questionnaire to evaluate psychopathology?

Clinical interviews are assumed to be more accurate than questionnaires, but questionnaires are faster and cheaper to administer.

In a study evaluating diagnostic agreement between an interview and questionnaire, what is the typical gold standard?

The interview classification

How is behavioral observation typically used by clinicians?

To identify behavior patterns, to generate hypotheses about causal/maintaining factors, and to inform intervention planning

What is the Mental Status Exam?

A system of behavioral observation that is commonly used in psychiatric contexts

What is naturalistic behavioral observation?

Observation within normal situational contexts and under naturally occurring reinforcements and consequences

What is structured behavioral observation?

Observation in role-played scenarios in which person engages in one or more simulated social interactions

True or False: Observing an aggressive child during recess at school is an example of a structured behavioral observation.

False

True or False: Observing a couple discussing an area of conflict specified by a therapist in the therapist's office is an example of a structured behavioral observation.

True

What is functional behavioral assessment?

A form of observation that involves classifying observed behavior into antecedents, behaviors, and consequences (ABCs)

What are antecedents in functional behavioral assessment?

What happens before a person engages in a specific behavior

What are behaviors in functional behavioral assessment?

What the person is actually doing

What are consequences in functional behavioral assessment?

What happens after a person engages in a specific behavior

Is external validity higher in naturalistic or structured behavioral observation?

Naturalistic

Is internal validity higher in naturalistic or structured behavioral observation?

Structured

Is reliability higher for naturalistic or structured behavioral observation?

Structured

What is self-monitoring?

Observing and recording your own behaviors, thoughts, emotions, bodily sensations, events, and the contexts in which they occur, etc.

True or False: Self-monitoring can be used to highlight connections between thoughts, behaviors, feelings, physical sensations, contexts, etc.

True

True or False: Self-monitoring may contribute to objective self-awareness and can encourage behavioral change.

True

True or False: Self-monitoring can be inaccurate, and the reliability and validity of self-monitoring can be low.

True

What is reactivity with respect to self-monitoring?

Changes in behavior being assessed due to self-monitoring

True or False: From the perspective of functional behavioral assessment, problematic behavior may be reinforced by negative outcomes (consequences).

False

True or False: From the perspective of functional behavioral assessment, problematic behavior may be more likely under some conditions (antecedents).

True

True or False: From the perspective of functional behavioral assessment, it may be possible to modify problematic behavior by changing antecedents and/or consequences of the behavior

True

True or False: One of the advantages of self-monitoring assessments is that it provides a great deal of information at low cost.

True

True or False: One of the disadvantages of self-monitoring assessments is that they can be used to track treatment progress.

False

True or False: Self-monitoring assessments cannot be used to characterize a problem and its presumed causal/maintaining factors.

False

True or False: Naturalistic behavioral observation typically costs more but has higher external validity than structured behavioral observation.

True

True or False: Cognitive-Behavioral Therapy for Panic Disorder is highly effective in the short-term but not in the long-term.

False

True or False: Self-monitoring is central to all treatment components in Cognitive-Behavioral Therapy for Panic Disorder.

True

True or False: On average, self-monitoring produces positive changes in maladaptive behavior.

True

True or False: Self-monitoring can be helpful, but it is not considered an empirically supported treatment for any mental or behavioral health problems.

False

True or False: Reactivity to self-monitoring may occur because clients recognize that their behavior is somewhat predictable in ways that they potentially can anticipate, control, better prepare for, etc.

True

True or False: Reactivity to self-monitoring may occur because clients become more aware of the frequency of maladaptive behaviors.

True