Chap 13

Clinical vs. Counseling Psychology

• Clinical psychology: diagnosis & treatment of mental disorders

• Counseling psychology: helps with life problems (stress, relationships, career)

• Today → lots of overlap

2. Purpose of Assessment

Used to answer:

• Does the client have a disorder?

• What is the diagnosis?

• What is their level of functioning?

Common Tools

• Interviews (client + others)

• Tests:

  • Intelligence (e.g., WAIS)

  • Personality (e.g., MMPI)

• Case history (past records)

• Helps determine premorbid functioning (before disorder)

3. DSM-5 & Diagnosis

• Manual used for diagnosing disorders

• Includes:

  • Symptoms criteria

  • Risk factors

  • Comorbidity

Key Terms

• Incidence = new cases

• Prevalence = total % of population

4. Clinical Interview

Almost always used

What clinicians observe:

• What is said

• How it’s said

• Behavior & presentation

Interview Skills:

• Open-ended → then closed questions

• Active listening

• Body language (nodding, posture)

5. Types of Interviews

• Structured: fixed questions (high reliability)

• Unstructured: free-flowing

• Semi-structured: mix

Special Types:

• Stress interview (induces stress)

• Cognitive interview (memory recall)

• Collaborative interview (client + clinician work together)

6. Standard Interview Questions

• Demographics

• Reason for referral

• Medical & psychological history

• Current concerns

7. Mental Status Examination (MSE)

Screens functioning

Areas:

• Appearance & behavior

• Orientation (person, place, time)

• Memory

• Mood & affect

• Thought content (hallucinations, delusions)

• Judgment & insight

8. Psychometric Qualities

• Reliability

  • Inter-rater (different evaluators agree)

  • Test-retest (consistent over time)

• Validity

  • Measures what it should

  • Criterion validity = matches real-world outcome

9. Psychological Tests

Examples:

• MCMI-IV → personality disorders

• BDI-II → depression severity

• CES-D → depression screening

Test Battery:

• Multiple tests used together

• Example: WAIS + MMPI + projective tests

10. Cultural Considerations

• Must consider:

  • Language

  • Values

  • Identity

  • Acculturation

ADRESSING Model:

• Age

• Disability

• Religion

• Ethnicity

• Social status

• Sexual orientation

• Indigenous heritage

• National origin

• Gender

11. Addiction Assessment

• Physical tests (urine/blood)

• Interviews

• Role-play tests

⚠ Clients may fake good, especially if court-ordered

12. Forensic Assessment

Used in legal settings

Evaluates:

• Competency to stand trial

• Criminal responsibility

• Custody decisions

⚠ Clients may lie → use multiple sources

13. Dangerousness

• If risk to self/others → can lose rights temporarily

• Clinician may have duty to warn

Risk factors:

• Past attempts

• Substance abuse

• Unemployment

14. Suicide Assessment

Higher risk with:

• Depression

• PTSD

• Substance abuse

Ask about:

• Plans

• Motivation

• Support system

15. Competency

Ability to:

• Stand trial

• Make decisions (legal/medical)

Tests:

• Competency Screening Test

• MacCAT-CA

16. Criminal Responsibility

• “Not guilty by reason of insanity”

• Based on ALI standard:

  • Could not understand wrongfulness

17. Child Custody Evaluations

• Determine best interest of child

Includes:

• Parent interviews

• Child interviews

• Observations

• Sometimes tests

18. Child Abuse AssessmentSigns:

• Physical: bruises, burns

• Emotional: withdrawal, aggression

• Neglect: poor hygiene, hunger

Tools:

• Interviews

• Observation

• Questionnaires

19. Elder Abuse

• Physical, emotional, financial harm

• Must be reported

20. Psychological ReportsSections:

• Demographics

• Reason for referral

• Tests used

• Findings

• Recommendations

• Summary

⚠ Avoid Barnum Effect (vague statements that seem true for everyone)