Clinical Psychology- Exam 1 (PSY 406)

Describe the individual level of the tripartite model.

"all individuals are in some respects, like no other individuals"

Describe the universal level of tripartite model.

"all individuals are, in some respects, like all other individuals"

Describe the group level of the tripartite model.

"all individuals are, in some respects, like some other individuals"; this is the level that is overlooked

Describe the APA general principles.

(1) Beneficence and nonmaleficence, (2) Fidelity and responsibility, (3) integrity, (4) Justice, (5) Respect for people's rights and dignity

What are the four conceptual Issues in the Evolution from QUORUM to PRISMA?

(1) Completing a Systematic Review Is an Iterative Process- protocol and possible changes to it (2) Conduct and Reporting Research Are Distinct Concepts (3) Study-Level Versus Outcome-Level Assessment of Risk of Bias (4) Importance of Reporting Biases

Give five examples of possible control groups in psychotherapy clinical trials.

(1) No therapy; (2) wait list control- they know they will get therapy or have to wait for it; (3) Attention-placebo (similar to treatment in time and dedication, but serves no purpose); (4) TAU (treatment as usual); (5) another active psychotherapy

What are the three prior forces to multiculturalism?

(1) Psychoanalysis, (2) Behaviorism, (3) Humanistic/ Person-Centered

What does the 5 years of schooling entail?

(1) coursework- smaller seminars(2) clinical practicum (supervision), (3) research (thesis/dissertation), (4) Qualifying/comprehensive exams, (5) pre-doctoral internship (clinical: 1 year)

What are the 10 APA 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

What are each of the kisses of death?

(a) damaging personal statements-including: personal mental health, excessive altruism, excessive self-disclosure, and professional inappropriateness (b) harmful letters of recommendation (c) lack of program information (d) poor writing skills (e) misfired attempts to impress.

What can undergraduate programs do to assist psychology students applying to graduate school?

(a) mentoring (b) academic advising (c) teaching classes designed to prepare students for their lives after un- dergraduate school

Briefly describe the major problems with current guidelines for ESTs: the criteria themselves; counting only hits; methodological standards; distinction between treatments (what type of therapy do they shoot down here?); DSM overreliance; removing treatments from the list; harmful treatments; and treatments/procedures/mechanisms of change.

1. Influence of the list on practicing clinicians 2. the rejection of empirical epistemologies and legit methods for evaluation 3. scientific status of specific procedures for identifying ESTs

Crombie lays out five steps of conducting a meta-analysis (location of studies, etc.). What are they and briefly explain each.

1. Location of studies (comprehensive search strategy) 2. quality assessment (deciding which studies to include and which not to) 3. calculate effect size - calculate the ratio 4. Check for publication bias- use a funnel plot to compare effect size against sample size 5. sensitivity analysis- explore the ways in which the main findings are changed by varying the approach to aggregation

Identify the differences among between vs. within group design vs. mixed group designs.

A between-groups design is where participants in different conditions receive entirely different treatments, within-groups design compares the participants in a single group at different times, and a mixed-group design combines the two.

Describe case study and case series designs.

A case study thorough and detailed examination of a single person or situation, while a case series is a descriptive study that follows a group of individuals.

Describe the difference between a cross-sectional design and a longitudinal design.

A cross-sectional design compares a group of participants at one particular point in time, while a longitudinal design makes within-group (same sample) comparisons from point in time to another.

What is a survey design?

A group sample that analyzes descriptive and inferential statistics for the group

What are quasi-experiments? What are the types?

A less-scientifically founded design where there is no randomization. The types include non-rat and within-subjects.

What are the professional activities/typical activities conducted by clinical psychologists?

A majority of clinical psychologists go into private practice (35%), the next work at universities (20%). Other activities include med school, hospitals, outpatient clinics, community mental health centers, industry/business, other (HMOs, schools, etc.)

Describe the issue of competence.

A psychologists ability to be skilled, proficient, trained, and knowledgeable in his or her practice. Psychologists should not practice outside of their proficiencies. This also includes cultural competence.

Describe a Non-RCT design.

A quasi-exp. design where participants choose their groups.

What is meta-analysis?

A statistical method of combining results of separate studies to create a summation of the findings. A study of studies.

What purpose does meta-regression serve?

A technique which allows researchers to explore which types of patient-specific factors or study design factors contribute to the heterogeneity

What were the contributions of Pinel?

Advocate for humane treatment in Europe.

Describe a within-subjects design.

Aka pre/post. One group is measured before and after the intervention method.

Describe the Vail model

Also known as the practitioner-scholar model, it was created at the Vail conference in 1973.

Describe the Boulder Model

Also known as the scientist-practitioner model, it was created at the Boulder conference in 1949.

What are 4 strategies of acculturation.

Assimilation; Separation; Marginalization; Integration

What is knowledge of diverse cultures, in relation to cultural competence?

Being informed about a client's cultural group through reading, direct experiences, and relationships with people in various cultures.

Describe factors in training issues in cultural issues and competence.

Can teach and give information on it all, but it comes down to the practitioner having " an attitude of respect, curiosity and especially humility"

How are clinical psychologists different from other mental health professionals such as psychiatrists, counseling psychologists, school psychologist, MA counselor, MFT, and MSW, both in training (including number of years in school and # of years until they are a fully, independently licensed professional) and professional activities?

Clinical psychologists are different from other professions in that they tend to work with the most severely affected individuals. Furthermore, they are in school for a national average of 5.5 - 6 years. They will not become a fully, independently licensed professional until 1 year after that. Other professionals might be in school anywhere from 2-5 years.

What are micro-aggressions? Give an example.

Comments or actions made in a cross-cultural context that convey prejudicial, negative or stereotypical beliefs and may suggest dominance or superiority of one group over another. An example of this is "you speak English very well" or "you don't act like a normal ____ person"

How do control groups differ for medication research vs. psychotherapy research.

Control groups for medication may receive a placebo, while it is much more difficult to find a placebo for psychotherapy research.

Describe the tripartite model of personal identity.

Developed by Sue and Sue and it consists of the following three levels: individual level, group level, and the universal level

What are culture bound syndromes and how are they accommodated in the current edition of the DSM.

Disorders or cultural concepts that are observed in various types of groups around the world. Some include sutso (a frightening event causes the soul to leave the body) and malady moun (can send problems through psychosis).

How do efficacy and effectiveness differ? Similar?

Efficacy is defined as the success of a particular therapy in a CONTROLLED study and setting, while effectiveness is defined as the success of a therapy in an actual clinical setting.

Describe multiple regression/prediction analysis.

Employed to learn more about the relationship between several independent or predictor variables and a dependent or criterion variable

What are evidence-based treatments and manualized treatments?

Evidence-based treatment is the integration of the best available research with clinical expertise in the context of patient characteristics, culture an preferences.

Describe a randomized controlled trial.

Experimental method (the gold standard); individuals are random assigned to the IV groups

What is the assumption of fixed effects and random effects models in regards to heterogeneity.

Fixed effects: If heterogeneity is absent; the assumption is that the size of treatment effect is the same (fixed) across all studies and the variation seen between studies is due only to the play of chance Random Effects: assumes that the treatment effect really does vary between studies

Discuss the contributions of Lightner Witner to the development of the profession of clinical psychology.

He is the father go clinical psychology. Founded the first psych. clinic, first publication of the term "clinical psychology," and created the first journal in the field- "The Psychological Clinic."

After the bachelor's degree, how long (years) does it take to get your Ph.D. in clinical psychology (if you go straight from your undergraduate program to a Ph.D. program)? After someone finishes the Ph.D. in clinical psychology, what else do they have to do (and how long does it take) in order to obtain a state license so they could practice independently?

If you go straight to a PhD, it should take you about 5 years to complete. After the PhD, the person then has to become licensed. Though it is dependent on the state, this takes about 1 year.

What is "culturally appropriate," in relation to cultural competence?

If, and how, treatments are adapted to clients with various cultural backgrounds.

How are internal and external validity different?

Internal validity is the extent to which he change in the DV is due solely to the change in the IV, while external validity is the generalizability of research results.

Describe the issue of boundaries and multiple relationships.

It can become an issue when a psychologist knows the client professionally and personally. There is difficulty in defining what relationships are considered unethical. This is why boundaries must be set from the beginning.

Why is the experimental method (random assignment) the strongest research design?

It controls for extraneous variable; thus, allowing us to determine causality.

What are the disadvantages of evidence-based treatment?

It creates threats to the psychotherapy relationship, diagnostic complications, restrictions on practice, and there is debatable criteria for empirical evidence.

Why is a between groups more efficient than a within groups design?

It doesn't address issue of placebo or regression to the mean

What is the process of random assignment?

It is a procedure used in experiments to create study groups with similar characteristics so that the groups are equivalent at the beginning of the study.

Who created the first psychology clinic in the US?

Lighter Witner

How have payment issues in this day and age impacted therapy and diagnosis?

Managed care often dictates what therapy can happen and how the patient can be diagnosed. Self-payment is often unaffordable, but 3rd party payment is very limiting.

What obstacles (current financial climate, etc.) face clinical psychologists who go into private practice?

Many have to deal with managed care which can prevent the proper care of the client and the proper reimbursement for the psychologist. Additionally, it is business-oriented (function as a business and be able to promote oneself, be very self-disciplined, and you do not get benefits.

How did WWII (Two) impact the field of clinical psychology?

Meds flooded to treat injuries and "shell shock" was on the rise. WWII helped clinical psychology take off as practitioners began providing therapy to adults.

What were the contributions of Todd?

Opened the retreat in Connecticut in 1824.

What were the contributions of Dixx?

Originally worked treating those in jail. Established over 30 mental institutions in the US.

What is PROSPERO?

Pre-registration of proposed systematic review and meta-analysis to ensure procedures and results are of highest methodological quality; provides a comprehensive list of systematic reviews

What does PRISMA stand for and what does it mean?

Preferred Reporting Items for Systematic Reviews and Meta-Analyses; 27 item checklist and 4-phase flow diagram

Describe the issue of confidentiality.

Psychologists have a duty to protect confidential issues; however, there are instances where this can be broken (someone else is in danger/children). For example, the Tarasoff case.

What were the contributions of Tuke?

Raised funds to form the "yorke" retreat (place for humane treatment of mentally unstable in England.

Describe the combined PhD model

Refocus / recommitment of clinical PhD program to scientist part of scientist-practitioner. It was a response to professional schools as PsyD.

Describe the issue of informed consent.

Research, assessment, and therapy all require informed consent to ensure that the client is capable of being aware of certain things.

Describe acculturation.

Response or adaptation to a new cultural environment, particularly with regard to adopting elements of new culture or retaining elements of the original culture.

Why is a firm grounding in psychological science important for future clinical psychologists?

Science can properly inform us on disorders and intervention methods. Scientific research enables the development of new treatments and the support of older ones.

What are the major potential problems/pitfalls for students who chose to train in these programs (PhD/PsyD)?

Students in the PsyD often do not receive as prestigious of education, pay higher amounts of tuition, and do not receive as much funding.

What are the main differences between systematic literature reviews and narrative literature reviews?

Systematic review research focuses on standardized method to determine articles to include (reduces bias), while narrative reviews are written by experts and often used for practitioners to be aware of treatment issues.

Describe/discuss recent professional efforts (APA ethical code, journals, DSM-V, etc.) to emphasize issues of culture.

The DSM now includes "cultural concepts of distress" and the APA no requires programs to address cultural differences.

Describe and discuss professional schools of training to be a clinical psychologist (Ph.D./Psy.D.).

The PhD model follows the scientist-pracititoner model, while the PsyD program follows a practitioner-scholar model.

Describe the development and growth of the profession of clinical psychology post WWII, the VA Hospital system, and other indicators of growth.

The VA began to fund therapeutic clinics and then ended up hiring the practitioners. The number of PhD programs in clinical psych. skyrocketed (0-45)

Describe multiculturalism as the 4th force in psychology.

The systematic study of all aspects of human behavior as it occurs in settings where people of different cultural backgrounds encounter each other. It instills sensitivity and awareness.

What are the types of blinding within an experimental design?

There is a single-blind experiment and a double-blinded experiment. Single refers to either the client or the researcher. Double blinded refers to both individuals being unaware of the treatment.

What was the involvement of psychologists in WWI (One)?

There was no therapy being done for adults at this time.

Do clinical psychologists always do applied work? Explain.

They most often do applied work, but not always. Some work in education, administration and conduct scientific research.

Describe the clinical scientist model

This is a relatively new program, and it emphasizes skill sets. There are currently 9 APA accredited around the country (one in Utah).

What is the purpose of the code? How do the general principles and ethical standards differ?

To describe a level of ethical behavior for psychologists. The general principles are aspirational while the ethical standards are enforceable rules of conduct.

What type of question does a meta-analysis statistic help us answer?

What is the effect of an intervention and how big is it.

What is cultural self-awareness, in relation to cultural competence?

When a psychologist comes to understand his or her viewpoint is unique and idiosyncratic.

Are observational designs "inferior" to experimental method studies? Why or why not?

While it is not inferior, it is not as strong as an experimental. That being said, it depends. Observational research is used to examine questions other than interventions

Does blinding apply to psychotherapy trials? Why or why not?

While it would be difficult, it is possible to employ single-blinding in psychotherapy. That being said, double blinding is impossible. In order to test the efficacy of a treatment, the researcher would have to know what type of therapy is being employed.

What are the main issues in ethics with clinical assessment and clinical research?

Within assessment the issues include test selection, test security, and test data. Within research the issues include efficacy of psychotherapy.

What are the main disciplines/specialties in psychology that are considered "applied?"

clinical; abnormal; psychotherapy; industrial/organizational; counseling; counseling; sports; school

What are major factors that contribute to the science-practice gap?

cognitive biases inherent in common methods of clinical decision making, widespread theoretical perspectives that devalue empiricism, and the sheer volume of the research literature

What are the three main benefits of meta-analysis?

overcoming bias, transparency and precision.

In what work settings do clinical psychologists most frequently work?

private practice (35%)

What are the advantages of evidence-based treatments?

scientific legitimacy, establishing minimal levels of competency, training improvements, and the decline reliance on scientific judgement.

What is cohen's d guidelines for effect size?

small (.2-.3) medium (~.5) large (.8 +)

What are Cochrane reviews?

state of the art systematic reviews and investigate the effects of interventions for prevention, treatment and rehab

Briefly describe the issues of heterogeneity in meta-analysis and what are the two commonly use test for heterogeneity?

the extent to which they mix studies that are different in kind; (1) Cochrane's Q, a statistic based on the chi-squared test & (2) I2 statistic, which scores heterogeneity between 0% and 100%

What is the strongest case for the effort to identify ESTs (same as RSTs).

the failure of many practitioners to use evidenced-based treatments in their work, despite dramatic advances in psychotherapy over the past three decades

What does it mean for a speciality to be applied?

use of psychology to solve human problems, where you are working with patients on a regular basis

What is a forest plot and what purpose does it serve?

way of displaying data from a meta-analysis is by a pictorial representation; it displays the effectiveness of treatments or possible treatments