PSYCH 481 EXAM 1

How to get licensed

-Exam for Professional Practice in Psychology (EPPP) -Standardized MCQ exam on psychology topics -Scores vary from state to state -Practice books and review courses -The last thing you do after grad school -Gives right to practice independently

Informed consent

-Facilitates an educated discussion -Required during research, assessment, and therapy -What's the study looking at? What type of questions will be asked? What's the time commitment?

Axis V

-Global Assessment of Functioning (GAF) -Scale of 0-100

Direct Payment Effects on Diagnosis

-Not paid if disorder does not qualify for a diagnosis -Psychologists diagnose mild symptoms only when insurance companies pay

Axis II

-Personality disorders or mental retardation (D/O) -Also informs Axis I

Objective Tests

-Personality tests that are administered and scored in a standard way -Criticism: People may not be honest -MMPI 2 and MMPI -PAI -PIM

Eli Todd (1762-1832)

-Physician in Connecticut -Spread Pinel's work in U.S. -Opened the Retreat -Emphasized patient's strengths, not weaknesses -Similar Institutions opened in other U.S. states -Looked for cause of people's problems -Let patients have a say in their treatment

Therapy/Approaches to Clinical Psychology

-Psychodynamic approach: influenced by psychoanalysis -Behavioral approach: emphasizes empirical methods, quantifiable, children -Humanistic therapy: Carl Rogers, client and therapist are equals, genuine, UPR -Family therapy -Cognitive therapy: correct distorted thinking

Pros for prescription rights

-Psychologist would know the client better than a psychiatrist -Shortage of psychiatrists -Clin. Psychs are more expert than PCP -Other non-physician professionals already have prescription rights -Convenient for clients -Professional autonomy -Professional identification -Evolution of the profession -Revenue for the profession

Dr. Martin, a clinical neuropsychologist, works diligently to be accurate, honest, and truthful as he provides services to his patients. Which ethical principle is Dr. Martin upholding? A. beneficence and nonmaleficence B. integrity C. Respect for People's Rights and Dignity D. fair billing and reporting

B. integrity

Lightner Witmer (1867-1956)

-Born in Philly -Degree in business -Received Doc. in Psych under Wilhelm Wundt 1892 -Studied under James McKeen Cattell -Father of Clinical Psych -Worked with children -Found 1st clinic at U Penn -Defined clinical psych as related to medicine, education, social work -Stated need for trained individuals to practice clinical psych

Charles Spearman (1863-1945)

-British psychologist who advanced the theory that a general intelligence factor, called the g factor, is responsible for overall intellectual functioning -Measured children's perceptual abilities and correlated them with academic performance -A general intelligence thought to overlap with many other abilities

Burnout

-Causes: high involvement in high-stress jobs, exhaustion -Effects: decreased effectiveness to client, negatively impacts the therapist/psychologist -Actions: self care, varying duties, maintaining reasonable expectations, balance, know when to get your own therapy

Evidence-based Manualized Therapy

-Clinical decision making that integrates the best available research with clinical expertise and patient characteristics and preferences -An attempt to create standardization -Development and proliferation of therapy manuals -Change in terminology in listed therapies

Differences between Clinical and Counseling Psychologists

-Clinical: More likely to work in hospitals and work with more serious psychopathology -Counseling: More likely to work in universities and work with less pathological populations

What makes multiple relationships unethical?

-Criteria for impropriety -Impairment for psychologist -Exploitation and harm to client -Need for caution and foresight

William Tuke (1732-1822)

-Devoted life to improving conditions in asylums in England -Raised funds to open York Retreat -Tuke's family continued to run York Retreat after he died -Treated patients humanely

Education & Training of a Clinical Psychologist

-Doc. Degree -Bachelor's degree (4 yrs. of coursework, 1 yr. full-time pre-doc internship) -Master's Degree (thesis and dissertation)

Emil Krapelin (1856-1926)

-Father of Descriptive Psychiatry -Terminology -His terms set precedent for creation of diagnostic terms -Led to development of DSM

Aspirational

-General principles -Describes an ideal level of ethical functioning, or what to strive for

Psychiatrists

-Go to med school and prescribe meds -Licensed physicians -Trained emphasis on biology -Clinical psychologists fix issues using non pharmacological methods (meds in combination with meds)

Marriage and Family Therapists (MFTs)

-Has Master's -Training focus on couples, families, singles having problems with partners -Relatively little emphasis on research and assessment

Professional Counselor (LPC)

-Has master's -Complete training in 2 yrs. -Counsel people with problems of living or mild mental illness -Little emphasis on psychological testing or research -Often specialize in career, school, addiction, couples/family, or college counseling

Origins of Psychology

-Has roots to philosophers -Socrates, Aristotle, Plato -Rich but short history -Psychologists seen as "clinical psychologists" practicing psychotherapy or assessment

Competent

-Having the ability to do what is needed -Skilled and experienced

What is the dilemma with confidentiality and children/adolescents?

-How much do you reveal to the parents? -How do you keep the child safe and have their trust, but also keep the parents involved?

Ethics in Research

-Informed consent, freedom from coercion, protection from harm, risk-benefit analysis, deception, debriefing, confidentiality -Ethical obligations -Efficacy of psychotherapy

Social Workers

-Master's in social work (MSW) -Problems as products of social ills -Connect individuals with social services -Strong emphasis on supervised field work -Little or no use of research methods, psychological testing, or physiological psychology

Wechsler Adult Intelligence Scale (WAIS)

-Most widely used intelligence test; contains verbal and performance (nonverbal) subtests -Scale for Children (1949) -Wechsler Preschool & Primary Scale Intelligence (1967)

Psychotherapy

-Movement toward combining all approaches in eclectic or integrative ways -Influence of cultural competence on approaches

Direct Payment Effects on Psychologists

-Negative impact on practice and quality -Too much control bore clinical decisions -NO confidentiality -Decreased pay by managed care compared to self-pay by clients -Extra time spent on paperwork, phone calls, and other interactions -Denial of care to patients

Criticism of DSM

-No real epidemic of mental illness -Extends scope of mental disorders -No validity to concept of mental disorders

Axis IV

-Psychosocial and environmental problems -Homeless, divorced, etc.

DSM III

-Published in 1980 -The third edition of the Diagnostic and Statistical Manual for Mental Disorders -Etiologically neutral diagnostic criteria and a multi-axial system of diagnosis

DSM-5

-Published in 2013 -More than 300% increase of disorders from DSM to DSM IV -More scientific discovery and social intervention

3-Legged Stool for EBMT

-Research -Clinician's knowledge and capability -Qualities of client (culture and personal preferences)

Similarities between Clinical and Counseling Psychologists

-Same internship sites -Often same degree and licensure status

Advantages for EBMT

-Scientific legitimacy -Establishing minimal levels of competence -Training improvements -Decreased reliance on clinical judgement

Direct Payment Effects on Clients

-Self pay allows therapists and clients to make important decisions -Self pay is more affordable (therapy more attainable)

Clinical-Scientist Model

-Stress on scientific side of clinical psych. -Emphasis on scientific method and evidence-based clinical methods

Neurosis

-Suffer from some psychiatric symptoms -Reality in tact -Modern day anxiety

Dorthea Dix (1802-1887)

-Sunday school teacher in Boston jail -Firsthand witness to poor treatment -Collected city wide data on treatment -Efforts established state institutions across U.S.

Postdoc Intership

-Takes 1-2 yrs. -More responsibilities than predoctoral internships, but supervised -Opportunity for specialized training -Earn required number fo hours to get license

Effectiveness of tele-therapy depends on...

-Tele-psychology being used -Device of delivery -Setting -Specific referral knowledgable source -Live human support

Ethics in Clinical Assessment

-Test selection -Test security -Test data -Know which tests are up to date

Subjective Tests

-Tests made up of questions that evaluate overall understanding of material by requiring the test taker to write opinions or comments, such as short-answer or essay -Rorschach Inkblot Method -Thematic Appreciation Test -Process-oriented task -Reveal unconscious stuff

Cultural Competence

-The ability to interact effectively with people of different cultures, identities, and backgrounds -Age, gender, race, religion, sexual orientation, socio-economic status

Clinical Psychology

-The branch of psychology concerned with the diagnosis and treatment of psychological problems and disorders. -More severe diagnoses -APA Definition: integrates science, theory, and practice to understand, predict, and alleviate maladjustment and personal development

Disadvantages for EBMT

-Threats to psychotherapy relationship -Diagnostic complications -Restrictions on practice -Debatable criteria for empirical evidence (there is supporting data for EBMT, but it's hard to quantify some forms of therapy) -EBMT best suited for cognitive-behavioral

In what areas can psychologists prescribe meds

-Underserved areas -Military bases -Guam (Comes with tremendous liability)

Psychosis

-Demonstrating break from reality delusions, hallucinations, disorganized thinking

Axis III

-Medical conditions -Can tell something about the etiology of Axis I

Tarasoff Case and Duty to Warn

-When a therapist who has reason to believe that a client is dangerous to someone must warn the endangered person or take other steps to prevent harm -Duty to warn and protect -From the first encounter, let a client know when confidentiality will be broken

How well do tele-psychology applications work?

-Works as well as traditional forms -Weaker client/therapist relationship, but reduction of symptoms are somewhat equal

______, a term coined by Emil Kraepelin, described a cluster of symptoms similar to what is now known as schizophrenia. A. Dementia praecox B. Paranoia C. Depressive psychosis D. Cyclothymic personality

A. Dementia praecox

The current edition of the APA ethical code includes two distinct sections: ______ and ______. A. General Principles; Ethical Standards B. Research Standards; Practice Standards C. Assessment Code; Treatment Code D. Aspirational Goals; Enforceable Principles

A. General Principles; Ethical Standards

At the first psychological clinic, the patients were primarily ______. A. children with school-related problems B. adults with personality disorders C. children and adults with depression D. couples experiencing relationship problems

A. children with school-related problems

The current edition of the DSM contains "proposed criteria sets." These sets are ______. A. descriptions of proposed disorders that may become official disorders in a future DSM edition B. list of disorders that will be eliminated in a future version of the DSM C. diagnostic aids to assist clinicians in distinguishing between disorders with similar presentations D. a new classification system for personality disorders

A. descriptions of proposed disorders that may become official disorders in a future DSM edition

The MMPI ______. A. is an objective test of personality B. was created prior to the Rorschach Inkblot test C. is a projective test of personality D. is modeled after the Thematic Apperception Test

A. is an objective test of personality

In 1800s Europe, mental illness was initially placed in one of two categories: ______, psychiatric symptoms, or ______, breaks from reality. A. neuroses; psychoses B. psychoses; neuroses C. exogenous disorders; endogenous disorders D. endogenous disorders; exogenous disorders

A. neuroses; psychoses

Some studies of manualized therapy have found that therapists who demonstrate flexibility while using manuals ______. A. produce better client outcomes and are more successful in getting clients engaged in therapy B. produce worse client outcomes and are less successful in getting clients engaged in therapy C. cause irreparable harm to clients D. are subject to malpractice lawsuits

A. produce better client outcomes and are more successful in getting clients engaged in therapy

The first APA code of ethics was published in ______. A. 1896 B. 1953 C. 1990 D. 2002

B. 1953

______'s 1950s assertion that therapy had no positive outcome helped to jump start what has evolved into the evidence-based practice movement. A. Raymond Cattell B. Hans Eysenck C. William F. Buckley D. Patrick H. DeLeon

B. Hans Eysenck

Eli Todd is most notable for ______. A. creating an inkblot personality test that is still used by many clinical psychologists B. advocating for humane treatment of the mentally ill in the United States C. coining the term clinical psychology D. creating the first widely used test of intelligence

B. advocating for humane treatment of the mentally ill in the United States

Compared to PhD programs, PsyD programs ______. A. typically place greater emphasis on research-related aspects of training B. are more often housed in "professional schools" rather than departments of psychology in universities C. prepare their graduates to work as researchers in academic settings D. are more likely to require a research-based dissertation

B. are more often housed in "professional schools" rather than departments of psychology in universities

Once a clinical psychologist is licensed, many states require the accumulation of a specific number of ______ in order to renew the license. A. postgraduate courses B. continuing education units C. seminar certificates D. state board phone conferences

B. continuing education units

Josephine is an undergraduate student wants to increase her odds of getting into a clinical psychology graduate program. Based on recommendations provided in the textbook, which of the following is the best advice you could provide to Josephine? A. avoid undergraduate courses in statistics and research methodology. These classes often lower an applicant's GPA B. get to know your professors. Build a positive, professional relationship with them so they can write meaningful, persuasive letters of recommendation for you C. limit yourself to one road to becoming a clinical psychologist. For example, once you have decided you want to earn a PhD from a scientist-practitioner program, do not consider other training options D. do not seek out clinically relevant experience while an undergraduate. Graduate programs prefer to train "fresh" graduate students, not students who have already acquired some skills through part-time experiences

B. get to know your professors. Build a positive, professional relationship with them so they can write meaningful, persuasive letters of recommendation for you

The number of health insurance/managed care companies that pay for psychotherapy services has ______. A. decreased since the earliest days of psychotherapy B. remained constant throughout the history of psychotherapy C. increased since the earliest days of psychotherapy D. not yet occurred, but is expected to begin within the next decade

C. increased since the earliest days of psychotherapy

Since the first edition of the APA ethics code, ______ revised editions of the ethical code have been published. A. zeroth B. second C. ninth D. 20

C. ninth

The Rorschach Inkblot Method is best identified as a(n)______. A. projective intelligence test B. objective intelligence test C. projective personality test D. objective personality test

C. projective personality test

Why is there emphasis on confidentiality?

Critical for developing trust

The most recent edition of the APA ethics code was published in ______. A. 1962 B. 1976 C. 1990 D. 2002

D. 2002

______ authorizes a psychologist to practice independently. A. Successful completion of the predoctoral internship B. Successful completion of the postdoctoral internship C. Successful completion of all graduate courses in an APA-accredited graduate program D. Licensure

D. Licensure

______ was the first person to operate a psychological clinic. A. Richard McFall B. Abraham Maslow C. Alfred Adler D. Lightner Witmer

D. Lightner Witmer

Which of the following is NOT among the ethical principles listed in the most recent edition of the APA ethical code? A. beneficence and nonmaleficence B. integrity C. Respect for People's Rights and Dignity D. fair billing and reporting

D. fair billing and reporting

According to the most recent edition of the APA ethical code, it is necessary to obtain ______ before proceeding with research, psychotherapy, or assessment. A. consent B. assent C. informed assent D. informed consent

D. informed consent

Guidelines regarding the use of new technologies by clinical psychologists include all of the following EXCEPT ______. A. obtain informed consent from clients about the services they may receive, the technologies that may be used to provide them, and the confidentiality of the communication B. ensure client confidentiality as much as possible by using encryption or similar methods C. be knowledgeable about emergency resources in any community from which your clients may seek services D. offer clients the option of using secure methods for conducting therapy sessions online

D. offer clients the option of using secure methods for conducting therapy sessions online

Compared to clinical psychologists, professional counselors ______. A. earn a master's degree rather than a doctoral degree B. place a higher emphasis on psychological testing C. are more likely to conduct extensive research in their training programs D. often specialized in career, school, or addiction counseling

D. often specialized in career, school, or addiction counseling

Tatiana Tarasoff ______. A. is the chair of the committee that created the most recent edition of the APA code of ethics B. was the author of the tripartite model of personal identity C. is a leading researcher in the field of informed consent for psychotherapy D. was a college student whose murder resulted in the creation of the duty to warn

D. was a college student whose murder resulted in the creation of the duty to warn

Exogenous Disorders

Emil Kraepelin's term for disorders caused by external factors

Endogenous Disorders

Emil Kraepelin's term for disorders caused by internal factors

How might small communities impact the effectiveness of therapy?

It's more common to run into a multiple relationship dilemma

Axis I

Primary psychiatric diagnosis

Influence of the Pharmaceutical Industry

-Drug companies have stake in the way mental disorders are defined -Prefer broader definitions (more people need meds) -DSM authors are on payrolls of pharmaceutical companies (Tons of psychiatrist and psychologist authors)

Cons for prescription rights

-Entire model of training would have to change dramatically -Threats to psychotherapy -Identity confusion -Potential influence of pharmaceutical industry -Psychiatrists highly specialized vs. PCP

Enforceable

-Ethical principles -Emphasizes specific rules of conduct that can be violated

A clinical psychologist who is sufficiently capable, skilled, experienced, and expert to adequately complete the professional tasks they undertake is fulfilling the ethical standard of ______. A. resolving ethical issues B. competence C. multiple relationships D. justice

B. competence

Alfred Binet and Theodore Simon

-Binet-Simon Scale (1905) -IQ= mental age / chronological age -Revised by Lewis Termin as Stanford-Binet Intelligence Scales

Edward Lee Thorndike (1874-1949)

"Each person possesses separate, independent intelligence."

DSM

- Published by APA in 1952 -Defined and organized mental illnesses

DSM II

- Published in 1968 -First revision of DSM -Provides common language for talking about disorders

Philippe Pinel (1745-1826)

-"Liberator of mentally ill" -Worked to move mentally ill out of dungeons in France -Convinced contemporaries that mentally ill were not possessed -Created institutions that were much kinder -Advocated maintenance of patient case history, ongoing treatment notes, and illness classifications -Treatise on Insanity -Turned down Napoleon's request to be personal physician

Predoctoral Internship

-1 yr. of supervised clinical experience in an applied setting -Considered year of transition

APA Code of Ethics

-1st published in 1953 -9 subsequent revisions -Applies to all specialties -Psychologists were consultants for US Gov. for terrorists interrogations

Scientist-Practitioner (Boulder) Model

-2 pronged approach to training -Practice and Research

Practitioner-Scholar (Vail) Model

-A model of training of professional psychologists that emphasizes clinical practice. -Less training in research -More towards practice

Multiple Relationships

-A psychologist has a professional relationship with an individual and also has another type of relationship with the same person or has a relationship with someone closely associated with the person -Can be problematic -Ethical standard 3.05 -Sexual and non-sexual relationships -You can't promise a relationship after therapy is over

Applications of Technology in Clinical Psych

-Accessibility -Affordability -Anonymity -Acceptability -Adaptability

Based on current reviews and meta-analyses, we can say that telepsychology generally appears to work ______. A. about as well as in-person forms of psychotherapy B. far worse than in-person forms of psychotherapy C. far better than in-person forms of psychotherapy D. we cannot compare telepsychology and in-person psychotherapy because no studies exist on this topic

A. about as well as in-person forms of psychotherapy