Clinical psychology Midterm. Chapters 1-7, 10 & 15

Paul Meehl

"If people with certain disorders tend to answer a variety of questions in a certain way (as a group), this pattern may predict who else has this disorder. The content of the questions becomes irrelevant". when clinicians are given access to information that they typically receive, such as interview impressions, the gap between statistical and clinical prediction remains

APA Division 12 Definition of Clinical Psychology

"The field of Clinical Psychology integrates science, theory, and practice to understand, predict, and alleviate maladjustment, disability, and discomfort as well as to promote human adaptation, adjustment, and personal development. Clinical Psychology focuses on the intellectual, emotional, biological, psychological, social, and behavioral aspects of human functioning across the life span, in varying cultures, and at all socioeconomic levels." (APA, 2012)

Benjamin Rush

"father of American Psychiatry" developed humane approaches to treatment Advocated such antiquated treatments as bloodletting and an immobilizing "tranquilizer" chair

DSM-III

(a) explicit diagnostic criteria, and (b) algorithms, or decision rules, for combining these criteria into a diagnosis. The criteria—which referred mainly to the presence of specific symptoms and symptom durations—became more numerous and more specific in subsequent editions, This system not only helped to guide clinicians' diagnostic decisions, but greatly facilitated research on psychopathology by ensuring that when a researcher publishes an article about, say, "bipolar disorder,"

Individual differences Charles Darwin

(a) variation of individual characteristics occurs within and between species (including humans); (b) natural selection takes place in part on the basis of those characteristics.

Clinical attitude/approach

- Needed to be a clinical psychologist - Experience - Competent testing (board and oral exam) A desire to combine knowledge from research on human behavior and mental processes in general with efforts at individual assessment and treatment.

burden of mental illness

-primary burden is the illness itself -secondary is the stigma attached to mental disorders -lack of parity in insurance coverage- no insurance- no access to care- very hard to treat -companies do not treat mental illness like physical illness -economic costs to individual and society -1 in 4 adults experiences a mental health disorder in a given year -early identification is key to prevent debilitation and suicide the burden of mental illness highlights the necessity of considering alternative treatment models in which therapy is delivered: (a) by closely supervised bachelor's-level paraprofessionals, (b) via empirically validated "apps" that are supplemented by occasional meetings with psychologists, (c) through the use of internet-based self-help instructional materials, (d) in group therapy formats, and so on

Ethical Standards

1 Resolving Ethical Issues 2 Competence 3 Human Relations 4 Privacy & Confidentiality 5 Advertising & Public Statements 6 Record Keeping & Fees 7 Education & Training 8 Research & Publication 9 Assessment 10 Therapy

Carl Rogers

1902-1987; Field: humanistic; Contributions: founded person-centered therapy, theory that emphasizes the unique quality of humans especially their freedom and potential for personal growth, unconditional positive regard, fully functioning person he disliked the idea of being a detached expert whose task is to dig into the past and "figure out" the client's problems. he saw it as vital to see the world from his clients' point of view, must concentrate on one purpose only: that of providing deep understanding and acceptance of the attitudes consciously held at this moment by the client as he explores step by step into the dangerous areas which he has been denying to consciousness. Noticed most people are so eager to gain the approval of their family, friends, supervisors, and others that they will do what is necessary to get it,

efficacious

2 experiments show that they are superior to a wait-list control meets criteria of a well-established treatment, but may not have been replicated small single case series that meets criteria for well-established.

well-established treatments

2 good between-group experiments that show effectiveness by: showing superiority to placebo or treatment or proves to be just as good as a treatment that has already been established. A large single case series design (n=9) that has a good experimental design and comparison of this treatment to another treatment, use of treatment manuals or descriptions of treatments, description of the sample, replicated by 2 investigators/teams.

How do you go about working in private practice?

3 models: Solo practice (own entire practice and pay for everything) Group practice (join forces and share costs) Mixed-model (work together but legally and financially independent)

Nuts and Bolts of Group Therapy

6-12 members At least one therapist Could be similar (or different) in: Age Sex Psychiatric issue Type of problem Typically 1-2 hours Open or closed to new members Clients often enrolled in individual therapy (or on a waitlist for individual therapy)

Ethical Standards regarding Research

7.01 Design of Education and Training programs 7.04 Student Disclosure of Personal Information 7.05 Mandatory Individual or Group Therapy 7.07 Sexual Relationships with Students and Supervisees 8.01 Institutional Approval 8.02 Informed Consent to Research 8.08 Debriefing 8.10 Reporting Research Results 8.15 Reviewers

Respect for People's Rights and Dignity

: Psychologists respect the dignity and worth of all people, and the rights of individuals to privacy, confidentiality and self-determination

Rational Emotive Therapy

A Cognitive Therapy based on Albert Ellis' theory that cognitions control our emotions and behaviors; therefore, changing the way we think about things will affect the way we feel and the way we behave.

Clinical science model

A clinical psychology training model that emphasizes empirically supported approaches to assessment, prevention, and clinical intervention. This model arose from concerns that clinical psychology was not firmly grounded in science.

general paresis

A deteriorating brain syndrome that had once been considered a form of insanity. Disease that leads to paralysis, insanity, and eventually death; discovery of this disease helped establish a connection between biological diseases and mental disorders Caused by syphillis

Preditction

A final goal of clinical assessment is to make predictions about human behavior. predictions might include forecasts about how the symptoms of a client's disorder might change with or without treatment prognosis), about future performance (descriptions of how someone will perform in a given job or situation), or about dangerousness (the likelihood that people will behave violently toward themselves or others). clinicians must obtain valid information about how the characteristics revealed by assessment relate to the behavior being predicted.

managed care

A health care system whose goals are to provide cost effective quality care.

Social work

A human service specialty whose practitioners employ various psychotherapy techniques, but also focus on how social and situational variables affect their clients' functioning. specialize in direct services to clients, or they may specialize in community services. Including hospitals, businesses, community mental health centers, courts, schools, prisons, and family service agencies.

Conditions of Worth (Rogers)

A person receives positive feedback from others (and, ultimately, from themselves) only when they express certain approved behaviors, attitudes, and beliefs.

referral source

A person who recommends home care services and supplies the home healthcare agency with details about the patients needs.

randomized clinical trial (RCT)

A procedure for evaluating the outcome of therapy, usually involving random assignment of participants to one or more treatment groups or a no-treatment control group. Current gold standard for treatment outcome studies Between subjects study design - can also look within MUST HAVE: Homogenous samples of clients Homogenous clinical problems Random assignment to conditions (for between subjects) Carefully monitored treatment regimens (make sure treatment is standardized)

Carl Jung's Word Association Test

A procedure for investigating how word meanings are stored in memory. In a word association test, the researcher presents a series of words to individual respondents. For each word, participants are instructed to respond with the first word (i.e., associate) that comes to mind.

To prove malpractice, four elements must be established:

A special relationship (i.e., service in exchange for fees) existed Clinician was negligent in treating the client. Negligence involves violation of a standard of care. The client suffered harm The therapist's negligence was the result of that harm

psychological test

A standardized measure of a sample of a person's behavior.

factor analytic approach

A statistical method often used in test construction to determine whether potential items are or are not highly related to each other.

Social systems approach

A view which highlights the clients' roles in various social networks and the resulting need to use assessment and treatment methods (such as group, family, or couples therapy) that take into account the social and cultural forces operating within those networks.

Scientific thinkng

A way of thinking that helps to minimize error in the conclusions we draw from evidence.

intelligence tests

Adults: WAIS-IV Stanford Binet-5 Kids: WISC-V WPPSI-V (preschooler age)

Mary Cover-Jones "Little Peter"

After hearing Watson lecture about Little Albert, she wondered if conditioning could be used to eliminate rather than create anxiety, The fearless examples set by these children helped Peter become more comfortable with the rabbit, but his treatment was interrupted by illness. Ex. Direct conditioning

Wechsler Scales (WAIS-IV, WISC-5, WPPSI)

All scales made by the Wechsler group Still get a full-scale IQ -combination of 4 factor scores Also get a General Ability Index score (GAI) that is only based on the 2 strongest factors Be wary of assessor bias in IQ testing (McDermott, Watkins, Rhoad, 2014)

Emotion-focused therapy

Also known as process-experiential therapy; in this therapy, emotion is viewed as centrally important in the experience of self, as either adaptive or maladaptive, and as the crucial element that brings about change and management of emotional experiences

humanistic approach

An approach to psychology emphasizing a person's positive qualities, the capacity for positive growth, and the freedom to choose any destiny. As individuals with an innate drive toward personal growth, a tendency for self-actualization.

Semi-structured interview

An interview in which questions are posed in a standardized yet flexible way. Humanistic clinicians tend to establish the least interview structure. Allows client to take some lead way but is redirected by questions the clinician has to ask. And clarifies the answer of the client.

nondirective interview/unstructured interview

An interview in which the client is allowed the maximum amount of freedom in determining the course of the discussion, while the interviewer carefully refrains from influencing the applicant's remarks clinician asks open-ended questions and does as little as possible to interfere with the natural flow of the client's speech and choice of topics. behavioral and cognitive behavioral clinicians are likely to be the most verbally active and directive. Allows client to take most of the lead in the interview. Clinician may repeat what client has said to clarify.

scientific attitude

Apply scientific approaches to understanding psychological distress

Culture and diversity

Assessment methods may not be appropriate for use with people from sociocultural groups on which those methods have not been standardized. Awareness of the role of culture in assessment results is one of the core competencies in clinical assessment that clinicians should possess.

analytic approach (rational approach)

Based on what items seem sensible to include. procedure in which items are chosen because they appear on logical grounds to measure the characteristic of interest to the tester. develop a test of racial prejudice. Their first step would be to ask themselves what kinds of test items are likely to be answered differently by people who are and are not prejudiced. analytic method often results in items that appear sensible but may or may not work

empirical appraoch

Based on which items are answered differently by people who differ on some characteristic of interest. data-based, so instead of deciding ahead of time what test content should be chosen to measure a particular target, testers who employ an empirical approach allow data to guide their choice of items. empirical approach more desirable, especially when attempting to make specific predictions about people. empirical approach more desirable, especially when attempting to make specific predictions about people. empirical approach often results in items that work but may not appear sensible.

Couples therapy

Behavioral couples therapy and emotion-focused couples therapy

Family therapy

Behavioral interventions (short-term benefits)

Example: Parent-child interaction therapy (PCIT)

Behavioral parent training that is based on attachment theory Directly coaches parents how to interact with children Use bug-in-the-ear techniques!

Binet-Simon Test

Binet's later work with Théodore Simon led to the development of the first formal intelligence test, the Binet-Simon scale Binet would surely be dismayed by the extent to which people mistakenly assume that intelligence test scores reflect a fixed number that perfectly captures people's cognitive abilities. Binet-Simon scale in recognition of the contributions of his colleague Théodore Simon—consisted of 30 questions and tasks, including things like unwrapping a piece of candy, following a moving object with the eyes, comparing objects of differing weights, repeating numbers or sentences from memory, and recognizing familiar objects. A child's score on this test was simply the number of things passed a child's "mental level," later called mental age, by determining the age level of the most advanced items that the child could consistently answer correctly.

McFall Manifesto

Cardinal Principle: scientific clinical psychology is the only legitimate form of clinical psychology First Corollary: services should be described clearly, validated, and the benefits must outweigh the risk Second Corollary: doctoral training programs must produce most competent clinical scientists possible

sequential system approach

Choosing items analytically, and then evaluating them empirically analytical and emperical

Monumental case: Tarasoff vs. Regents of the University of California

Client disclosed to his therapist he planned to kill a woman who rejected him romantically He later killed the woman, and the therapist did not warn the woman about the threat Duty to protect society applies to laws in 37 states

virtual reality assessment

Client is exposed to a realistic simulation run by a computer self-report measures, conduct behavioral observations, and collect physiological measures or other assessment indices.

Social influence (demand characteristics)

Clients are more likely to show intense fear during a BAT if the test is described as a test of fear than as a test of, say, human-animal communication.

Prescription Privileges

Clinical psychologists remain at odds with psychiatrists  Advantages: Medication is a frequent consideration See clients more frequently May not have access to a psychiatrist Criticisms: Existing training might not be enough Could be a health hazard We should do formal training (such as nurse practitioner) Tilt us more to a biomedical model Might overprescribe

Boulder Model (Scientist-Practitioner Model)

Clinical psychologists should be proficient in research and professional practice Earn a Ph.D. from a university Complete a 1 year long internship

objective test

Clinician scoring and interpretation is minimal Less ambiguous test stimuli (e.g., no blobs to interpret) Roots in empirical tradition

Depression treatment Behaviorally oriented

Clinicians might help Rachel learn to recognize the social situations in which she feels most anxious and to practice dealing with those situations in ways that allow her to manage her anxiety well enough as to no longer feel compelled to avoid or escape them.

Depression treatment Humanistically oriented

Clinicians would focus on helping Rachel to become aware of how conditions of worth, both in her family and in her peer group, may have led her to behave in ways designed mainly to gain approval, though at the cost of distorting her genuine feelings and impairing her personal growth.

Depression treatment Psychodynamically oriented

Clinicians would probably speculate about conscious and unconscious conflicts that motivate Rachel's behavior. They might use free association, dream analysis, and other therapy techniques described

intelligence

Cognitive abilities that include abstract thinking and reasoning, adaptive problem-solving, and capacity to learn. (a) abstract thinking or reasoning abilities (such as manipulating symbols and concepts); (b) problem-solving abilities that are adaptive for survival; and (c) the capacity to acquire new knowledge; that is, to learn

Depression treatment Cognitive behavioral

Cognitive behavioral clinicians would supplement the behavioral approach by including efforts in their therapy sessions to help Rachel identify and re-evaluate some of her self-defeating thoughts or dysfunctional beliefs and assumptions

Cognitive Behavioral Group Therapy

Cognitive-behavioral techniques are used 5x more than other techniques in group therapy In first session, emphasize: -confidentiality limits -group rules regarding time monopolizing, over-sharing, Sessions typically focus on psychoeducation and skill-building

Lightner Witmer

Coined the term 'clinical psychology' Helped Charles Gilman, (chronic bad speller) Decided to "take the case," and thus—probably without realizing it—became the world's first clinical psychologist. Proposed that there should be a field called clinical psychology Charles's case of visual verbal amnesia led to the establishment of what became the world's first psychological clinic. Witmer set up a residential school for training children with intellectual disabilities. Founded and edited the first clinical psychology journal (the psychological clinic) . Witmer first described his new branch of psychology in a talk at the 1896 American Psychological Association Emphasized that clinical psychology practices should be built on solid scientific evidence Focused mainly on psychological problems that have since become more strongly associated with school psychology, vocational counseling, speech therapy, and remedial education than with clinical psychology

4 Horseman of Professional Ethics

Confidentiality: the therapist protects the client's privacy and does not reveal information that the client shares in therapy Competency: The clinician will be professionally responsible and practice only within areas of expertise Consent: We are obligated to inform clients of limits to confidentiality, potential outcomes to treatment, and anything else about therapy PRIOR TO their enrollment Conflict of Interest: the therapist's personal interests compete with the best interests of the client - problematic because it impairs OBJECTIVITY

Remain unbiased!

Couples may try and 'get you on their side' Don't do that. Avoid it by: Don't take sides Don't proceed until the problem and goal was clarified Discuss problems concretely Don't discount problems Don't get hooked on the past Keep taking charge of the session

Critics of the traditional psychological diagnosing

Critics see signs and symptoms as superficial evidence of the psychological and neural processes that underlie disorders, but do not provide information about the processes themselves With these criticisms in mind, clinical psychologists and psychiatrists are developing a number of alternative approaches to diagnosis.

Ethnic and Cultural issues

Cultural differences between clients and interviewers require sensitivity, particularly when clients' cultural assumptions, values, and practices do not fit well with those of the mental health services offered. Members of racial and ethnic minority groups generally receive less mental health care and lower-quality mental health care than does the general population key reasons for underutilization of mental health care relate to limits on access to services whereas others relate to cultural norms and misunderstandings that can derail the interview process Cultural norms stigmatize disclosure of problems and emotions to strangers, or dictate that they be discussed only with spiritual leaders, medical personnel, or trusted There is also evidence that members of racial minority groups are underrepresented in research on psychopathology It can be just as easy for a naïve clinician to mistakenly assume that an Asian client's reluctance to disclose personal information is evidence of resistance or lack of insight rather than a cultural prohibition Misunderstanding of the meaning of spoken and body language seems to be an especially important problem.

Malingering

Deliberate faking of a physical or psychological disorder motivated by gain.

Treatment

Designed to help people better understand and solve distressing psychological problems. These interventions might be described as psychotherapy, behavior modification, psychological counseling,

Personality tests: Minnesota Multiphasic Personality Inventory (MMPI)

Developed in Minnesota in the 1930s Clients respond to True/False questions  Looked for differences between "Minnesota normal" and psychiatric patients 550 items and 4 validity scales

Alfred Binet

Developed the first practical Intelligence test: the Stanford Binet IQ test French lawyer and scientist, was another key figure in the mental testing movement. Binet and his colleague Victor Henri developed a battery of mental tests for both typically developing children and those with intellectual disabilities. Tested space judgment, motor skills, muscular effort, and memory, but also comprehension, attention, suggestibility, aesthetic appreciation, and moral values.

Treatment Utilization

Disorders occur at any point in life, but the more serious disorders usually start early - symptoms often appear by age 14 HOWEVER not everyone seeks treatment (Minority and low SES groups less likely to seek treatment or finish it) Those seeking outpatient psychotherapy are more likely to be: Middle aged, educated, white, female, divorced or separated, to have public insurance and to be unemployed

Ph.D. Vs Psy.D.

Doctorate of Philosophy 312 of them (as of 2019) Smaller class & more financial aid Higher internship acceptance rate Higher EPPP scores Doctorate of Psychology 93 of them (as of 2019) Larger class sizes Accept more (lower GPA means & lower GREs) Less financial aid

Supernatural clinical psychology

Early explanations of disordered behaviors involved possession by demons or spirits third main source of clinical psychology's emergence and growth is the centuries-old desire to understand and change human behavior that appears bizarre, irrational, or otherwise disordered.

Measuring the validity of observational assessment

Ecological: Does observed behavior accurately represent client's behavior in other situations? Convergent: correlation between observational data and evidence from other sources (e.g., family). Predictive: Does observational data accurately forecast client's behavior?

Therapist Features

Education Training Theoretical orientation Experience Strong interpersonal and communication skills Sense of ethics and profeissionalism Willingness for introspection and self-reflection Cultural sensitivity Empathy, Social justice orientation

Group therapy

Effective for many disorders with strong TA & group cohesion

How you know a therapy works

Efficacy: Controlled and standardized, determines if outcomes result from an intervention in a laboratory setting (high internal validity) Effectiveness: Effects from an intervention when applied to a context similar to the intended real-world use (high external validity)

Consulting

Entails such a challenging combination of activities that some clinicians find the work so personally and financially satisfying that it becomes their full-time job. Suggest and develop new procedures for screening candidates for various jobs within an organization, set up criteria for identifying promotable personnel, Offering education, advice, assessment, treatment, evaluation, and conflict resolution.

Salt Lake City Conference of 1987

Established standardized curriculum for training programs Graduate students must be trained in knowledge of: Statistics Ethics Assessment Individual differences History and systems Biological Social Cognitive/affective

Ethical standards vs state laws: Duty to Warn

Ethics code is generally consistent with state laws, but not always, so it's best to follow the more stringent of the two A large number of states adopt the ethics code as law - this wasn't always the case

clinical prediction

Expert prediction relying on an understanding of the linkages between causes and effects. Drawing clinical inferences based primarily on intuition, informal observations, assumptions, and experience.

Common Factors

Factors present in all therapies, regardless or orientation or protocol Client variables: -more open to therapy -less resistant in session Relationship variables: -high therapeutic alliance and rapport Therapist Variable - therapist characteristics or behaviors Variables that were the most effective (had the best outcomes for treatment): Higher levels of empathy Collecting client feedback

Depression treatment Social Systems

Family sessions would surely be scheduled by clinicians who take a social systems approach, because they would want to focus specifically on how family dynamics influence Rachel's problems.

State that allow CPs to prescribe

First, Guam, Military Services, and Indian Health Service could prescribe (APA, 2011) As of 2020, Iowa, Idaho, Illinois, New Mexico, & Louisiana are states that have prescription privileges

Step 3: Closing the interview

First, the impending conclusion of the interview is signaled. Second, the client is praised for cooperativeness and reassured that the clinician recognized how stressful the interview was (emotional support). Third, the suggested plan for the final minutes invites the client to ask questions or make comments that may be important but had not yet been expressed. Some clients wait until the end of the interview to reveal this kind of information because they want the clinician to know about it, Others might just let the information slip out because the interview "feels" over and they feel less guarded. We didn't talk about that today, but maybe next time we can. I hope things turn out well for you.

Descriptive assessment: psychodynamic therapist

Focus descriptive assessment on her ego strengths and weaknesses, her cognitive functioning and defense mechanisms, the quality of her early parental relationships and current relationships with family and friends, and the characteristics of her sense of self

Couples & Family Therapy

Focus is on the disturbance within the relationships - not individual problems Who is the client then? Can you diagnose a relationship with a disorder?

Descriptive assessment: Cognitive behavioral therapist

Focus on identifying factors such as antecedent conditions, environmental incentives and disincentives in her life, on alternative sources of reward, and on her thinking style, such as the types of attributions she makes for situations and whether she shows a bias toward certain kinds of judgments

Psychoanalysis Therapy

Freudian therapy designed to bring unconscious conflicts which usually date back to early childhood experiences into consciousness.

John B. Watson

Furthered Pavlov's concepts and pioneered behaviorism Working with Rayner, Watson championed psychology as the science of behavior and demonstrated conditioned responses on a baby who became famous as "Little Albert" to fear a harmless laboratory rat Ex. Classical conditioning

Franz Gall

Gall thought he saw a relationship between his schoolmates' mental characteristics and the shapes of their heads. He believed certain parts of the brain is associated with a different "faculty" or function (self-esteem, kindness, or religiosity, for example). A few of Franz Gall's ideas turned out to be correct.

Clinical research

Gathering and analyzing evidence related to disorder, assessment, and treatment; an activity that helps clinicians stand out from other health service providers.

Family Therapy

Goal: change patterns of family interaction to correct the disturbances Typically begins by focusing on one family member who is having problems Therapist's role: re-frame the family disturbance and ask everyone to reflect on their contribution As its often kids who are blamed, a lot of family therapy uses behavioral targets

MMPI-2 (1989)

Goals: 1 ) New standardization sample (2600 people) with gender norms 2) Test out new items (final item count = 567) Most widely used assessment of clinical symptoms and personality Still had clinical scales, but augmented with code types (i.e., profiles based on two or three highest scales) E.g., 49/94 - impulsive, extraverted, sensation-seeking, antisocial tendencies

More than half the US population is expected to be a minority background in 2050 But, only 28% of first-year graduate students in psychology are non-white Need to train students to competently (i.e., humbly) deal with issues of diversity and multiculturalism

Guideline 1. Psychologists seek to recognize and understand that identity and self-definition are fluid and complex and that the interaction between the two is dynamic. To this end, psychologists appreciate that intersectionality is shaped by the multiplicity of the individual's social contexts. Guideline 2. Psychologists aspire to recognize and understand that as cultural beings, they hold attitudes and beliefs that can influence their perceptions of and interactions with others as well as their clinical and empirical conceptualizations. As such, psychologists strive to move beyond conceptualizations rooted in categorical assumptions, biases, and/or formulations based on limited knowledge about individuals and communities. Guideline 3. Psychologists strive to recognize and understand the role of language and communication through engagement that is sensitive to the lived experience of the individual, couple, family, group, community, and/or organizations with whom they interact. Psychologists also seek to understand how they bring their own language and communication to these interactions. Guideline 4. Psychologists endeavor to be aware of the role of the social and physical environment in the lives of clients, students, research participants, and/or consultees. Guideline 5. Psychologists aspire to recognize and understand historical and contemporary experiences with power, privilege, and oppression. As such, they seek to address institutional barriers and related inequities, disproportionalities, and disparities of law enforcement, administration of criminal justice, educational, mental health, and other systems as they seek to promote justice, human rights, and access to quality and equitable mental and behavioral health services. Guideline 6. Psychologists seek to promote culturally adaptive interventions and advocacy within and across systems, including prevention, early intervention, and recovery. Guideline 7. Psychologists endeavor to examine the profession's assumptions and practices within an international context, whether domestically or internationally based, and consider how this globalization has an impact on the psychologist's self-definition, purpose, role, and function. Guideline 8. Psychologists seek awareness and understanding of how developmental stages and life transitions intersect with the larger biosociocultural context, how identity evolves as a function of such intersections, and how these different socialization and maturation experiences influence worldview and identity. Guideline 9. Psychologists strive to conduct culturally appropriate and informed research, teaching, supervision, consultation, assessment, interpretation, diagnosis, dissemination, and evaluation of efficacy as they address the first four levels of the Layered Ecological Model of the Multicultural Guidelines. Guideline 10. Psychologists actively strive to take a strength-based approach when working with individuals, families, groups, communities, and organizations that seeks to build resilience and decrease trauma within the sociocultural context.

Ethical considerations in Assessment

Having this access places a heavy responsibility on the clinician to use and report this privileged information in a fashion that safeguards the client's welfare and dignity. (a) how psychological assessment data are being used; (b) who should have access to confidential material; and (c) the possibility that improper or irresponsible interpretation of assessment information will result in negative consequences for clients. clinicians must first be sure that their inquiries do not constitute an unauthorized invasion of a client's privacy. they do not always know who might gain access to assessment information once that information is transmitted to a referral source. When test scores, conclusions, predictions, and other information are communicated in a report, they may be misused by people who are not qualified to interpret that report. Clinicians must also take care to ensure that assessment goals are not socially or culturally biased such that certain clients, including members of ethnic or racial minorities, are placed at a disadvantage

The king of alliance: Carl Rogers

He discussed how to build rapport by finding their humanity and seeing them as people

HiTOP

Hierarchical Taxonomy of Psychopathology to describe most or all mental disorders in terms of extremes of one or more broad personality dimensions, thereby merging the traditionally disconnected fields of personality and psychopathology

Hippocrates

Hippocrates boldly proposed that these conditions stem from natural causes, not supernatural ones. Believed behavior disorders is distribution of four bodily fluids, or humors: blood, black bile, yellow bile, and phlegm.

Eclectism

Holding no clear or coherent theoretical orientation to guide one's view of disorder, and being willing to draw on various techniques combine approaches in reasonable ways rather than to strictly segregate them.

content validity

Icluding all of the relevant aspects of a target domain

Case study guide

Identifying data, including name, sex, occupation, income (of self or family), marital status, address, date and place of birth, religion, education, cultural identity. 2. Reason for appearance or referral, expectations for service. 3. Present and recent situation, including dwelling place, principal settings, daily activities, number and kinds of life changes over several months, impending changes. 4. Family constellation (family of origin), including descriptions of parents, siblings, other significant family figures, and client's role growing up. Early recollections, descriptions of earliest events and their circumstances. 6. Birth and development, including age of walking and talking, problems compared with other children, view of effects of early experiences. 7. Health and physical condition, including childhood and later diseases and injuries; current prescribed medications; current use of unprescribed drugs, tobacco, or alcohol; comparison of own body with others; habits of eating and exercising. 8. Education and training, including subjects of special interest and achievement, out-of-school. Work record, including reasons for changing jobs, attitudes toward work. 10. Recreation, interests, and pleasures, including volunteer work, reading, view of adequacy of self-expression and pleasures. 11. Sexual development, covering first awareness, kinds of sexual activities, and a view of adequacy of current sexual adjustment. 12. Romantic relationships and family data, covering major events and what led to them,

Ethical Complaints

If an issue arises, ethical complaints can be made to the APA or state licensing boards There are 120,000 APA members, and in the last few years only 12 cases were investigated by the Board Most severe APA sanction: remove the accused from the organization Unethical behavior can also lead to revocation of license by state board

Independent practice

In 2015, the median salary for all doctoral-level clinical psychologists was $80,000  $120,000 was the median for those in private practice VAs are offering more benefits to CPs to remain an attractive option

Role-playing tests

In most role-plays, the clients' or trainees' responses are recorded and then rated by observers on any of dozens of criteria such as appropriateness of content, Staged naturalistic observation: behavior in a controlled setting that appears naturalistic to the client The client is asked to meet and carry on a conversation with a stranger (actually a clinician's assistant) who has been instructed to confront the client with three "critical moments": not catching the client's name, responding to a lunch invitation kid given a doll, see what the kid does

Limitations in funding have inspired future trends

Increased use of self-help interventions Offering of mental health services within easily accessible locations (e.g., schools, medical clinics, workplaces) Integrated primary care setting - may lead to greater collaboration between PhDs and MDs Expansion of service delivery options (e.g., internet, cell phones) Focus on quality assurance

Mechanism of Change

Insight impacting behavior; insight to past and bad experiences; insight or meaning effect experiences

Evidence Based Practice (EBP):

Integrate the best available research with clinical expertise to best fit the client on their characteristics, culture, and preferences Treatment is effective in the real world Effectivness: High external validity. High validity is only possible with high reliability Triad: Scientific evidence Clinical evidence, patient preference

Other Routes for Clinical Psychology

Integration: Clinical psychology will integrate with other fields Example: Neuroscience International Outreach: expand beyond NIMH

Internships

Internship is a requirement for graduation of an APA program Apply in November, interview December-February Put rankings into a computer system, and that's when you match (in February)! In 2012, only 53.3% of students matched More sites were created, and now there are not enough students for sites!

James McKeen Cattell

Introduced mental testing in the U.S. Constructed a standard battery of mental tests for use by researchers interested in individual differences. He chose 10 tests that reflected the then-prevalent tendency to use sensorimotor functioning (such as the ability to detect differences in the pitch of two similar sounds) as an index of mental capacity, First psychologists to appreciate the practical usefulness of tests in the selection and diagnosis of people. "psychology cannot attain the certainty and exactness of the physical sciences unless it rests on a foundation of experiment and measurement"

Assessment process

Involves a series of steps, beginning with a problem or referral and ending with the psychologist's communicating the results of the assessment to appropriate parties. clinician must make a number of decisions, such as which instruments to use and how best to convert clinical assessment data into a clinical judgment. Gathering information to answer a question: What is this client's diagnosis? What are her major ongoing problems? Is she at high risk of suicide? Will she benefit from treatment, and if so, what kind of treatment? clinical assessment activities should be organized in a sequence of systematic, logically related steps driven by a goal. Clinicians must answer two related questions before they begin the clinical assessment process: What do I want to know, and how best can I find out about it?

Alternative Medicine

Is actually traditional medicine, such as home remedies herbology, yoga, biofeedback Studies show it's helpful for depression and anxiety Ineffective ones: recovered memory therapy & rebirthing therapy (Representativeness heuristic) like goes with like

Ivan Pavlov (classical conditioning)

Ivan Pavlov was one of the first behaviorists. *Classical conditioning* focuses on learning of *involuntary* emotional or physiological responses, such as fear, increased muscle tension, salivation, or sweating. it refers association of *automatic response with new stimuli*. In classical conditioning, you can program one stimulus to take over for another. *Unconditioned stimulus*: The teacher blows a whistle in the classroom *Unconditioned response*: The students cover their ears and subsequently stop talking Couple the teacher's raised hand (a conditioned stimulus) with using the whistle for a period of time and eventually the students will cover their ears and stop talking (*conditioned response*) with only the teacher's raised hand. Pavlov's research contributed several terms to the world of education. Three major concepts and examples are listed: • Stimulus generalization: Because children feel secure when they see a police officer's uniform, they generalize that all uniforms should make them feel safe • Discrimination: The children realize that not all uniformed people are like police officers • Extinction: The raised hand of the teacher no longer quiets the children

Albert Ellis

Kelly, Ellis was a psychologist who saw disorders such as anxiety and depression arising from people's misguided beliefs and expectations about the world. clinical psychologist's task in therapy is not just to point out the irrational, unrealistic, self-defeating nature of these beliefs, but to actively challenge them and push clients to learn and adopt more rational, logical, and less distressing ways of thinking.

Future of Training Programs

Likely some disconnect between PhD and PsyD programs In order to be competitive, all training should programs focus on: Evidence-based practices Multicultural training Competency in practice, teaching, research

Examples of Multicultural issues:

Low socioeconomic status Various religions Spirituality Countries outside of the US Physical disabilities Sexual orientation Same-sex couples Transgender clients English as a second language Age Race/ethnicity Sexual orientation Same-sex couples Transgender clients English as a second language Age Race/ethnicity

Description-orientated assessment

Makes it easier for clinicians to attend to clients' assets and adaptive functions, not just to their weaknesses and problems. Data provides pretreatment measures of clients' behavior, guide treatment planning, and evaluate changes in behavior after treatment. can also improve measurement in clinical research.

Teaching

Many clinical students teach in personality, abnormal psychology, introductory clinical psychology, psychotherapy, behavior modification, conduct specialized graduate seminars on advanced topics, and supervise the work of graduate students who are learning assessment and therapy skills in practicum courses.

predictive validity

Measured by evaluating how well the results of an assessment method forecast events such as violent behavior or suicide attempts.

Between-subjects

Measuring change as a function of condition between two samples Only one condition is given the experimental treatment Pre-treatment assessment, post-treatment assessment, and sometimes follow ups Key is random assignment: each subject has an equal chance of being placed in the experimental condition 2 people get treatment A, 2 get treatment B, Control treatment (Case study trials)

Revolution in diagnosing

Medical doctors that see mental disorders as physical diseases also led some of them to think that disorders might have psychological causes.

Self-help resources

Minimal research

Multicultural Psychology

More than half the US population is expected to be a minority background in 2050 But, only 28% of first-year graduate students in psychology are non-white Need to train students to competently (i.e., humbly) deal with issues of diversity and multiculturalism

Prognosis

Most often, prognosis refers to a prediction about the outcome of treatment, but it can also refer more generally to predictions about changes in symptoms without treatment or under certain circumstances. a head injury might change the prognosis for treatment of an anxiety disorder because the injury might make a client less likely to follow-through on agreed-upon "homework" assignments between sessions. DSM provides few specific prognostic statements, It is not difficult for clinicians to recognize that some disorders tend to be more disabling than others, more chronic or prone to relapses, or more responsive to treatment or to certain positive or negative life circumstances. assessing a client's level of social support and subjective distress can alter a prognosis in one direction or another. DSM might suggest that clients with relatively high levels of social support and moderate, but not overwhelming, distress tend to have better prognoses than clients with relatively low levels of support and intense distress. A prognosis can also be influenced by assessment of such client factors as impulsivity and coping style, and repeated resistance to therapist suggestions.

Professional Multicultural Competence

Multicultural Competence = an awareness of the existence and impact of sociocultural differences that helps clinicians be more effective when working with diverse client populations Multicultural humility = is a humble and respectful attitude toward individuals of other cultures that pushes one to challenge their own cultural biases, realize they cannot possibly know everything about other cultures, and approach learning about other cultures as a lifelong goal and process

Concerns About Psychotherapy Research

Must balance internal and external validity - usually end up forgoing one for the other Most studies do not assess both common and therapy factors (e.g., alliance) Findings not disseminated because of paywalls (subscription services)

Entering WW1

Needed to measure intellectual ability and psychological stability. Army Alpha and Army Beta intelligence tests were created. First was used with recruits who could read; the second with those who could not.

Dorothea Lynde Dix

New England schoolteacher, campaigned to improve mental hospital conditions, launched public information campaigns, lobbied legislative groups, and eventually played a role in founding more than 30 state institutions for people with mental illness In the 19th century, what disease solidified the role of physicians treating mental disorders? Syphyllis

What criteria are used to evaluate the value of psychological tests?

Norms: Measures of central tendency and variability for the test obtained from a large, representative standardization sample; these allow meaningful interpretation of scores. Internal consistency: A measure of reliability, usually accomplished by the split-half method. Test-retest reliability: Similarity of results from repeat testing of the same people. Interrater reliability: Similarity of results when multiple raters independently score the same tests. Content validity: Test items adequately sample all important domains associated with the trait or ability being measured. Convergent validity: Results of the test correlate with other well-established measures of the same construct. Discriminant validity: Results of a test do not correlate with measures of constructs that are conceptually different. Diagnostic or clinical utility: The degree to which test results clearly point to specific diagnoses or preferred treatments, or can reliably measure changes that result from treatment.

Galton (cousin of Darwin)

Notion that intelligence is inherited Applied Darwin's notions to research on the inheritance of individual differences—especially in mental abilities. Measured people's ability to make fine discriminations between objects of differing weight and between varying intensities of heat, cold, and pain. Developed the word association test to explore mental connections people make between psychological concepts Set up the world's first mental testing center, where, for a small fee, anyone could take a battery of tests and receive a copy of the results. Launched mental testing movement

termination interview

Occur when it is time to end a clinical relationship. If a treatment has ended successfully, many loose ends must be tied up: Helps make the transition from treatment to posttreatment as smooth and productive as possible. When treatment is less successful, clients drop out early, termination interviews can inform clinicians or researchers about the dynamics leading to dropout

Communication Training

Often involves active listening Soft vs. hard expressions -most angry statements (hard expression) are actually masking sadness or hurt (soft expression) Increase use of "I" statements as opposed to "you" statements Role play in session

Leta Stetter Hollingworth

One of the first psychologists to focus on child development and on women's issues Suggested practiced-focused graduate training

Physiological measures

Other performance tests measure physiological activity, such as heart rate, respiration, blood pressure, skin conductance, muscle tension,

Therapy Settings

Outpatient Settings: Most common setting Privacy is a huge concern Example: therapist office in a private practice Inpatient Settings: Hospitals, residential centers, prisons, jails - more severe problems Part of a treatment team Not always the most private Example: Laurette Hospital eating disorder inpatient unit

Placebo Effect

Placebo effect: benefit from a treatment that is not attributed to the treatment itself Due to the client's belief in the treatment

Positive Psychology

Positive psychology: focuses on understanding and promoting personal growth and human potential https://www.youtube.com/watch?v=5CpLEOO5oyo Examples: ØPosttraumatic growth: making meaning from trauma ØResilience: adapting in the face of adversity ØPrevention of psychological problems: identify at-risk group and provide skills ØOptimism: Can this be instilled in order to inspire hope? ØGratitude

Nonverbal communication

Posture, body language, ext, eye contact A client who is struggling to express complex feelings will perceive the words "take your time" as more genuine if the clinician says them slowly and quietly than if they are said mechanically and accompanied by a glance at the clock.

Possible outcome of coupes therapy: break up/divorce

Predictors- The four horseman Criticism Defensiveness Contempt Stonewalling

Professional Regulation

Primary purpose: protect the public from unauthorized or incompetent practice "Buyer beware" model is inadequate due to risk of harm for clients

Ethical Decision Making

Process that requires striking a balance between science and morality

Myers-Briggs Type Indicator (MBTI)

Produces 16 different personality types Derives the personalities from 4 dichotomies Type-based vs trait-based Should be bimodal- it isn't Its not reliable Its not valid

The professionalization and current status of clinical psychology- 5 main issues

Professional training: What training does one need to become a CP? Professional regulation: What are the mechanisms for ensuring that CPs meet minimal requirements to function professionally? Professional ethics: What principles guide ethical behavior? How is unethical behavior managed? Professional independence: How does CP relate to other professions? Professional multicultural competence: How has the field changed regarding diversity and multicultural competence?

Dialectical-Behavioral therapy

Promising treatment for borderline personality disorder that involves exposing the client to stressors in a controlled situation, as well as helping the client regulate emotions and cope with stressors that might trigger suicidal behavior.

Emil Kraepelin

Proposed the first formal classification of mental disorders. He categorized disorders according to the specific patterns, or syndromes, of signs and symptoms that he saw as distinguishing various forms of disorder from each other. symptoms are indicators and used to classify Kraepelin's classification system also took into account the typical patterns of change seen in various disorders. Ex. Schizophrenia usually stays more or less constant over time, whereas manic depression (now called bipolar disorder), Kraepelin's system itself is no longer used, but his approach—classifying mental illnesses in terms of signs, symptoms, and natural history

community mental health clinics

Provide a wide range of mental health services for those who do not have access to private mental health care; sometimes includes psychosocial rehab program and some even provide intensive psychiatric case management

evidence-based practice

Psychological services that integrate the best available research with clinical judgment and expertise in the context of patient characteristics, culture, and preferences. Evidence-based practitioners are expected to choose diagnostic and therapeutic methods that high-quality evidence has found to be most effective,

B. Fidelity and Responsibility

Psychologists establish relationships of trust with those with whom they work

1900s measuring individual differences

Psychologists were involved in measuring individual differences in mental functioning using two overlapping approaches: (a) the Galton-Cattell sensorimotor tests, aimed at assessing largely inherited, relatively fixed mental structures; and (b) the instruments of Binet and others, which emphasized complex mental functions that could be taught to some degree.

American Psychological Association (APA)

Publish training standards or guidelines, establish codes of ethical conduct, define professional boundaries, and work with state legislators to establish licensing laws. APA members who wanted the discipline to only be a basic, pure science and those who wanted it also to be an applied science. APA realized that psychology was becoming a discipline whose members had strong applied interests. American Board of Examiners in Professional Psychology (ABPP) was established to certify that clinicians holding a Ph.D. were fully qualified.

internal consistency reliability

Reliability assessed with data collected at one point in time with multiple measures of a psychological construct. A measure is reliable when the multiple measures provide similar results.

Shakow Report (1947)

Report in 1947 that outlined how clinical training should be evaluated These guidelines standardized clinical training 1] Trained as a psychologist first 2] Clinical psych Ph.D. should be as rigorous as any other Ph.D. program 3] Training should be broad and directed at assessment, research, therapy

The Vail Conference of 1973

Representatives came from a wide range of psychology specialties and training orientations Recognized "professional training" as an acceptable model for program's whose mission was to produce clinicians Practitioner-Scholar model and Psy.D was born Psy.D. is not as focused on research, may not even have to do a dissertation

The Boulder Conference of 1949

Required the APA to do 2 things: Name the Universities that offered satisfactory training programs Develop acceptable programs in Universities that didn't have them Adopted Shakow report for scientist-practitioner model of training - Shakow's plan thus became the Boulder model Clinical training programs encompass clinical psychology, counseling psychology, and school psychology Training schools are visited for accreditation every 5 to 7 years. Max is up to 10 years!

realability

Researchers study the reliability of interviews in part by examining the consistency of clients' responses across repeated interview occasions. No general conclusion warranted, but test-retest reliability generally higher when clients are adults, interval between interviews is short, and innocuous information is requested. Interrater reliability tends to be higher when clinicians all see the same interview.

Binet & Stanford - Binet Scale

Results are expressed as an intelligence quotient (IQ) (Mental age divided / chronological age) * 100 Mental age- age that is correlated with the client's performance (aka, skills are the same as a # old) ***it does not mean they are mentally that age!!

concurrent validity

Results of an assessment method are similar to those of other methods that are designed to measure the same construct. if people's scores on that new anxiety test are about the same as the scores they earned on other anxiety tests, the new test's concurrent validity would be high.

MMPI-3 (2020)

Revision process started immediately after RF was finished (go Ben-Porath!) Goals Update normative sample Changes to item content MMPI-2-RF-EX 335 items (11 validity scales)

comparison of the MMPI-2 and the MMPI-2-RF

Same items (only reduced for RF) Same normative sample Some of the same scales (only shortened and improved in the RF) Fewer items on the RF (567-338) Unlike the 2, scores on the RF are not based on gender norms Some new scales in the RF and some scales were dropped all together New hierarchical structure More "standardized" interpretation on the MMPI-2-RF - no code-types

Dodo Bird Verdict

Saul Rosenzweig publishes a paper that says all therapies are equally effective Therapies are effective due to common factors, like the placebo effect (client belief in therapy)

School psychology

School psychologists have much in common with most clinical and counseling psychologists: they generally use similar training models, satisfy similar internship and licensure requirements, conduct assessments, design interventions at the individual and system levels, and evaluate programs.

Group Therapy

Seeing several clients within one session typically 6-12 members in one group Every major orientation now has a form of group therapy Lots of advantages, but LOTS to manage (e.g., keep everyone on task, manage difficult self-disclosures and emotional reactions)

Pythagoras

Selected members of his brotherhood on the basis of their facial characteristics, apparent intelligence, and emotionality

Common Factors of Group Therapy

Sharing New Information Group leader offers advice Other members give support and feedback/advice Altruism Group members will help others Increased feelings of self-worth Instill Hope Group members provide hope Comment on positive changes seen in other members See group members improve Interpersonal Learning Practice social skills Learn new interpersonal skills Receive immediate feedback in a safe way Universality Client isn't alone Soothes anxiety about "going crazy" or "losing control" Group Cohesiveness May be more open to feedback from a peer than group leader Members of group accept one another

Therapeutic Goals

Should be client chosen Common goals are: Reducing emotional discomfort Fostering insight Interventions used: Educate the client Assigning homework Develop client faith, hope, and expectations for change

Economics of mental health care

Should psychologists be eligible for insurance reimbursements? Insurance companies are legally required to provide the same coverage for mental health issues as for physical illnesses Mental Health Parity Act

Misperceptions of psychotherapy

Show us as people who: Violate professional boundaries (romantic relationships with clients) Violate ethics code Shoot from the hip in treatment Treatment is oversimplified (mostly psychoanalysis)

Representativeness (ecological validity)

Social behaviors observed when a client has a bad cold are not likely to be as typical of that client's behavior when healthy.

Controlled observation

Some control over variables takes place to observe how people may interact/behave. They take place inside and outside of a lab. allows clinicians to maintain control over the assessment stimuli in much the same way as they do when giving the psychological tests The candidates did not know that the tester was purposely trying to frustrate them by giving increasingly complicated instructions accompanied by negative feedback

Problem-referral interview

Sometimes clinicians serve as diagnostic consultants to physicians, psychiatrists, courts, schools, employers Goal is to address the referral question Example: "Is Mr. P. competent to stand trial?" referral questions must be stated clearly.

Should the therapist have self-disclosed?

Sometimes it's good to, to relate with the client about certain things but at your own risk

statistical prediction

Statistical prediction results when a clinician uses data from large groups of people to make a judgment about a specific individual. It has been proven to be more accurate than a clinical prediction.

Stanford-Binet 5

Still common g Verbal IQ: Verbally respond to questions Standardized scoring for response Non-verbal IQ: minimal verbal responses Lots of pointing & universal gestures Non-verbal IQ: minimal verbal responses Lots of pointing & universal gestures Below 90 is below average, above 109 is above average

Performance measure

Supernanny does this a bunch In some cases, the "control" consists of asking clients—usually couples, families, or parent-child pairs—to come to a clinic or laboratory where they are observed while engaging in a discussion or an attempt to solve a problem. For example, during marital therapy, a couple might be asked to discuss an area of conflict between them as the therapist makes audio or

Target clarity

Targets of observation must be clearly defined and consistently coded.

ipsative measurement

Test scores can also be interpreted by comparing a person's score, not to other people's scores or to an external criterion, but to the person's own scores.

Measuring the reliability of observational assessment

Test-retest: Can be reduced by changes in client behavior across time. Interrater: Reduced by high task complexity and lack of observer training.

Therapeutic Alliance

The "third participant" The emotional bond that develops between the therapist and the client Shared understanding of has been done and what will be achieved Essential, but not sufficient ( CBT often see this as essential - but not sufficient) How do you promote the therapeutic alliance? Matching - ethnicity, race (greater interpersonal understanding of the situation) MATCH THERAPY TYPE TO ATTITUDE OF CLIENT e.g. more resistance - non directive treatments

The MMPI-2-Restructured Form (MMPI-2-RF; 2008)

The 2 is replaced by the MMPI-2-RF in 2008 Caused significant push back! Authors wanted to increase psychometric properties of the MMPI-2 Did not touch the normative sample, but dropped items and restructured the scales (338 total items, 10 validity scales)

science practice gap

The disconnect between the scientific evidence/the evidence based clinical guidelines and actual practices. Several commonly used assessment strategies have major problems and the majority of clients receive treatments without adequate empirical support even though better treatments are available. people with major mental disorders are receiving inadequate treatment

3 legs of clinical psychology

The empirical, psychometric, and clinical traditions in clinical psychology provided stable base for the field

independent variable

The experimental factor that is manipulated; the variable whose effect is being studied. the type of therapy given

Bandwidth-Fidelity

The fact that in clinical assessment, the more detailed one's exploration is, the fewer topics can be addressed, and the more topics are explored, the less detailed the exploration can be. Clinicians have found that, given limited time and resources, the more extensively they explore a client's behavior, the less intensive each aspect of that exploration tends to become The breadth of an assessment method is thus referred to as its bandwidth and the depth or detail of the information it yields is called its fidelity If, during a 2-hour interview, a clinician asks a long list of questions, the result would be relatively superficial information about a wide range of topics (broad bandwidth, low fidelity). If the same amount of time is spent exploring the client's early childhood memories, the result would be a lot of detailed information about only one aspect of the client's life (narrow bandwidth, high fidelity).

Clinical psychology

The field of psychology that involves research, teaching, and services relevant to the application of principles, methods, and procedures for understanding, predicting, and alleviating cognitive, emotional, biological, social and behavioral maladjustment, impairment, distress, and discomfort, applied to a wide range of client populations.

Justice

The impartial and fair settlement of conflict and differences, typically by legal process and the imposition of proportionate punishment.

prescription privileges

The legal ability to prescribe medication. There is currently a heated debate among clinical psychologists as to the desirability of obtaining this privilege. Psychologists are often in a better position to monitor the effectiveness of the medications. Training for psychologists to prescribe medicine maybe inadequate Some clinicians may find themselves prescribing medicine more

Certification and Licensure Laws

The most important type of regulation is state laws Two types of statutes: certification and licensure Certification: Protects the title of psychologist by restricting it to persons with certain qualifications Licensure: Defines the practice of psychology by specifying services that a psychologist is authorized to provide to the public State Boards of Psychology are charged by legislature to regulate the practice of psychology in each state

Research Designs

The most powerful design is the controlled experiment

WWII

The need for psychological testing services during World War II was even greater than in World War I, as was the need to treat military personnel who had experienced combat-related trauma. Many military family members and others who suffered stress-related disorders on the home-front also needed psychological help. Psychologists who had any amount of clinical training were recruited in large numbers to help meet these needs in hospitals and clinics, where they worked side by side with psychiatrists and social workers. After the war, many of them wanted to continue to work as psychotherapists,

super ego (freud)

The partly conscious and partly unconscious. It is composed of the conscience and ego ideal Reflects the equally strong demands of our internalized sense of morality

Treatment should be decided based on client features

The presenting problem Client personality Coping styles Motivation Cooperation vs. resistance Openness vs. defensiveness Active participation Positive expectations for therapy Openness and cooperation are essential to treatment outcomes Motivation can also be influenced by clients beliefs and expectations - those who have hope of improvement, and open to change see better outcomes

Standardization

The process of administering a test or other assessment method to samples of people that are large enough and representative enough to establish clinically useful norms for interpreting a client's score on those assessments.

Assessment

The process of collecting information about people, their behavior, problems, personality traits, abilities, and intellectual functioning diagnose problematic behavior, provide a more complete picture of a client's problems, Consists of three categories: tests, interviews, and observations.

referral question

The question about the patient that prompted the assessment. The trigger that shapes the clinician's choice of assessment instruments and the interpretation and communication of results.

Report clarity

The report must be clear and concise to the client to ensure he/she gets proper treatment outside of psychotherapy. If wrong things are being taken place, it may affect the client negatively. To prevent this, jargon should not be used within the report.

Box score reviews:

The researcher makes categorical judgements on if the study had a positive or negative outcome for each subject .....Not great....

peer review process

The review of the design and validity of a research experiment by experts in the field of study who did not participate in the research.

Clinicians become psychotherapists

Their role as therapists evolved as a natural extension of their diagnostic and remedial services. clinicians providing psychotherapy was not immediately supported by the psychiatric community, or by some psychologists. Interest and acceptance slowly grew, though, because: (a) psychological testing had already expanded to include measures of personality and psychopathology; (b) Many of the child guidance clinics where clinical psychologists worked had broadened their client base to include treatment of social as well as educational maladjustment; (c) as English translations of Freud's theories began to appear after 1909, more and more clinicians wanted to learn about his psychoanalytic treatment methods. (pseudoscience) Training for psychotheraphy was scarce as there was no training. At first, opportunities for training in psychotherapy were hard to come by, mainly because training in any aspect of clinical psychology was scarce. Psychotherapy did not become a major activity for clinical psychologists until the end of World War II.

Factors to successful therapy

Therapeutic relationship Empathy/support Genuiness Expectations Regardless of what treatment you are in, it is the common factors that usually lead to the most change Not just feeling the pain but feeling it together

How do you start to treatment plan?

Therapist based Top down approach Client based Bottom up approach

DSM-5 (Diagnostic and Statistical Manual of Mental Disorders)

This manual provides an extensive list of mental disorders, classified by type, along with lists of criteria that clinicians can use in deciding which diagnostic category best describes each client. If individuals meet a certain number of criteria, they are said to "have" a disorder; if not, they are said not to "have" it. statistical evidence suggests that there is no clear boundary between being clinically depressed and not being clinically depressed So many critics argue that most diagnoses should be considered as extremes along one or more underlying dimensions rather than as discrete categories Behaviorally oriented clinicians, for example, have been concerned that DSM-5 classification ignores the context in which symptoms occur, Also missing from the DSM are many types of relational disorders, such as couples' conflicts, parental discipline problems, child neglect, sibling conflict, domestic abuse, incest, and the like. DSM-5 did not substantially change the number of possible diagnoses; rather, it modified the diagnostic criteria for certain disorders and reorganized disorders into 17 broad categories.

Psychodynamic Diagnostic Manual (PDM)

This manual was developed by a task force whose members represented five major psychoanalytic groups. Advocates of this alternative system argue that it promotes more in-depth assessment. Claims that it also encourages clinicians to look beyond overt disorder features. Allows for more sophisticated case formulation and better treatment planning PDM appears so far to have had relatively little impact on clinical practice or research. What is missing, they say, is the systematic assessment of clients' strengths

Stage 2 middle of interview

Transition to speaking of clients problems must be smooth. Should be a bit non-directive since being directive may make the client suddenly feel uncomfortable and not allow a smooth transition. Open-ended questions and encouraging remarks are used whenever the clinician wishes to prompt clients How did that make you feel?" and remarks such as "Tell me a little more about that." These strategies are supplemented by tactics designed to help clients express themselves fully and to enhance rapport. active listening helps (agreeing with them and letting them know you're genuinely listening "mhmm" "yeah"), which involves responding to the client's words in ways that indicate understanding and acceptance and encourage further elaboration. "I see," "I'm with you," "Right," or even just a nodding of the head or providing other "empathic noise," such as a friendly grunt (lmaoo friendly grunt) paraphrasing: clinicians restate what their clients say to show that they are listening closely and to give clients a chance to correct the remark if it was misinterpreted.

A. Beneficence and Nonmaleficence

Treat people in ways that benefit them. Do not cause suffering. Conduct research that will benefit society.

ESTs for Common Disorders

Treatments for Depression Strong: Behavioral Activation therapy Cognitive Behavioral therapy Interpersonal Therapy: https://www.youtube.com/watch?v=-PcpAZpk9MY Problem Solving Therapy Modest: Acceptance and Commitment Therapy (being re-evaluated) : https://www.youtube.com/watch?v=Z29ptSuoWRc Short-term Psychodynamic Therapy Emotion Focused Therapy

Empirically supported treatments (ESTs)

Treatments for various psychological conditions that have been shown through careful empirical study to be either "well established" or "probably efficacious." A list of ESTs is updated and published periodically by the APA's Division of Clinical Psychology. Following a treatment manual or protocol that has empirical support from numerous research studies The treatment itself is effective Efficacy: High internal validity

Self-help Interventions

Typically accessed online (online support groups) Rose to fame through Alcoholics Anonymous support group How can you tell if they are good? Many leading disorder experts have self-help books Look at the research critically Avoid things with only testimonials

therapy-outcome research

Ultimate question: "What treatment, by whom, is most effective for this individual, with that specific problem, under which set of circumstances, and how does it come about?" Kazdin (1982) published a list of goals: Determine efficacy of treatment Compare treatments Determine what parts of therapy actually work Assess lengths of benefits Identify side effects

projective test

Unstructured stimuli are presented Meaning or structure projected onto stimuli Projections reveal hidden motives Rorschach inkblot test Thematic apperception test Sentence completion test Projective tests offer rich observational date, but there are issues Reliability - inter-rater and test-retest Validity - accuracy of instrument Standardization - no standardized administration Subjectivity in interpretation

Signs of Pseudoscience (Schmaltz & Lilenfeld, 2014)

Use psychobabble jargon Rely on anecdotal evidence Extraordinary claims - panacea Unfalsifiable claims Doesn't build on other research No peer review No self-correction

intake interview

Used to establish the nature of someone's problems and assign a DSM diagnosis A client comes to the clinician because of one or more problems in living. designed mainly to establish the nature of the problem, often called the presenting problem. The client is asked to describe the problem in terms of a DSM or ICD diagnosis (e.g., major depressive disorder). Asked to develop broader descriptions of clients and the environmental context in which their behavior occurs. Helps the clinician decide whether the client has come to the right place.. If not, the clinician will commonly refer the client to another professional or agency for alternative services. Sometimes mental status examination (MSE) is assessed. A planned sequence of questions designed to assess a client's mental functioning in a number of important areas grooming and clothing are assessed. lient's speech coherent and understandable?, alse beliefs not shared by others in the client's culture)?, senses clear or clouded? ext.. May lay some groundwork for therapy regarding their problems A well-conducted intake interview is important to successful treatment

Group intervention

Used with 2 or more client's who develop interactive relationships and share at least one common goal or issue; may be closed or open and group may be small or large; common to have nurse-led intervention groups include those that focus on medications, symptom mgmt, anger mgmt and self care Ending self stigma by relating to others and having others help out and share their issues and how they cope with it. Helps motivates others in the room. Person 1: "I'm worthless" Person 2: "No you're not, you're doing great on this journery"

Meta-analyses:

Uses statistical analyses to compare outcomes from many studies and calculate overall effect sizes Much better! psychological treatment is effective for many psychological disorders

Reliability and Validity

Validity is related to reliability because an assessment device cannot be valid without first being reliable. Still, the validity of an instrument is not guaranteed just because it is reliable. If your bathroom scale varied by only a few ounces in an assessment of its test-retest reliability, you would probably still consider it reliable enough for weighing yourself, but if a postal scale varied by that much, you would probably consider it unacceptably unreliable because you would attach too little postage or too much.

Research on other modes of interventions: Psychotherapy and Medication

What is the most effective treatment course? Psychotherapy alone Psychiatric medication Combination of both for some disorders, combined is better than psychotherapy alone For others, psychotherapy alone is equal to or better

frame setting

When clinicians set the frame, they explain to the client the basic ground rules for the interaction. Introduction and small talk, clinician explains what is going to occur and what will occur during the current meeting. Establishing norms and expectations for the interview frame-setting leads to a transition into the second stage of the interview using nondirective, open-ended questions. Common examples are "So what brings you here today?" or "Would you like to tell me something about the problems you referred to on the phone?"

Psychiatry

a branch of medicine dealing with psychological disorders; practiced by physicians who sometimes provide medical (for example, drug) treatments as well as psychological therapy

counseling psychology

a branch of psychology that assists people with problems in living (often related to school, work, or marriage) and in achieving greater well-being - Offer psychotherapy, career counseling to life changes

True negative

a clinician correctly labels someone as not dangerous

False positive

a clinician labels someone as dangerous when that person is not actually dangerous.

False negative

a clinician labels someone as not dangerous when that person actually is dangerous.

Interview

a conversation with a purpose or goal natural source of clinical information about clients, an easy means of communicating with them. Interviews are flexible, relatively inexpensive, and, perhaps most important, provide the clinician with simultaneous samples of clients' verbal and nonverbal behavior. introduction to interviews and observations as sources of assessment data.

diathesis-stress model

a diagnostic model that proposes that a disorder may develop when an underlying vulnerability is coupled with a precipitating event biological, psychological, and sociocultural factors can predispose us toward a disorder, but it takes a certain type or amount of stress to actually trigger it

general intelligence (g factor) Spearman's g

a general intelligence factor that, according to Spearman and others, underlies specific mental abilities and is therefore measured by every task on an intelligence test Observation that that almost all tests of cognitive ability are positively correlated If you do well on one test, you are likely to also do well on all of the others. People's cognitive abilities can vary somewhat across different domains, but g is presumed to be an underlying biological or psychological trait that influences them

client-centered therapy

a humanistic therapy, developed by Carl Rogers, in which the therapist uses techniques such as active listening within a genuine, accepting, empathic environment to facilitate clients' growth. (Also called person-centered therapy.)

test-retest reliability

a method for determining the reliability of a test by comparing a test taker's scores on the same test taken on separate occasions

RDoC (Research Domain Criteria)

a method that defines basic aspects of functioning and considers them across multiple levels of analysis, from genes to brain systems to behavior it conceptualizes mental disorders as brain diseases generated by disturbances in neural circuitry Proponents of the RDoC say that a proper system for classifying psychopathology should focus on identifying the disrupted systems in the brain and elsewhere that lead to the appearance of various psychological disorders. psychopathology arise when either very high or very low levels of personality traits combine in maladaptive ways. alcoholism, may often be produced largely by high levels of anxiety combined with high levels of impulsivity. mental disorders are best conceptualized as disorders of brain circuitry involving dysfunctions in various psychobiological systems, such as the brain circuits associated with reward processing, threat sensitivity, and social attachment.

cognitive behavioral therapy

a popular integrative therapy that combines cognitive therapy (changing self-defeating thinking) with behavior therapy (changing behavior)

cognitive behavioral therapy

a popular integrative therapy that combines cognitive therapy (changing self-defeating thinking) with behavior therapy (changing behavior) Behaviorally oriented clinicians began to acknowledge the importance of studying the cognitions associated with various disorders,

standardization sample

a representative group of people who take the test and establish the norms. (Provide a baseline)

participant observation

a research method in which investigators systematically observe people while joining them in their routine activities

anchoring bias (anchoring heuristic)

a shortcut in the thought process that involves adding new information to existing information to reach a judgement much as the rest of us form first impressions quickly—they let their view of a client's disorder be influenced more strongly by the first few pieces of assessment information they receive than by any subsequent information Anchoring bias is related to another cognitive error called confirmation bias, which refers to the tendency to seek out and interpret new information in line with existing beliefs

dismantling study

a study that seeks to isolate the factors responsible for the efficacy of a form of therapy Type of between-subjects design Clients are randomly assigned to get specific components of a known effective treatment, and you are trying to see which group has the stronger effect sizes Intended to identify which aspect of a therapy is most associated with a positive outcome

existential therapy

a therapy that encourages clients to accept responsibility for their lives and to live with greater meaning and value

cognitive therapy

a treatment method designed to identify and correct distorted thinking patterns that can lead to feelings and behaviors that may be troublesome, self-defeating, or self-destructive

Diathesis

a vulnerability or predisposition to developing a disorder

modern psychodynamic theories and therapies

a) see the ego as doing more than just being a "referee" between the id and the superego; (b) place greater emphasis on social and cultural factors and less emphasis on sexual and aggressive impulses—in causing conflict; (c) involve briefer programs of treatment in which therapists play a more active role and clients sit facing their therapists rather than lying on a couch.

3 traditions that shaped the clinical psychology field

a) the use of scientific research methods—the empirical tradition. (b) the measurement of individual differences—the psychometric tradition (c) the classification and treatment of behavior disorders—the clinical tradition.

Psychodynamic Approach (Freud)

an approach that regards personality as formed by needs, strivings, and desires largely operating outside of awareness-motives that can also produce emotional disorders The idea that human behavior is derived from the constant struggle between the individual's desire to satisfy inborn sexual and aggressive instincts and the need to respect social rules and realities Freud, the human mind is a place where what the person wants to do (instincts, impulses) must somehow be adjusted in light of what the world says can or should be done (reason, norms, morality). Freud compared his treatment method to archeology: the therapist searches for deeper meaning, uncovering the forgotten or buried (repressed) memories and unexpressed emotions that are presumed. (Dreams)

Transdiagnostic approach

an approach that views most psychological disorders as different manifestations of a few core, heritable, underlying dimensions

psychometric

approach to studying intelligence focus on the "products" of intelligence, including academic grades, job performance, and especially scores on intelligence tests.

Biological Approach

behavior and mental processes are significantly shaped by biological processes. Studies hormones, genes, brain activity, and other biological variables. Neuroanatomical, and neurophysiological characteristics of people with psychological disorders. biological factors combine with psychological, social, and cultural ones in causing problems such as depressive, anxiety, personality,

self-monitoring

being attuned to the way one presents oneself in social situations and adjusting one's performance to create the desired impression Recording when they do something they're not supposed to be doing. How often it occurred.

thought disorder

breakdown in the logical structure of thought and speech, revealed in the form of a loosening of associations

structured interview

carefully planned question-and-answer format. Structured interviews are increasingly popular, partly because of their greater reliability and validity, they also have some disadvantages. Psychodynamically oriented clinicians often provide more structure the interviewer asks a series of specific questions phrased in a standardized fashion and presented in an established order. structured interviews do not prohibit open-ended Branching rules are involved tell the interviewer what to do in certain situations (e.g., "if the respondent answers no, skip to question 32; if the respondent answers yes, inquire as to how many times it happened and continue to the next question"). structured interviews eliminate much of the flexibility of open-ended interviews; they prescribe conversation topics and constrain client answers. they are less prone to certain sources of error that can affect the reliability and validity of interview assessment data.

threat to interview validity

clients misremember or purposely distort information. distortion increases when clients are intellectually disabled distortion increases when clients are intellectually disabled appear mentally disturbed may give inaccurate interview responses aimed at suggesting the existence of a mental disorder Poorly phrased questions. Lack of rapport with client. Biased interpretation of clients' responses. Clients' inability to remember information or motivation to distort information.

information variance

clinicians differ in the information they elicit from patients during an interview. if two clinicians ask questions in different ways, they might receive different answers. That would certainly be the case if, for example, the questions were phrased as follows: "Do you get anxious whenever you are in crowded places such as malls?" and "What situations seem to make you the most anxious?

Assessment report

clinicians must explain to their clients the procedures and purposes of the whole assessment process, using language clinicians must think broadly when planning assessments, weighing the features of assessment instruments against practical considerations with the time available. must be both clearly written and clearly related to the goals

concurrent validity

comparing interview results with other valid measures of the same concept

Id

contains a reservoir of unconscious psychic energy that, according to Freud, strives to satisfy basic sexual and aggressive drives. The id operates on the pleasure principle, demanding immediate gratification reflects the unreasoning demands of our basic impulses

content validity

content validity of an assessment method is determined by how well it captures all the relevant dimensions of its target construct.

debriefing interview

designed to provide clients with information and assess their understanding of that information after an event, can occur in a number of situations. to know "what the doctor found," how the information will be used, and who will have access to it. A debriefing interview can help alleviate clients' anxiety about the assessment enterprise by explaining the procedures and protections involved in the transmission of privileged information and by providing a summary and interpretation of the assessment results.

intelligence quotient (or IQ)

dividing mental age (MA) by chronological age (CA) and multiplying by 100.

Within-Subjects

each participant experiences all levels of the independent variable Measuring change as a function of time within one sample Requires the dependent variable be measured more than one time Participants get a single kind of treatment, but the manipulation (i.e., IV) comes from the time point Ex: a depression study in which each subject goes through a: baseline (pre-treatment) assessment Treatment Post-treatment assessment

William Wundt

established the first formal research laboratory devoted to studying consciousness - Founder of psychology because his laboratory so clearly proclaimed psychology as a science

availability heuristic

estimating the likelihood of events based on their availability in memory; if instances come readily to mind (perhaps because of their vividness), we presume such events are common May lead psychologists to overestimate the likelihood of psychological problems that they see often and that therefore come most easily to mind.

predictive validity

evaluating an interview's ability to forecast expected future outcomes

Combining interview techniques

facilitate the flow of a client's words with open-ended requests, paraphrasing, prompts, and other active listening techniques, and then use more directive questions to "zoom in" on topics of special importance. Asking direct questions and not 100% client led due to the questioning by the clinician as the client answers questions. Asks questions based off the client's responses and not really standardized.

psychometricians (measurement psychologists)

focus on methods for acquiring and analyzing psychological data; measure mental traits, abilities, and processes

behavioral therapy

focuses on changing behavior by identifying problem behaviors, replacing them with appropriate behaviors, and using rewards or other consequences to make the changes

emperically supported treatment

focuses on identifying treatments, such as cognitive behavior therapy, that work best for specific conditions, such as major depressive disorder it requires clinicians to master a different package of therapeutic techniques for each specific disorder.

Jean-Martin Charcot

found that hypnosis could alleviate certain behavior disorders, particularly hysteria

Sigmund Freud

founder of psychoanalysis (pseudoscience) Freud had proposed the first version of his own theory, which described mental disorders not as organic problems but as evidence of dynamic struggles within the mind to satisfy instinctual (mainly sexual) desires while also coping with the rules Heavily Confirmation bias and didn't care to listen to the history of the patient. Believed dreams unfolded hidden information of the person's past and reason for mental disorder. Created theories for all observations (poppers after the fact)

multiple intelligences

idea that people vary in their ability levels across different domains of intellectual skill. Analytical intelligence, the kind that is measured by traditional intelligence tests, would help you solve a physics problem; creative intelligence is what you would use to compose music; practical intelligence would help you to figure out what to do if you were stranded on a lonely road during a blizzard. Gardner says that traditional intelligence tests measure only the first three of these intelligences, the ones that are most valued in school. His theory

Conceptualization

informs treatment planning

Stage 1 beginning the interview

interview begins prior to meeting the client as the clinician processes the information available from the referral source. This information can help the clinician to decide whether specific interviewing formats or testing materials might be needed. Interview setting: These alternative locations are particularly appropriate for clients whose cultural background might make standard office surroundings threatening. creating a sense of privacy helps clients to recognize the interview's confidential nature. the clinician should try to create a warm, comfortable environment that encourages the client to speak freely and honestly about whatever topics are relevant to the interview. Clients may not be ready to talk candidly about personal matters, preferring to take a wait-and-see approach in which they closely control what they say and don't say. Rapport can be built in several ways, many of which involve common courtesy.

Administration

involves managing or running the daily operations of organizations.

interrater reliability

measured by comparing the conclusions drawn by different clinicians using the same assessment system to diagnose, rate, or observe the same clients. When clinicians judging the same set of assessment results arrive at significantly differing conclusions, interrater reliability is low. The more they agree, the higher is the interrater reliability. ask several clinicians to view interview videos and then make ratings or draw other inferences from them. However, reliabilities tend to be lower when diagnoses are based on interviews conducted by different clinicians than when different clinicians all view the same interview video In other words, an interview method that displays acceptable reliability with one group (e.g., English-speaking European Americans) might not have acceptable reliability with another group (e.g., Spanish-speaking Hispanic Americans).

IAT

measures attitudes and beliefs that people may be unwilling or unable to report by recording how quickly they come to associate pairs of words (such as "science" and "men," vs. "science" and "women") or to associate images with words (such as "good" with light-skinned vs. dark-skinned faces).

naturalistic observation

observing and recording behavior in naturally occurring situations without trying to manipulate and control the situation

deinstitutionalization

patients were released from large psychiatric hospitals so that they could be treated in less restrictive environments, including outpatient community mental health centers. many of these deinstitutionalized patients received inadequate care in their communities. Many dropped out of treatment, never to return, and now endure the dangers of homelessness on city streets or confinement in jails and prisons

Personality

pattern of behavioral and psychological characteristics by which a person can be compared and contrasted with other people

illusory correlation

perception of a relationship where none exists, or perception of a stronger relationship than actually exists

Behavioral approach

personalities and the psychological problems that we may have are a reflection of environmental influences that have shaped how we have learned to behave. assumption that human behavior is determined mainly by what a person has learned in life, especially through rewards and punishments and observation.

Gestalt therapy (humanistic)

practitioners take a holistic view of the self, seeing individual as complete person

orientation interview

prepare a client for treatment or research, problem-referral interviews the client is encouraged to ask questions and make comments, misconceptions that might impede treatment progress can be discussed and corrected. Second, orientation interviews can help clients understand upcoming assessment and treatment procedures and what their role in these procedures will be the clients who benefit most from treatment are those who are candid, cooperative, serious, and willing Ensures that each participant understands the nature of the tasks to be performed and any risks associated with them.

vail model (practitioner-scholar model)

proportionately less emphasis on scientific training and more on preparation for the delivery of clinical services

cognitive apporach

psychological perspective concerned with how we receive, store, and process information; think/reason; and use language Thus, the research and assessment methods used by clinical psychologists who take a cognitive approach focus on what and how clients are thinking, and their treatment methods focus on modifying maladaptive behavior by influencing what clients believe, assume, and expect about the world, what they say to themselves, and the cognitions that guide (or misguide) their efforts at problem-solving.

internalizing disorders

psychosocial problems that are manifested in a turning of the symptoms inward, as in depression or anxiety

externalizing disorders

psychosocial problems that are manifested in a turning of the symptoms outward, as in aggression or delinquency

Joseph & Wood

real" psychopathologies, the ones that "carve nature at its joints," might be better understood as the absence of character strengths, not as the presence of symptoms described by DSM

criterion variance

refers to disagreements that occur if clinicians apply different standards of judgment to the same set of client responses. the disagreements between clinicians can come not from inconsistencies in client responses but from inconsistencies in the way clinicians collect, interpret, and use those responses

Reliability

refers to the consistency with which it measures some target variable, such as depression or intelligence. If the results of the same test with the same clients are very similar, that test would be said to have high test-retest reliability, much as a bathroom scale would if it shows the same weight reading when someone steps off it and then steps back on.

Client-Therapist Relationship

relationship is based on mutuality, equality, and empowerment. Models how to use power responsibly. Therapist clearly states values, allowing client to choose whether or not to work with the therapist. Demystify counseling relationship by sharing the therapist's own perceptions of what is going on in the relationship, by making client an active partner in determining a diagnosis. Most importantly, the relationship is egalitarian Evolving & collaborative - you shouldn't be doing all the work! Rapport building - if ruptures occur, address them Therapeutic alliance -working/team alliance Emotional bond - but with understood boundaries Shared understanding of the relationship

"credentials" of assessment instruments

reliability, validity, standardization, and utility, the clinician's level of experience and theoretical orientation, the situation in which assessment occurs, and a variety of cultural factors. Sound clinical judgments depend on the soundness of the tests and other assessment instruments clinicians use to help make those judgments

Chapter 6

religion

discriminant validity

results coming from measures of one construct are largely unrelated to theoretically irrelevant constructs

self-disclosure

revealing intimate aspects of oneself to others

convergent validity

scores on the measure are related to other measures of the same construct

Plato

suggested that prospective soldiers be tested for military ability before being accepted in the army,

response bias

tendency of subjects to systematically respond to a stimulus in a particular way due to nonsensory factors

Medical model

the assumption that abnormal behavior is the result of physical problems ( linked mental disorders to bodily functions) and should be treated medically

impression management

the attempt by people to get others to see them as they want to be seen Lowkey make them feel guilty about malingering so they don't do that

behavioral avoidance test

the behavioral assessment strategy used to assess avoidance behavior by asking a patient to approach a feared situation as closely as possible Clients were asked to enter a room containing a harmless caged snake and to approach, touch, and pick up the animal. It is designed to assess overt anxiety in relation to specific objects and situations.

Cattell 2-factor Heirachical g, and then 2 subfactors

the brain probably does not contain a single, unified "thing" corresponding to what people call intelligence. Instead, cognitive abilities appear to be organized in a hierarchy, or pyramid, of "layers. Crystallized: ability to use skills, knowledge and experience Fluid: ability to solve new problems, use logic and identify patterns.

The dependent variable

the change in clients

confirmation bias

the clinician may ignore contradictory evidence, discount its validity, or even distort it to fit initial impressions

Clinical assessment

the collection and synthesis of information to reach a clinical judgment about people and their problems.

criterion validity

the extent to which a measure is related to an outcome high reliability, and good validity for routine IQ testing, diagnosing intellectual disabilities, and predicting and explaining academic achievement

incremental validity

the extent to which a test contributes information beyond other more easily collected measures Is the assessment report useful? The ability of an assessment report to add something important to what is already known about a client. assessor's report may have limited usefulness because it says nothing beyond what would be expected on the basis of base-rate information, past experience, and common sense. Being misdiagnosed for schizophrenia without much knowledge of the person and confirmation bias. The report is essentially useless and not helpful.

Validity

the extent to which a test measures or predicts what it is supposed to

ego

the largely conscious, "executive" part of personality that, according to Freud, mediates among the demands of the id, superego, and reality. The ego operates on the reality principle, satisfying the id's desires in ways that will realistically bring pleasure rather than pain. seeks compromise in light of the limits imposed on us in the real world.

Salary

the median annual salary for all doctoral-level clinical psychologists was $80,000. It was $85,000 for those in direct service jobs, and $120,000 for those in private practice.

true positive

the patient has the disease and the test is positive clinician correctly labels someone as dangerous.

client variance

the same client provides different answers or displays different behaviors in response to the same questions asked by different clinicians

Wechsler-Bellevue Intelligence Scale

the test that later renamed WAIS

Several factors influence the degree of structure in an interview;

theoretical orientation and personal preferences of the client.

family therapy

therapy that treats the family as a system. Views an individual's unwanted behaviors as influenced by, or directed at, other family members

crisis intervention interview

to offer support and guidance during and following a crisis. interviewers do not have the luxury of scheduling a series of assessment and treatment sessions. they attempt to provide support, collect assessment data, and offer help, all in a very short time. Must make the person calm, assure that they are not close to things that can harm them. Work on the immediate problem directly or put the client in touch with other services.

Psychotherapy

treatment offered by trained metal health professionals administered within a professional relationship to help clients overcome psychological problems.

interpersonal therapy

treatment that strengthens social skills and targets interpersonal problems, conflicts, and life transitions

Henry Murray

used specialized tests, interviews, and observations to select soldiers who would be the most successful spies, saboteurs, and other behind-enemy-lines operatives

Non-Reactive/Unobtrusive Measures

which clinical psychologists and other behavioral scientists use to learn about people's behavior without altering it in the process Unobtrusive measures may also be used in clinical research to test theories about the causes of behavior problems

Heuristiscs

xperiences that are recent or remarkable are especially available to recall. The bias associated with the availability heuristic can be seen in the results of publicity for lotteries. Mental shortcuts, or rules of thumb people use to help them make judgments and decisions.

observational assessment

yields descriptions of student behavior in natural settings, intended to be as objective as possible with little inferences Limitation: Observers interpret what they see, may lead to confirmation bias. Could be more than one interpretation. Prevention: Don't draw a full on conclusion, just take notes on what was observed.

Technology

ØAPA accredited programs are forbidden from being taught solely online Ø ØTechnology to deliver mental health services (telehealth) Ø ØVirtual reality assisted treatments Ø ØComputer assessments

C. Integrity

●A personality trait and comprises the personal inner sense of "wholeness" deriving from honesty and consistent uprightness of character.