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72 Cards in this Set

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When is it particularly important to solicit collateral information during a clinical interview?
When client has a serious mental disorder, cognitive limitations, or substance-related disorder that prevent providing reliable info on own.
Functional Analysis
Assessment of antecedents and consequences of a behavior.
When to use behaviorally oriented interview
To gain impression of presenting problem and varibales maintaining it, relevent history, clients past efforts to cope wi problem
Cogfnitive-behavioral assessment
Explores client's cognitions & strategies to identify which contribute to the problem
Psychophysiological assessment
Using physiological activity (MRI, CAT, PET, biofeedback) to assess psychological states
Naturalistic Observation
+Observing client in evironment in which problem occurs. Allows u a more precise understandi9ng b/c u see the behavior at variables that control it.
-Client may behave diff if know is being observed (reactivity)
-may be exprensive
Controlled Observation
You force target behavior to take place in a simulated manner & then observe it firsthand (roleplay)
=Having the client record info about frequency and conditions surrounding target behavior
=Client may also keep record of thoughts and feelings assoc wi this behav
=Tells u abouit nature and magintude of behv, dev tx strategy
+self-mon often changes nature of target behav in desired direction, promotes pos behav
Stages of Change Model (Prochaska & DiClemente, 1982)
1.Precontemplation-unwilling/unaware of problem. 2.Contemplation-person considers possibility of change. 3.Determination-person becomes determined to change. 4.Action-takes action to change. 5.Maintenance-attempts to maintain change over time. 6.Relapse-before stable change a relapse occurs.
Steps to take if client doesn't speak language requested by client.
1.make referral to therapist who works in the language requested by cl. 2.offer cl translator wi cultural knowledge & prof background. 3.may use para-prof from client's background. not use someone who will have a dual role wi the client
Cultural Relativity
Judgements about the abnormality of given behaviors vary from culture to culture.
Minority Identity Development (Atkinson, Morten, & Sue) 5 stages
1.Conformity= +attitude toward maj culture & -attitude toward own culture. 2.Dissonance=confusion about attitudes towards one's culture,dom culture and self. may believe personal probs related to cultural identity issue. 3.resistance & immersion= rejection of dom culture;+attitude toward self &group; conflict with outside groups, personal proibles due to oppression. 4.introspection=uncertainity about the rigidity of previous stage,conflict between loyality nd personal autonomy. 5.synergistic artiuclation & awareness= sense of fulfillment in cult identity, objective exam & acceptance of other groups, want to eliminate oppression.
A client who strongly idenitifies with with her racial or ethnic group and may not feel comfortable with a therapist who is racially or culturally dissimilar is in what stage of Minority Identity Development
Stage 3 - Resistance and Immersion
A client with this worldview emphasizes personal self concept over family life, relates sense of well-being to personal control, sees events in terms of personal preferences
What style of communication does a personal with a worldview focused on indiviudalism prefer? In conflict resolution what approach do they prefer?
1. Low-Context Communication.
2. Confrontational and attributional approach
What style of communication does a personal with a worldview focused on collectivism prefer? In conflict resolution what approach do they prefer?
1. High-Context communication
2. Accommodation & negotiation approach
Low-Context communication
-Transmitted explicitly & concretely through language.
-less unifying & changes rapidly
-Euro-american cultures
-self worth tied to individual terms
High-Context communication
-Grounded in situation, depends upon group understanding, relies on nonverabl cues, use of gestures, facial expression, stories to convery a point
-Unifies a culture & changes slowly
-Many culturally diverse groups in U.S.
-self worth tied to the group
Refugee process: 4 stages: name,time, event,stressors (Gonsalves, 1992)
1.New arrival (1wk-6months) learns about nw cult but highly involved in old, stress=saddness,loss,guilt (some feel excitement)
2.Destabilization (6mo-3yrs) acculturate,survival skills, support network. stress=lonliness,angry withdrawl, resistance
3.exploration & restabilization (3-5yrs) acquires more flexible ways of learning about culture, may connect wi other refugees to avoid further adaption, siolation, fear of failure, anger about reduced status
4.Return to normal life (5-7yrs)cult accomodation wi retention of naive cult values,forms pos personal identity,develops realistic expecations 4 next generation stress=delayed grief reaction
Credibility & Giving (Sue,1981)
1.Credibility=being seen as trsutworth helper, must acheive this wi cultural diff client
2.Giving-client believes that something is gained by having met you.
If client's mistrust is too high due to cultural diff and exp - refer client out
Credibility & Giving (Sue,1981)
1.Credibility=being seen as trsutworth helper, must acheive this wi cultural diff client
2.Giving-client believes that something is gained by having met you.
If client's mistrust is too high due to cultural diff and exp - refer client out
Advantages of Structured Diagnostic Interviews vs. unstructured
1.Higher Diagnostic Reliability through standardization
2.Less subject to threats of clinician bias.
3.Diagnostic criteria is applied more correctly.
4.Using unstructured format may lead one to ignore comorbidity
Advantages of unstructured Diagnostic Interviews vs. structured
1.Can't tailor interview to client't indiviudal needs.
2.If interview seems too rigid, some client's may reject whole process
3.Focusing too much on words may make clinician ignore observations
"Mood" versus affect?
Mood is a realively stable emotional state (depressed,anxious) while affect may be more variable
Attention vs. concentration
Attention is ability to focus on current topic. Concentration is ability to attain attention over a sustained period of time. Both require client to filter out extrtaneous stimuli
Internal Consistency/Split-Half reliability is best used when...
+Best when test measures single characteristic
+Characteristic fluctuates over time
+scores will be a affected by repeated exposure to test
reliability in state vs. traits
Unstable attributes (states) produce lower reliability than traits.
Reliability of True/false vs. multiple choice
Multiple choice is more reliable b/c a person has 50% chance of getting a T/F question right by chance.
Content validity
test is used to obtain information about familiarity with content or behavior domain
construct validity
administered to determ extent to which one possesses a hypothetical trait
criterion-related validity
used to estimate an examinee's performance on a single criterion
1 (Hypochondriasis) 2(Depression)
3 (Hysteria) 4 (Psychopathic Deviate)5 (Masculine-Feminine Interests) 6 (Paranoia) 7 (Psychasthenia) -Anxiety
8 (Schizophrenia) 9 (Mania) – excessive energy 10 (Social Introversion-Extraversion)

T = 65+ = clinically sig
MCMI-III Millon Clincial Multiaxial Inventory
Age: 18 + w/8th grade reading lev MACI = age 13-19 if reading level above 6th grade.

11 clincial scales: 1 Schizod, 2A Avoidant, 2B Depressive, 3 Dependent, 4 Histrionic, 5 Narcissistic, 6A Antisocial, 6B Agressive/Sadistic, 7 Compulsive, 8A Passive-Agressive/Negativistic, 8B Self-defeating

3 Sever Pathology Scales= S Schizotypal, C Borderline, & P Paranoid

7 clinical syndrome scales = A Naxiety, H somatform, N Bipolar: manic, D Dysthymia, B Alcohol Dependence, T Drug Dependence, and PT PTSD

3 Severe syndrom scales = SS Thought Disorder, CC Major Depression, & PP Delsuional Disorder
Base Rates MCMI-III
~75-84 = Prescence on a scale
~85+ = Prominence
~greater the score of BR, more likely client possesses personality/clinical features meas by scale.
Usefulness of MCMI-III
1.Only used for clincial assessment, not gen population.
2.Indicual scale cutting lines can reveal disorders/behaviors & level of severity
3.Should not be only source to det disorder (use to rule in or out)
4.shorter than MMPI and takes 20-30 mins to take
NEO Personality Inventory
Revised (NEO-PI-R)

BIG 5 Personality Traits
1.Extraversion 2.Agreeableness 3.conscientiousness 4.neuroticism 5.openess to experience
Rorscach Advice
~Don't use alone to create tx plan
~The infor about personality organization in useful in making general predictions
Verbal-Performance Discrepancies on the WAIS-III
+More than 12 points is clinically significant
+Higher verbal IQ is assoc w/depression,bipolar,ms,alcoholism,poor vmi,High SES,Higher education.
+Higher performance IQ linked to bilingualism,illiteracy,autism,
delinquency,psychopathology,learning dis,MR,low SES
~Ages 6.0 - 16.11
~WPPSI-III = 2 yrs,6 mo to 7 yrs 3 months.
~Based on Catell-Horn-Carroll's cognitive abilities:Verb Comp, Percep Reasoning,Working Memory,short term memory,processing speed,quantatative knowledge
Requirements for Diagnosis of MR
~Measure of IQ
~Low adaptive functioning (may be scored on Vineland or AAMR
Multiple Cutoff
I/O: a minimum score on ea predictor must be obtained before a job applicant can be selected
Multiple (successive) Hurdles
Predictors are administered one at a time in predetermined order, administered only if the previous one has been passed.
+Saves time and $
Adverse Impact
Use of a procedure results in a substantially different selection, placement or promotion rate for a subgroup.
Differential validity and unfairness
Differential validity: a measure is valid for one group but not another.

Unfairness: members of one group consist obtain lower scores on a predictor than other group but predictor is unrelated to job performance.
Which of Big 5 personality traits is most predictive of job performance?
Conscientiousness found to be best predictor across jobs, settings, & criterion measures.
Are Kuder Occupational Interest scores and Strong-Campbell Interest scales good predictors of job perfomance
No. They are susceptible to faking and best used in vocational counseling. General mental ability tests are good predictor of performance on a work sample.
~Faking Bad~ conscious effort by the client to present self as being worse than they are.~to get into therapy or hospital,get off on a crime,suing for damages
~Faking Good~ conscious effort by client to present self as better than they are.~custody eval,to get released from hospital,for family members
Clinical Biases affecting clinical judgment
1.Preconceived Notions-race,sex orientation, ethnicity. the client is already a mental health client,the setting in which u see client. theoretical orientation may lead one to associate certain symptoms together.
2.Confirmation bias-paying attention to symptoms that confirm your hypotheses
3.Primacy effect-giving more weight to info obtained early in data collection,seek support for your initial assertion
4.Hindsight bias-tendency to believe, once an outcome is known,that outcome could have been predicted more easily than is the case
5.overconfidence-psychologists tend to remember vividly the cases in which they predicted correctly and less of those that they were wrong.
Clues to malingering
a.person has a test protocol that indicates symptoms, but they are calm and appear normal.
b.inconsistent response w/in same test ~disturbed~ normal
c.inconsistency btwn interview or tests and actual circumstances.
Mental Retardation
subaverage intellectual functioning & deficits in 2 areas of adaptive functioning - measured on vineland
IQ~Mild=50-70, mod=35-50, severe=20-20 to 40, profound= below 20-25.
~90% of MR have mild
Borderline Intellectual functioning
IQ = 71-84, but not 2 deficits in adaptive functioning.
Symptoms of schizophrenia
1. Psychotic symptoms during active phase for 1 mo, continuous symps for 6 mos, marked deterioration in func.
Active phase symptoms in schizophrenia
hallucinations, disorganized speech, catatonic or disorganized speech,negative symptoms
5 types of schizophrenia
catatonic, disorganized, paranoid, undifferentiated, residual
6 differential diagnosis for schizophrenia
1. brief psychotic disorder - symps of schiz lasting at least one day, but less than one month
2. schizophreniform - symps of schiz lasting 1 month, but less than 6 mos
3. schizoaffective dis - sig mood symp concurrent with psychotic symp & 2 wks when only psych symps present
4. mood dis wi psych feas - psyh features occur only during course of mood episode
5. delusional dis - delusions are nonbizarre & overall func is not impaired
Depression time frame
-depression = depressed mood most of the day, nearly every day, for at least 2 weeks.
-at least 1 discrete episode that is dif from person's norm func
depressed symptom present more days than not over period of 2 years (1 yr in kids/teens)
at least 2 symptoms of depression, less vegetative symps than dep
Bipolar Disorder basic def
one or more mixed or manic episodes - history of major depressive disorder. sig impairment in func or hospitalization.
manic = at least 1 week; elevated exp mood, irriatble, an d 3 other symp like dectreased need for sleep, grandiosity, racing thoughts, flight of ideas
-mixed = lasts 1 week and nearly every day person meets criteria for dep and manic ep
bipolar disorder types
~single manic episode- 1 manic ep only
~most recent ep manic- previously had a mixed, manic or dep episode, most recent ep mixed, hypomanic, depressed
severity specifiers for bipolar
mild, moderate, severe without psychotic features, severe with psychotic features, in partial remission, in full remission, with rapid cyclingh if has had at least 4 mood episodes in past year
Bipolar II basics
1 hypomanic episode & 1 major depressive episode. never had a manic or mixed episode.
hypomanic episode
lasts 4 days and includes abnormally elevated, expanisve, or irritable mood and 3 symptoms of a manic episode. no psychotic symptoms and not sever enough to hospitalize.
Cyclothymic Disorder
2 or more years of depressed mood and hypomanic episodes for 2 years with no more than 2 months without either. depressed moods never meet criteria for major dep disorder
Basics of social phobia
~marked fear of performance or social situations in which one is exposed to unfamiliar people or scrutiny by others.
~lasting at least 6 mos.
~may include situationally bound attacks
*for children, child must have capacity for soc relationships & occurs with peers, not only adults. may do poorly at school or refuse.
OCD basics
~recurrent obsessions and/or compulsions severe enough to produce distress, time consum, interfere w/ func,
~an adult must be aware of that this is excessive. w/poor insight if they don't
~ocd in teens & kids more common in males
PTSD basics
1.exposure to traumatic event
~starts with intense fear, helplessness, horror sign of reexperiencing the event least three signs of avoiding stimuli associated with event
4.persistent symptoms of increased arousal
~lasts one mosth
~acute=less than 3 months
~chronic=3 months or longer
~delayed onset = 6 mo between trauma and onset of symptoms - poorer prognosis when delayed
Generalized Anxiety Disorder
excessive worry about multiple life events or activities - present for at least 6 mos.
~must have 3 symptoms (1 in kids) restless, o edge, irritability, trouble concentrating.
~symptoms r extreme given nature o feared event
somaticize their psychological symptoms; lack psychological sophistication; and be unlikely to benefit from insight-oriented therapy.
These are characteristics associated with a 12/21 code
have low self-confidence; be suspicious and distrustful; and be likely to benefit most from concrete, behavior-oriented interventions.
These characteristics are associated with a 68/86 code.
have severe adjustment problems; be impulsive, nonconforming, and unpredictable; and be unable to form a beneficial therapeutic relationship.
These characteristics are associated with a 48/84 code.
have antisocial tendencies; be self-indulgent, impulsive, and sensation-seeking; and, in therapy, express little motivation to change.
A two-point code of 49/94 on the MMPI-2