Clinical Psychology Chapters 5 And 6

Front 1

Beck Depression Inventory

Back 1

What does BDI stand for?

Front 2

What is BDI?

Back 2

created by Dr. Aaron T. Beck, is a twenty-one question multiple choice self-report inventory that is one of the most widely used instruments for measuring the severity of depression.

Front 3

What areas should you get information on for your interview?

(there are 6)

Back 3

1. the history of parents and grandparents
2. early childhood
3. school years
4. adolescence
5. adult life
6. family information

Front 4

questions you should ask about the history of parents and grandparents

Back 4

-tell me about your parents' lives
-what can you tell me about your grandparents' lives
-inquire about their lives before and after marriage, including important events in their life, their childhood, education, occupation, ethnic and religious background. If they leave out a parent or grandparent, inquire about them

Front 5

questions you should ask about early childhood (before school)

Back 5

-what do you know about yourself as a baby
-what was your mother's pregnancy like
-were there any family stories or jokes about what you were like as a child
-what are your earliest childhood memories
-what do you remember or know about major early events in your life - like eating habits, walking, talking, and toilet training
-were there any stresses in your family at that time

Front 6

questions you should ask about school years

Back 6

-what were your early years in school like
-do you remember the very first day of school
-how did you do at school work through the years
-what were your relationships like with your teachers and schoolmates
-who were your friends and what sorts of things did you do with them

Front 7

questions you should ask about adolescence

Back 7

-what was you adolescence like
-how was your social and school life at that time
-when did you mature sexually, and what was that time of your life like for you
-what was your relationship with your friends like at that time
-what was your relationship with your family at that time
-when did you start to date, and what were those relationships like

Front 8

questions you should ask about adult life (including college)

Back 8

-what has been important about your adult life
-what have your adult relationships with friends and co- workers been like
-what has your relationship with your (husband/wife, fiancee, boyfriend/girlfriend) been like
-what types of jobs have you worked at, and what did you think about those jobs
-what was college like for you
-what hobbies or other interests do you have

Front 9

questions you should ask about family information

Back 9

-what has your family been like over the years
-tell me about your brothers and sisters (age, education, marital status, their relationship with the interviewee)
--how would you describe the personalities of the people in your family
-what role did each parent take in raising you
-were there any emotional problems in the family, or conflicts between family members
-did your family ever move, what was that like
-what is the ethnic background of your family
-what has been your religious upbringing, and your attitudes about religion
-describe your own family (relationship with children, how children relate to each other and spouse, typical activities, etc.)

Front 10

What background information should you be sure to get?

Back 10

relationships, educational, medical history, mental health history, substance use, criminal/legal history

Front 11

what should be included in psychological evaluation?

Back 11

-purpose for evaluation
-assessment procedures
-background information
-mental status examination
-results of evaluation
-diagnostic impressions or summary/recommendations

Front 12

reason for: purpose for evaluation

Back 12

briefly introduce the client/patient and the problem
-begin with a concise demographic picture
-use this section to tell your reader what issues you will address in the body of the report

Front 13

what to include in the assessment procedures

Back 13

call it this name instead of tests administered because it allows you to include the MSE and the clinical interview
-be sure to note who gave the tests, the dates the tests were administered, and how long it took

Front 14

what to include in background information

Back 14

maintain chronological order whenever possible
-family, educational, social, medical history, previous history of mental health treatment, legal/criminal history, and any substance abuse history

Front 15

what to include in the mental status examination

Back 15

-focus on your observations and impressions
-avoid quoting the patient's opinion or his own mood, affect, etc.
-avoid mixing in background information or test information with this section
-general appearance and behavior
-speech and thought
-consciousness
-perception
-obsessions and compulsions
-orientation
-memory
-attention and concentration (serial 7s)
-general information
-intelligence
-insight and judgment
-higher cognitive functioning

Front 16

what to include in results of evaluation

Back 16

-separate paragraphs in this section by integrating data from the history, mental status exam and behavioral observations with data from all the tests

Front 17

what to include in diagnostic impressions or summary/recommendations

Back 17

-begin by specifically answering the questions you posed under "purpose for evaluation"
-elaborate as much as needed to present your conceptualization of the case
-any recommendations for treatment can also go here

Front 18

Psychological assessment involves 4 stages that overlap
Those stages are...

Back 18

-Planning
-Data Collection
-Findings
-Data Processing

Front 19

what are the 3 types of psychological evaluations

Back 19

1. classification
2. description
3. prediction

Front 20

classification

Back 20

-traditional goal is to classify by using diagnostic labels (DSM)

Front 21

Diagnostic and Statistical Manual of Mental Disorders I

Back 21

1952
-glossary of descriptions of 60 diagnostic categories

Front 22

Diagnostic and Statistical Manual of Mental Disorders II

Back 22

1968
-145 categories, based on psychoanalytic theory

Front 23

Diagnostic and Statistical Manual of Mental Disorders III

Back 23

1974
-atheoretical, specific # diagnostic criteria, multiaxial system (5 axes), hierarchy (if criteria met for > 1 disorder, diagnosis higher in hierarchy given)

Front 24

Diagnostic and Statistical Manual of Mental Disorders III-R

Back 24

1987
-changed hierarchy

Front 25

Diagnostic and Statistical Manual of Mental Disorders IV

Back 25

1994
-based on empirical research of disorders, decision rules, 300+ diagnostic disorders, changes included coding personality disorders and mental retardation on Axis II

Front 26

Diagnostic and Statistical Manual of Mental Disorders IV-TR

Back 26

2000
-revised the text to include research in the descriptions

Front 27

criticisms of diagnostic labels

Back 27

-by giving the problem a label the clinican has not furthered his or her understanding of the problem
-association with a medical model
-poor reliability
-negative social stigma

Front 28

true positive prediction

Back 28

predict that a certain behavior will occur and it does

Front 29

false positive prediction

Back 29

predict that a certain behavior will occur and it does not

Front 30

sensitivity

Back 30

when a behavior predicted to occur, it does

Front 31

specificity

Back 31

a behavior predicted not to occur ad it doesn't

Front 32

true negative

Back 32

used to describe the prediction that, in one case, the person will relapse into alcohol abuse and the person does

Front 33

false negative

Back 33

the prediction that the person will relapse but the person stays sober

Front 34

factors limiting the ability to predict behavior

Back 34

-base rate problem
-psychologists limited knowledge of wide variety of situational influences that impact the client

Front 35

base rate problem

Back 35

over prediction (lots of false positives) when one deals with low base rate events

Front 36

methods of combining information for making predictions

Back 36

-clinical method
-statistical method

Front 37

clinical method

Back 37

psychologist constructs a model to explain the person's psychological functioning and uses this model to predict how the individual will behave in the future

Front 38

statistical method

Back 38

classifying the person based on characteristics he or she shares with others

Front 39

data collection: 4 basic methods + 1

Back 39

1. interviews
2. norm-referenced tests
3. observations
4. informal assessment
- examination of life records

Front 40

what are the "pillars" of psychological assessment

Back 40

-clinical interview (most common method for collecting data)
-standardized tests(administered the same test same way)
-observation (helps clinician develop hypotheses)
-informal assessments ("testing the limits")
-examination of life records (direct questions)

Front 41

processing assessment data

Back 41

-based on theoretical orientation-sign interpretation: behavior is viewed as a sign of some underlying characteristic
-sample interpretation: view assessment as a sample of clients behavior
-correlates: inference between signs and samples
-clinical judgment: clinician's subjective decision making about client

Front 42

communicating findings: organization of the findings

Back 42

-identifying information (demographic data)
-reason for referral
-background information
-behavioral observations
-assessment results and interpretation
-summary and recommendations

Front 43

what are collateral interviews?

Back 43

another perspective from one of the patients family members

ex. husband/wife, children

Front 44

clinical interview vs. social conversation characteristics

Back 44

-different social roles of the two participants (professional vs. "patient")
-settings where the interviews occur
-clinical interview is one-sided
-clinical interview has an objective or purpose

Front 45

types of clinical interviews

Back 45

-intake
-case history
-diagnostic interview
-mental status exam
-crisis interview

Front 46

intake interview

Back 46

-determine the nature of the client's problem
-determine whether or not the psychologist or agency has the resources to help the person

Front 47

CBT "think" rules to help clients define problems

Back 47

-behavior (actions that define the problem)
-solution (how might problem be handled differently?)
-positive (focus on client's strengths)
-small steps (think in increments)
-flexible (trial and error)
-future (understanding the problem doesn't help the client change the problem in the future)

Front 48

psychosocial history

Back 48

detailed description of the client's background *attitudes/emotional responses to events

Front 49

diagnostic interview

Back 49

-elicit information necessary to arrive at a formulation (based on medical model)
-asking a series of questions about the presence or absence of "symptoms"

Front 50

Mental Status Exam

Back 50

-comes from a psychiatric tradition
-protocol for organizing one's observations of the client (based on sensorium)

Front 51

what is included in sensorium?

Back 51

-general appearance and behavior
-speech and thoughts
-orientation
-memory
-intelligence

Front 52

crisis interview

Back 52

-provide reassurance
-assess the problem
-explore potential resources
-goal is to resolve the problem immediately at hand so that a catastrophic outcome is avoided (1-2 sessions)

Front 53

rapport

Back 53

mutual trust and harmony that characterized a good relationship and it is necessary

Front 54

techniques for building rapport

Back 54

-greet the client in a warm and friendly manner
-offering a cup of coffee or water
-be aware of your own cultural biases

Front 55

communication strategies

Back 55

-verbal: use open ended questions
-nonverbal: clinician's facial expressions, body posture
-congruence: consistency between verbal and nonverbal information
-listening skills: active- clarification, paraphrase, reflection, summarization

Front 56

clarification

Back 56

help me understand...
are you saying that...

Front 57

paraphrase

Back 57

take what the client has said, rephrase it, and say it back (client is understood)

Front 58

reflection

Back 58

similar to paraphrasing, but clinician describes emotional component of client's message ("that must make you feel sad")

Front 59

summarizing

Back 59

extension of paraphrasing and reflection; ties together two distinct parts of what the client has said

Front 60

types of interviews

Back 60

structured: given as they are
unstructured: very flexible, and open
semi-structured: midpoint between structured and unstructured

Front 61

interviewing with children

Back 61

-behavioral checklists
-new set of verbal strategies for children
-developmental considerations: verbal skills, memory, conceptual skills, organizational skills not fully developed
-provide alternatives to verbally answering questions

Front 62

cultural diversity

Back 62

-differing communications styles (Native Americans)
-be aware of your own cultural background and experiences
-educate yourself about communication styles
-be willing to modify your characteristic communication style in order to facilitate communication