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120 Cards in this Set
- Front
- Back
What are the steps of the Experimental Method?
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Observation of events
Development of a hypothesis -define independent variable: those variables in the study that are manipulated by the experimenter. and dependent variables: variables expected to change as a result of changes in the independent variable. Emperical testing of hypothesis Presentation of results at a conference: not required, only as necessary per results. |
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cross-sectional between group designs
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participants in different conditions receive entirely different treatments
-often an experimental condition receives the treatment and the control group receives no treatment. different groups of participants receive different tests or treatments -compare participant or group of participants at one particular point in time. -more efficient than longitudinal designs. |
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within group
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each participant receives the same set of tests or treatments.
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control group
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does not receive treatment
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longitudinal
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changes across time, often making within group comparisons from one point in time to another.
-require much longer period of time -less efficient than cross-sectional designs but can be more valid in assessing change across time. |
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Quasi-experimental
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random, not true experimental
-used in place of true experiments when practical, ethical, or other issues limit manipulations. -less scientifically sound than true experiments, but common in clinical psychology -take a group of people who phobias and look at it to see how they can treat them, cant randomize. |
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Analogue
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-used when actual clinical populations or situations can’t be assessed.
-an approximation or stimulation of the “real thing” -can involve asking participants to remember or imagine themselves in a certain situation. |
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Efficacy
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how it works in clinical setting
-the success of a particular therapy in a controlled study conducted w/ clients who meet specific criteria -In short, “How well a therapy works in the LAB” -develop a new treatment for depression but no drug addiction-> screen them out & end up w/ a pool of participants who are by the book. -practiced by manualized methods & outcome for treated individuals is compared for those without the treatment. |
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Effictiveness
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* success of a therapy in actual clinical settings which client problems span a wider range & are not chosen as a result of meeting certain diagnostic criteria.
-effectiveness of a psychotherapy of how well it works “in the real world” -real life conditions -a lot less control, good work in real world, generalizes natural population -Ex. November 1995 issue of consumer reports survey of readers is an example -study not designed and controlled by researchers from the outset. -generally positive toward psychotherapy, but scientific rigor is questionable. |
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When did clinical psychology come into existence?
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Early 1800s
The emergence of clinical psychology around the turn of the 20th century was preceded by numerous important historical events These events “set the stage” for clinical psychology Some pioneers in the treatment of the mentally ill made important contributions in the 1700s and 1800s Mentally ill were generally viewed to be possessed by evil spirits or deserving of their symptoms |
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what is the most popular single psychotherapy orientation?
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cognitive
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What are the two models
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Boulder Model & Vail Model
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Boulder Model
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Scientist-practitioner model
-Created in 1949 at a conference in Boulder, Colorado of directors of clinical psychology training programs -Also known as scientist-practitioner model -Emphasizes both practice and research -Graduates should be able to competently practice (e.g., therapy, assessment) and conduct research, grad students conduct both clinical work and their empirical research then be awarded the PhD degree. -A balanced approach -this approach was the most dominated in the field until new models came about. |
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Vail Model
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Practitioner-scholar model
-Created in 1973 in a conference in Vail, Colorado -Also known as practitioner-scholar model -Emphasizes practice over research, less related to research and stats. -Yields the Psy. D. degree (not the traditional Ph. D.-) or Vail model. -Higher acceptance rates and larger classes for Psy. D -Proliferated in recent years |
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Clinical Scientist Model
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Emerged in 1990s, primarily as a reaction against the trend toward practice represented by Vail model
-Richard McFall’s 1991 “Manifesto for a Science of Clinical Psychology” sparked this movement -A subset of Ph. D. institutions who strongly endorse empiricism and science -Tend to train researchers rather than practitioners -Academy of Psychological Clinical Science: from the conference was to unite in an effort to promote clinical science. |
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PhD
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Emphasize practice and research
Smaller classes Lower acceptance rate Typically in university depts. Offer more funding to students |
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PsyD
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Emphasize practice over research
Larger classes Greater acceptance rate Often in free-standing professional schools Offer less funding to students |
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Clincal Supervision Pre-Doctoral?
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Last year of PhD program
Takes place at the end of doctoral training programs (before Ph. D. or Psy. D. is awarded) A full year of supervised clinical experience in an applied setting An apprenticeship of sorts, to transition from student to professional |
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Clinical Supervision Post Doctoral?
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After completion of PhD program
Takes place after the doctoral degree is awarded Typically lasts 1-2 years Still supervised, but more independence Often specialized training Often required for state licensure |
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The DSM-Who publishes it?
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American Psychiatric Association
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The DSM-How are mental disorders rated?
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-categorically (pathological/healthy)
-some push to make it more continuum recently , still somewhat up to therapist to make diagnosis. |
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Directive interview
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: questions, concrete things-How old are you? interviewer runs interview, asks directly for info, client responds with as short as a single information and client responses typically brief.
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Non-directive interview
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client runs interview; fewer direct questions, open-ended, how you feel.
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Crisis Interview
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• Assess problem and provide immediate intervention
• Clients are often considering suicide or other harmful act • Empathy , conducted in person but often take place via hotlines etc. |
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Intake Interview
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• To determine whether to “intake” the client into the agency or refer elsewhere.
-ask questions about personal history , at the end use all info and decide whether Julia’s problems would be best treated there or another place. |
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Diagnostic Interview
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To provide DSM diagnosis, like special education needs
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Mental status exam
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• Typically used in medical settings
• To quickly assess how a client is functioning at that time • Brief, flexible administration, primarily in hospitals and medical centers requiring no manual |
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High reliability
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yields consistent, repeatable results
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High Validity
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measures what it claims to measure
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Internal Validity
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-extent which change in the DV is due soley to change in the IV.
-generally high in efficacy studies. |
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External validity
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-generalizability of result
-generally high in effectiveness studies. |
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research on assessment tools
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Examples can include:
-Validation or expanded use of assessment tools -establishing psychometric data for assessment tools -comparing multiple assessment tools to each others. -studies may involve development, validation or expanded use of new instruments. -others, design questionaire. |
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Normative data-generalizable
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has test been given to broad range of people, or white males 15-25, manual for each Wechsler test includes norms collected from about 2,000 people, closely match recent U.S. census data in terms of gender, age, race/ethnicity and geographic region among other variables.
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Neuropsychological test
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Halstead Reitan Battery , focuses on cognitive dysfunction, often from brain injury or illness.
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Stanford Binet Intelligence Tests
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which is still widely used today, helps to determine which public school students should qualify for special services. Binet’s test was intended for children
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"g"
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a single, general intelligence
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"s"
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specific intelligence
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Wechsler-Bellevue
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1939, which was designed for adults
Wechsler later created tests for school-age and preschool children Revisions of Wechsler’s tests are among the most commonly used today |
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Achievement tests
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Various tests K-12, example: English, math, French, 4th grade entry.
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Aptitude
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Scholastic Aptitude Test SAT
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Projective Tests,Personality tests subjective
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Rorschach Inkblot Method—1921
Clients respond to ambiguous inkblot Thematic Apperception Test (TAT)—1935 Clients respond to ambiguous interpersonal scenes, clients asked to tell stories to go along with the interpersonal situations presented in the TAT cards. MMPI |
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objective tests
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MMPI-2difference correct answer
Typically paper-and-pencil, self-report, and more scientifically sound MMPI (1943)—comprehensive personality test measuring various pathologies MMPI-2 (1989)—revised and restandardized MMPI-A (1992)—for adolescents |
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subjective test
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Rorschach Ink Blot
Clients respond to ambiguous inkblot |
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reasons for inkblot tests -projective,subjective tests
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maybe multiple choice doesnt express your feelings
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reasons against it, projective subjective tests
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low validity, not based on close ended, low reliability
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Reasons for evidence-based therapies
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insurance basis, make goals. Scientific legitimacy: need to have the same discipline uniformly practiced for that treatment
Establishing minimal levels of competence Training Improvements Decreased reliance on clinical judgment |
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Reasons against evidence based therapies
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client may not fit into category not one illness or one disorder
Threats to the psychotherapy relationship: therapist/client relationship should not be neglected. Diagnostic complications “textbook” cases vs. “real world” cases Restrictions on practice Mandated manuals vs. creatively customized treatments Debatable criteria for empirical evidence: behavioral and cognitive therapies dominate lists of evidence-based therapies |
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Diagnosis:
How does a psychotherapist decide how to diagnose a client? |
-tests, DSM-checklist, intuition, experience, insurance purposes
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The influence of technology
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In recent years, clinical psychologists have increasingly used technology in the direct delivery of psychological services
Assessment Treatment Telehealth can replace or supplement face-to-face meetings Benefits can include accessibility, affordability, and anonymity, and more |
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applications of tech in clinical psych
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Videoconferencing to interview or treat
Email psychotherapy Interactive Internet sites Online psychotherapy programs Virtual reality therapeutic experiences Computer-based self-instruction Therapist/client interaction via hand-held devices (e.g., iPhones, cell phones, Blackberries) |
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technology suggestions for emerging proffessional issues
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Obtain informed consent about the technology
Follow relevant telehealth laws Follow APA ethical code Ensure confidentiality via encryption Make efforts to appreciate culture Obtain relevant training Know client’s local emergency resources -how can the psychologist be sure that the client is in fact the person agreeing to the informed consent statement, responding to assessment or providing comments during online therapy. |
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technology-additional potential problems
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Confirming the identity of the client
Confidentiality across electronic transmission Making interpretations in the absence of nonverbal cues that would be present face-to-face Competence in technical as well as clinical skills |
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technology effectiveness of the treatment
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Early research is beginning to demonstrate that it can work
Success depends on many factors: Which treatment, disorder, device? What setting? How clients found or were referred to treatment? Live support available? |
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APA attention
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Sexual Orientation: yes
Cultural Orientation: yes Health: yes |
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School Requirements-Accreditation in clinical psych
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-look for cultural awareness, multiculture
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Which values are inconsistent with cultural values and experiences of clients?
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-Time,place, self disclosure (Type), treatment approaches
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Etic
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similarities
-Emphasizes similarities between all people - Assumes universality - Downplays culture-based differences |
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Emic
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-more culturally difference
- Emphasizes culture-specific norms - Appreciate clients in the context of their own culture -considers a clients behavior thoughts and feelings within the context of the clients own culture rather than imposing norms of another culture onto the client. |
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What is cultural competence
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-To be culturally competent, a psychotherapist needs to: not make assumptions, be self aware
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What might happen if psychotherapist is not culturally aware?
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microaggression, overpathologize: viewing as abnormal that which is culturally normal.
-parents automatically think our students have condition w/ child’s progress -psychotherapist-come across gently. |
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Acculturation
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response to new cultural environment
-respond by a variety of ways, especially regard to adopting elements of the new culture or retaining elements of their original culture. |
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Assimilation
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high new,low original. individual adopts much of the new culture and abandons much of the original
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Seperation
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low new, high original. the individual rejects much of the new culture and abandons much of the original
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Marginilization
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low new and orinigal, which the individual rejects both the new and the original culture
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Integration
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high new and original, individual adopts much of the new culture and retains much of the original.
-by choice, by chance |
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desirable psychotherapist actions
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-quieting oneself
• -establishing rapport: a positive, comfortable relationship between interviewer and client • Client feels “connected” and that interviewer empathizes • Consider cultural norms -developing positive working relationships (with whom) -> colleagues, clients, parents, children -becoming self aware |
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Techniques and Qualities of Effective Therapists I(Wampold)
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Affective modulation:
Empathy Interpersonal Skills( to develop rapport) : ex. Listening, trust, reliable, genuine |
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what is the significance of th tarasoff case?
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the Duty to Warn
-Tarasoff is a court case regarding a college-student client who told his therapist he was going to kill his girlfriend (Tatiana Tarasoff) - Therapist contacted campus police who detained him, but after he was released, he killed her -Her family sued and won - The finding was that the therapist had the “duty to warn” the potential victim - This finding now sets a precedent for all therapists for breaking confidentiality |
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what is considered unethical or undesirable?
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Multiple relationships-none
Consultation with colleagues about challenging situations regarding clients -conflict of interests |
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just say no
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-fabricating or falsifying data
-sloppy data analysis -failing to check work -not letting other researchers check work -studying or interviewing clients without -informed consent (Adults) -assent (children) |
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who can prescribe?
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podiatrists, advance practice nurses, dentists, psychologists, psychiatrists
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prescription priveledges? the states
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Historically, prescribing has distinguished psychiatrists from psychologists
However, in recent decades, clinical psychologists have actively pursued prescription privileges Since 2002, two states have agreed to grant prescription privileges to appropriately trained psychologists New Mexico Louisiana Other states have considered similar legislation, and may pass it soon |
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why psychologists should prescribe
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Shortage of psychiatrists
Especially in rural areas Important factor in NM and LA decisions CPs more expert than primary care docs,cps may be able to correctly diagnose problems and select effective medications. Other non-physicians have privileges Dentists, podiatrists, optometrists, and some nurses, among others “one-stop” shopping for clients -save time and money instead of having to refer to another person for the medication. |
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why psychologists should prescribe continued
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Professional autonomy-may feel restricted in what they can accomplish for client.
Professional identification-sets psychologists apart from nonprescribing therapists. Evolution of the profession Revenue for the profession |
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reasons against prescribing
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Training issues
Which courses? When? Taught by whom? Need to be trained about medicine and how it works. Threats to psychotherapy Would medications replace talk therapy? Identity confusion Especially when only some prescribe Influence of pharmaceutical industry |
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Lightner Witmer
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first to operate a psycholigical clinic
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clinical psychology
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branch of psychology that studies,assesses and treats people with psychological disorders.
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Lightner Witmer
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first to operate a psycholigical clinic
1867-1956 Received doctorate in 1892 in Germany Psychology was essentially academic; no practice, just study in the 1800s In 1896, Witmer founded the first psychological clinic at the U. of Pennsylvania -first time psychology was systematically and intentionally applied to people’s problems. By 1914, there were about 20 clinics in US By 1935, there were over 150 Witmer also founded the first scholarly clinical psychology journal, The Psychological Clinic, in 1907 Clinical psychology is uninfluenced by Freud -late 1800s Tuke, Pinel, Todd, Dix set the stage for the birth of clinical psych. |
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clinical psychology
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branch of psychology that studies,assesses and treats people with psychological disorders.
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Getting Licensed as a Clinical Psychologist
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Licensure enables independent practice and identification as a member of the profession
Requires appropriate graduate coursework, postdoctoral internship, and licensing exams Each state has its own licensing requirements To stay licensed, most states require continuing education units (CEUs)-stay up to date in the field. |
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Where do Clinical psychologists work?
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A variety of settings, but private practice is most common
True since 1980s Other common work settings include Universities Psychiatric and general hospitals Community mental health centers Other settings |
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What do Clinical Psycholgosits do?
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A variety of activities, but psychotherapy is most common
True since 1970s Other common professional activities include: Diagnosis/assessment Teaching/supervision Research/writing Consultation Other activities |
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What do Counseling Psychologists do?
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Tend to see less seriously disturbed clients
Tend to work less often in settings like inpatient hospitals or units Tend to endorse humanism more and behaviorism less May emphasize “positive” psychology and individual strengths more (and psychopathology less) Similar to clinical psychologists because their graduate students occupy the same internship sites, often earn the same degree. Clients can’t tell whether or not the psychologist with the PhD is in clinical or counseling psychology. |
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Early Pioneer-William Tuke
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1732-1822
Lived in England Appalled by deplorable conditions in “asylums” where mentally ill lived Devoted much of his life to improving their treatment Raised funds to open the York Retreat, a model of humane treatment, received good food, frequent exercise and friendly interactions with staff |
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Early Pioneer Phillipe Pinel
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1745-1826
Lived in France Advocated for more humane and compassionate treatment of the mentally ill in France Also introduced ideas of a case history, treatment notes, and illness classification, indicating care about their well-being Sense of empathy towards the patients |
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Early Pioneer: Eli Todd
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1762-1832
A physician in Connecticut At the time, there were very few hospitals for the mentally ill Burden for their care fell on families Using Pinel’s efforts as a model, he opened humane treatment centers in US Emphasized patients strengths rather than weaknesses, pts have input in their own treatment decisions. |
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Early Pioneer: Dorothea Dix
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1802-1887
Worked in a prison in Boston, and observed that many inmates were mentally ill rather than criminals Traveled to various cities to persuade leaders to build facilities for humane treatment of mentally ill Resulted in over 30 state institutions in US and other countries |
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Emil Kraeplin
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1855-1926) is considered a pioneer of diagnosis
Coined some of the earliest terms to categorize mental illness, through his creation of diagnostic terms it lef to the DSM-the manual. Published by American Psychiatric Association, originally in 1952 |
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mental illnes in begininng were shaped into two broad categories of?
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neurotic: suffer from what we call anxiety and depression
psychosis: break from reality, hallucinations, delusions,grossly disorganized thinking |
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what is the most drastic change in the DSM?
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DSM II to DSM-III
Larger, including more disorders Specific diagnostic criteria; lists exactly what symptoms constitute each disorder. Multi-axial system: |
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the difference between projective test and objective tests?
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Projective tests were among the first to emerge—clients “project” personality onto ambiguous stimuli
Rorschach Inkblot Method—1921 Clients respond to ambiguous inkblot Thematic Apperception Test (TAT)—1935 Clients respond to ambiguous interpersonal scenes, clients asked to tell stories to go along with the interpersonal situations presented in the TAT cards. Objective tests soon followed projectives Typically paper-and-pencil, self-report, and more scientifically sound MMPI (1943)—comprehensive personality test measuring various pathologies MMPI-2 (1989)—revised and restandardized MMPI-A (1992)—for adolescents |
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evidence based treatments/manualized therapy
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When researchers measure therapy outcome, they often use therapy manuals
To ensure uniformity across therapists To minimize variability When outcome data supports the use of a manualized therapy, the treatment is known as “evidence based” |
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third party payment on therapy can result in?
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Negative impact on quality
Too little control over clinical decisions Ethical problems, including confidentiality Confusion about informed consent (what to tell clients about payment method) Greater affordability for many clients |
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effect of third party payment diagnosis
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Surveys of psychologists suggest that third-party payment can result in
Increased likelihood of being diagnosed with a mental disorder Certain diagnostic categories being used more or less often -clients with mild symptoms of depression or anxiety more likely to assign a diagnosis when clients paid managed care rather than out of pocket. |
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effect of third party payment on psychologist
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Lower pay
Time required for paperwork, phone calls, etc. Frustration due to denial of care psychologist believes to be necessary |
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Fourth Force
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Multiculturalism
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Culture Bound Syndrome
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described as categories designed to capture repetitive, patterned and troubling experiences of people within a specific cultural group or society.
-not disorders per se but troubling experiences of people within a particular culture -some related to DSM disorders; others unique |
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heterogenity
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better served by a psychologist who appreciates the cultural group norms but also appreciates heterogeneity in herent in ever y culture.
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microagressions
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- Comments or actions made in cultural context that (often unintentionally) convey prejudiced or negative beliefs
- Can suggest dominance and cause marginalization or invalidation - Psychologists can avoid by examining their own beliefs that could produce them |
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three levels of identity
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- Individual level
- Every person is totally unique - Group level -Every person is like some others - Universal level - Every person is like all others - Clinical psychologists can recognize all three levels for any client |
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APA code of ethics
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Aspirational:
- General Principles section describes an ideal level of ethical functioning, or what to strive for -Enforceable: - Ethical Standards section includes rules of conduct that can mandate minimal levels of behavior and can be specifically violated |
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8 step model
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ethical code
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informed consent
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Required for research, assessment, therapy, and other professional activities
-For therapy, informed consent is an ongoing process rather than a one-time event -As psychologist learns more about client, more information can be shared -Informed consent for therapy must allow client the opportunity to ask questions and receive answers -Informed consent process can be an early part of a strong therapeutic relationship -signing your name did your research begin. |
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mixed group design
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-combination of between and within groups
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correlational designs
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examine the relationship that exists between two or more variables.
-do not identify variables as independent or dependent. -causality is not determined -often used when experimental or quasi-experiment designs are not deasible. |
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meta analysis
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Statistical method of combining results of separate studies in a single summary finding.
-many comparable studies -findings translated in effect sizes -can quantitively capture the trends of many individuals studies. -examples include meta-analyses of psychotherapy outcomes. |
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harmful dysfunction theory-jerome wakefield
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-harmful dysfunction theory proposes our efforts to determine what is abnormal, both scientific data (dysfunction) and the social values in the context (harmful) of which the behavior takes place.
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categorical approach
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• The current approach of DSM
• An individual falls in the “yes” or “no” category for having a particular disorder • “black & white” approach—no “shades of gray” • May correspond well with human tendency to think categorically • Facilitates communication -talk about shared issues |
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dimensional approach
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• “shades of gray” rather than “black & white” , cant say yes or no
• Place clients’ symptoms on a continuum rather than into discrete diagnostic categories • Five-factor model of personality could provide the dimensions • Neuroticism, extraversion, openness, conscientiousness, and agreeableness • More difficult to efficiently communicate, but more thorough description of clients? • May be better suited for some disorders (e.g., personality disorders) |
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all assessment techniques including interviews should have adequate?
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• Validity—measures what it claims to measure
• Reliability—yields consistent, repeatable results • Clinical utility—benefits the clinician and ultimately the client |
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unstructured interview
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involves no predetermined or planned questions.
-interviews improvise , determine their questions on the spot |
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structured interviews
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-predetermined planned sequence of questions that an interviewer asks. –usually diagnostic
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three Weschler tests
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• Wechsler Adult Intelligence Scale—Fourth Edition (WAIS-IV) (age 16-89)
• Wechsler Intelligence Scale for Children—Fourth Edition (WISC-IV) (age 6-16) • Wechsler Preschool and Primary Scale of Intelligence—Third Edition (WPPSI-III) age (2-7) |
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similarities among the weschler IQ tests
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• Yield a single full-scale intelligence score
• Also yield 4 index scores: Verbal Comprehension, Perceptual Reasoning, Working Memory, Processing Speed • Also yield about a dozen specific subtests scores • One-to-one, face-to-face administration with the psychologist. |
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UNIT?
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• Recently created (1996) test
• Entirely language free -universal nonverbal intelligence test • No speaking necessary for test administrator or test taker • All instructions are hand gestures • All responses are manual, not verbal • Some drawbacks (only for kids age 5-17, limited psychometric data, more limited range), but many strengths in terms of cultural fairness |
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what is intelligence and what is achievement?>
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• Intelligence is what a person can accomplish intellectually
• By contrast, achievement is what a person has accomplished, especially reading, spelling, writing, or math |
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RBANS
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• Repeatable Battery for the Assessment of Neuropsychological Status
• Neuropsych screen focusing on a broader range of abilities than Bender-Gestalt or Rey-Osterrieth • 12 subtests in less than half hour |
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Bender Visual-Motor Gestalt Test-Second Edition
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• Most commonly used neuropsychological screen among clinical psychologists
• Takes only about 6 minutes to administer • Simple copying test using 9 geometric designs and pencil & paper • A quick “check,” followed by more tests as necessary • Can suggest brain damage in a diffuse, but not specific, way -draw accurately Rey-Osterrieth Complex Figure Test • Brief pencil-and-paper drawing task, but unlike Bender-Gestalt, involves just a single, more complex figure • Also includes a memory component (recall figure and draw it again from memory), single figure,see it draw from memory |
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objective personality tests defintion
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• Include unambiguous test items, offer clients a limited range of responses, and are objectively scored
• Typically self-report questionnaires • Typically a series of brief statements or questions to which clients respond in a true/false or multiple choice format, check yes or no • MMPI most common |
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Beck Depression Inventory
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• Not a comprehensive test of personality, but a brief, targeted measure of one characteristic (depression symptoms)
• 21 items; takes 5-10 minutes to complete • Pencil & paper, self-report format • Lacks validity scales, and much more limited scope than other tests discussed to this point • Depression screener in college they do this, can quickly flag someone who is feeling depressed |