4. Interviewing/Evidence-based treatments

Question 1

What are 6 possible interview biases?

Answer 1

1. First impressions
2. Halo effect
3. Reverse halo effect
4. Similarity – identification (when client is like me)
5. Attribution error
6. Stereotyping

Question 2

What is the halo effect?

Answer 2

When observer likes one aspect of something (e.g., looks), and then is positively predisposed to everything about it.

Question 3

Three types of interviews?

Answer 3

1. Recruitment –to hire for work
2. Appraisal –member of staff appraises work of other member
3. Complaint/grievance

Question 4

What are some questions that might be asked in a recruitment interview?

Answer 4

Tell me about yourself?
Why do you want to work here? Why should I hire you? What did you like/dislike about your last job?
What would you like to be doing five years from now? Can you work under pressure?
How do you take direction?
What is the most difficult situation you have faced?
Do you prefer working with others or alone?
Give me an example of a problem you encountered and how you handled it?
Give me an example of a time when you faced a lot of obstacles to achieving a goal
Tell me about a project or role that you’ve taken on that is outside your job description
How have you handled situations in which you had to deal with something that you’re not totally comfortable with?

Question 5

What is motivational interviewing?

Answer 5

An interviewing approach for eliciting behaviour change by helping clients to explore and resolve ambivalence.

Question 6

In MI, where should the motivation to change come from?

Answer 6

It should be elicited from the client.

Question 7

In MI, it is the client’s task to articulate and resolve _________.

Answer 7

It is the client’s task to articulate and resolve ambivalence.

Question 8

In MI, ____ ________ is not seen as an effective method.

Answer 8

In MI, direct persuasion is not seen as an effective method.

Question 9

MI is generally a ____ and ______ interviewing style.

Answer 9

MI is generally a quiet and eliciting interviewing style.

Question 10

In MI, the therapeutic relationship is more like a ______ than _____/_______ roles.

Answer 10

In MI, the therapeutic relationship is more like a partnership than expert/recipient roles.

Question 11

What are 5 techniques of MI?

Answer 11

• Understand the person’s frame of reference, particularly via reflective listening
• Express acceptance and affirmation
• Elicit and selectively reinforce the client’s own self motivational statements expressions of problem recognition, concern, desire and intention to change, and ability to change
• Monitoring the client’s degree of readiness to change
• Affirming the client’s freedom of choice and self-direction

Question 12

Solution-focused brief therapy (SFBT) focuses on what clients want to _____ rather than on their ______.

Answer 12

Solution-focused brief therapy (SFBT) focuses on what clients want to achieve rather than on their problems.

Question 13

SFBT does not focus on the _____.

Answer 13

SFBT does not focus on the past.

Question 14

SFBT identifies things that the client wishes to _____ and those things that are currently ______.

Answer 14

SFBT identifies things that the client wishes to change and those things that are currently working.

Question 15

In SFBT you set _____, ________ goals.

Answer 15

In SFBT you set small, reachable goals.

Question 16

SFBT focuses on what two things?

Answer 16

1. Supporting people to explore their preferred futures

2. Exploring when, where how and with whom that preferred future is already happening

Question 17

What is the ‘miracle question’?

Answer 17

Suppose our meeting is over and you go home and do whatever you planned to do for the rest of the day. And then you go to sleep. And in the middle of the night, when you are fast asleep, a miracle happens and all the problems that brought you here today are solved just like that. But since the miracle happened overnight nobody is telling you that the miracle happened. When you wake up the next morning, how are you going to start discovering that the miracle happened? What else are you going to notice? What else?

Question 18

What are 4 specific techniques of SFBT

Answer 18

1. Scaling Questions
   - Typically range from the worst the problem has ever been to the best things could ever possibly be
2. Exception Seeking Questions
   - The goal is for the client to repeat what has worked in the past, and to gain confidence in making improvements
3. Coping questions
   - Designed to elicit information about client resources
4. Problem-free talk.
   - This strength from one part of their life can then be transferred to the area with the current problem

Question 19

What is the purpose of a diagnostic interview? 6 things

Answer 19

1. Understand client’s problem and reason for presentation
2. Gain awareness of client’s personal, social and
   environmental history
3. Establish diagnosis
4. Start to develop formulation
5. Rationale for treatment
6. Flexibility: Changing diagnosis and formulation in light of new information

Question 20

What should you do at the very beginning of a clinical interview?

Answer 20

Establish rapport –small talk, put person at ease.

Question 21

What’s the first question to be asked at the beginning of diagnostic interview?

Answer 21

Something that elicits a brief description of problem. E.g. “What brings you here today?”

Question 22

What are the two aims of the diagnostic interview?

Answer 22

1. Develop problem formulation

2. Develop treatment plan

Question 23

In a diagnostic interview, how can the problem be described?

Answer 23

In terms of its:

• Precipitants and consequences (functional analysis)
• Duration & pattern
• Behaviours
• Cognitions
• Physical symptoms
• Affect

Question 24

What are 9 signs of a good treatment?

Answer 24

1. Symptoms and complaints lessened; end-point functioning improved
2. Risk factors reduced
3. Improvement lasts after treatment ends
4. Better than alternative therapy, non-specific therapy and no therapy (efficacy)
5. Improvement not due to spontaneous remission, regression to the mean, or placebo effects
6. Acceptable to client (cost, pain, duration, side-effects, adherence)
7. Easily disseminated (available competent practitioners, training requirements, need for costly technologies)
8. Can be generalised across patient groups; robust effects across clinical settings and time frames
9. Costs of delivering intervention outweigh cost of withholding

Question 25

What is the difference between efficacious and specific;

efficacious; and possibly efficacious treatments?

Answer 25

Efficacious and specific
- Evidence from at least 2 setting that that treatment is superior to placebo condition or another bona fide treatment
Efficacious
- Evidence from at least 2 settings that the therapy is superior to no treatment
Possibly efficacious
- Evidence from at least one study in a single setting that therapy is superior to no treatment

Question 26

What happens in CBT?

Answer 26

Goals of therapy are agreed at start. Each session is planned. A formulation is developed using a cognitive-behavoural model –identifying cognitions and behaviours that cause distress. Empirically validated strategies enhance coping by modifying emotions, behaviours and thoughts. Outcome assessed during, after and some time later.

Question 27

How does interpersonal psychotherapy work?

Answer 27

Like CBT, is time-limited and focuses on a specific vulnerability to social stressors. It helps identify areas in need of skill-building to improve the client’s relationships through linking changes in mood to events occurring in his/ her relationships, communicating feelings and expectations for the relationships, and problem-solving solutions to difficulties in the relationship.

Question 28

What are the four general areas in which a person may be having relationship difficulties?

Answer 28

1) grief after the loss of a loved one;
2) conflict in significant relationships;
3) difficulties adapting to changes in relationships or life circumstances; and
4) difficulties stemming from social isolation

Question 29

What’s the difference between BRIEF dynamic therapy and standard psychotherapy?

Answer 29

One major focus, developed during initial evaluation, rather than the more traditional psychoanalytic practice of allowing the client to associate freely and discuss unconnected issues. Therapist takes a more active role

Question 30

What’s the method of MBCT?

Answer 30

Becoming aware of all incoming thoughts and feelings and accepting them, but not attaching or reacting to them.

Question 31

What’s the theory of MCBT?

Answer 31

When individuals who have had depression get distressed, they return to automatic cognitive processes that can trigger a depressive episode.

Question 32

What’s the goal of MBCT?

Answer 32

To interrupt the automatic cognitive processes that lead to depression and teach the participants to focus less on reacting to incoming stimuli, and instead accepting and observing them without judgment.

Question 33

What is family-focussed therapy and what is it for?

Answer 33

Family Focused Therapy (FFT) includes immediate family members, who are:
- given psychoeducation about the symptoms and etiology of bipolar disorder and the need for medication adherence

• taught to respond early to emergent symptoms, and provided with training about the best coping responses.
• taught communication and problem-solving skills for reducing conflict and resolving family problems, drawing on evidence that overly negative family interactions (expressed emotion) can trigger relapse of bipolar disorder.

Question 34

What is an efficacious and specific treatment for major depression?

Answer 34

CBT; Interpersonal therapy

Question 35

What is an efficacious and specific treatment for GAD?

Answer 35

CT

Question 36

What is an efficacious and specific treatment for Social Phobia?

Answer 36

Exposure therapy; CBT

Question 37

What is an efficacious and specific treatment for OCD?

Answer 37

Exposure and response prevention

Question 38

What is an efficacious and specific treatment for preventing relapse?

Answer 38

CBT

Question 39

What is an efficacious treatment for bipolar?

Answer 39

CBT and FFT –as an adjunct to medication

Question 40

What is a risk for a therapist in using non-evidence-based treatments?

Answer 40

They may have to come before a board and provide evidence for why they have chosen that therapy. (Which is hard because there is no evidence).

Question 41

What are some of the implications of making a diagnosis?

Answer 41

1. People carry it forever – especially if a PD
2. Can be helpful if common and treatable; can normalise for the patient
3. Can be damaging if rare and incurable – such as SZ

Question 42

What should you do when a patient walks in with a diagnosis?

Answer 42

Always question it – they may have been misdiagnosed.