Bias in the counseling process Flashcards
Availability Heuristic
How available relevant information is in your memory. ie you make the judgment that just because something is more accessible in your memory it is also more likely in life.
AV example
ie. counselors working with substance abuse in teens may acutally over estimate how likely this is to occur because of their experience.
Representativeness Heuristic (RH)
what are prercieved as salient features of an object are compared with characteristics of certain groups to determine the object fits into that catergory.
RH example
Child may determine unfamiliar animal is a bird because of characteristics (feathers, beak, flies etc)
RH example
Counselors may make inferences about client based on characteristics ie if they are poor they also have received little education. They are a man therefore they like professional wrestling.
RH avoidance
consider base rates of disorders or the reliability of the information obtained.
Research
Psychodynamic therapists had different impression of video tape of the same person based on whether they were told the individual was applying for a job or seeking therapy. No differences were seen in bhaviorists.
what to take note of?
seemingly less important details and details with which you are less familiar.
How to question the client>
Tailor inquiries to each individual regardless of similarities to previous clients.
Sound clinical judgement
Do not use just your previous experience, use the DSM
different angles
adopt a view point of a counselor from a different theoretical background, see how diagnosis may differ.
Base Rates
always look at how common the disorder is, and ask how likely is it that this individual with these characteristics fits this diagnostic category?
Base rates among general public and sub populations/clincal populations should be considered.
Fundamental Attribution Error (FAE)
you attribute your actions factoring in situational factors. You attribute other’s actions more to stable personality dispositions.
Issue
Counselors may focus on client contribution to problem while downplaying situational factors that need to be addressed. Also causes a fundamental disagreement between counselor and client.
other problems
Counselors may develop unrealistic negative perceptions of clients, while clients may due the same to themselves to align with counselors opinion.
Awareness
Just be aware that you will try to attribute client problems to the client not to the situation
Alternate Hypothesis
formulate ideas about the case that focus purely on situational factors.
Perspective
Put yourself in the client’s shoes.
Treatment
Don’t only treat the individual, look at ways that client can find resources that aid in situational factors ie welfare, community agencies, etc
Anchoring
when intial beliefs or pre-conceptions are not revised in light of new contradictory information.
Prior Knowledge
can increase anchoring. Ie if you are give information on a client before meeting them.
Labeling
ie if you are given a diagnosis
Research on Prior Knowledge
When shown a tape of a “normal” individual vs an “abnormal” individual. No psychotic features were found in the healthy label group 94% of clincians labled the confederate as psychotic in the abnormal label group.
Rosenhan Study
They over simplified the research causing the reader of this article to make assumptions without a full picture for the sake of brevity.
Timing of label
Study on labels had clients with lable of anorexia nervosa first vs other positions among the diangosis. The closer the anorexia dianosis was to the first statement made on the client, the more the clincian achored that diagnosis.
when to look at previous medical/case notes
After making your own notes.
Referal source reliability
THey are also susceptible to biases. Do not think that the person who saw client before you made the best clincal judgement on the client.
who to ask
ask client to check if info is correct.
also ask collegues to evaluate the existing information.
how to check if info is correct.
challenge yourself to look for information that actually contradicts your preconceptions
Diagnosis
Original diagnosis and treatment plan may not stick. You must periodically re-evaluate client individually and with client to ensure early impressions are valid.
changing probabilities
allows you to examine all logical possibilites on a continuous basis.
Confirmatory Hypothesis Testing (CHT)
once intial iimpressions have been formed it becomes more difficult for clincian to test accuarcy of hypothesis in an unbiased fashion.
CHT problem
counselor is likely to ask questions and intitate discussion that confirm the hypotheses they have formed about the client.
what to ask
ask both questions that may confirm or disconfirm your original hypotheses.
Openess
welcome information that is contradictory to your conceptualization of the client.
Hypothesis
test them, think of reasons why they might be wrong. Even ask client.
Impression
Make them explicit by writing them down. That way they don’t influence you willy nilly they exist outside of you and can be systematically tested and revised.
reconstructive memory
when people inadvertantly fill gaps or alter memories to be consistent with present experience.
memory confidence
many people are inappropriately confident in there memory and misconstrue their recolections for fact. Vividness does not = realness
case notes
can help remember essential details based in reality. The longer you wait to complete them though, the less likely they are to be accurate and contain essential information.
case notes
have to be done, and have to be done in a timely fashion. bad for the client, also bad for you if there is legal involvment.
tape sessions
can help keep a record, and for accuracy checking.
polocies
talk about this with collegues and try to influence polocies that make it easer to keep good records.
