Ch 13 and 14 Clinical, Counseling, and Neuropsychological Assessments Flashcards
Clinical vs Counseling Psychology [placeholder]
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Clinical
- Primarily concerned with severe forms of pathology
- Major Depression, Schizophrenia
Counseling
Primarily concerned with everyday problems Ex: relationship or occupational problems
Purposes of Assessment
- Clarify the psychological problem
- Make a diagnosis (DSM-5)
- Design treatment
- Perhaps make placement recommendations
Assessment Tools
- Interviews
- Tests
- Case History Data
- Observations (by self or others)
After you assess, findings must be interpreted, and a lot of graduate school clinical training involves learning about the interpretation
Interviewing
Generally includes info on:
- Demographics
- Reason for referral
- Medical info (past, present, & familial)
- Psychological info (past, present, & familial)
Interviewing
Importance of both content and process
- Content is what you say
- Process is how you say it (also nonverbal behavior)
Interviewing
Importance of both content and process
- Content is what you say
- Process is how you say it (also nonverbal behavior)
- Variation related to structured
Varied Interview Structures [Placeholder]
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Unstructured
- Flexible
- Gather in-depth info
- Need skilled interviewer
Semi-structured
- Some flexibility
- May be lengthy
Structured
- Useful for screening
- Little skill needed
- Increased reliability (often)
The Interview in Clinical Assessment (General Interview Questions)
- Demographic data
- Reason for referral
- Medical history and present medical conditions
- Familial medical history
- Psychological history and present psychological conditions
- History with medical or psychological professionals
Structured
- Useful for screening
- Little skill needed
- Increased reliability (often)
The Interview in Clinical Assessment (General Interview Questions)
- Demographic data
- Reason for referral
- Medical history and present medical conditions
- Familial medical history
- Psychological history and present psychological conditions
- History with medical or psychological professionals
Mental Status Examination
An examination intended to screen for intellectual, emotional, and neurological deficits
The Psychological Report
Psychological reports vary depending on their purpose
Barnum effect
The finding that people tend to accept vague personality descriptions as accurate descriptions of themselves
Clinical prediction
The application of a clinician’s own training and clinical experience as a determining factor in clinical judgement and actions
Mechanical prediction
Clinical prediction
The application of a clinician’s own training and clinical experience as a determining factor in clinical judgement and actions
Mechanical prediction
The application of empirically demonstrated statistical rules and probabilities to the computer generation of findings and recommendations
Mechanical prediction
The application of empirically demonstrated statistical rules and probabilities to the computer generation of findings and recommendations
- Grove et al (2000) - a meta-analysis of 136 studies
- Mechanical approach about 10% more accurate than clinical approach
Forensic Assessment
Psychological evaluation in a legal context
Differs from “regular” clinical practice
- Your “client” may not be the assessee
– Who gets the results?
– What’s confidential?
- Assessee MAY NOT be a willing participant!
– Who Pays?
Forensic Psychological Assessment:
The theory and application of psychological evaluation and measurement in a legal context
- Dangerousness to oneself or others
- Tarasoff v. the Regents of the University of California
- Competence to stand trial
– Dusky v. United States
Criminal responsibility
- Durham v. United States
- Readiness for parole or probation
Custody Evaluations
A psychological assessment of parents or guardians and their parental capacity and/or of children and their parental needs and preferences
- Evaluation of the parent
- Evaluation of the child
Neuropsychology
The branch of psychology that focuses on the relationship between brain functioning and behavior
- Formerly a specialty area within clinical psychology, has since emerged as a specialty in its own right
Neuropsychological Assessment
The evaluation of brain and nervous system functioning as it related to behavior
Purposes of NP Assessment
- Extent of behavioral impairment
- Future behavioral impairment
- Disease progression (how far long)
Purposes of NP Assessment
- Extent of behavioral impairment
- Future behavioral impairment
- Disease progression (how far along)
- Potentially effective treatments
- Evaluating treatment effectiveness
History Phrenology (Gall)
- Intellect, thinking and behavior by surface of the skill
History Broca and Wernicke
Attributed certain parts of the brain to aphasia
- Damage to Broca’s area disabled speech
- Damage to Wernicke’s area disabled language comprehension
History Phineas Gage
The patient had one of his brain areas damaged by a pole and had problems with impulsivity
History Arthur Benton
Father of clinical neuropsychology paired neurology with clinical psychology
History Ward Halstead and Ralph Reitan
- Studied brain damaged patients
- Developed tests based on observing patients
When is a neuropsychological evaluation indicated?
- In most cases a patient is referred to a psychologist
- A battery of tests will be conducted (most likely including an intelligent test, a personality test, and a perceptual-motor/memory test)
Hard sign
An indicator of definite neurological deficits (cranial nerve damage: neuroimaging)
- MRI, fMRI, SPECT, CT, PET, EMG, EEG
Soft sign
- What neuropsychological tests try to get at
- An indicator that is merely suggestive of neurological deficits (an apparent inability to accurately copy a stimulus figure)
Fixed vs Flexible [placeholder]
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Fixed
A fixed battery is a set of neurological tests determined by the test publisher
- Luria-Nebraska
-Halstead-Reitan
-Mini-Mental State Exam
Flexible
A flexible approach permits the clinician to choose the most appropriate tests case by case
- Impaired memory
- Schizophrenia
- Localized brain damage
Specific Assessment Areas: Memory
Short Term/Working Memory
Long Term:
- Explicit Memory (declarative, semantic, episodic)
Semantic - factual material
Episodic- Memory for particular context or situation
Implicit Memory (procedural)
- Memory for skills (e. g., riding a bicycle)
Tests
- California Verbal Learning Test-II (CVLT-II)
- Wechsler Memory Scale (WMS-IV)
Specific Assessment Areas: Abstract Thinking
NP decicits often involve very concrete thinking
- Can you pass the salt
- They made me jump through a lot of hoops
Assessing Abstraction
Similarities subset (WAIS)
- Object sorting task (Wisconsin Card Sorting Test)
- Such deficits can be caused by psychological problems (e.g., schizophrenia, Autism)
Specific Assessment Areas: Executive Functioning
Organizing, planning, cognitive flexibility, & impulse inhibition associated with frontal and prefrontal brain regions
Assessing EF:
- Tower of Hanoi
- Trail Tasks
- Mazes
Specific Assessment Areas: Verbal Functioning
- May assess aphasia:
- Loss of ability to express oneself or understand spoken or written language
Controlled Word Association Test:
- Examinee lists words that begin with a specific letter
- Naming tasks
- Following verbal instructions
- Writing familiar words
