Chapter 13 Flashcards
Problem-Solving
Framework
Intake
Initial interview process
* Intake paperwork
* Discuss fees, insurance coverage, policies, procedures
* Provide professional qualifications and therapeutic orientation
* Develop therapeutic rapport
* Discuss limits to confidentiality
* Personal Health Information Protection Act (PHIPA, 2004)
* Therapist becomes a conditioned positive reinforcer
* Smiling, answering questions, providing hope, non-judgmental
* Screen for acute needs (suicidality, duty to warn and protect)
* Provide appropriate referrals for additional support
* Agree to continue to the behavioural assessment and treatment phase
Diagnosis ≠ Behavioral
Assessment
Categories:
* Neurodevelopmental Disorders
* Schizophrenia & other Psychotic Disorders
* Bipolar & Related Disorders
* Depressive Disorders
* Anxiety Disorders
* OCD & Related Disorders
* Trauma & Stressor Related Disorders
* Dissociative Disorders
* Somatic Symptom & Related Disorders
* Feeding & Eating Disorders
* Elimination Disorders
* Sleep-Wake Disorders
* Sexual Dysfunctions
* Gender Dysphoria
* Disruptive, Impulse-Control, and Conduct Disorders
* Substance-related disorders
* Neurocognitive Disorders
* Personality Disorders
* Paraphilic Disorders
* Other Mental, Medication-induced Disorders, etc.
Cultural Diversity & Social
Determinants of Health
(SDH)
Mental health services have NOT been
accessible, available, or effectively provided in
marginalized groups (e.g., racialized, LGBTQ2S+,
SES, etc).
Cultural
Competence
Attitudes: awareness of one’s personal biases and assumptions
Knowledge: nonjudgmental understanding of the client’s cultural perspective and expectations for mental health services
skills: intervention techniques that are culturally sensitive and responsive to diverse clients
Changes
Needed for
more
Culturally
Sensitive
Therapy
CBT
* Identify environmental factors that need to be changed
(rather than individual factors that need to be changed)
* Validate the client’s self-reported instances of discrimination
(rather than questioning)
* Emphasize client-therapist collaboration (not confrontation)
* Be aware of not challenging client’s thoughts and core
cultural beliefs (from therapist’s lens)
BT
* No such thing as “culture-free” treatment – the
establishment is within a dominant culture system
* Be aware of cultural norms, but cannot assume all members
of a given group will follow specific practice/rule
(stereotyping)
* Therefore, it is very important to do an individualized
behavioural assessment with an awareness of:
* the client’s context
* the client’s perspective
* your own biases
* your own cultural competence (or lack thereof)
Second
Step:
Behavioural
Assessment
Goal is to determine the relationships between:
- Antecedents = the stimuli from environment
(controlling conditions) - Behaviour = target behaviour
- Consequences = response after that
increases/decreases behaviour
= ABCs of behaviour
Collecting RAC-S
Order of data collection is:
* Response = target behaviour/response (problem
areas)
* Antecedents = the stimuli from environment
(controlling conditions)
* Consequences = response after that
increases/decreases behaviour
* Strength = the magnitude and the latency (time) of
the response
= RAC-S assessment approach
RAC-S
Assessment
Form
five steps
Interobserver Agreement (IA)
- IO = Identical Observations
- DO = Different Observations
- Goal: 80-100% interobserver reliability
equation IA=IO/IO+DO
Subjective Units of Discomfort
(SUDs)
- Also called Subjective Units of Distress
- Commonly used
- Very useful
Formal
Assessment
Instruments
Questionnaires
* Rating Scales
* Screening
* Checklists
* Personality assessments
* Etc…
Functional
Behavioural
Assessment
Specific tool as part of an overall
Behavioural Assessment
What is the function of this behaviour?
What contingencies
maintain this
behaviour?
Antecedents?
Consequences?
Use observation, interviews, and
functional analysis
Functional
Analysis
To manipulate the antecedents and
consequences to understand their effects
* Ethical considerations when used as an
experimental tool
* Less often used as a experimental tool
now and primarily as an observational
tool
