Clinical And Counselling Psychology Flashcards
Diagnosis - definition
A process of identifying a disorder by signs and symptoms
Diagnostic classification - definition
Develop categories based on shared attributes
Assessment vs Diagnosis
Assessment - idiographic approach
Focus on unique qualities of the individual. Not single label is assigned as the result of an assessment
Diagnosis - nomothetic approach
Focus on similarity of this case to other cases of the same disorder/condition. A label is assigned
both are important in formulation and intervention planning
Types of assessments
Assessment interview
Clinical interview
Objective tests
Projective tests
Behavioural observation
Medical/neurological examinations
Mental status examination
Trust and Rapport
Clients should understand the underlying rationale of the assessment
Confidentiality
Motivation of client for being assessed
Importance of providing feedback to client
Assessment can work as therapy
Interviews
Used to assess the person holistically in the context of their social environment
Best practice - get corroborating information
Structured interviews in which questions and sequence are predetermined
Unstructured interviews are usually free flowing and informal
Interviewing - Advantages and Disadvantages
Advantages
Rapport with clients pace according to clients needs, observe non verbal behaviours
Disadvantages
Client controls degree of disclosure, can be lengthy, prone to interviewer bias, clients can be difficult to work with
From assessment to diagnosis - Clinical interviews
Clinical interview - used to make DSM diagnosis
Most common clinical assessment method
Best are structured or semi structured
Collect info on past and present behaviour, attitudes emotions and history
Usually these interviews are based on DSM criteria and provide a systematic means of assigning diagnoses
Objective tests
used to gain information that is free as possible form bias
the value of the test depends on the interpretation and the competence of the interpreter
Questionnaires, self report, forced choice, problem solving
Can be more precise and reliable than interviews or some observational techniques
Objective tests - disadvantages
Social desirability biases, forced choice responses, misinterpretation of items
case formulation
Attempt to illustrate the relationships between different aspects of a clients presentation
To indicate where an intervention might be useful
To shed light on the most appropriate type of intervention
Case formulation - Benefits and Limitations
benefits
Allows understanding to be checked
Accessible to clients
Can be dis confirmed
Parsimonious
Grounded in research
Facilitates the therapeutic alliance
limitations
Not always sensitive to cultural issues
Can be influenced by therapist bias
Can be overly influenced by clients perception of accuracy and these can vary with time
Doesn’t untangle mediating influences
Focus is on problems rather than whole person
benefits and limitations of diagnosis
benefits
Shared language which eases communication and record keeping
May improve access to services for some
May improve access to insurance cover
May encourage developmental in research and treatment
Can provide an explanation of experiences for some and possibly comfort
Limitations
A diagnosis is not a disorder
Lack of convincing evidence of distinct psychopathology d’s for different disorders
Diagnostic concepts are unstable
May limit access to services
Artificial distinctions between normal and abnormal
Stigma
May be used as an excuse for unacceptable behaviour by some
Poor predictor of prognosis and treatment outcome
May skew research efforts
Limits likelihood of prevention work
What is the definition of a clinical assessment?
The systematic evaluation and measurement of psychological, biological and social factors in an individual presenting with a possible psychological disorder.
May lead to diagnostic classification.
