Clinical Psych Flashcards
5 priorities of clinical psych
- reduce suffering + improve mental health
- engage with latest research to advance clinical
- evidence based treatment + interventions
- community + public health
- policy + systems change
3 earliest clinical psychs
- Wilhelm Wundt
- Freud
- Carl Rogers
education needed to become clinical psych
- 10+ yrs academic study + practical experience
- pHD
triangulation in clinical psychology
- clinical interview
- psych assessment
- patient case history
types of issues clinical psychs treat
- behavioural
- interpersonal-social
- adjustment issues
- emo + psych difficulties - >death + illness
- intellect, cog, neurological disorders
3 levels clinical psychs work with
- individual
- couples
- family
clinical assessment definition
structured collecting, analysing + interpreting data of psychological state + functioning to get understanding of individual’s mental health
purpose of psych evals
- informed decision making
- choose appropriate interventions
methods used for clinical assessments
- standardised psych tests
- structured + unstructured interviews
- observational techniques
what do behavioural observations show us
- behavioural patterns
what do interviews show us
qualitative
- individual history
- symptoms
- experience
clinical diagnosis definition
mental health professionals identify and classify mental disorders based on
*observable symptoms
*history
*standardised criteria
pros and cons of diagnostic criteria (DSM-5)
pro:
- structured approach
- research driven treatment
cons:
- rigid categorisation (overlooking individual variation)
- ignores diff human experiences
assessment vs diagnosis
A:
- understanding of psych makeup
- enhance therapeutic strats thru detailed insight
- personalised treatment plans
D:
- classify and label mental disorders
- assign mental health label
- alignment of treatment strats w identified disorder
mental disorder definition
combo of abnormal thoughts, emotions, behaviours + relationships
mood disorder definition + examples
extreme changes in mood that impact daily functioning
*major depressive disorder
*bipolar disorder
major depressive disorder: core symptoms + additional
core:
- depressed mood
- loss of interest in most activities
additional:
- weight change
- low energy
- recurrent thoughts of death + suicide
bipolar disorder Type 1 : core + additional symtpoms:
- manic episode = elevated mood lasting 1 week
*increased self-esteem + distractibility + impulsive behaviour
*decreased ned for sleep - depressive episode
CBT for depression
- address negative self-beliefs
- encourage behavioural activation
CBT for Bipolar
- manage depressive symptoms
- manage mood stability
interpersonal therapy for depression
- address grief
- role transition
- social conflicts
interpersonal therapy for Bipolar
- manage relationship challenges
- improve social support
anxiety disorders definition
excessive fear, worry
OCD symptoms
- obsessions: unwanted thoughts or images that cause distress
- compulsions; repetitive behaviours driven by urge to reduce anxiety
diagnostic criteria for OCD
- obsession are time consuming (more than 1 hr) or cause sig distress
- symptoms not due to substance use or other condition
PTSD symptoms (DSM criteria)
- after exposure to actual or threatened death, injury or sexual violence
- intrusive symptoms
- avoidance
- negative changes in mood and cognition
- arousal and reactivity
more than 1 month
CBT for anxiety
change unhelpful thoughts + behaviours
exposure + response prevention
- expose patients to obsessional triggers while preventing compulsion
medication for OCD + PSD
- selective serotonin reuptake inhibitors (SSRI)
crisis planning definition
- ID triggers + warning signs of relapse
- create action plan for high-stress period
relapse prevention definition
- dev coping skills + regular check-ins to maintain treatment gains
eye movement desensitisation + reprocessing on anxiety
- process traumatic memories thorugh guided eye movements
*patients recall distressing experiences while following guided eye movements to reduce emotional intensity
does eye movement work for PTSD?
- yes there is decreased trauma symptoms
psychotic disorders definition + examples
- distorted thinking, percpetions and loss of touch with reality
*schizophrenia
*delusional disorder
*schizoaffective disorder
key symptoms of psychotic disorders
- delusions = fixed false beliefs
- hallucinations
- disorganised thinking
- disorganised or abnormal motor behaviour
- negative symptoms
schizo duration + ipairsment
- 6months +
- impairment of work, relationships, self-care
steps of diagnosing schizo
- clinical interview
- mental status exam
- rule out other conditions
- functional assessment
CBT on schizo
- iD delusional beliefs + maladaptive thoughts
- challenge these thoughts
other treatments for schizo
- family therapy
- psycheducation
- social skills training
relapse prevention on schizp
- recog early warning signs
- establish cooping strats
- dev support network
- promote consistent check-ins
personality disorder definition
eduring patterns of behaviour, cog and inner experience that deviate from cultural expectations
3 clusters of personality disorders
- Cluster A = odd or eccentric
- Cluster B = dramatic or erratic
- Cluster C = anxious or fearful
narcissistic personality disorder
core symptoms + specific symptoms
core: grandiosity, need for admiration + lack of empathy
specific:
- exaggerated sense of self-importance
- sense of entitlement
- interpersonal exploitation
- envy of others or belief that others envy them
- arrogant
Borderline Personality Disorder
core features + specific symptoms
core: instability in relationships, self-image+ emotions (impulsivitiy)
specific symptoms:
- fear of abandonment
- distorted self-image
- emotioanl instability
- suicidal behaviour or self-harm
- stress-related paranoia
diagnostic steps for personality disorders
- clinical interview to assess long-term patterns
- self-report questionnaire
*personality assessment inventory (PAI) + millon clinical inventory (MCMI) - observation of behaviour
- functional impairment
common factors of bipolar and antisocial
- irritability
- impulsivity
- dangerous behaviour
- suicidal
narcissistic personality disorder treatments
- psychodynamics therapy
- CBT -> modify dysfunctional beliefs about self-importance
goals to treat narcissism
- icrease empathy + interpersonal skills
- challenge grandiosity
- dev healthier sense of self-worth
treatment of borderline personality
CBT: restructure maladaptive thoughts
- mindfulness to imrpove awareness of thoughts
- emo reg
- interpersonal effectiveness
- distress tolerance
psychodynamic therapy for borderline
- explore + resolve unconcsious conflicts that influence behaviour
- focus on early relationships that shape current behaviour
schema therapy for personality disorders
- ID + modify deep-seated schemas that make bad behaviour
- cognitively
- experiential (role-playing to reprocess traumatic events)
2 categories of sexual disorders
- paraphilic = wack sexual interests
- sexual dysfunction = issues in sexual response cycle
challenges in treating sexual disorders
- stigma + shame
- risk management -> disorders involve urges to pose risk to others
CBT for sexual disorders
- cog restructuring
- impulse control techniques
- relapse prevention
psychodynamic therapy for sex disorder?
- insight-oriented therapy -> early life epxeriences
- attachment-focused -> issues of attachment + intimacy
2 types of meds for sex disorders
- SSRI (reduce sex urges)
- anti-androgen(reduce sex drive)
3 steps of psychoeducation for pedophiles
- educate patients + families
- community resources -> guide individuals to support services
- empowerment -> manage symptoms
psychodynamic theory what does it show us
unconscious influences on problematic behaviour
- gain access to repressed thoughts + feelings
- resolve conflicts that arose in childhood
- assist clients in gaining awareness of unconscious desires
techniques in psychodynamics
- free association
- analysis of resistance
- transference
- dream analysis
epigenetics meaning
how environment can cause genetic changes
ethical considerations in clinical
- confidentiality
- informed consent
- professional integrity
cultural competence definition
understand + respect diverse cultural backgrounds
- cultural awareness
- cultural knowledge
- cultural skill
how cultural competence affects therapy
- effective communication
- client engagement
- evidence-based adaptatio s
- cultural competence models and tools
5.
psychopathology definition
study of mental disorders
self harm
direct behaviour that causes injury without conscious suicidal intent and without psychosis or intellectual impairment
prevalence of SH
- 30% in adolescents
- has increased esp among women
is SH in DSM?
Nope but physical manifestation of other disorders
factors on suicide
- psych factors
- emotional distress
- interpersonal dynamics
psychological functions of NSSI (non-suicidal, self injury)
- affect regulation
- communication
- control/punishment
- anti-dissociation
- anti-suicide
- interpersonal influence / boundaries
- self-punishment
- sensation seeking
chapman experiential avoidance model for SH
- SH primarily for coping with emotional distress (over time automatic conditioned response)
- experiential avoidance
- negative reinforcement (alleviating anxiety or guilt)
- emo reg deficits
- automatic escape responses
Dual Harm Model definition
- intersection of self-injury + aggressive behaviour ESPECIALLY in correctional settings
2 issues:
- impulse control
- emo dysregulation
Links of suicide + self-harm with cognitive deficits
- impulsivity
- problem solving
- emotional management
impulsivity definition
- premature responding, sensation seeking, risk taking + inability to inhibit response
*preferring immediate over delayed rewards
who is most likely to commit suicide
- men
- under 45 yrs old
- clinical or correctional settings
risk factors of self harm in prison
- young age
- male
- longer time in custody (unless first experience)
- prison climate
- social + mental health support
risk factors for suicide in prison
- male
- 21-39 yrs old
- not yet sentenced (fear of unknown)
- soon after release from prison
- long sentence length
- single cell location
therapeutic approach to prevent suicide
crisis response planning = strategies for prisoners when they are experiencing suicidal thoughts
ACCT document definition
assessment care in custody and teamwork
*members of staff note down causes for concern
*all staff have access so they can be mindful of factors and provide best care
measures to reduce SH and suicide
- staff training
- communication + continuity of care of prisoners
- assessment of prisoners
- monitor at risk prisoners
- prison: regular activities + social opportunities
- encourage reg contact with fam
- external expertise
7 principles of care
- suicide is NOT inevitable
- change is possible
- awareness of suicidal thoughts reduces risk of committing
- person must consent to getting help
- positive listening to alleviate despair
- some deaths will still occur even with good care
- staff also needs to be supported
theory of planned behaviour
behaviour influenced by
- attitude -> individ eval of performing specific behaviour
- subjective norm
- behavioural control -> eval of prob successful completion
transtheoretical model of change
- pre-contemplation -> no intention to change
- contemplation -> considering change in next 6 months
- preparation -> planning to act within month
- action -> engaged for less than 6 months
- maintenance -> engaged for more than 6 months
actuarial risk assessment
assesses risks through statistics
- removes human bias
clinical assessment
subjective decision-making of clinician using education + experience + intuition
- quantitative
dialectical behaviour therapy
- what disorder is it used for
- what is it
BPD
- emo regulation, interpersonal skills + distress tolerance
static risk factor
characteristic of offender predictive of reoffending that can’t be changed
dynamic risk factor
characteristic of offender predictive of reoffending that can be changed
