Communication Flashcards
You are a seeing family with 6 yr old. Wants to be picked up by father, and he does this. Mother tells child he’s being childish and he father he shouldn’t be doing this. Father sighs and they walk into room. Best way to engage family?
1. Ask parents about the childs strengths with a child there
2. Engage child separately
3. Leave child at reception and talk to parents
4. Ask mum why she thinks child being childish
5. Tell parents session is going to be fun and relaxed.
- Ask parents about the childs strengths with a child there
1 is the best, they’re all not good but 1 is best.
Q. Client. Business man. Tells you he is concerned about his relationship with his wife and feels depressed, anxious and stressed. Doesn’t understand why his wife is so unhappy – he makes money and gives her nice things. When talking about session fees he tells you his GP said it would be bulk billed.
What to do? Best initial response.
- Ask him if the GP bulk bills
- Discuss rates for psychological TX in private practice
- Refer back to GP for a new referral
- Refer client to hospital for TX
- Tell him he has enough money
- Discuss rates for psychological TX in private practice
Q. Writing a report for an assessment you did of a 15yo boy. You assess his emotional functioning and clinical assessment of psychopathology. The report is for the boy’s parents and for the school counsellor. The parents are interested in his functioning and how to help. The school principal wants a copy for files. The school counsellor wants recommendations for implementation at school. What is most appropriate way to report?
- Individual report for each person
- Report for school counsellor and give copies to the other two
- One report presenting all info in integrated format
- Separate report for school counsellor and parents and a copy for the principal
- One report with separate sections for each interested party
- One report presenting all info in integrated format
Q. Working in a school. Seeing 13yo student. Referred by teacher. Teacher tells you the girl’s academic performance declined recently. Previously high performance. Teacher would like a report to see how to help the girl improve performance. Girl is having difficulty making friends and with appearance. What is the most appropriate focus for recommendations?
- Strategies focus on strengths and weaknesses
- Strategies to help student improve social performance
- Strategies to help student improve academic performance
- Strategies that explain why there are difficulties
- Strategies that focus on client peers increasing support
- Strategies to help student improve academic performance
‘Strategies that focus on strengths and weaknesses’ is too vague. Doesn’t say what you are doing. If the reasons for the decline is to do with social problems would look at that but we don’t know that yet. The focus needs to cover the referral Q.
Teacher has referred. Anytime you see report focusing on strengths and weaknesses, it’s blah blah blah.
Asked by a school to do assessment of student so student can access learning support. Child’s results don’t meet criteria for funding. Principal rings and says student will struggle without funding and support, asks you to reconsider diagnosis so student can get funding. Most approp. Response?
1. Recommend they get 2nd opinion
2. Tell the you will reassess in 12 months
3. Tell principal consequence of misdiagnosis
4. You change diagnosis as it was close anyway
5. Arrange peer review of scoring to make sure you are right.
- Tell principal consequence of misdiagnosis
Explain that you cannot fudge the results. No basis for seeking a second opinion or changing the diagnosis based on the information provided in the question.
Q. What is the most important consideration for writing background section of a report?
- Only including info the client gave permission
- Deep dive narrative
- Summarize relevant factual info about client’s life
- Integrate critical pieces of client life into the whole report
- Only include info that can be corroborated by difference sources
- Summarize relevant factual info about client’s life
Q. Male psych starts seeing married woman from Afghanistan, referred by GP for depression and marital diff. Speaks good English. Do a few sessions in English with her, do some treatment planning with her, agree on certain gaols. In fourth session husband shows up with her and asks whether he can attend session with his wife. Your client nods. What is the most important initial action for this psych to take?
- Do treatment session with both
- Meet with each separately to discuss concerns individually
- Decline husbands request and tell him that you’ll continue seeing wife alone
- Discuss first with wife alone if she wants husband present
- Tell husband and wife that you cannot continue with treatment
- Discuss first with wife alone if she wants husband present
The fact she is from Afghanistan is a red herring. Would always get consent from the client.
Q. Working with a young female who identifies as aboriginal. Lives in inner suburb of Sydney. Is seeing you for TX of anxiety. Which of these options will help you build a therapeutic alliance with this client?
- Didactic methods and psychoeducation to teach client about anxiety
- Recognize importance of sharing personal information about your family with the client
- Recognize cultural reasons for client’s anxiety
- Establish if drug and alcohol is involved in the clients anxiety
- Treat her same as everyone else. Urban aboriginal people are same as everyone else
- Recognize importance of sharing personal information about your family with the client
For Aboriginal people the best way to establish an alliance is when they know something about you. Connection based on family and connection is crucial.
When asked questions about testing Aboriginal people, the answer is usually to interpret with caution and to note that most tests are not normed with Aboriginal clients.
For aboriginal people, best way to establish alliance is to know something about you. Where you come from, where your ancestors come from. Aboriginal connect through kinship and family. For them to know something about you.
Board will mainly ask about family and belonging with aboriginal people.
Tests with aboriginal : take results with caution. Maybe do non verbal test.
Q. You are running a social skills group in your practice. You advertised in the area. Local GP starts referring a lot of clients to you. You realize many of these clients don’t meet criteria for the program. What to do?
- Decline the referral with a letter to GP and each client
- Call clients to discuss inclusion criteria again
- Refer clients to another social skills program
- Stop the program
- Change criteria for the program to fit the referrals
- Decline the referral with a letter to GP and each client
Most conservative answer here is 1. Written format. AHPRA’s favourite is to write to everyone.
With communication ahpra always want most conservative option. If there’s an option between ringing someone or writing letter, always write letter.
Q. GP in your practice asks you to do a WISC for one of her children. She wants to know if the child is eligible for a gifted and talented program. What is best way to proceed?
- Refuse the request and counsel GP about misuse of assessments
- Do the assessment and send the GP the raw scores
- Refuse the request and provide the name of a colleague who will do the assessment
- Do the assessment and send GP the report
- Refuse request and tell GP to go to school and ask for assessment
- Refuse the request and provide the name of a colleague who will do the assessment
Schools don’t do assessments for gifted stuff so wouldn’t refer back to school. First thing you do is refer to colleague. Conflict of interest / dual relationship.
There is no misuse.
Q. 60yo client. Referred for TX of insomnia. Client tells you he has difficulties falling asleep. Recently he has seen a neurologist for an assessment. Psychologist writes letter with TX plan and a copy for the neurologist. What is the most important reason to send a copy to all relevant professionals?
- AHPRA requirement
- Ethics code requirement
- Medicare reporting expectation
- In best interest of the client
- To maintain good relationships with referrals
- In best interest of the client
Q. Work cover report. What is something you never include in reports?
- Diagnosis irrelevant to the injury
- Raw scores
- TX plan and progress to date
- Observations of client
- MSE
- Raw scores
Never include raw scores, they mean nothing. If you see an answer raw scores ignore other answers. This is always the answer.
Q. You are F psychologist. Client is M. Chronic pain and depression after work injury. Client is Arabic background. Wants to return to work ASAP. When client arrives, limited eye contact and short answers. Regularly attends appts. Wants to return to work ASAP. Most likely explanation of client behaviour in session?
- Pain reduced ability to engage in sessions
- Injury impacts his comprehension of your questions
- Cultural beliefs influence his behaviour
- Client is not motivated to change
- Client is so depressed it impairs his mental state
- Cultural beliefs influence his behaviour
This is a bit of a curly one. Board might be looking for a cultural understanding here as there is nothing much else you can derive from the information given.
You working in one clinic, and starting to work in another clinic. Seeing someone in one clinic and they want to start seeing you as well in the other clinic. What do you do?
1. Take files with you on your laptop
2. Tell them you can’t
3. Do you carry the files
4. Do you keep separate files in each clinic.
- Do you keep separate files in each clinic.
Board not keen on you taking things on your laptop. Board might give some weird scenarios, don’t get stuck on that. It’s just about them asking about keeping notes.
How do you keep client records in multidisciplinary practice (like a hospital) / test protocols.
1. In the file that everyone can access
2. Own cupboard at home
3. Separate filing cabines that only psychs have access
4. Destroy them
5. Sep filing cab that people can access If they need them.
- Separate filing cabines that only psychs have access
