Counseling Psych Exam 2 Flashcards
Explain the ways in which we might we define “abnormal.”
- personal distress
- deviance from cultural norms
- statistical infrequency
- impaired social functioning
*qualities will be seen together
Who defines abnormality?
Technically, the psychopathy researchers/ psychiatrists and authors of the DSM (the book of psychology disorders)
Explain why the definition of abnormality is important to professionals
facilitates research, awareness, communication, and treatment
- also keeps diagnosis concrete and consistent
Explain why the definition of abnormality is important to clients.
- demystify experience (“de-mistify” or make clear)
- feels like “not the only one”
- access to treatment and insurance coverage
- acknowledges significance
Possible downsides to diagnosis of abnormality:
- stigma
- legal consequences
Explain the purposes of diagnosis. Why is it important?
- helps counselors to better understand the nature and severity of a client’s emotional, psychological, or behavioral issues.
- allows assessment of symptoms, struggles, and challenges in a structured and systematic way.
- can develop into a personalized treatment plan tailored to the client’s specific needs
Explain the purpose of the DSM.
Originally, it standardized the many mental health treatments at facilities across the US during the early 19th century.
Describe the evolution of the DSM from its first edition to the second version
DSM-I: 100 disorders based on need to help the army
DSM-II: 182 disorders, not empirically based, Freudian influence, had 3 categories of disorders (psychoses, neuroses, and character disorders), no specific criteria for diagnosis
Describe the evolution of the DSM from its third version including its revisions
DSM-III: based on empirical data, had specific criteria for diagnosis, theoretical (authors did not take a stance like Freudian), multiaxial assessment
DSM-III-R: minor changes
In the DSM-III, there was a multiaxial assessment (5 axes). What is this and what is the purpose?
I- episodic disorders (time limited)
II- long-standing disorders (personality and intellectual disability)
III- medical issues (where to note a cancer diagnosis)
IV- psychosocial issues (issues related to disorders that are more personal, like fighting with spouse)
V- global assessment of functioning scale (GAF= numeric scale used to show how impaired a client is from 1 nonfunctional to 100 functioning perfectly)
Describe the evolution of the DSM from its fourth version including its revisions
DSM-IV: added more disorders (295)
DSM-IV-TR: text revision to include more context to diagnosis and new research
Describe noteworthy changes that were made to the DSM-V
- task force and work groups shaped the development (composed of researchers, no clinicians)
- allowed for consumer input before publishing
- aligned DSM and ICD (the international classification of disease= making it easier to collect public health data on a national level)
Describe noteworthy changes that were considered, but NOT made
- emphasis on neuropyschology
- dimensional defintion of mental disorders (like removing categories)
- dimensional approach for personality disorders
- removing 5 of 10 personality disorders
- some disorders considered but not included (do have a section for “conditions for further study”)
Explain how the DSM relates to the ICD-10
the ICD is the international classification of disease
- aligning it with the DSM-V made it easier to collect public health data on a national level
why is the “conditions for further study” of the DSM-V important?
- section outlines areas lacking research
- promotes research in those areas
- has led to the creation of diagnoses like binge eating disorder
other non implemented examples could be non-suicidal self injury, internet gaming disorder, caffeine use disorder, and attenuated psychosis syndrome
What is assessment?
a broad category for the way to evaluate the nature of the problem, strengths, challenges, potential treatments/solutions.
- ongoing process
- is not a standardized set of procedures (but this depends on the clinicians bkg)
Explain why we engage in assessment.
assessment helps find the best treatment for an individual based on their personal needs
What is a referral question and why is it important?
- It’s the client’s specific reason for seeking therapy
- can be from a parent, friend, doctor, the client, etc
- sets a focus/ goal for treatment planning
- Helps measure progress, ensure ethical practice, and engage clients effectively
Explain the concepts of reliability in the context of assessment tools.
reliability assesses the consistency and repeatability of results for a test
- EX: A reliable anxiety test should yield similar scores when taken by the same individual on different occasions.
Explain test-retest and inter-rater in the contest of reliability of diagnosis tests.
Test-Retest: results of an assessment are stable across time
Inter-Rater: get similar results across different administrators of the test
describe the basic qualities of a GOOD clinical intervention
- high validity (content, convergent, discriminant)
- high reliability
- high clinical utility (ideally assessment is helpful to the client)
Explain convergent validity in the context of assessment tools.
assessment of how well the test’s measures correlate with other techniques that measure the same thing
- matches other established tests
- EX: comparing a new self-esteem tool with established self-esteem assessments.
Explain discriminant validity in the context of assessment tools.
determines if an assessment tool does not correlate with assessments designed to measure something else
- It tests whether the tool does not correlate strongly with measures of different concepts.
- EX: A stress assessment tool should not strongly correlate with a happiness assessment– demonstrates discriminant validity
Explain content validity in the context of assessment tools.
ensures the assessment tool adequately covers the content or domain it’s intended to measure.
- assessment items should be representative and comprehensive.
- EX: A depression questionnaire should cover various symptoms of depression to be content valid.
What is clinical utility and why is it important in the context of assessment?
clinical utility assesses how well an assessment tool can benefit clinicians, patients, and the overall healthcare process.
- includes ease of administration, cost-effectiveness, relevance to treatment planning, and the impact on patient outcomes.
- EX: A depression assessment tool with high clinical utility is easy for clinicians to use, provides valuable information for treatment decisions, and improves patient well-being.
How is client feedback relevant to assessment and why is it important?
feedback from the psychologist to client provides results of tests or interviews
- often given face-to-face and as a written report
- common to all psychological assessments
- good for communication
- may help the client improve themself
Summarize key skills and behaviors for a psychologist conducting a clinical interview
general skills:
- quiet own thoughts and feelings
- self awareness (how you appear to client or seem to impact them)
- develop a positive working relationship that can segue into therapy
- respect and empathy
specific behaviors:
- listening (attending behaviors)
what are attending behaviors in the context of psychotherapy
quality of the therapist to show they are listening
- healthy eye contact
- open body language
- vocal qualities (tone, pitch, volume)
- verbal tracking (words said like “wow” “oh” to show you are following their thought)
- refer to the client by proper name (ask)
Define “rapport” as it relates to a clinical interview
“how” interviewer is with the client, ie what they do with them
- ideally, connection is a positive and comfortable between interviewer and client
- technique: directive (interview runs the show) or nondirective (client leads the interview) style
Explain major techniques (including clinician “responses”) that a clinician may use during a clinical interview
- open or closed questions
- clarification (points out discrepancies or inconsistency in the client’s communication)
- paraphrasing (restates client comments in your own words to show that you are listening and understanding)
- reflection of the feeling (echo emotions even if not explicitly mentioned)
- summarizing (ties together various topics that a client has raised to IDa theme– bouquet analogy at the end of interview)
Explain the difference between open and closed ended questions, as well as the utility of each.
open: do not have yes/no answer; may be long answer; might not get desired answers
closed: yes/no questions; short answer; less self expression and elaboration; precise answers
Evaluate the potential impact of note taking during a clinical interview
- Enhances Memory of crucial patient details
- Vital for accurate history, treatment records, and legal records
- notes must be discreet to maintain trust and privacy
Describe the characteristics of a clinician’s office that may contribute to successful clinical interviews
- calm and welcoming environment
- private room ensures confidential discussions
- neutral Decor to avoid distractions and maintain professionalism
- bigger, sunlit rooms are preferred
Example: An office with soft lighting, comfortable chairs, and a well-organized desk encourages open and successful clinical interviews.
describe the intake interview
intake: determines whether to intake the client into the agency or refer elsewhere
describe the Diagnostic interview (esp the SCID)
diagnostic: to provide DSM consistent diagnosis (often structured interview to be reliable)
- SCID: “structured clinical interview for the DSM” is used to select clients for a research study; very detailed and lengthy
describe the crisis intervention interview
used to assess problems and provide immediate intervention
EX: acute suicidal state
(more correct to say “died by” or completed suicide)
Describe the Mental Status Exam. List and describe typical components of the MSE.
How is a MSE conducted?
an interview that is typically used in medical settings to quickly get a snapshot of a client’s functioning at that point in time
Typical Components:
- Appearance and Behavior: Observe grooming, posture, and movements.
- attitude towards the examiner
- Speech and Language coherence, rate, and content.
- Mood and Affect
- Thought Process (coherence and organization)
- perceptual disturbances (hallucinations)
- memory and intelligence
- reliability, judgment, insight
EX: used for drugs, concussion, car accident, dementia, etc.
Propose ways a psychologist could acknowledge cultural differences while interviewing clients from differing backgrounds
- Sensitivity to diverse cultural backgrounds
- Active Listening
- Open-Ended Questions: Encourage clients to share their cultural experiences and perspectives.
- Avoid Assumptions and biases
- Cultural Assessment Tools if available
- Seek guidance from experts on specific cultural considerations.
Describe the components and purpose of a “commitment to treatment statement” and how it differs from a no-suicide contract.
Commitment to Treatment Statement: A statement in which the client expresses their commitment to participating in treatment, following safety plans, and seeking help when needed.
Purpose: Reinforces the therapeutic alliance, encourages client engagement, and promotes treatment adherence.
No-Suicide Contract: A written or verbal agreement where the client promises not to attempt suicide and agrees to seek help if experiencing suicidal thoughts.
Purpose: Intended to create a safety plan in the event of suicidal ideation and reduce immediate risk.
Explain why the “commitment to treatment statement” is generally seen by mental health professionals to be superior and explain why
- elicits expectations of therapist and client saying how each with participate
- gives the client control
- emphasizes open and honest communication
- has an action plan if the client feels suicidal
- addresses the root causes of distress rather than just risk management.
Compare and contrast major theories of intelligence from the early 1900s to present
- Spearman’s G
- Thurstone’s theory
- Cattell’s theory (Crystallized intelligence vs fluid intelligence)
- Carroll’s three stratum theory
- Spearman’s G: Single-factor intelligence theory (general intelligence).
- Thurstone’s Theory: Proposed multiple primary mental abilities.
- Cattell’s Theory: Differentiated between crystallized (learned) and fluid (problem-solving) intelligence.
- Carroll’s Three-Stratum Theory: Hierarchical model with three strata, from general intelligence (g) to specific abilities.
Key Differences:
- Spearman and Thurstone differed on the nature of intelligence.
- Cattell introduced the concept of crystallized and fluid intelligence.
- Carroll’s model integrates these theories hierarchically, encompassing broad and specific abilities.
describe Spearman’s G theory of intelligence testing
- Believed in one general intelligence factor (g)
- g= an individual with high ability in one domain has high ability in another
- made to help in a school setting to ID children struggling and get them more assistance
- was not intended to be used as a measure of worth. For example, the test was used in job interviews to prove that someone was a good candidate
- theory criticized it for oversimplification.
- remains influential in intelligence testing
describe Thurstone’s theory of intelligence testing
- intelligence is “plural” abilities that may not relate to each other
- recognized different abilities like math, memory, and language.
- challenged the idea of a single intelligence factor (g).
- developed factor analysis (statistical strategy used to examine the results of a long questionnaire which allocates points based on correlation of topic between questions)
describe James Cattell’s theory (Crystallized intelligence vs fluid intelligence) of intelligence testing
proposed 2 kinds of intelligence:
- Fluid: ability to reason when faced with new problems
- Crystallized: the body of knowledge and skills acquired through learning and life experience
describe John Carroll’s three stratum theory of intelligence testing
Three-level model of intelligence:
Stratum I: General intelligence (g).
Stratum II: g composed of 8 categories
Stratum III: 8 categories have many specific abilities
- acknowledges variability and differences between individuals
- is the most modern theory of intelligence
why is it necessary to use multiple tests and measures when assessing a client?
- one test can be too general or misrepresentation
- there is really a combination of factors that impact each individual
- people can be good at one thing and suck at another
Describe the structure, content and purpose of the Wechsler intelligence tests and explain how these tests are used for intellectual assessment
Three types for different age groups:
- WAIS-IV for adults (16-89)
- WISC-V for kids (6-16)
- WPPSI-IV for preschoolers (2 yrs, 6 months- 7yrs, 3 months)
Similarities:
- yield a single full-scale intelligence core
- yields 4-5 index scores
For the Wechsler intelligence tests, differentiate among full-scale scores, index scores, and subtest scores
full-scale score: equals a standard IQ score
4-5 index scores (that each has a dozen specific subtest scores) below:
- verbal comprehension
- perceptual organization
- working memory
- processing speed
Describe the structure, content, and purpose of the Stanford Binet Intelligence Scales (IN BOOK, not discussed in class)
- Hierarchical model, offers a full-scale IQ score “g”, 5 factor scores, and specific subtest scores.
- Measures intelligence of 5 factors: fluid reasoning, knowledge, quantitative reasoning, visual-spatial reasoning, and working memory
- 5 factors assessed verbally and nonverbally
- highly respected test for assessing intelligence across the lifespan (2-85+)
- administered one-to-one in person
- comparable approach to Wechsler’s tests.
Describe the structure, content and purpose of the UNIT-2
Universal Nonverbal Intelligence Test-2:
-designed to be culturally fair because it is language-free and nonverbal
- instructions are given by 8 hand gestures
- appropriate for ages 5-21
- normed on 1,800k people and is generally accepted as relatable and consistent
- has 2 sections: memory and reasoning
- shortcomings: limited range of abilities and age range; not generalizable due to small norm
Describe the podcast “G: The Miseducation of Larry”
psychologists are prohibited from administering IQ tests to black children in California because the tests are racially biased in their questions.
- Larry P. was a black student in this situation incorrectly IDed as intellectually disabled based on “g” from Spearman’s theory
- the test was normed on white, middle-class kids, so it was not culturally representative
- The test was particularly biased in the “verbal subscale” section
- implications today: multiple tests are needed to ID a child who is struggling
- intersects with the ethics code: trying to look out for the child’s best interest
Discuss the role of cultural fairness in the assessment of intelligence
cultural fairness ensures…
- fair, unbiased assessments.
- recognition of cultural influences.
- promotion of culturally sensitive tools.
- acknowledgment of bias and discrimination.
