Eppp 2 Flashcards
Downward arrow technique
- exploring underlying beliefs and assumptions through successive questions
Paradoxical intervention
- encourage clients to engage in or exaggerate behavior they wish to avoid
- usually highlights the effects of avoidance
Generalized anxiety-7(GAD-7)
- Assessment targeting anxiety severity
Patient Health questionnaire-9 (PHQ-9)
- measure of depression severity
Many mental state exam (MMSE)
- brief assessment tool to evaluate cognitive functioning
- usually used as a screening for cognitive impairment for dementia or other neurocognitive disorders
In vivo exposure tasks
- involve client facing fears at different levels of challenge
Working with a client ambulent to exposure
- offer flexibility and support
- discuss the pros and cons of exposure
-0 discuss that can start with less anxiety provoking exposure tasks - discuss that would never do exposure that you don’t agree to in advance
Family therapy
- develop roles and boundaries around respectful communication
Family therapy with a parent saying hurtful things to a kid
- set ground rules about how to have respectful conversations and type of language that will be permitted
When asked to self-disclose?
- show curiosity about the question and assess the appropriateness for self-disclosure
Insurance opt out form
- can’t advise the client to not use insurance
- shouldn’t exclude cash pay clients from sliding scale fee options
- clients are not choosing to end their insurance coverage by signing an insurance opt out form
Credit card pre-authorization forms
- cannot charge claims for services as early as a week ahead
- can’t charge clients a cancellation of appointments that the clinician canceled
- formats have an expiration date?
Informed consent
- can’t restrict the client’s ability to ask questions or concerns
- can’t be unclear about how long appointments are
- can’t pressure clients to forgo insurances without a clear reason
Client presents with elevated mood, tangential with rapid speech, and irritability and hostility
– bipolar one and BPD
Next steps after intake with client presenting with possible bipolar one or BPD
- discuss and explore motivations for therapy if questionable
- continue engaging in treatment and referred to psychiatrist
- discuss the possibility of scheduling future sessions with partner
When arranging individual session with partner
- gather information about client symptoms and behavior to understand presentation and relational Dynamics better
Conducting a study and a student thinks they can tell who gets the real treatment versus placebo based on weekly questionnaires and report of discomfort
- discuss students observations with supervisor
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What steps should be taken to ensure a studies, ethical integrity and participants all being
- review students observations to determine if blinding has been compromised
- consultant research protocol and IRB guidelines to decide appropriate steps
- monitor, safety and well-being more closely and provide necessary support
When publishing a study, what the what ethical consideration should be taken to ensure transparency and integrity in reporting?
- include a detailed explanation of methodology, including how this study binding was maintained
- acknowledge relevant concerns raised during the study, how they were addressed in potential limitations or biases
You’re a supervisor and you receive a call from a trainee seeking phone supervision during a therapy session. There’s a depressed client expressing feeling hopeless and wishing to be dead and the supervising needs guidance. What are appropriate responses?
- When you hear suicidal ideation, directly assess for safety by determining if the client has thoughts, intent, and or plan to self-harm
- if the client denies intent or a plan to kill themselves but expressing significant distress, collaborate with them to make a safety plan
- reassure the client that discussing these thoughts is important and that you are there to support them
Client mentions a plan to jump off a bridge after session but it’s unsure about acting on it. Trainee contact supervisor to ask whether the client should go to the ER. What are appropriate responses?
- advise the trainee to discuss the client’s concerns and the next steps for safety planning
- direct training to call the police to escort the client to the nearest emergency room
- advise a trainee that it’s better to air on the side of safety when there is an active imminent suicide risk and plan of death even if the client isn’t certain about following through
Borderline intellectual ability with a processing score 122
- clients focus challenges may be due to environmental or emotional factors rather than cognitive deficits
Working with the client for 6 months with minimal progress. Client struggles to process trauma in session and expresses frustration, and you’ve already tried the modalities that you’re competent in. Most appropriate recommendations
- The possibility of referring to the client to someone specializing in edmr
- possibility of referring the client to a provider specializing in TMS
- a possibility of referring to a clinician that specializes in exposure
There are pimodalities beneficial to process trauma
- edmr
- TMS
You’re supervising and your associate has not made progress in 3 months. What should you do first?
- reflect on any differences on how the associates are being supervised
How can you Foster a positive and equitable environment for both associates in a group practice?
- facilitate team building activities to help associates feel more connected and supported in their roles
- hold joint supervision sessions to allow associates to learn from each other’s feedback-end experiences
Play therapy
- allows young kids to express emotions and experiences in ways more available and safe
- anxiety and attachment issues can be effectively treated with play therapy
Cbt
- challenges negative thought patterns and increases engagement in meaningful activities
- would be helpful for a client with depressive symptoms that are affecting self-worth and ability to work and complete responsibilities
ACT
- helpful for clients stuck in unhelpful thought patterns and juggling to accept difficult circumstances
Behavioral therapy
Effective for children with conduct and behavioral problems
You’re assassinated 8-year-old with social and situational avoidance at school. You’re considering the diagnosis of social anxiety disorder or obsessive-compulsive disorder which approach better helps you determine the correct diagnosis?
- administering a comprehensive battery would be helpful for diagnostic purposes, especially in kids
Case study
- drawback is generalizability because case studies usually focus on single individual outcomes or small group which makes them poor representatives of larger populations
Naturalistic observation studies
- effective for gathering data on how various phenomena present in real world settings. But because the. Data is reliant on researchers or readers observations. They are prone to subjectivity bias
Randomize controlled trials
- have strict inclusion and exclusion criteria which limits external validity of study
Longitudinal studies
- maturation effects are a drawback
58-Year-Old starting therapy reports, intense worry, irritability, and a blank mind. What should you do first?
- explore whether psychosocial or medical factors could be impacting symptoms
- it’s too premature to refer for neuropsych assessment or medication email
17-Year-Old shares that she is attracted to girls. Family is really religious. What should you avoid doing?
- avoid helping the client replace her current thoughts with examples and reasons that validate her heterosexuality because being gay could lead towards substantial harm
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Avoid encouraging the client to leave her religious community so that she can have freedom to explore her identity
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You’re invited by a friend to provide mental health insights on a podcast. What should you do to ensure you behave ethically?
- State in each podcast episode that you are not establishing a professional relationship with any podcast listeners and your advice is not a substitute for therapy
Client frequently interrupts other participants in group. How can you address the behavior while maintaining professionalism and fostering a respectful and supportive atmosphere in group?
- remind the group about the importance of letting others speak without interruption, highlighting respect and acknowledging the values of each individual’s contributions
- gently but firmly to redirect the conversation when the patient interrupts
+ Praise a patient when he waits his turn
- trust the behavior in real time without being confrontational and use reinforcement for positive behavior
MCMI - HIGH DISCLOSURE (X = 88)
8 AVERAGE DESIRABILITY (X = 60) AND HIGH DEBATABILITY (Z EQUALS 88)
- scores may be somewhat exaggerated
Mcmi: low disclosure( x = 20 ), high desirability (y = 85) and average debatement (z =40)
- approach interpretation with caution as scores may be slightly understated due to guarded nature of the responses
Mcmi: average disclosure( x = 73 ), love desirability score y. (Y = 25) And average debasement score (z = 53)
Responses can be made, no unusual attitude
Practicum student is struggling to build rapport with the client. Doing supervision. He tells the supervisor that he’s recently had a positive interaction in long conversation with this client at a bar. How should the supervisor handle this?
- explain how this type of interaction could be detrimental to the therapeutic process
During this intake session, a patient from a collectivist Caribbean culture emphasizes the importance of family unit over individual members and explains the family approval is Paramount to her. Which intervention is most likely to support the client in success full therapy?
- invite family members to attend sessions, this enables the psychologist to observe family Dynamics and supports which are important to the patient’s life and treatment success
My patient with OCD is anxious about contracting an STD from a new partner. When she thinks about this, she can’t stop. What are two non-engagement responses that could help her manage this obsession?
- maybe I will and maybe I won’t. Anything is possible
- it would be difficult if something were to actually happen
- encouraged to accept uncertainty without seeking assurance and acknowledge discomfort when you accept the possibility without catastrophizing or over engaging
A psychologist meets with the parents of a 14-year-old client. The parents say they’re unhappy with the clients progress and question the effectiveness of therapy and demand a refund. What would be the best way to respond?
- thank the parents for their feedback, which will adjust the treatment plan, and explain that therapy fees reflect time and expertise. Not progress or outcomes
Program centered administrative consultation
- assisting the administration of a program with program development or improvement
Ex. A consultant helps a local community college improve initiatives to promote stress Management among the student body
Client-Centered case consultation
- helping a consultee with issues related to specific client. The goal is to improve outcomes for that client
Ex: consultant helps that therapist determined the underlying cause of a client’s mood swings and determine treatment plan based on these findings
Client-Centered case consultation
- helping a consultee with issues related to specific client. The goal is to improve outcomes for that client
Ex: consultant helps the therapist determine the underlying cause of a client’s mood swings and determine treatment plan based on these findings
Consulting centered case consultation
- helping a consultant determine and address the cause of their difficulties or undesired outcomes
- does not typically involve direct assessment of a client
Ex. Consultant assist a therapist in identifying ways in which the therapist can improve their active listening skills when working with therapy clients
Consulty centered administrative consultation
- involves assisting a group of professionals in addressing challenges to their functioning as administration, focusing on how they can improve their work as a team rather than challenges of each individual
Ex. A consultant helps the administration of a psychiatric hospital determined ways in which they can improve their approach to training nursing staff in crisis intervention skills
At an integrated community Health Center, a psychologist works with a cancer patient with depression. During rounds. The primary position asks for input on the client’s mental health. How should the psychologist respond?
- provide general psycho education about cancer and mental health, including general therapy recommendations
A psychologist is using CBT with exposure and response prevention to treat a teen with social anxiety disorder. Which of the following are the most beneficial in vivo social exposure tasks for the clients exposure hierarchy?
- start a conversation with another student at school. Ask two questions and share one piece of information about yourself
- call another team to see if they would like to get together on the weekend
- drop books on the floor at the library attracting attention to from others who are quietly studying
- tasks that put you in a real life feared social situation without a warrants or escape
A psychologist who conducts assessments for various mental health concerns is going through a difficult divorce. Well, completing a recent evaluation they noticed they made a bunch of mistakes. What is the most appropriate course of action?
- correct the errors and communicate the mistakes to the client during feedback session
A 24-year-old man in therapy reveals that he spent successive time organizing, making less, obsession over details and it’s impacting his task completion at work. What questions would be the best to help you differentiate between OCD and ocpd?
- Do the client symptoms appear ego dystonic or ego syntonic
- how do the symptoms affect your relationships?
- does do you try to ignore suppress or neutralize these obsessions through other thoughts or actions?
- with OCD, symptoms are usually ego dystonic meaning they don’t align with your needs values or self-image
With ocpd they are usually ego syntonic meaning they do align with their needs values and self-image
A psychologist encounters, a former client in a coffee shop and chats with her. Following an engaging conversation, you consider a romantic relationship with the client. He and the client terminated their therapeutic relationship 4 years ago. What additional factors are most important for you to consider before pursuing the relationship?
- The potential for adverse effects on the client
- the reason why the client thought therapy with the psychologist
Decline arise for therapy and tells you that they had been drinking. What is the best response?
- Tell the client that you’re worried about their current state and want to ensure they get the most out of therapy so ask if you could help them arrange a ride home and reschedule
- consider immediate risks and take measures to get them home safe
A study of 40 healthy adult subjects were asked to practice diaphragmatic breathing for 8 weeks. At the end of the 8 weeks, the subjects reported reduced anxiety and negative affect, improved emotion regulation increased stress. And mental clarity suggesting the cognitive benefits of regular practice. What are the main limitations to the study?
- study had a small sample size which limits its generalizability to a more intensive or diverse population
- the study relied on self-report measures which may introduce bias in assessing the effectiveness of the interventions due to subjective nature or participants’ responses
+ The study lacks a control group, which makes it difficult to determine whether the observed effects were due to diaphragmatic breathing or other factors
KBIT-2
- used for brief evaluation of verbal and nonverbal intelligence and kids and adults with circumstances that do not require a full-scale assessment of cognitive ability
A client from a Southeastern Asian background 6 therapy poor depression. He primarily expresses distressed through somatic complaints like headaches, fatigue and stomach pain. Which action should the psychologists take to best demonstrate cultural awareness with?
- ask the client how he sees his symptoms affecting his mood or energy level
- ask the client how health is understood in their culture or family
- guide towards exploring the emotional and psychological aspects of physical distress in a culturally sensitive way
A 20-year-old with ADHD intense therapy with his parents. He’s been on 20 mg of methamphenidate since being diagnosed 3 years ago. His parents have noticed an increased impulsivity, irritability, and a isolation over the past 3 months. The client confirms saying it’s my thoughts. I always feel on edge like they’re out of my control. They make me sad. What therapeuticities would be suitable for this client?
- cbt can help change negative thinking patterns and learn to manage thoughts in a healthier way
- our EBT can help identify and challenge irrational beliefs that lead to negative emotions and behaviors and replace them with more rational ones
A woman diagnosed with OCD reports of relapse of symptoms. She was previously treated with CBT and exposure with response prevention. She said it’s not working anymore. Recently her attempts to do exposures independently haven’t worked. What scientific theory would help the client approach exposure differently and more effectively?
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Inhibitory learning model
- The current theory of how exposure helps reduce fear.
- focuses on exposure should be on anxiety tolerance rather than anxiety. Habituation, clients learn that neither the feared item or their emotional response is dangerous
Emotional processing model
- ## habituation is a core component of fear reduction
Learned helplessness model
- You learn through your conditioning that you don’t have any control over the environment and you feel powerless
A faculty psychologist over here is graduate students discussing a student sexual relationship with their professor and they show private photos and messages from this professor. What should you do?
- report to the state licensing board
A psychologist was newly hired to provide consultation services to school district. What key points should you prioritize you in your first meeting in this new role?
Schizoaffective disorder bipolar type versus bipolar 1
- client experiences uninterrupted periods of illness in which major mood symptoms occur congruently with criteria a of schizophrenia
- psychotic symptoms have been present for 2 months while mood symptoms have been present for 6 weeks and there’s been at least 2 weeks where there’s an absence of prominent mood symptoms
Wais fsiq
- average range is 90 to 109
- high average 110 to 119
Supervising submitting late notes and missing several documentation deadlines
,- offer training and resources on time management and organization skills to help balance work-related duties more effectively
- gets to the root cause of difficulties
