Lecture III

Question 1

Assessment

Answer 1

Clinicians do tests, observations, interviews to summarize client’s symptoms

Question 2

Diagnosis

Answer 2

Process through which the clinician gets a “summary classification” of the patient’s symptoms using a diagnostic manual such as DSM-5

Question 3

Referral question

Answer 3

The first step in diagnosis where the problem is identified and summarized. Considerations: situational/pervasive, duration, prior attempts at treatment, effects, DSM

Question 4

Comprehensive Assessment

Answer 4

Second step in diagnosis: can include general physical exam, neurological exam, neuropsychological exam

Question 5

Neuropsychological exam

Answer 5

Assesses cognitive, perceptual, motor performance to assess if there is brain damage and to characterize level of cognitive functioning

Question 6

Psychodiagnostic assessment

Answer 6

Assesses individual’s psychological presentation. Three common procedures: assessment interviews (structured/unstructured), clinical obs of behavior, psychological tests

Question 7

Assessment interviews

Answer 7

Face-to-face where clinician obtains info on client’s situation, personality, behavior. Structured - less freedom but more reliability. Unstructured - more freedom to explore

Question 8

Clinical observation of behavior

Answer 8

Ideally takes place in natural setting, but often in clinic or hospital. Rating scales can help increase validity

Question 9

Two kinds of psychological tests

Answer 9

(1) Intelligence tests (WISC-IV, Stanford-Binet, WAIS-IV)

2) Personality tests (projective tests with unstructured stimuli, objective tests

Question 10

Projective personality tests

Answer 10

Unstructured stimuli presented; patient must come up with meaning; believed to indicate unconscious. Includes Rorschach Inkblot Test, Thematic Apperception test, Sentence Completion test. Criticisms: inefficient, subjective, hard to score

Question 11

Objective personality tets

Answer 11

Structured questionnaires; self-reports. Include MMPI. Advantages - cost effective, objective. Disadvantages: mechanistic, reduces complexity, self-report biases

Question 12

Integrating assessment data

Answer 12

Data from various sources must be used to create a working model of the client’s condition

Question 13

Assessment report components

Answer 13

Referral question, background information, behavioral observations, tests administered, test results, summaries, diagnostic impressions, recommendations

Question 14

Ethical issues in assessment

Answer 14

Possible problems from cultural bias, theoretical orientation, underemphasis on external factors, insufficient validation, inaccurate data, premature evaluation

Question 15

Classification pros and cons

Answer 15

Benefits: order, ability to communicate, statistical research, insurance.

Question 16

Three models of classification

Answer 16

(1) Categorical - patient is healthy or disordered; no overlap
(2) Dimensional approach - there is a spectrum from superior functioning to absolutely impaired
(3) Prototypal - concept of an idealized combo of characteristics, some which patient may not have

Question 17

2 major classification systems for mental disorder

Answer 17

Diagnostic and statistical manual of mental disorders (DSM) and International classification of disease (ICD)

Question 18

DSM-IV Diagnosis - Axes

Answer 18

5 axes: (1) Syndromes or conditions

(2) Personality disorders, retardation
(3) General medical conditions
(4) Psychosocial and environmental
(5) Global assessment of functioning

Question 19

DSM-V Diagnosis - non-axial

Answer 19

Non-axial documentation of diagnosis with separate notations for important psychosocial and contextual factors, disability

Question 20

Why seek psychotherapy?

Answer 20

Believed that those who have psychological problems can learn more adaptive ways of perceiving, evaluating, and behaving

Question 21

Therapeutic relationships

Answer 21

Must be a working alliance, with collaborative relationship, agreement on goals, affective bond, clear communication, motivation

Question 22

Outcome assessment

Answer 22

Good ways to determine: therapist impression, client report, family/friend report, pre- vs post- treatment scores, measures of change in behavior. Though some conditions naturally resolve, therapy usually more effective. Sometimes can result in deterioration (boundary violations)