Module 4 Flashcards
What are three components of evidence-based assessment?
- Assessment measures should be based on sound science: the constructs measured and the theoretical frameworks from which these constructs are derived should have been tested extensively;
- Measures should be reliable, valid, and have clinical utility in that they are easy to administer and score and are useful and practical
- The administration of interviews and tests should be accompanied by continual reflection and critical assessment of the procedures and findings to ensure accuracy and good decision-making
Do biological tests help with diagnosis?
no biological tests exist at the present time to determine, for example, whether someone has major depressive disorder or an anxiety disorder.
Why might a clinician recommend a biological test if they are not helpful with psychological disorders?
To rule out medical conditions that may be creating symptoms that mimic those of psychological disorders
perhaps Jan(depression example) has a vitamin deficiency that is bringing about fatigue, headaches, low mood, and feelings of anxiety
What are the 5 components of a Psychological Assessment?
- A clinical interview
- Psychometric testing (i.e., administration of questionnaires and performance-based tasks)
- A diagnostic formulation
- Recommendations for treatment
- Provision of feedback to the client
What are two types of Clinical interviews?
Structured interviews consist of predetermined questions that are specifically designed to explore certain themes and symptoms in a prescribed manner, based on DSM or WHOICD.
Unstructured more open-ended, and are largely based on the theoretical orientation of the clinician
What factors could interfere with the clinician’s ability to gather accurate information for a diagnostic formulation?
The client may underreport their symptoms. This can be due to several factors: feelings of embarrassment, motivation to “look healthy” or low insight into the symptoms.
The client may overreport their symptoms. This can happen if a client wants to be certain that the clinician understands they are in distress. A client may believe being overinclusive in responding to questions is best.
A clinician’s biases may interfere with the interview. Based on little data, they may have a preconceived notion of what the likely problem or diagnosis may be, like a referral question. This preconceived notion may lead a clinician to ask only certain questions and not others, especially if the interview is unstructured.
A client may not understand the wording or meaning of questions in a more structured interview.
What is Psychometric Testing? Provide examples of two versions.
questionnaires or performance-based tasks
planned behavioural observation ; for example, asking a client who is seeking treatment for a fear of dogs, to look at photos or videos of dogs, to see how they respond to these images
Self-monitoring; may also be included. This typically consists of logging one’s thoughts, feelings, or behaviours in a diary, a calendar or an app
What needs to be considered while making an accurate diagnosis?
We need to assess the life circumstances and stressors a person has encountered, as their symptoms may (or may not) represent a normal reaction to stress.
We need to think about the clinician’s theoretical orientation, and how the particular lens through which they are “seeing” a client’s behaviour may affect how they interpret the behaviour.
We need to think about how culture may influence how people describe and report on their behaviour.
We need to think about the implications and consequences of inaccurately evaluating or assessing a client’s presenting problem. This brings us back to the reliability and validity of the DSM itself.
What are key challanges with the DSM?
The disorder descriptions in the DSM sometimes contain signs and symptoms that are not actually indicative of pathology.
The disorders are set up to be categorical—either one has the diagnosis or one does not (issue; number of problems have been identified with this approach. For one, many of the thresholds for diagnosis are not founded in research)
All editions of the DSM have received criticism for issues related to reliability.
Experts at this point question whether the categorizations that have long existed in the DSM are the right ones.
How is treatment decided for a diagnosis? Provide of an example of what a cognitive-behavioural therapist would do to help a client with depression?
given treatment is typically consistent with the theoretical orientation or theoretical understanding of a disorder.
if you are a cognitive-behavioural therapist who believes that maladaptive thoughts and behaviours are involved in clinical depression, you would likely help clients to re-evaluate maladaptive or unhelpful depressogenic beliefs and reduce or eliminate behaviours that may contributing to depression
