Prevention & Consultation Flashcards
Caplan Model of Prevention
Primary
(reduce number of cases/ aimed at entire population)
Secondary
(reduce prevalence/ early detection/ specific population)
Territory
(reduce severity/ reduce duration / those with a diagnosis)
Gordon’s Model of Prevention
Universal
(aimed at entire population)
Selective
(people identified as being at risk)
Indicated
(people known to be at high risk or have early signs)
client-centered consultation
therapist seeking consultation on a client and how to proceed with treatment.
Consultee- centered consultation
therapist is seeking consultation regarding their characteristics/ abilities in treating a client or clients.
Program-centered Administrative consultation
organization seeks consultation to help with concerns related to their specific program.
Consultee- centered administrative consultation
Organization leader is seeking consultation to work on leadership skills or other factors related to training/ employment, etc.
Interprofessional Collaboration (IPC)
*integrative healthcare
- partnership between care team and patient
-occurs most in Primary Care
3 Functions:
-improvement of care
-improvement of health outcomes
-decrease health cost
IPC research with older adults
-improved access to care
-increased satisfaction
-fewer emergency visits
-fewer hospitalizations
-fewer long-term care
Efficacy research & effectiveness research
Efficacy
-maximize internal validity
-cause and effect of treatment
Effectiveness
-maximize external validity
-ability to generalize conclusions
- First conduct an efficacy study (determine the internal validity of the treatment in a controlled setting)
- Then conduct a effectiveness study of the treatment in the real-world.
Smith, Glass & Miller - outcome from meta analysis
-Average patient was better off than 80% of those not in treatment.
**Effect size = .85
Howard’s - Phase Model
1- Initial- remoralization (outcome is increased hope)
2- Remediation (decreases symptoms)
3- Rehabilitation (unlearning behaviors, new ways to deal with sx).
Big 5 & Therapy alliance
Conscientiousness and openness to new experiences = stronger relationships with the therapist and better prognosis.
Race - outpatient services -highest attendance
- Multiracial
- White
- NA
Race - outpatient services -lowest attendance
Asian
Race-inpatient services- highest attendance
- NA
- Black/ or multiracial
Race-inpatient services- lowest attendance
Asian
Cost benefit analysis
compare cost of multiple treatments - monetary cost
Cost effectiveness analysis
compare cost of multiple treatments - non-monetary cost
Cost utility analysis
compare multiple tx based off of quality-adjusted-life-years
WEIRD
W- western
E- educated
I- industrial
R- rich
D- democratic
*overly used populations in research
*limited generalizability
Routine Outcome Monitoring (ROM)
-Feedback informed treatment/ measured based care
*transtheoretical/ transdiagnositic
4 components
-assessment (typically before every session)
-review of assessment
-patient review data
-collaborative reevaluation of tx plan
*increases rates of significant improvement
*decreases rates of premature termination
*most effective for those at risk for tx failure
Benefits of Transdiagnostic Treatments
-Reduces the time and cost for training
-Equal or superior to other tx
-Seen as more beneficial for treating comorbidity
*As effective as other therapy for treating anxiety and superior for treating depression.
Stepped Care
2 fundamental features
-treatment should be the least restrictive of those available but likely to provide care.
-increase efficiency and the accessibility of effective treatment.
Model for Depression
- Assessment & monitoring
- Intervention requiring minimal practitioner involvement (bibliotherapy, computer treatment)
- Intervention requiring more practitioner involvement
(individual therapy, group therapy and medication) - Most restrictive and intensive form of care.
(inpatient care)
Digital Mental Health Interventions
Can have similar outcomes to face-to-face psychotherapy.
Inconsistency in research on effects may be due to multiple factors such as guidance on how to use the device.
The Health Belief Model
identifies the following factors as contributors to the likelihood that a person will engage in behaviors that reduce the risk for developing a disorder:
- perceived SUSCEPTIBILITY to the disorder
- perceived severity of the CONSEQUENCES of having the disorder.
- perceived BENEFIT of taking ACTION
- perceived BARRIERS to taking action
- SELF-EFFICACY , and CUES TO ACTION
Based on a review of psychotherapy outcome studies, Hans Eysenck (1952) concluded that
72% of patients with neuroses can be expected to experience spontaneous recovery without treatment.
Gender and seeking therapy
Women are more likely to seek therapy and medication management.
Age and seeking therapy
People 18 to 24 y.o. are the most likely to be in therapy and taking medications.
Psychological intervention and medical cost
Psychotherapy reduces medical utilization and creates a 90% medical cost offset.
Alpha bias in research
exaggerated differences between men and women
Beta bias in research
ignoring small differences between men and women
