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Clinical Psychology > Prevention, Consultation, & Psychotherapy Research > Flashcards

Prevention, Consultation, & Psychotherapy Research Flashcards

1
Q

Models of Prevention

list the 3 types of prevention according to Caplan’s (1964) model

A
  1. primary
  2. secondary
  3. tertiery
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2
Q

Models of Prevention

match the goals of prevention with the correct type: primary, secondary, or tertiary

a. to reduce the severity and duration of a mental or physical disorder
b. to reduce the occurrence of new cases of mental or physical disorder
c. to reduce the prevalence of a mental or physical disorder through early detection & intervention

Caplan’s (1964) Model

A

a) tertiary
b) primary
c) secondary

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3
Q

Models of Prevention

who are primary preventions aimed at?

Caplan’s (1964) Model

A

entire populations/groups

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4
Q

Models of Prevention

match the following examples of preventions with the correct type: primary, secondary, or tertiary

a) providing tutoring to elementary school students who are beginning to have academic difficulties
b) prenatal care for low-income mothers
c) relapse prevention programs (e.g., AA)
d) providing individuals with counseling
e) public education program about depression & suicide
f) rehabilitation programs
g) using a screening test to identify individuals at risk for depression
h) halfway houses
i) a school-based program for 5th graders to prepare them for the transition to middle school
j) social skills training for patients with schizophrenia

Caplan’s (1964) Model

A

a) secondary
b) primary
c) tertiary
d) secondary
e) primary
f) tertiary
g) secondary
h) tertiary
i) primary
j) tertiary

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5
Q

Models of Prevention

the goal of secondary prevention

Caplan’s (1964) Model

A

to reduce the prevalence of a mental or physical disorder in the population through early detection & intervention

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6
Q

Models of Prevention

who are secondary preventions aimed at?

Caplan (1964) Model

A

specific individuals identified as at elevated risk for mental or physical disorders

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7
Q

Models of Prevention

goal of tertiary prevention

Caplan’s (1964) Model

A

to reduce the severity and duration of a mental or physical disorder

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8
Q

Models of Prevention

who are tertiary preventions aimed at?

Caplan’s (1964) Model

A

reduce the severity & duration of a mental or physical disorder among people who have already received a diagnosis

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9
Q

Models of Prevention

list the types of prevention according to Gordon (1983)

A
  1. universal
  2. selective
  3. indicated
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10
Q

Models of Prevention

who are universal preventions aimed at?

Gordon (1983) Model

A

reduce risk factors in entire populations or groups (not restricted to individuals who are at risk for a disorder)

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11
Q

Models of Prevention

who are selective preventions aimed at?

Gordon’s (1983) Model

A

individuals/subgroups who have been identified as being at increased risk for a disorder due to their biological, psychological, or social characteristics

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12
Q

Models of Prevention

who are indicated preventions aimed at?

Gordon’s (1983) Model

A

individuals who are known to be at high-risk because they have early or minimal signs of a disorder

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13
Q

Models of Prevention

match the following examples of preventions with the correct type: universal, selective, or indicated

a) a drug abuse prevention program for adolescents whose parents have a substance use disorder
b) a drug abuse prevention program for adolescents who have experimented with drugs
c) a drug abuse prevention program for all high school students in a school district

Gordon’s (1983) Model

A

a) selective
b) indicated
c) universal

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14
Q

Models of Prevention

according to the Institute of Medicine, who is the target population for universal, selective, & indicated preventions in the continuum of care model

Mrazek & Haggerty (1996)

A

people who have not received a diagnosis of a mental or physical disorder

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15
Q

Models of Prevention

according to the Institute of Medicine, what is the focus of treatment & what is the primary maintenance strategy for people who have received a mental or physical diagnosis?

Mrazek & Haggerty (1996)

A
  • preventing chronicity or relapse
  • providing rehabilitation
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16
Q

Mental Health Consultation

how does mental health consultation differ from collaboration?

A
  • consultation has no direct contact with clients
  • the consultant is not responsible for client outcomes

a collaborator usually has direct contact with the client & shared responsibility for the client’s outcomes

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17
Q

Mental Health Consultation

according to Caplan (1970), list the 4 types of mental health consultation

A
  1. Client-Centered Case Consultation
  2. Consultee-Centered Case Consultation
  3. Program-Centered Case Consultation
  4. Consultee-Centered Administrative Consultation
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18
Q

Mental Health Consultation

Client-Centered Case Consultation
1. focus
2. goal(s)

Caplan (1970)

A
  1. a particular client of the consultee. who is having difficulty providing the client with effective services (e.g., having trouble identifying an appropriate treatment)
  2. to provide the consultee with a plan that will benefit the client
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19
Q

Mental Health Consultation

Consultee-Centered Case Consultation
1. focus
2. goal(s)

Caplan (1970)

A
  1. the consultee
  2. goals
    * to improve the consultee’s ability to work effectively with current & future clients who are similar in some way (e.g., clients with TBIs, clients from specific backgrounds/cultures)
    * to improve consultee’s knowledge, skills, confidence, and/or objectivity
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20
Q

Mental Health Consultation

Program-Centered Case Consultation
1. focus
2. goal(s)

Caplan (1970)

A
  1. focus
    * program administrators
    * an existing mental health program
  2. to provide administrators with recommendations for dealing with the problems they’ve encountered in developing, administering, and/or evaluating a mental health program
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21
Q

Mental Health Consultation

Consultee-Centered Administrative Consultation
1. focus
2. goal(s)

Caplan (1970)

A
  1. improving the professional functioning of program administrators
  2. improve program administrators ability to develop, administer, and evaluate mental health programs
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22
Q

Mental Health Consultation

list & describe 1 factor Caplan (1970) identified as a contributor to a consultee’s lack of objectivity

A

theme interference - occurs when a consultee’s biases & unfounded beliefs interfere with their ability to be objective when working with certain types of clients

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23
Q

Interprofessional Collaboration

list the 3 primary functions of Interprofessional Collaboration (IPC) in primary care settings according to Dragan & Marino (2018)

A
  1. improvement of patient care
  2. improvement of health outcomes for patients
  3. decreased healthcare costs
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24
Q

Interprofessional Collaboration

According to a meta-analysis conducted by Carron et al. (2021), IPC has inconsistent clinical outcomes, particularly on what factors?

A
  • quality of life
  • physical, emotional, & social functioning
  • health behaviors & practices
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25
Q

Interprofessional Collaboration

According to a meta-analysis conducted by Carron et al. (2021), IPC has positive clinical outcomes, particularly on what factors?

A
  • the process of care
  • patient satisfaction
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26
Q

Interprofessional Collaboration

research on healthcare needs of older patients has provided some evidence that integrated care is associated with what outcomes?

Baxter et al. (2018); Hebert et al. (2010)

A
  • improved access to care
  • increased patient satisfaction with services provided
  • fewer ED visits, hospitalizations, & long-term care placements
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27
Q

Psychotherapy Outcome Research

define efficacy research & list its benefits

A

clinical trials
* maximize experimental control
* maximize internal validity (e.g.. the ability to draw conclusions about the cause-effect relationship betwee therapy & outcomes)

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28
Q

Psychotherapy Outcome Research

describe ways that efficacy research maximizes experimental control

A
  • assigning participants to groups
  • therapists using treatment manuals to ensure standardization of treatment
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29
Q

Psychotherapy Outcome Research

define effectiveness research & list its benefits

A

naturalistic settings
* maximize external validity (e.g., the ability to generalize the conclusions drawn from the study to other people & conditions)

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30
Q

Psychotherapy Outcome Research

the most useful strategy for evaluating treatment outcomes

Jacobson & Christensen (1996)

A
  1. first conduct an efficacy study to determine a treatment’s effectiveness in well-controlled conditions
  2. then conduct an effectiveness study in “real world” settings to determine its generalizability, feasibility, & cost-effectiveness
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31
Q

Psychotherapy Outcome Research

what is researcher, Hans Eysenck, best known for?

A

his conclusions about intelligence & personality

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32
Q

Psychotherapy Outcome Research

what did Eysenck propose?

A

intelligence is primarily due to heredity, with about 80% of variability in IQ scores being due to genetic factors

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33
Q

Psychotherapy Outcome Research

list the 3 major personality traits according to Eysenck’s (1952) personality theory

A
  1. extroversion
  2. neuroticism
  3. psychoticism
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34
Q

Psychotherapy Outcome Research

why was Eysenck’s (1952) literature review of treatment outcomes for “neurotic” patients who participated in psychoanalytic or eclectic psychotherapy controversial?

A

the studies did not:
* include no-treatment control groups
* randomly assign participants to groups
* account for patient characteristics
* Eysenck used other studies to estimate the spontaneous remission rates of neurotic patiens who received care in an inpatient facility or from a physician

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35
Q

Psychotherapy Outcome Research

list the percentage associated with Eysenck’s (1952) average recovery rates for a) patients in psychoanalytic psychotherapy, b) patients in eclectic psychotherapy, and c) patients who did not participate in psychotherapy.

A

a) psychoanalytic: 44%
b) eclectic: 64%
c) no-treatment: 72%

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36
Q

Psychotherapy Outcome Research

what did Eysenck (1952) conclude from his psychotherapy outcome literature review?

A
  • psychotherapy is ineffective
  • psychotherapy may actually have detrimental effects since the average recovery rates for psychotherapy patients were lower than the average spontaneous remissio rate for patients who did not receive psychotherapy
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37
Q

Psychotherapy Outcome Research

Bergin (1971) noted that the criteria Eysench used to determine the recovery rate were questionable. He found different criteria produce what recovery rates for patients who received psychoanaltic psychotherapy vs. patients who did not receive treatmet?

A

a) psychoanalytic psychotherapy: 83%
b) no treatment: 30%

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38
Q

Psychotherapy Outcome Research

who were the first researchers to use meta-analysis in psychotherapy outcome research?

A

Smith, Glass, & Miller

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39
Q

Psychotherapy Outcome Research

how many studies were included in Smith, Glass, & Miller’s (1980) meta-analysis and what was the mean effect size? what does the mean effect size suggest?

A
  • 475 studies
  • mean effect size of .85
  • that the average patient who received psychotherapy was “better off” than 80% of patients who did not receive psychotherapy
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40
Q

Psychotherapy Outcome Research

what does an effect size indicate

A

the mean difference between groups in terms of a standard deviation

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41
Q

Psychotherapy Outcome Research

in a normal distribution, what percentage of scores are below a standard deviation of 1.0? a standard deviation of .85?

A
  • 84%
  • 80%
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42
Q

Psychotherapy Outcome Research

Howard et al. (1986, 1996) investigated the relationship between psychotherapy outcomes and what?

A

the duration of psychotherapy

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43
Q

Psychotherapy Outcome Research

list the 2 models resulting from Howard et al. (1986, 1996) studies of the relationship between duration of psychotherapy and its outcomes

A
  1. dosage model
  2. phase model
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44
Q

Psychotherapy Outcome Research

according to Howard et al. (1986, 1996), this model proposes that there is a predictable relationship between the number of therapy sessions & the probability of measurable improvement in symptoms
predictions re: clinically significant improvement in symptoms
* 50% of patients; expected by 6-8 sessions
* 75% of patients; expected by 26 sessions
* 85% of patients; expected by 52 sessions

A

dosage model

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45
Q

According to Howard et al. (1986, 1996)

this phase consists of the first few sessions and is characterized by increased hopefulness

A

initial remoralization phase

46
Q

According to Howard et al. (1986, 1996)

this phase consists of the the next 16 sessions and is characterized by reduction of symptoms

A

remediation phase

47
Q

According to Howard et al. (1986, 1996)

this phase has no associated number of sessions and is characterized by unlearning troublesome maladaptive, habitual behaviors and establishing new ways of dealing with various aspects of life (e.g., problematic relationships patterns, faulty work habits, & troubling personal attitudes)

A

rehabilitation phase

48
Q

Psychotherapy Outcome Research

an implication of the phase model

Howard et al. (1986, 1996)

A

requires use of different outcome measures during different phases of therapy

49
Q

Psychotherapy Outcome Research

match the examples of outcome measures with the appropriate phase of phase model: remoralization, remediation, or rehabilitation phases

a) measures of severity & frequency of symptoms
b) measures of life functioning
c) measures of subjective well-being

**Howard et al. (1986, 1996)

A

a) remediation
b) rehabilitation
c) remoralization

50
Q

Other Psychotherapy Research

based on their review of the literature, Norcross & Lambert (2011) found that this element of psychotherapy accounts for ____% if variability in outcomes, making it the largest contributor.

A

patient contributions; 30%

51
Q

Other Psychotherapy Research

Sue et al. (1991) found that the effects of matching on treatment outcomes varied depending on what factor? And that this factor reduced ____ ____ ____ for Asian, Hispanic, and European American clients but not for African American clients.

A
  • client race/ethnicity
  • premature termination rates
52
Q

Other Psychotherapy Research

Sue et al. (1991) found that client-therapist matching was associated with what only for Hispanic American clients.

A

improved treatment outcomes

53
Q

Other Psychotherapy Research

Comas-Diaz’s (2012) found that what factors were more important than ethnic matching between client and therapist.

A

clinicians’ cultural competence, compassion, & worldview

54
Q

Other Psychotherapy Research

what were the findings of Taber et al.’s (2011) study examining the impact of client-therapist personality similarity on therapeutic alliance & therapy outcomes

A
  • positive impact on clients’ perceptions of the relationship
  • no direct affect on outcomes of therapy
55
Q

Other Psychotherapy Research

what were the findings of Perez-Rojas et al.’s (2021) study on the effects of clients’ perceptions of similarity to their therapist based on the Big Five personality traits?

A

perceived similiarities on levels of conscientiousness & openness = stronger therapeutic relationships and better progress in therapy

56
Q

Other Psychotherapy Research

list the age ranges that reported the highest to lowest perentage of utilization of mental health services

2020 National Mental Health Interview Survey (NIHS)

A
  • ages 18 to 44
  • ages 45 to 64
  • ages 65 and older
57
Q

Other Psychotherapy Research

most cited barrier to utilizing mental health services among college students

Ebert et al. (2019)

A

attitudinal barriers:
* preferring to handle problem alone
* preferring to talk to friends & family members about the problem
* being embarrassed

58
Q

Other Psychotherapy Research

list structural barriers to utilizing mental health services cited by college students

Ebert et al. (2019)

A
  • cost of treatment
  • scheduling conflicts or problems with time
59
Q

Other Psychotherapy Research

define education-based interventions and contact-based interventions

A
  • education-based: challenge and replace stereotypes and myths about mental illness and its treatment with accurate information
  • contact-based: provide face-to-face or internet-mediated contact with a person who has successfully managed a amental disorder
60
Q

Other Psychotherapy Research

among adults ages 18+, the use of outpatient substance misuse & mental health services was highest for respondents who identified how? lowest for respondents who identified how?

A
  • as belonging to 2 or more racial groups
  • followed by white
  • lowest for those who identified as Asian
61
Q

Other Psychotherapy Research

among adults ages 18+, the use of inpatient substance misuse & mental health services was highest for respondents who identified how? lowest for respondents who identified how?

A
  • identified as belonging to 2 or more racial groups
  • followed by those who identified as American Indian or Alaska Native
  • lowest for those who identified as Asian
62
Q

Other Psychotherapy Research

what does economic evaluation of healthcare programs involve?

A

cost and benefits inform decision-making

63
Q

Other Psychotherapy Research

list 3 methods of economic evaluation

A
  1. Cost-Benefit Analysis (CBA)
  2. Cost-Effectiveness Analysis (CEA)
  3. Cost-Utility Analysis (CUA)
64
Q

Other Psychotherapy Research

when using cost-benefit analysis, costs and benefits are expressed in what terms?

A

monetary

65
Q

Other Psychotherapy Research

when should you use a cost-effectiveness analysis? Give an example.

Knapp et al. (2013)

A
  • to compare the costs & benefits of 2 or more interventions when benefits cannot be expressed in monetary values
  • benefits being measured by percent of participants who:
    a) worked at least 1 day during a follow-up period
    b) dropped out of the program they were assigned to
    c) had to be readmitted to the hospital

(Knapp et al., 2013)

66
Q

Other Psychotherapy Research

when should you use a cost-utility analysis? Give an example.

Sava et al. (2009)

A
  • to compare 2+ interventions by look at how much each costs & how much it improves the duration & quality of a patient’s life (i.e., quality-adjusted life-years or QALYs)

aka measures of gain in quality & duration of life OR “values for money”

  • comparing 3 treatments for depression:
  • compared cognitive therapy (CT), REBT, and fluoxetine for the treatment of depression
    found that CT & REBT had greater cost-utility than fluoxetine but treatments did not significantly differ

(Sava et al., 2009)

67
Q

Other Psychotherapy Research

findings from research on the effects of age, gender, & SES on psychotherapy outcomes

A
  • all 3 have little to **no impact on outcomes **
  • any apparent differences are due to other factors (e.g., link between low SES & premature termination is likely more attributed to transportation difficulties)
68
Q

Other Psychotherapy Research

define alpha bias and describe its potential impact(s)

A
  • tendency to exaggerate differences between men & women
  • can reinforce gender stereotypes & justify discriminatory practices
69
Q

Other Psychotherapy Research

define beta bias and describe its potential impact(s)

A
  • tendency to ignore or minimize differences between men & women
  • can lead to the erroneous conclusions, such as the results of research that included only male participants also applies to females & vice versa
70
Q

Other Psychotherapy Research

alpha & beta bias has been linked to androcentricism. Define.

A
  • means **male-centered **
  • occurs when male behaviors & traits are considered to be the norm, while female behaviors & traits are viewed as deviations from the norm & often as abnormal or inferior
71
Q

Other Psychotherapy Research

what does the acronym WEIRD stand for

A

Westernized
Educated
Industrialized
Rich
Democratic

72
Q

Other Psychotherapy Research

according to Gurven et al. (2013), the Big Five personality traits do not accurately describe the personalities of which specific popoulation?

A

largely illiterate indigenous forager-farmers in the Bolivian Amazon

73
Q

Other Psychotherapy Research

define & list alternative names for Routine Outcome Monitoring (ROM)

A

a transtheoretical & transdiagnostic evidence-based practice
* feedback-informed treatment
* measurement-based care

74
Q

Other Psychotherapy Research

list the 4 components of Routine Outcome Monitoring (ROM) according to Lewis et al. (2019)

A
  1. a routinely administered assessment measure of symptom, outcome, or process (ideally) before each clinical encounter
  2. practitioner review of data
  3. patient review of data
  4. collaborative reevaluation of the treatment plan informed by the data
75
Q

Other Psychotherapy Research

what is the Partners for Change Outcome Management System used for?

Lambert & Harmon (2018)

A

to assess a client’s progress & the quality of the therapeutic relationship

76
Q

Other Psychotherapy Research

list the benefits of Routine Outcome Monitoring (ROM)

A
  • increased rates of clinically significant improvement
  • significant reductions in premature termination & client deterioration during therapy
77
Q

Other Psychotherapy Research

client barriers to utilizing Routine Outcome Monitoring (ROM)

Boswell et al. (2015); Lewis et al. (2019)

A
  • concerns about confidentiality
  • time needed to complete the measure
78
Q

Other Psychotherapy Research

clinician barriers to utilizating Routine Outcome Monitoring (ROM)

Boswell et al. (2015); Lewis et al. (2019)

A
  • belief that information provided by ROM is not more accurate than clinical judgement
  • lack training in the use of ROM
  • unease about ROM’s potential effects on therapeutic relationship
  • concerns about the time it takes to administer, score, & interpret measurs, create a report, & provide feedback to clients
  • concerns about how results of ROM will be used by employers & insurance companies
79
Q

Transdiagnostic Treatments

benefits of transdiagnostic treatments

A
  • reduce the cost & time of training psychologists to deliver numerous diagnosis-specific interventions
  • better suited than single-diagnosis treatments for addressing comorbidities
80
Q

Transdiagnostic Treatments

according to Newby et al. (2015) how do transdiagnostic treatments compare to diagnosis-specific treatments when treating anxiety? depression?

A
  • transdiagnostic treatments are as effective for anxiety
  • transdiagnostic treatments may be more effective for depression
81
Q

Transdiagnostic Treatments

Cognitive-Behavioral Therapy - Enhanced (CBT-E) was designed for treating which class of disorders?

Fairburn et al. (2003)

A

eating disorders (e.g., anorexia & bulimia)

82
Q

Transdiagnostic Treatments

what type of interventions are used in the The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders? what class of disorders was it designed to treat?

Barlow et al. (2011)

A
  • an emotion-focused, cognitive-behavioral intervention
  • mood disorders (e.g., anxiety, depression)
83
Q

Transdiagnostic Treatments

The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders
1. assumptions
2. focus of treatment

A
  1. assumption: neuroticism as a core characteristic shared by mood disorders (e.g., anxiety, depression)
  2. focus: mechanisms associated with neuroticism, including deficits in emotion regulation & avoidance of intense emotional experiences
84
Q

Transdiagnostic Treatments

Emotion-Focused Therapy - Transdiagnostic (EFT-T)
1. developed for what class of disorders?
2. focus of treatment

Timulak & Keogh (2020)

A
  1. mood disorders (e.g., anxiety, depression)
  2. targets chronic painful emotions
    * e.g., loneliness/sadness, shame, and fear/terror that underlie these disorders
85
Q

Transdiagnostic Treatments

Acceptance & Commitment Therapy (ACT)
1. type of intervention
2. developed for what class of disorders
3. assumptions
4. primary goal

A
  1. 3rd wave cognitive-behavioral intervention
  2. wide range of mental health & medical conditions
  3. pain, grief, disappointment, illness, and anxiety is an inevitable part of human life
  4. helping individuals adapt to painful experiences and the typical challenges in life by developing greater psychological flexibility
86
Q

Transdiagnostic Treatments

Parent-Child Interaction Therapy (PCIT)
1. developed for what class of disorders?
2. assumptions
3. primary goal

A
  1. disruptive behavior disorders, anxiety, trauma-related disorders and child maltreatment
  2. emotion dysreguation is a core process in the etiology of early-onset psychopathology symptoms
  3. improving a child’s emotion regulation
87
Q

Telepsychology

benefits of delivering evidence-based psychotherapy (EBP) via telepsychology over in-person

A
  • decreases costs for both patients & providers (e.g., travel & transportation)
  • increases access to mental health care (e.g., rural & underserved populations)
  • reduces stigma & embarrassment
88
Q

Telepsychology

clinician cited challenges of providing therapy via telehealth

A
  • tech issues:
    • internet access/connectivity
    • general technological difficulties
    • inadequate access to technology
  • diminished therapeutic alliance
  • diminished quality/effectiveness of delivered care
  • privacy concerns - finding a private place to connect form
89
Q

Telepsychology

findings from Berryhill et al.’s (2019) systematic review of studies evaluating the effectiveness of telehealth sessoins - most often CBT - for treating anxiety disorders

A
  • majority of studies found significant improvement in symptoms following telehealth treatment
  • controlled studies found no significant difference between telehealth & in-person treatment
90
Q

Telepsychology

findings from Stubbing et al.’s (2013) study comparing telehealth delivered CBT to in-person CBT for treatment of anxiety & depression

A
  • similarly effective for reducing comorbid anxiety & depression and improving quality of life
91
Q

Telepsychology

findings from Turgoose et al.’s (2018) systematic review of studies evaluating telepsychology vs. in-person treatment for veterans with PTSD

findings re: treatment, therapeutic alliance, developing rapport

A
  • trauma-focused therapies (e.g., exposure therapy, behavioral activation) were similar in terms of reduction of PTSD symptoms
  • inconsistent findings re: therapeutic alliance
    • some therapists reported no trouble developing rapport
    • some therapists reported barriers to developing a therapeutic alliance, such as inability to detect nonverbal communications
92
Q

Telepsychology

Wangelin et al. (2016) found that attrition rates for various modes of telepsychology for the treatment of depression vary depending on what factors?

A
  • population
  • type of intervention
93
Q

Telepsychology

findings from research evaluating the effectiveness of telepsychology vs. in-person for the treatment of bulimia nervosa

A

telepsychology had beneficial effects, but not as effective as in-person

94
Q

Telepsychology

list the 2 differences found from Mitchell et al.’s (2008) study comparing telehealth-delivered and in-person delivered versions of manual-based CBT for bulimia nervosa

A

in-person CBT
* higher rates of abstinence from binge eating & purging
* greater reductions in eating disorder cognitions and depression

95
Q

Telepsychology

findings from Zerwas et al.’s (2017) study comparing telehealth-delivered and in-person manualized CBT group therapy for bulimia nervosa

A

slower pace of recovery for patients who received telehealth services

96
Q

Telepsychology

list reasons why in-person CBT for bulimia & other eating disorders might be more effective

Gros et al. (2013)

A

regular in-session weight measurement is an important component of CBT for ED

this may be omitted when its delivered via telehealth due to logistical difficulties

97
Q

Stepped Care

list the 2 foundational features of stepped care

Bower & Gilbody (2005)

A
  1. apply the least restrictive treatment of those currently available, but still likely to provide significant health gain
  2. the stepped care model is self-correcting - the results of & decisions about treatments are monitoried systematically & changes are made if current treatments are not achieving significant health gain
98
Q

Stepped Care

primary goals of stepped care

A
  1. increase efficiency of health care services
  2. increase accessibility of effective treatments
  3. better allocate scarce mental health resources
99
Q

Stepped Care

4 steps within the commonly cited stepped care model for depression

Broten et al. (2011)

A
  1. Assessment & Monitoring
  2. Interventions Requiring Minimal Practitioner Involvement
  3. Interventions Requiring More Intensive Training & Specialization
  4. Most Restrictive & Intensive Forms of Care
100
Q

Stepped Care

who is Step 1: Assessment & Monitoring of the stepped care model for depression most appropriate for & what is included in this step of treatment

A
  • patients with minor depressive symptoms
  • evaluating & monitoring the patient’s symptoms
101
Q

Stepped Care

who is Step 2: Interventions Requiring Minimal Practitioner Involvement of the stepped care model for depression most appropriate for & what is included in this step of treatment. Give some examples of treatment approaches at this step.

A
  • patients at high risk for depression or are experiencing an increase in symptoms
  • psychoed about symptoms, course of depression, treatment options, & signs of relapse
  • bibliotherapy, computer-based interventions that track symptoms, multimedia with interactive components designed to increase coping skills for depression & anxiety
102
Q

Stepped Care

who is Step 3: Interventions Requiring More Intensive Care & Specialized Training of the stepped care model for depression most appropriate for & what is included in this step of treatment. Give examples of treatment approaches at this step.

A
  • patients who are experiencing significant increases in symptoms of depression
  • group therapy, individual therapy, and/or medication
  • referring to group & brief therapy initially; for patients who don’t respond adequately to these therapies, referring to longer-term therapy with or without medications
103
Q

Stepped Care

who is Step 4: Most Restrictive & Intensive Forms of Care of the stepped care model for depression most appropriate for & what is included in this step of treatmemt

A
  • patients with severe depressive symptoms & suicidality
  • voluntary or mandated inpatient care
104
Q

Treatment Fidelity

list measures of fidelity for community-based interventions according to Breitenstein et al. (2010)

A
  • self-reports by the practitioner & client
  • observations of in vivo or recorded intervention sessions by a trained observer who rates the practitioner’s adherence & competence
105
Q

Digital Mental Health Interventions

list some examples of online and/or mobile delivery of psychological strategies & interventions

A
  • activity & mood trackers
  • self-monitoring eating behaviors
  • relaxation/meditation/mindfulness practices
  • CBT for depression
106
Q

Digital Mental Health Interventions

research on DMHIs suggest there is a research-to-practice gap & research in health care settings on the effectiveness of DMHIs is inconsistent. List the factors that may be contributing to these findings

A
  • inconsistent use by patients
  • uncertainty of providers about how to engage patients
  • a lack of clarity about how providers should integrate digital interventions into the overall care of patients
107
Q

Digital Mental Health Interventions

The best conclusion that can be drawn from the results of Werntz et al.’s (2023) meta-review of research on digital mental health interventions (DMHIs) is that their effectiveness is…

A

often improved by adding human support whether the support is provided by a professional or a nonprofessional

108
Q

Models of Disability

list the 4 scientific models of disability identitied by APA’s (2012) Guidelines for the Assessment of and Intervention with Persons with Disabilities

A
  1. biomedical
  2. social
  3. functional
  4. forensic
109
Q

Models of Disability

this scientific model of disability views disabilities as intrinsic medical conditions that deviate from the norm & disrupt a person’’s physical and/or cognitivr functioning and focuses on identifying & providing treatments that will manage, alter, or cure the medical condition causing the disability

A

Biomedical Model of Disability

aka the medical model

110
Q

Models of Disability

this scientific model of disability views disabilities as a difference rather than an abnormality or deficiency & as primarily due to aspects of society that create barriers for people with disabilities (e.g., negative attitudes, discrimination, exclusion, architectural barriers) and focuses on making societal & environmental changes

A

Social Model of Disability

111
Q

Models of Disability

this scientific model of disability views disabilities as the cause of a person’s inability to perform their function or role at work or elsewhere and focuses on identifying what accommodations, modifications, or assistive tech devices are needed to improve the person’s functioning

A

Functional Model of Disability

112
Q

Models of Disability

this scientific model of disability views disabilities as malingerers and focuses on legal concepts & requires objective proof of impairment & disability and honesty & motivation of individuals seeking recognition, benefits, or compensation for disability and primarily focuses on distinguishing between honest & dishonest people and identifying appropriate interventions or consequences

A

Forensic Model of Disability

Clinical Psychology (7 decks)

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