PSYC 528: Evidence Based Practice Flashcards
Adjunct Treatment
One or more secondary interventions used concurrently with a primary intervention to enhance treatment effectiveness. Some common types of adjunct treatments include medications, group therapy, and couples/family therapy.
Case Conceptualization or Formulation
A complete case formulation ties all the following parts into a logically coherent whole: all of the client’s symptoms, diagnoses, and problems, hypotheses about the mechanisms causing and maintaining the diagnoses/problems, recent precipitants of current issues, and the origins of the mechanisms.
Client Factors
Client factors refer to specific characteristics or beliefs that reside within the individual and influence their experience of the world. This can include the client’s overall temperament/affect, motivation for change, perception of therapy, values, assets etc.
Efficacy vs. Effectiveness Research
Efficacy research is explanatory and determines whether or not an intervention produces the expected change (i.e. does the treatment work). Effectiveness research refers to the degree of how beneficial the treatment effect is in “real world” clinical settings (i.e. does the treatment work in practice and not just in controlled research).
Evidence Based Practice
Evidence based practice refers to the integration of best available empirical research results with clinical expertise and client preferences and values. This integration is meant to provide effective psychological services that are responsive to each client’s unique needs. The definition of evidence-based practice in psychology closely mirrors that of the one used in medical practice. EBP is important because it is how clients receive the best possible care.
Failure to Respond
This occurs when the client does not respond to treatment. If after repeated efforts to turn the therapy around and the client continues not to respond, the therapist must ethically refer the client to another therapist.
Practice Guidelines
These refer to criteria and strategies designed to assist mental health providers in the recognition and treatment of specific disorders, as indicated by the best available research findings. Practice guidelines assist in clinical decision making by presenting systematically developed treatment strategies in a standardized format. This term can also refer to the code of ethics, by which all clinicians ought to abide by.
Precipitants of the Problem
Precipitants of the problem can be internal, external, biological, psychological, or all of the above. They refer to proximal activating events that worsen or maintain the problem(s). Precipitants are not always immediately evident and are often explored by asking clients the “why now” question, regarding why they’ve decided to start treatment at that particular time.
Problem List
A comprehensive, priority-ordered list that names client issues that in turn directly link to treatment goals. Problem lists often only contain 5-8 items so as to keep the list manageable for both client and clinician.
Nonadherence
Nonadherence refers to when a client does not abide by the proposed therapeutic regimen. Nonadherence can occur due to client resistance, physical or cognitive limitations that prevent the client from following therapeutic recommendations, or by inadequate communication between the clinician and the client. It typically can be addressed with more clear communication between the clinician and client.
Outcome Measures
Assessments of the effectiveness of an intervention on the basis of measurements taken before, during, and after the intervention. These tools capture changes in client functioning, symptoms, and treatment experiences throughout the course of treatment. Outcome measures are useful in that they can guide treatment decision and help clients recognize their own improvement.
Origins of Mechanisms
Origins are distal in time and can be external environmental events, cultural factors, or biological factors. Origins are the root cause of client problems and allows the clinician to better understand the “why” of problems beginning in the first place.
Spheres of Influence
A biopsychosocial model used to understand all the different forces that influence a client. This model includes five components: the individual, interpersonal relationships (family/friends), organization (schools/employers), communities (neighborhoods),and society (governmental laws/policies). Each of the components interact and influence the others, therefore a change in one will likely cause change in another sphere.
Therapy Interfering Behavior
This refers to either client or therapist behaviors that get in the way of treatment progress. These behaviors shut down the productivity of a session. Some therapy interfering behaviors include being late to sessions, continually cancelling sessions, refusal to engage in sessions, refusal to acknowledge problem, threat of quitting therapy, and chronic suicidal behavior.
Treatment Goals
This refers to anything that the client wants to achieve through therapy. Treatment goals can be immediate or prolonged and often directly relate to the problems that brought the client in for treatment.
