Study Guide Exam 3

Question 1

Have a clear understanding of what case formulation, treatment plan, clinical interview, and behavior plan intel.

Answer 1

Case Formulation is a hypothesis about the particular psychological mechanisms that give rise to an maintain an individuals psychological distress and dysfunction.

Treatment Plan is the process of using a case formulation to guide the selection of an intervention.

Clinical Interview is one of the ways that psychologists can conduct assessments, and thorough assessment will of course rely on multiple approaches, maybe even collecting information from multiple people to get the most complete information.

Behavioral plan a written improvement plan created for a student based on the outcome of the functional behavior assessment (FBA).

Question 2

Know about the DSM-5, when it was created, who creates it and what ‘s it’s purpose.

Answer 2

DSM-5 (2013), the APA created it, its purpose is to identify diagnostics for mental illnesses
- Scientific data reviewed for medical treatments
DSM-5-TR (2022): 265 disorders
- Some disorders added or removed

Question 3

Know what a feature of a diagnosis is?

Answer 3

Criteria include a disorder’s signs, symptoms, and associated features
- Sign: Outwardly observable phenomenon.
- Symptom: Subjective experience reported by the client.
- Associated feature: Aspect of a psychiatric disorder such as its prevalence, course, prognostic factors, or common co-occurring diagnoses.

Question 4

What elements does case formulation intel.

Answer 4

Four elements of case formulation are:
- Problem list outlines the presenting problem
- Hypotheses about mechanisms for treatment problems
- Predisposing factors leading to psychological problems
- Precipitants: events that trigger/worsen client’s problem

Question 5

Know the difference between diagnosis, assessment, formulation, and treatment.

Answer 5

Psychologist gathers assessment data when case formulation is complete

Case formulations function as hypotheses about the causes and maintaining factors of target problems and inform the selection of interventions with research supporting their efficacy in modifying these factors to achieve improvement.

Treatment Planning: selection of intervention guided by case formulation

Diagnosis: through the DSM diagnosis is when someone is diagnosed with a disorder

Question 6

Know the difference between predisposing factors and precipitating factors.

Answer 6

Predisposing factor: Factor that makes the client more susceptible to developing problems.

Precipitants: events that trigger/worsen client’s problem

Question 7

Know functional analysis and how it is utilized in treatment planning.

Answer 7

• Clinician relates target behavior and factors controlling it.
• Treatment plan developed for modifying frequency, intensity, and duration of behavior.
  Functional Analysis – a central feature of behavioral assessment, analyses are made of stimuli preceding a target behavior and the consequences following from it to gain a precise understanding of the relationship between the target behavior and the situational factors that exert control over that behavior.

Question 8

Understanding of presenting problems, target behavior

Answer 8

Presenting problems are the initial symptoms that cause a person to seek professional help from a doctor, therapist, or another mental health provider.

Target behavior is any behavior that has been chosen or ‘targeted’ for change.

Question 9

Understand the difference between each version of the DSM’s.

Answer 9

The DSM-5-TR states a mental disorder is
- An emotional, cognitive disturbance
- A dysfunctional psychological, biological behavior or underlying developmental processes
- A disability in social, occupational, and other activities
Behaviors may not be considered mental disorders:
Culture-bound behaviors
- A common stressor (death of a loved one)
- Conflicts between individual and society
Approximately 265 disorders listed
- Criteria include a disorder’s signs, symptoms, and associated features
“bible” of mental health

DSM-I and DSM-II
- 1952: first edition of DSM developed by American Psychiatric Association
- Used nation-wide; 102 diagnostic categories influenced by Freud
- DSM-I served little diagnostic utility
- 1968: DSM-II published
- Described 182 mental illnesses
o Vague descriptions
o Difficult interpretation
o Poor interrater reliability

DSM-III and the Remaking of Psychiatry
- 1980: DSM-III released with a biomedical focus
Specific sets of diagnostic criteria included
- 256 disorders; PTSD, ADHD added; homosexuality removed as a disorder (DSM-II)
DSM-III-R
- Renaming and reorganizing of some disorders
- 292 diagnostic categories

DSM-IV and DSM-IV-TR
- 1997: DSM-IV: 297 disorders listed
- Person to experience clinically significant distress to meet diagnostic criteria
- 2000: DSM-IV-TR released with updates to DSM-IV
DSM-5 (2013)
- Scientific data reviewed for medical treatments
DSM-5-TR (2022): 265 disorders
- Some disorders added or removed

Question 10

Know the difference between intervention, behavioral observations and outcome assessment

Answer 10

Intervention – are actions performed to bring about change in people.

Behavioral observations – are same self-report, self-monitoring, observations, and interviews.

Outcome assessment – observation and assessment of target behavior continues throughout treatment, progress monitored to evaluate effects of intervention, and process concludes if successful.

Image:

Target definition and baseline assessment
—>
functional analysis and treatment planning
—->
Implementation
—->
Outcome assessment
—->
Reformulation (as necessary)

Question 11

Understanding of misinterpretations, preconceptions and biases.

Answer 11

Misinterpretations, preconceptions, and biases need to be understood by psychologists so that they won’t use these when dealing with different clients.

Question 12

Know what psychoeducation is used for and understanding of termination as well as the process

Answer 12

Psychoeducation: psychological treatments may include an educational component
- Clients understand themselves, problems, and treatment
- Misinformation corrected
- Bibliotherapy: client reads informative material on own
- Effective in reducing some psychological problems
If client terminates therapy midway, clinician must find out reasons for it
- Encourage client to return for later sessions
- “Booster sessions” scheduled moths after termination
- Found to be helpful
- Progress evaluation with client is important
- Clinicians to compile such (progress) data

Question 13

Understanding of case study, controlled trial, meta-analysis and self-report assessment.

Answer 13

Case study - a process or record of research in which detailed consideration is given to the development of a particular person, group, or situation over a period of time.

Controlled trial - A study design that randomly assigns participants into an experimental group or a control group.

Meta-analysis - an objective examination of published data from many studies of the same research topic identified through a literature search.

Self-report assessment - any test, measure, or survey that relies on an individual’s own report of their symptoms, behaviors, beliefs, or attitudes.

Question 14

Understand what common factors, outcome measures, interventions and specific factor are.

Answer 14

Common factors in psychological treatment:
- Empathy, supportive client-clinician relationship, and client’s expectation of improvement
- Different treatment strategies target different mechanisms lead to similar outcomes
Outcome measure: In psychotherapy research, indicator of client functioning following treatment; used to gauge the treatment effectiveness.
Specific Factors:
Clinician prompts client to act resulting in:
- changes to the psychological processes that cause, maintain target problem, and
- reductions in psychological distress, dysfunction
Some methods used:
- behavioral interventions
- cognitive-behavioral treatments
- dynamic therapies
- acceptance and commitment therapy

Question 15

Know the difference and understand what both evidence-based and diagnosis based are.

Answer 15

Evidence-based treatment (EBT): interventions or techniques that demonstrate beneficial effects in RCTs.
Evidence-based practice (EBP): treatments informed by many sources, including scientific evidence about the intervention (i.e., EBT), clinical expertise, and client needs and preferences
Diagnosis-based: based around the diagnosis??? (HELP)

Question 16

Know what pretreatment, posttreatment assessment, pretreatment cognitive and posttreatment conceptualization are.

Answer 16

Pretreatment assessment – serves a baseline for post-treatment comparison

Posttreatment assessment – often are initiated in the weeks and days before treatment in order to establish a workable, patient-specific clinical plan

Pretreatment cognitive – evaluating the baseline for thoughts

Posttreatment conceptualization - HELP

Question 17

Understanding of cognitive behavioral and dialectical

Answer 17

Dialectical = behavior
Cognitive Behavioral = thinking

Question 18

Know what systematic desensitization, exposure, social skills training and behavioral activation mean.

Answer 18

Systematic desensitization (clients with anxiety) - a behavioral technique for reducing anxiety in which clients practice relaxation while visualizing anxiety-provoking situations of increasing intensity. In this way, the client becomes “desensitized” to the feared stimulus.

Exposure therapy - conditioned fear reduced/eliminated by extinction

Social skills Training: Behavioral intervention to improve social skills necessary for healthy interpersonal relationships and successful employment (e.g., communicate effectively, display appropriate manners, use good hygiene, show empathy and consideration for others, and tactfully express one’s own needs and opinions).

Behavioral activation (BA): Behavioral treatment in which clients are helped to (a) more routinely engage in pleasurable and rewarding activities that provide consistent positive reinforcement to improve their mood and (b) decrease engagement in activities that increase the risk of feeling depressed.

Question 19

Understanding the difference between passive and active behavior.

Answer 19

Passive mindset: life happens to me. I have little to no control.
Active mindset: I am in control of my life. I am responsible for what happens.

Question 20

Understanding avoidance, adaptive and oppositional behavior

Answer 20

Avoidance behavior: any actions people use to escape or distract themselves from difficult thoughts, feelings, and situations

Adaptive behavior: is behavior that enables a person to cope in their environment with greatest success and least conflict with others

Oppositional behavior: is uncooperative, defiant, and hostile toward peers, parents, teachers, and other authority figures.

Question 21

Understanding of awareness training, functional intervention, behavioral treatment, and danger-based expectation

Answer 21

Awareness training: client keeps log of problem habit: time it occurs, accompanying physical, emotional states, and behavior

Functional intervention: is a systematic approach used to support students with the most intensive intervention needs with the goal of teaching students functionally equivalent replacement behaviors to support them in enjoying a high quality life.

Behavioral treatment: is founded on principles of classical and operant conditioning that study antecedents, behaviors, and consequences

Danger-based expectation: client’s prediction of being exposed to feared situation.

Question 22

Know the techniques when utilizing time-out, Premack principle, contracting and shaping techniques.

Answer 22

Time-out: A contingency management technique in which a person is removed temporarily from the situation that is reinforcing the undesired behavior.

Premack principle: Also known as “ Grandma’s rule ,” the contingency management technique in which a behavior is reinforced by allowing the individual to engage in a more attractive activity once the target behavior is completed.

Contracting: A contingency management technique in which the therapist and client draw up a contract that specifies the behaviors that are desired and undesired as well as the consequences of engaging or failing to engage in these behaviors.

Shaping: A contingency management technique in which a behavior is developed by first rewarding any behavior that approximates it and then by selectively reinforcing behaviors that more and more resemble the target behavior.

Question 23

Understanding of automatic thoughts, schemas, cognitions, and beliefs.

Answer 23

Automatic thoughts - the kind of negative self-talk that appears immediately, without us even being aware of forming a thought, in response to a certain stimulus

A schema describes a pattern of thought or behavior that organizes categories of information and the relationships among them.

Cognition is the “mental action or process of acquiring knowledge and understanding through thought, experience, and the senses”.

Belief is typically defined as an internal mental state (e.g., a mental model) or a disposition that is often associated with a particular response that could be in the form of a statement or an action.