Week 5: Assessment + Interviewing

Question 1

What are 6 major functions of Theories in therapy?

Answer 1

1. To UNDERSTAND behavior (how it’s acquired/changed + differences)
2. To PREDICT behavior.
3. To CHANGE behavior.
4. To determine HOW abnormal behavior is MEASURED
5. TREATMENT choice
6. HYPOTHESES

Question 2

What are the Core Competencies of psychological Assessment according to Krishnamurthy et al. (2004)? (8)

Answer 2

1. Background in Psychometric Theory
2. Knowledge of Bases of Assessment (scientific, theoretical, empirical, and contextual)
3. Assess human experience.
   Knowledge, skill, techniques to assess cognitive, affective, behavioral, and personality dimensions of Human Experience
4. Ability to assess Outcomes of Treatment/intervention
5. Assess relationships and assessment activity.
   Ability to evaluate roles, contexts, Relationships within which Patients and Psychologists function, and the reciprocal Impact of those roles, contexts, and relationship on Assessment Activity
6. Respect collaborative relationship between patient and therapist.
   Establish, maintain, and understand the Collaborative Professional Relationship that provides a context for all psychological activity
7. Assessment + Intervention
   An understanding of the Relationship between Assessment and Intervention, assessment as an intervention, and intervention planning
8. The following Technical Skills:
   • Problem identification and case conceptualization
   • Understanding and selection of appropriate assessment methods
   • Effective application of the assessment procedures
   • Systematic data gathering
   • Integration of information, inference, and analysis
   • Communication of findings, recommendations
   • Provision of feedback

Question 3

What/Where are the Core Competencies (Krishnamurthy et al. (2004)) derived from?

Answer 3

Derived from Competencies Conference: Future Directions in Education and Credentialing in Professional Psychology.

Question 4

What are some goals of psychological assessments? (6)

Answer 4

1• Problem Explication:
Often through diagnosis or description of diagnostic picture without formal diagnosis.

2• Formulation
Determine the causes, maintenance factors, and interplay of issues that influence the genesis and continuation of problems or difficulties.

3• Prognosis
The expected course of a disorder and the expected degree and speed of recovery from the disorder.

4• Treatment Issues and Recommendations
Information for appropriate treatment and for determining issues that might interfere with or be particularly helpful with therapy.

5• Provision of Therapeutic Context
Establish a collaborative, positive, and therapeutic experience for the person(s) being assessed.

6• Communication of Findings
A psychological assessment typically begins with either the patient or a referring professional who requests answers to specific questions regarding the patient’s difficulties.
The clinical psychologist communicates his findings to the referral source. This typically takes the form a psychological report that outlines the problem, formulation, prognosis, and treatment recommendations.

Question 5

Define: Formulation.

Answer 5

Attempt to explain genesis, maintenance, and process related information for treatment.

Question 6

True or False:
•Structured Interviews –> Diagnosis
•Psychological Assessment –> Some Diagnostic Information and Formulation

Answer 6

True!

Question 7

What are some assumptions in Diagnoses? (4)

Answer 7

1• Diagnostic Entities UNIFORM (must be same for all with presenting similar symptoms)
2• Diagnosis involves assigning the diagnostic construct or LABEL
3• Structured Interviews
4• Based on current Diagnostic System

Question 8

Wha are some assumptions in Formulation? (4)

Answer 8

1• Formulation assumes each person UNIQUE
2• Formulation involves the PERSON
3• Interview, objective & projective tests, process variables
4• Based on theoretical perspective

Question 9

Name information needed for Formulation. (4)

Answer 9

1• Intra-individual issues
2• Interpersonal issues
3• Environmental Issues
4• Process-related Issues

Question 10

Explain the McWilliams (1999) example of formulation.

Answer 10

This book shows that while seasoned practitioners rely upon established diagnostic categories for record-keeping and insurance purposes, their actual clinical concepts and practices reflect more inferential, subjective, and intuitive processes.

It sounds like you are shy and sensitive by temperament, but it seems that no one in your family knew how to help you get braver around people. With the best intentions, they made things worse by forcing you into social situations, where you clutched. Because you had one after another failure socially, you began to think there was something very strange about you, and eventually, you related only to yourself and your thoughts.
You were lonely, but the idea of being close to someone terrified you. Then when your boss criticized you, you retreated even further into yourself, to the point that you were hearing voices. We need to work on getting you more comfortable with others, including me, and part of that will involve looking at things that you believed makes you so alien. Once we understand the meaning of some of your preoccupations, I think you’ll find you’re not so bizarre. In the meantime, if you’re still hearing voices, you may want to consider seeing someone who will prescribe antipsychotic medications. Does that make sense to you?

Question 11

Define: Prognosis.

Answer 11

Expected course, and the degree and speed of recovery.

Question 12

Define: Psychological Assessment

Answer 12

the gathering and integration of psychology-related data for the purpose of making a psychological evaluation, accomplished through the use of tools such as tests,
interviews, case studies, behavioral observation, and specially designed apparatuses and measurement procedures.

Question 13

What’s the difference between psychological testing and psychological assessment?

Answer 13

psychological testing: measures the issues, problems, concerns, strengths, and limitations a person has.

psychological assessment: extends this to include how and why the person developed the problems and how the problems are maintained. (also, this includes tests but combines it with more data for a more holistic view of a person)

Question 14

What’s the use of core competencies of psychological assessment?

Answer 14

1. provide an example of the extensive coverage and training necessary to develop assessment skills in clinical psychology
2. point out the knowledge and skills that would likely be focused on in graduate school.

Question 15

Define: Idiographic approach to assessment.

Answer 15

to understand an individual, couple, or family and the psychological issues that pertain to that individual, couple, or family.

Question 16

Define: Nomothetic approach to assessment.

Answer 16

to understand broader issues or constructs pertaining to the types of problems or treatments.

Question 17

Identify 2 approaches to psychological assessments?

Answer 17

Idiographic and Nomothetic

Question 18

Which approach to assessments is used more in direct clinical work?

Answer 18

Idiographic; useful for psychodiagnosis and treatment planning.

Question 19

Which approach to assessments is used more in research?

Answer 19

Nomothetic; to understand how certain variables that exist in people, couples, or families are related to other relevant clinical variables such as treatment outcomes, efficacy, or process.

Question 20

What are the 2 tools psychologists use in assessment?

Answer 20

Tests and Technique.

Question 21

Why are tests useful?

Answer 21

Scores can be compared to normative information in

order to determine whether an individual scores the same as or different from a normative sample.

Question 22

What are some examples of techniques?

Answer 22

1. Semi- or unstructured clinical interviews
2. Projective techniques such as the Thematic Apperception Test or drawing tasks
3. Collateral reports
4. History taking
5. Behavioral observations

Question 23

What is an area of concern in techniques?

Answer 23

Validity and reliability.

Question 24

Define: Psychodiagnosis

Answer 24

a process that uses both psychological tests and psychological tools to gather data in order to provide comprehensive information about a unique individual and her assets, liabilities, strengths, defenses, conflicts,
symptoms, vulnerabilities, and so forth, in order to provide important information regarding the nature and origins of problems for treatment planning.

Question 25

Types of Assessments:

Answer 25

1. Psychodiagnostic assessment:
   Focuses on issues such as personality variables, symptom picture, environmental influences, personality structure
   including underlying dynamics and conflicts, etc. that contribute to the psychological problems the patient is struggling with.
   This often involves either assigning a formal diagnosis, causes, or treatment.
2. Intellectual/cognitive:
   Focuses on both the strengths and the liabilities of cognitive functioning.
   One particular type of cognitive assessment is known as Neuropsychological Assessment that assesses intellectual, cognitive, and behavioral brain functioning in brain-injured individuals.
3. Behavioral:
   Focus on attempt to determine antecedents, reinforcement histories, and maintenance issues for psychological or behavioral problems.
   For example, the clinical psychologist might focus on the assessment of specific drinking behavior, cues or contexts that influence drinking behavior, and situations or stressors that impact on desire for drinking.
4. Health:
   With respect to health-related assessments, the clinical psychologist attempts to determine behaviors, personality structures, and environmental features that influence a patient’s physical health status.
   For example, when assessing contributions to hypertension, there may be a focus on assessing anger styles and levels of hostility, ability and strengths in managing stress reactions, and cognitions related to interpersonal problems.
5. Psychophysiological:
   Focus is on assessment of physiological processes, such as heart rate, skin temperature, or muscle control that are factors in physical and psychological health problems.
   For example, in the assessment and treatment of sex offenders, there may be assessments of sexual arousal in response to specific types of stimuli.
6. Rehabilitative:
   Focus to attempt to determine the functional capacity of individuals following psychological or physical injury.
   This can take the form of cognitive assessments following head injuries or more broad assessments of functioning following a traumatic experience.
7. Forensic:
   Assess factors that may have contributed to criminal behavior, likelihood of reoffending, and treatment of issues pertaining to criminal behavior.

Question 26

What is a quantitative/actuarial approach to assessment interpretation?

Answer 26

Rather than using clinical impressions or basing decisions on clinical experience, the clinical psychologist uses the scores from tests or other information in a statistical fashion in order to make decisions or come to conclusions.

Question 27

What is a clinical judgement/subjective approach to assessment interpretation?

Answer 27

Decisions that are made based on clinical experience, intuition, subjective impressions, and idiosyncratic information relevant to the individual patient.

Question 28

What is a Base rate issue?

Answer 28

In making judgments or predictions, clinicians can make errors by not taking account of the rate that particular behaviors, traits, symptoms, or disorders occur in the general population (i.e., base rates).

Question 29

What is the Barnum effect?

Answer 29

Statements can be made of an individual that sound idiosyncratic and uniquely descriptive, but are actually so commonplace among people that the statements become meaningless for the particular person.

Question 30

What is Illusory correlation?

Answer 30

Clinicians may make judgments based on these untrue relationships known as illusory correlations.

Question 31

What is Confirmation bias/Preconceived notions?

Answer 31

Clinicians will look for evidence to confirm their prejudged or preconceived notions and, importantly, ignore disconfirming information.

Question 32

What is inappropriate use of Heuristics?

Answer 32

Heuristics are cognitive shortcuts that normally
serve us well in making quick judgments and decisions.
Errors can occur when the heuristics are used inappropriately or in inappropriate situations.

Two heuristics, come into play in clinical work the most:
1. the Representativeness heuristic: error in judging a person/situation based on how similar it is to the prototypes/preconceived notions of it in their mind.
Which leads to the untrue belief in the reliability and validity of small numbers.

2. the Availability heuristic: shortcuts/error in deeming what is significant - a small thing that happens, in your mind, can become the most important thing, when it reality it is not significant.
   Which leads to putting too much weight on vividly recalled information.

Question 33

What are the differences between diagnosis and formulation? What role does each play in an assessment?

Answer 33

Diagnosis is reliant on standardized diagnostic criteria of which does not encapsulate the entire context of a person.
Formulation, however, attempts to determine the causes, maintenance factors, and interplay of issues that influence the genesis and continuation of problems or difficulties.

Question 34

What are the similarities and differences between tests and techniques in assessment?

Answer 34

Tests are thought of as highly valid and reliable instruments of assessing a person’s functioning. Personal scores are compared to normative ones to determine abnormalities.
Techniques however don’t always compare a patients experiences to norms. They both aid in assessing a person’s functioning however.

Question 35

Why do you think it is important to provide feedback to patients following an assessment?

Answer 35

It can provide them with a sense of comfort and control, in that not only do they feel understood but they also understand themselves.

Question 36

What is ego-strength?

Answer 36

Some people are more fragile and cannot tolerate anxiety or other emotions as effectively as others.

Question 37

What is psychological mindedness?

Answer 37

An individual’s ability to observe their own internal life, see patterns in their own behavior, and develop insight.