what clinical psychologists do 2 Flashcards
what are some criticisms of classification systems
Many diagnostic labels are not valid - do not represent discrete entities with natural boundaries
Often inadequate reliability between clinicians and across patients
Diagnoses do not rely on presence of all symptoms in a list – heterogeneity within categories
Many disorders are associated with diverse aetiological factors not only symptoms
Can be over inclusive – all human problems can be pathologised
Do not allow for continuum – suggest presence or absence
what are some problems with developing new classification systems
They would have to have significant advantages over the current system to be adopted
They would have to be widely adopted to be of any use
Would require sea of change in current thinking
classification vs diagnosis
classification: identifying sets of symptoms which are thought to co-oocur as clusters
Diagnosis: assigning clusters with a label
what are the uses of psychiatric diagnosis
Provide a common language for professionals
Facilitate research into aetiology, outcomes and
interventions
Identify prevalence rates used for mental health service planning
Guide intervention decisions in clinical practice
Can provide access to services and support
what are some difficulties with using a medical model in mental health
Relies solely on symptom reporting rather than objectively measurable signs
Symptoms are examples of unusual thoughts, feelings and behaviours – clinical cut off?
what are some problems with psychiatric diagnosis
Labelling - risk that people are understood in terms of their diagnoses and associated stereotypes e.g. Mr Smith is schizophrenic
Depersonalisation – can reduce a person to a collection of symptoms which can obscure understanding of whole person and ability to help them in ways which are meaningful
The myth of mental illness – some argue that conceptualising human experience and behaviour in this way is not based on scientific research but is a deception which serves psychiatry and the pharmacological industry
what does reflective practice involved
Being aware of your own feelings
Being aware of difference and diversity
What kind of biases you have
psychodynamic formulation models
addresses if the patient’s equilibrium has been disturbed and how problems or symptoms are maintained
what are the consequences of change?
there is no single psychodynamic formulation model
life seen as a struggle
Means of avoiding pain are developed outside of conscious awareness
Therapy is about getting in touch with feelings that we have tried to avoid.
Therapy is about trying to help clients formulate about what they are experiencing and to tolerate the pain that this involves.
all human behaviour is meaningful and significant
psychodynamic - self deception
1) hidden feeling
2) awareness of this feeling leads to anxiety, due to conflict between feeling and another perceived need
3) anxiety signals danger
4) action must be taken to resolve conflict by conflicting aspects of self - defence is to avoid conscious acknowledgement of the conflict
5) if person cannot tolerate this conflict, there is self deception and the aspect is disguised
these defensive strategies can give rise to unhelpful cycles of attempted solutions
CBT model summary
based on cognitive and behavioural therapy
Utilises concepts such as schemas, beliefs, conditional assumptions and maintenance cycles.
From presenting to pre-disposing
Created in collaborative partnership
Complementary with diagnoses.
systematic models (family therapy) of formulation
Deconstruction of the problem
Problem maintaining patterns and feedback loops
Beliefs and explanations
Transitions, emotions and
attachments
Contextual factors
key characteristics of systematic formulation
Problems are seen as residing in relationships rather than individuals.
Formulation is focused on family member’s perceptions of meanings and explanations of the problems
Formulation is a dynamic and collaborative process
social inequalities perspectives
Social Inequalities exist when an ascribed characteristic such as gender, race, class, disability influences access to power, money, rights and privileges
social inequalities
‘Low status’ groups experience negative and disempowering contact with services (BPS, 2012).
Western psychology decontextualises individual’s social, political and financial realities.
Three principles: Liberty, empowerment and social justice (Kagan et al., 2011)
Dominant discourses can demonise groups: ‘chavs’, ‘welfare scroungers’ and migrants
Key characteristics of social inequalities formulation
Provide recognition and respect
Making material realities visible
Mapping events across time
Paying attention to language, positioning and sense making
Recognising ‘othering’
Situating personal accounts in social and political contexts
Naming of power and abuses
why do psychologists use formulation
to collaborate with clients to help make sense of their problems
provide bridges between theory and practice and assessment and interventions
