Wk 12 - Clinical Assessment Flashcards
What are three key areas of clinical psych?
Psych assessment of diagnosis
Treatment
Research
What is clinical assessment? (x1)
It provides info that is crucial for… (x4)
The process by which clinicians gather info on their clients Diagnosis Formulation Treatment planning Predicting course of a mental disorder
What to tasks make up the beginning of the clinical assessment process?
Which are designed to assess functioning across which three dimensions?
And clinicians should also consider the … (x1)
Clinical intake interview
Mental Status Examination
Emotional, behavioural, cognitive
Bio-psycho-social model
What are the two main diagnostic manuals used in clinical practice, and in which contexts? (x3 and x2)
DSM-5 in private practice and in the US
• Constantly changes – eg in version 2-3, homosexuality was a pathology
• So need to remember that they’re not perfect
ICD-10 used in hospitals and also in the UK
In what ways can clinical diagnosis be helpful?(x5)
Communication between clinicians - Ease of description/communication
Helps guide questioning, differential diagnoses - Some diagnoses very complex, so helpful to whittle down areas
• Overlap between diagnoses, a lot of depression for example looks like bi-polar, looks like PTSD, looks like alzheimers
Helps with treatment options
Make client feel at ease – normalisation, understanding
In what ways can clinical diagnosis be unhelpful?(x5)
Potential stigma/added burden
Self-fulfilling prophecy
• “I am a depressed person, nothing I can do to change this”
Use as an ‘excuse’
• As in anxiety, ‘I can’t do that, I’ve got anxiety’
What constitutes a major depressive episode?
Need five of following for 2 weeks (at least 1 of first 2):
Depressed mood most of the day, nearly every day (In children and adolescents, can be irritable mood)
• Subjective report – feel sad; Observation – appears tearful
Diminished interest or pleasure in activities most of the day, nearly every day (subjective or observation)
Significant weight loss or weight gain or decrease or increase in appetite nearly every day
(In children, failure to make expected weight gains)
Insomnia or hypersomnia nearly every day
Psychomotor agitation or retardation
Fatigue or loss of energy
Feelings of worthlessness or inappropriate guilt
Diminished ability to concentrate
Recurrent thoughts of death, suicide ideation
What are 7 different clinical assessment options?
Interview = parent, child, teacher Self-Report Questionnaires Self-Monitoring Behavioural Observation = coding system Standardised Neuropsychology Assessments Medical examination Collateral information
What kind of interview measures might be used in clinical assessment? (x3)
o Intake – first session
o Structured Clinical Interviews – if eg work cover
o Anxiety and Related Disorders Interview Schedule for DSM-5 – DSM takes about an hour, but higher accuracy
What kind of self-report measures might be used in clinical assessment? (x4)
Beck Depression Inventory -
Depression, Anxiety, Stress Scale
What kind of self-monitoring measures might be used in clinical assessment? (x1 plus explain)
Thought diary – underline the most pressing thought of the time, and what the consequences were, eg left an event
What kind of behavioural observation/coding system measures might be used in clinical assessment? (x1 plus e.g.)
Family Observation Scale
o Kids on Speed: multidisciplinary team to help parents of kids with ADHD - hese kind of tests are very time consuming and expensive…
What kind of neuropsych measures might be used in clinical assessment? (x3)
E.g., WAIS & WISC
Neuropsych for cognitive deficits
o Eg dementia, difficult learning disorders, can be better to refer on
What kind of medical measures might be used in clinical assessment? (x1)
eg if they’re not listening to you, check their hearing
What kind of collateral information measures might be used in clinical assessment? (x3)
Report Cards – if child or adolescent
Previous reports or referral information (e.g., GPs, OTs, Speech)
Psychiatrist referrals– eg medication allows day to day functioning, but then psych helps build skills for that
What is it important for clients and clinicians to communicate during the assessment process? (x5)
Ensuring honest, detailed and comprehensive reporting from client
Explaining purpose and role of assessment
Explaining your role/client’s role
If using psychometric tools, ensure client understands what is expected of them
Assessment can be very burdensome for the client, so you want to make sure they understand the rationale, and what’s going on, and the conditions under which you’ll be testing
What are the two broad aims of the clinical psych interview? (x4 and x2)
Why is it challenging? (x1)
What happens if you don’t do both properly? (x1)
Gather Information
• Diagnosis
• Formulation
• Implementation of appropriate assessment strategies
Establish therapeutic relationship
• Micro-counselling skills (active listening, sensitivity)
Constantly tricky - can’t just manualise it…
Blowing it impacts on likelihood of client return
What biographical info are you trying to get in a clinical interview? (x7)
o Name o Age o Marital status o Gender o Occupation o Religion o Current circumstances of living
What referral info are you trying to get in a clinical interview? (x3)
o Referring agency
o Reason for referral
o Client often has gone through a series of referrals/obstacles befo getting to you…
Eg GP, then you get 6, review with potential for another 4 in year
• It’s great, but eg no cure for major depression shown to work over such short times – sets up dodgy expectations for the client
What presenting problem areas are you trying to get a handle on during a clinical interview? (x4)
Identifying problems in all symptom domains
Their typography
Recent precipitants
Impact of problems
What are the symptom domains that you try to access during a clinical interview> (x5)
- Cognitive
- Behavioral
- Affective
- Physiological
- Medical
