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Lecture 3

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Uzma Rehman

Chapter 3: Clinical Assessments and Diagnosis I. Why Asses patients?  To know what type of medication, Prognosis, course of ailments, what type of disorder needed 1. Characteristics of assessment tools  Reliability - Consistency is measurement; most basic  Validity - What the test measures and how well it does so  Standardization - Standards and norms help ensure consistency in the use of a technique  Reliability is the consistency of a test - Two main types: a. Test–retest reliability – retest of the certain disorder the next months later b. Interrater reliability – e.g.: a student not convinced with a psychologists’ method, then went to another psychologist because not convinced but the other psychologist has different diagnosis – low interrater reliability - Suggests that the instrument is not reliable - The instrument itself even though used by the same psychologists, could give different diagnosis  Validity is the accuracy of a test’s results - A good test must accurately measure what it is supposed to be measuring - Some types of validity: a. Predictive validity – how well your assessment tells you what will happen in the future e.g.: GRE’s predict performance of students going to graduate schools. If GRE doesn’t correlate with the students’ performance, there’s a low predictability b. Concurrent validity – comparing the result of one test to another c. Discriminative validity – d. Construct validity - 2. Assessment tools  The specific tools used in an assessment depend on the clinician’s theoretical orientation  Hundreds of clinical assessment tools have been developed - Interviews (patient and family) - Physical Exams - Behavioral Observations - Psychological Tests 3. Clinical Interviews  Face-to-face encounters - Often the first contact between a client and a therapist/assessor  Used to collect detailed information, especially personal history, about a client  Allow the interviewer to focus on whatever topics they consider most important  Can be either structured or unstructured - In unstructured interviews, clinicians ask open-ended questions, let the client discuss whatever they want to talk about, let them determine the flow of session - In structured interviews, clinicians ask prepared questions, often from a published interview schedule - Semi- structureD – combination of structured and unstructured; include detailed questions and ask follow up questions II. Strengths and weaknesses of Clinical Interviews Strengths: a good path way to reach diagnosis Weakness: unstructured interviews are not highly reliable 1. Behavioral Assessment and Observation  Behavioural Assessment - Focus on here and now - Tends to be direct and minimally inferential - Purpose is to identify problematic behaviours and situations - Identify antecedents, behaviours, and consequences  Behavioural Observation and Behavioural Assessment - BEHAVIORAL OBSERVATION: Can be either formal or informal - Self-monitoring vs. others observing - Problem of reactivity using direct observation methods: people behavior changing as the function of being observed 2. Psychological Testing  Projective tests – developed by individuals who inherited psychodynamic process - Require that subjects interpret vague and ambiguous stimuli or follow open- ended instruction - Mainly used by psychodynamic practitioners - Most popular: i. Rorschach inkblots ii. Thematic Apperception Test iii. Sentence completion
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