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PS381 Midterm notes, summary of all chapters and lectures

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Pamela Sadler

Clinical: midterm 1 Ch 1. Clinicians spend the majority of their time: giving psychotherapy, diagnosing, teaching, giving clinical supervision, research, consultation and administration Ch 2. 1940-present -MMPI -IQ reevaluated Play therapy: a technique that relies on the curative powers of expressive play, derived from Freudian principles Ch. 3 Professional regulation: Certification- only people that have training can call themselves psychologists, or use the word psychological to describe their services, they get certification via either a test or review the applicant’s training Licensing- specifies nature of the title as well as services offered, requires an exam and continuing education requirements National register- psychologists who are certified or licensed in their state pay to be listed on a national roster Pros of prescription privileges: -wider variety of treatments for clinicians to use -increased efficiency for patients -competitive advantage in the workplace Cons: -de-emphasizes psychological forms of healing Ambulatory assessment: form of telehealth, can give real time reports of symptoms, more ecologically valid, they are in their natural environment. Can also get more variable info than just one time in clinician’s office Computer assisted therapy: more efficient, accessible, longer hours available Multiculturalism: clinicians have to formulate hypotheses regarding the status of their culturally different clients, must not adhere to myth of sameness, must know when to generalize and be inclusive or individualize and be exclusive, must be informed in their own culture and the cultures with which they work, if able use culturally informed interventions Ethics • Beneficence and non-maleficence, do good and do no harm • Fidelity and responsibility, professional and scientific responsibilities to society and establish trusting relationships • Integrity, accurate, honest and truthful • Justice, everyone is entitled to access to and benefit from the profession of psychology, psychologists should recognize their biases and capabilities • Respect for rights and dignity • Confidentiality of client info Ch 4. Beck’s depression model: sociotropic (socially dependent) and autonomous (excessively achievement oriented) personalities combined with thematically related life events lead to depression. Unsystematic observation- establishes a base of knowledge from which to form a hypothesis Naturalistic observation- in real life settings, more rigorous and systematic Controlled observation- may be in field or natural settings but researcher exerts control, Case study- intensive study of a client in treatment Epidemiology- study of prevalence of an illness in a population Internal validity- we are sure that changes on dependent variable are due to changes in independent variable External validity- extent to which results can be generalized Single case design- records subject’s behavior under certain conditions but only one subject ABAB- A baseline, B treatment, A no treatment, B treatment again Multiple baseline- when there are more than one behaviors changed and they attempt to change one at a time to prove the validity of the method Mixed designs- experimental and correlational methods mixed Ch 5. Statistical infrequency: doesn’t conform to usual behaviors Advantages: has quantitative cutoff points, also allows us to ‘know it when we see it’ or use intuition Disadvantages: where to choose cut off point, how many behaviors must be abnormal to make the person a deviant? Subjective distress: subjective ceilings and individual’s sense of well-being Advantages: reasonable to expect adults and some children can assess this Disadvantages: young children unable to reflect on their own distress, some people that have little contact with reality show no personal distress, also how much subjective distress is required for a diagnosis Disability, dysfunction, or impairment: create some degree of social or occupational problems Advantages: little inference required, the problems prompt people to seek help Disadvantages: who establishes standards for dysfunction? Patient, therapist, friends, employer? Judgment on functioning is relative not absolute DSM definition: significant behavioral or psychological syndrome or pattern in an individual associated with present distress, disability or significantly increased risk of suffering, death, pain, disability or loss of freedom. Why diagnose- communication, enables and promotes empirical research, studying etiology and can help find the most effective treatment 1952 first DSM Axis 1 Clinical disorders Axis 2 personality disorders and mental retardation Axis 3 general medical conditions that may be pertinent Axis 4 psychosocial and environmental problems Axis 5 global assessment of functioning scale 0-100 Ch 6. Clinical assessment: evaluation of an individual’s strengths and weaknesses, a conceptualization of the problem at hand, an ongoing process Are computer assisted assessment tools equal to diagnostic interview? Can’t pick up on non- verbal cues, can’t process unrestricted free form language, only a clinician can properly encode or apply clinical judgment Interviewing essentials: - Privacy, No interruptions - Recording, jotting down a few key phrases - Rapport , Beginning with casual conversation, Use of language patient can understand - Open ended questions give patient responsibility and latitude for responding - Faciliative questions encourage patient’s flow of conversation ex. Tell me more about that - Clarifying ex. I guess this means you felt like…. - Confronting questions challenge inconsistencies or contradictions ex. Before when you said… - Direct once rapport is established and patient is taking responsibility - Intake admission interview: determines why the patient has come and whether the facilities will meet the needs of the patient - Case history interview: gets entire history, concrete facts and patient’s feelings about them - Mental status examination: assess presence of cognitive, emotional or behavioral problems - Crisis interview: hotlines or advice, meet problems as they occur and provide immediate resources - Diagnostic interview: standard set of questions and follow UPS, better inter rater reliability than unstructured Ch 7. Definitions of intelligence types: - Emphasize adjustment or adaptation to the environment and new situations - Focus on ability to learn - Emphasize abstract thinking, ability to use symbols, concepts, verbal and numerical symbols Spearman 1927: Posited existence of g factor of general intelligence and s factor of specific intelligence Thurstone followed with a series of group factors 7 Cattell 1987: 17 primary concepts, and fluid ability (genetically based capacity) and crystallized ability (capacities of culture based learning), hierarchical system Guilford’s classifications: structure of intellect model, three dimensions (operations, contents and products) 120 separate intellectual abilities Gardner 1983: Intellectual competence includes set of problem solving skills, eight intelligences: musical, linguistic, logical mathematical, spatial, bodily kinesthetic, naturalistic, interpersonal and intrapersonal Sternberg 2005: Triarchic theory of intelligence: componential, experiential, contextual Binet began mental age MA and it was based on a certain number of items passed but because discrepancy between MA and chronological age, CA , mean different things depending on age there is a ratio Stern created intelligence quotient IQ= MA/ CA X 100 Deviation IQ compares the IQ score with peers of the same age group IQ scores not always stable throughout life span Proven to be partly genetically correlated Flynn effect: average IQ has increased 3 points each decade Stanford binet scale assesses 5 factors: fluid reasoning, quantitative reasoning, visual spatial processing, working memory and knowledge Wechsler scale: more for adults, included performance items that weren’t just linguistic WAIS IV: revised Wechsler, starts off with two basal questions and works backward until a perfect score is achieved on two consecutive items, more efficient than having to administer questions way below ability level Ch 9 Sample vs sign: If we see the test as a sample we can expect they will act as we see on the test, if it is a sign it is taken as an indirect manifestation of some other characteristic Functional analysis: exact analysis made of the stimuli that precede a behavior and the consequences that follow, must include precise descriptions. S stimulus, O organismic variables related to behavior, R response or problematic behavior, C consequences of the behavior Behavioral interviews: asks about hoped for results and ultimate outcomes. Therapist learns client’s priorities and what obstacles would be present. - naturalistic observation: home observation, coding recordings of behavior, school observation , hospital observation - Controlled observation: ex. parent-adolescent conflict (coding of a recording of them discussing resolving a problem) - Controlled performance techniques: exposing people to graduated series of anxiety provoking stimuli to study response, must pay attention to demand characteristics - Self-monitoring: maintaining logs, can help bring attention to their behavior and reduce it also able to compare to baseline - Role playing methods - Cognitive behavioral assessment: patients can be instructed to think aloud Lecture: training in clinical psych Coursework includes: measurement, analysis, basics as well as more in depth courses in subjects of interest Practicum: learning through exposure to clinical work and practical application of skills Research: courses in statistics, research methodology, and most programs require a master’s thesis, require intensive original research (a dissertation) to receive a doctorate Qualifying Exam: in 3 year after Master’s degree, often written, sometimes oral covering either all of psych or just clinical Internship: full year internship in Canada or US, stimulates ideas from future research projects, differentiates clinical psych from other psych degrees, exposes to professionals Clinical training models: Scientist practitioner model (Boulder 1949) -predominant training philosophy -students acquire research competence by contributing to ongoing studies and eventually conducting their own original research project -integrates role of scientist with practitioner Doctor of Psychology (Psy.D) programs, based on Practitioner scholar (Vail 1973) model -emphasis on development of clinical skills, relative de-emphasis on research competence -offered in both university-affiliated and non-university affiliated professional schools -compared to Ph.D. programs: Higher acceptance rates, tuition fees, less obtain financial assistance or internships, more Psy D are awarded than PhD Clinical scientist model 1990 -arose from concerns that clinical psych not sufficiently grounded in science -focuses on evidence based approaches to assessment, prevention and clinical intervention -over 50 programs identify themselves with this model Lecture: interpersonal theory Interpersonal theory or interpersonal circumplex theory: (circumplex: circle, prototype, fuzzy set quality), relationship to big five personality factors -trait based, situation based -theories of personality: describe consistent, stable differences (Personality: a person is comfortable with a typical interpersonal style) -theory of social interaction: how we accommodate those we interact with (Social interaction: people affect each other when they interact) -Two dimensions: y axis dominance (status, control, power, and agency) X axis friendliness (affiliation, warmth, love, and communion) -interpersonal researchers segment this space (quadrants, octants, sixteenths) -most agree there are two main underlying dimensions, labeled in accordance with endpoints -Big 5: openness, conscientiousness, extraversion, agreeableness, neuroticism -difficult styles and psychopathology: constricted to only one or two segments on circumplex, exaggerated, intense versions of the circumplex Complementarity: Tendency to evoke similar behavior on affiliation dimension, called correspondence -friendliness often causes friendliness Tendency to evoke opposite behavior on dominance -submissiveness, causes dominance Complementary behaviors: opposite on dominance, similar on friendliness Anti-complementary behavior: not similar in friendliness but similar in terms of dominance Acomplimentary behaviors only opposite on dominance or similar on friendliness but not both According to Kiesler: (1983-1996) Complementary- most satisfying and rewarding Anti-complementary: unrewarding, aversive Acomplimentary: somewhat less satisfying Interpersonal transaction style: How interpersonal style is perpetuated. An individual when interacting, what we do is a consequence of our internal experience (the way we see ourselves) a person’s internal style is broken down into a feedback cycle Internal experience vs actual behavior, and the other person’s internal experience and actual behavior Internal experience causes external behavior other person is affected by this but also their own internal system leading to output that either confirms or denies how the first person feels internally -self-perpetuating due to self-fulfilling prophecy -applies equally to normal behavior and abnormal behavior, pulls persistently, consistently for similar reaction from others Maladaptive transaction cycle of dysthymia: Interpersonal theorists have in mind therapy has to be a learning experience, provide safe environment for client to learn to interact in a different (more adaptive) way. Therapist adopts partially different, disconfirming style, not acting the same as everyone else in their environment, elicit different complementary response from client. Ways interpersonal therapist may intervene: -move own interpersonal style to various quadrants as needed -may demonstrate some interpersonal flexibility -may show asocial responding- purposefully non-confirmational -targeting/ intervening with problematic aspects of the maladaptive transaction style Lecture: peer review process Winnowing process: get rid of articles that don’t meet the standards th 17 century journals: began because there were too many books to read, so made it more manageable, it was originally as much social as it was technical, had rumors, letters, 18 and 19 century journals: were used to publish new information, became increasingly important to put a claim on one’s new discovery th st 20 and 21 century: publication in journals is at the heart of modern day science, ensuring survival of one’s ideas ad projecting one’s career, publication count determines salary, tenure -prestige of journals are different based on amount of scrutiny an article goes through before publication. High prestige journals reject the majority of papers and are often cited. Mentors and peers can teach you which articles have higher prestige. Journal impact factor is an attempt to quantify how prestigious journals are, reflects on average how many times an article in that journal is cited per year. A high factor
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