studyguide clinical 2011 final.docx

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University of California - Irvine
Cognitive Sciences
Al Valdez

Clinical Psychology - Final Examination Study Guide 1. Discuss culturally competent and clinical psychology. PP10 #3 Culturally competent psychology: - Every culture has its own definitions of “normal” and “abnormal” - Culturally competent clinical psychologist are aware of this, and of the influence of their own cultural perspective. - Especially important not to over pathologize o View as abnormal what is culturally normal Clinical psychology: 2. Discuss the MMPI-2, validity, reliability, test-taking attitudes measurements. PP10 #5 MMPI-2: Minnesota Multiphasic Personality Inventory-2 - Most popular and most psychometrically sound objective personality test o Used worldwide: translated into dozens of languages - Pencil and paper format - 567 self-descriptive sentences - Client marks true or false for each - Original MMPI was published in 1943 o Primaryy authors were Strake Hathaway and JC McKinley o Empirical criterion keying was used as test construction mathod  Item is included in test only if it elicits different responses from clinical groups. - Revised edition, MMPI-2, was published in 1989 o Better norms (especially demographically/cultrally) o Less outdated wording of items - MMPI and MMPI-2 feature 10 clinical scales o 1. Hypochondriasis o 2. Depression o 3. Hysteria o 4. Psychopathic Deviate o 5. Masculinity/feminity o 6. Paranoia o 7. Psychasthenia o 8. Schizophrenia o 9. Mania o 10. Social Introversion - Also feature supplemental scales and context scales for additional clinical information. - MMPI and MMPI-2 also feaature validity scales o To measure test-taking attitudes o Can identify clinets who “fake good” or “fake bad” or clients who respond randomly Clinical Psychology - Final Examination Study Guide - MMPI –A (for adolescents 14-17) was published in 1992 o Similar clinical scales, calidity scales and administration - MMPI-2-RF – msot recent edition- briefer less overlap between clinical scales - Strenths include psychometrics (established reliability and validity) and comprehensiveness - Limitations include length, reading requirement, attention requirement, and emphasis on pathology/ abnormality. - Therapeutic Assessment o Interesting use of MMPI-2, developed by Stephen Finn and colleagues o MMPI-2 feedback used as a brief therapeutic intervention o What psychologist intend as assessment clients can experience as therapeutic. 3. What is a shortcoming of projective tests. PP10 #15 - Based on the assumption that clients will “project their personalities when presented with unstructured, ambiguous stimuli and an unrestricted opportunity to respond. - Lack of objectivity in scoring and interpretation. o Considered by many to be empirically inferior to objective tests o Usage has declined in recent decades - Advocates claim they are less “fake-able” 4. Define and discuss efficacy vs. effectiveness. - Efficacy- the extent to which psychotherapy works “in the lab” o In controlled outcome studies o Therapists’ methods are controlled or manualized o Clients are selected for diagnostic criteria o Better interbal validity than external validity - Effectiveness- the extent to which psychotherapy works “in the real world o Greater variability in therapist’ methods o Greater variability in clients’ issues and diagnoses o Better external validity than internal validity - Results of effectiveness studies o Not as many studies as efficacy studies. But similar results: psychotherapy works o Consumer Reports study is example of a large scale effective study  Therapy had positive effects  Results lasted over time  Some methodological concerns  Sampling bias  No control group What do efficacy studies say about psychotherapy? Clinical Psychology - Final Examination Study Guide What do Norcross, Hedges, and Prochaska, 2002, say about the future of psychotherapy? - Experts expect the future of psychology to include a rise in o Cognitive and behavioral therapy o Culturally sensitive therapy o Eclectic/integrative therapy o Evidence-based therapy  Both involve multiple approaches  Eclectic therapy involves selecting the best treatment for a give client based on empirical data from studies of the treatment of similar clients  Integrative therapy involves blending approaches in order to create a new hybrid 5. Discuss Smith et al, 1980. 6. Psychodynamic theory: define & discuss major elements. Goal of therapy. Primary goal. - The primary goal of psychodynamic psychotherapy is to make the unconscious conscious o “Insight” into thoughts, feelings, and other mental activity previously outside of awareness o The very presence of the unconscious was a fundamental idea of Sigmund Freud 7. Discuss defense mechanisms- what is displacement, reaction formation, sublimation… - Defense Mechanisms o Unconscious techniques created by ego, as an attempt to handle conflict between id and superego  Repression – keep impulse in unconscious  Projection – attribute impulse to others  Reaction formation – do opposite of impulse  Displacement – redirect impulse  Sublimation – redirect impulse in a way that benefit others 8. What is brief psychodynamic psychotherapy? Clinical Psychology - Final Examination Study Guide 9. Humanistic theory: define & discuss major elements. What is meant by healthy growth? - Carl Rogers was a leading figure o Abraham Maslow was another o Humanism was a reaction against Freud’s approach o Assumed that human nature wasn’t so bad (eg id-driven) o Overlapping terms for humanism include “nondirective” “client- centered” and “person-centered” - Humanistic Concepts: clinical Implications o People have an inborn tendency toward self-actualization o People also have a need for positive regard- warmth, acceptance, “prizing” o Sometimes people are forced to sacrifice self-actualization in order to obtain positive regard from important others (eg parents) - Goal of Humanistic Psychotherapy o Primary goal of humanistic psychotherapy is to foster self-actualization o Problems stem from stifled self-actualization or growth o Therapist’s task is to create a climate in which the client can resume their natural growth toward psychological wellness - In humanistic therapy, there are no conditions of worth on the client o Clients’ real selves can match their ideal selves o This match is know as congruence, and is the root of psychological wellness o Mismatch between real and ideal selves is know as incongruence, and is the root of psychopathology What is the role of empathy? - The role of empathy is for the therapist to be able to sense the client’s emotions just as the client would - A deep understanding of the client’s experiences. What are the three important factors related to a good therapist/client relationship? - Empathy o The therapist is able to sense the client’s emotions just as the client would o A deep, nonjudgmental, compassionate understanding of the client’s experience - Unconditional positive regard o Accepting or “prizing” the client “no matter what” and without judgment - Genuineness o Honesty toward client, rather than playing a role 10. Behavioral theory: define & discuss. Behavioral therapy represents a reaction against the lack of empiricism inherent in psychodynamic and humanistic approaches Clinical Psychology - Final Examination Study Guide - A reaction against mental processes that can’t be precisely defined, directly observed, or scientifically tested. Primary goal. What are the major elements of behavioral therapy? - The primary goal of behavioral psychotherapy is observable behavior change - No emphasis on internal, mental processes o In contrast to previous approaches (eg psychodynamic and humanistic) - Emphasis on empiricism o Study of human behavior should be scientific o Clinical methods should be scientifically evaluated via testable hypotheses and empirical data based on observable variables  For example, baseline measures of problem behavior at outset; subsequent measures after some therapy - Defining problems behaviorally o Client behaviors are not symptoms of some underlying problem- those behaviors are the problem o Behavioral definitions make it easy to identify target behaviors and measure changes in therapy  Clients’ own definitions can be very hard to assess or measure - Measuring change observably o Other kinds of therapist may measure change in clients in more inferential ways, but behavioral therapist use more unambiguous indications of progress o Introspection is not an acceptable way to measure progess- not directly observable. Discuss exposure therapy, contingency management, token economies, observational learning. What is exposure and response prevention used to treat? Techniques based on Classic Conditioning (eg Pavlov’s dog studies) - Exposure therapy o Clinical psychologist’s version of “facing your fears” o Often used to treat anxiety disorders o When the client is repeatedly “exposed” to the feared object and the expected aversive outcome does not take place, the client no longer experiences the fear o Exposure is typically gradual (“graded” exposure), following an anxiety hierarchy o Exposure can be imaginal or in vivo (real) o Exposure-and-response-prevention is a particular form of exposure with empirical evidence in the treatment of OCD Techniques based on Operant Conditioning (“operates” in own environment) - Contingency Management Clinical Psychology - Final Examination Study Guide o A powerful way to change behavior is to change the contingencies controlling it  If consequences change behavior will change o Reinforcement and punishment should be identified and altered as needed  Reinforcement is typically preferred over punishment  Aversion therapy is one type based on punishment of unwanted behavior - Token economies o Is a setting in which clients earn tokens for participating in predetermined target behaviors  Tokens can be traded for reinforcements o Most feasible in sites where behavior is continuously monitored  Ex impatient unit, correctional facility - Observational learning (or modeling)
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