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Chapter 4

PSY240H5 Chapter Notes - Chapter 4: Neuropsychological Assessment, Prefrontal Cortex, World Health Organization


Department
Psychology
Course Code
PSY240H5
Professor
Ayesha Khan
Chapter
4

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CHAPTER 4: CLINICAL ASSESSMENT
psychological assessment
oprocedure by which clinicians. using psychological tests, observations and
interviews, develop a summary of the client’s symptoms and probs
clinical diagnosis
oprocess through which a clinician arrives at a general “summary
classification” of the patient’s symptoms by following a clearly defined
system such as DSM-IV-TR or ICD-10 (International Classification of
Diseases), published by the World Health Organization
assessment is an ongoing process and may be imp at other points in treatment
THE BASIC ELEMENTS IN ASSESSMENT
first, clinician must identify the presenting problem, or major symptoms and
behaviour
The Relationship between Assessment and Diagnosis
imp to have an adequate classification of the presenting problem and also a diagnostic
categorization if possible for many reasons
oformal diagnosis necessary for some health insurance coverage
ocan help in planning and managing appropriate treatment
oto determine which treatment facilities need to be available
Taking a Social or Behaviour History
Social Context
what kind of environmental demands are typically placed on the person
what supports/special stressors exist in that person’s life
diverse and often conflicting bits of info about the individual’s personality traits,
behaviour patterns, environmental demands and so on must be integrated into a
consistent and meaningful pic
osome clinicians refer to it as “dynamic formulation” because it not only
describes the current situation but also includes hypotheses about what is
driving the person to behave in maladaptive ways
The Influence of Professional Orientation
biologically oriented clinician
olikely to focus on biological assessment methods aimed at determining any
underlying organic malfunctioning that may be causing the maladaptive
behaviour
psychodynamic/psychoanalyst
omay choose unstructured personality assessment techniques to identify
intrapsychic conflicts or simply proceed with therapy, expecting these
conflicts to emerge as part of the treatment process
behavioural
oto determine functional relationships between environmental events or
reinforcements and the abnormal behaviour; will rely on techniques like
behavioural observation and self-monitoring
cognitively oriented behaviourist

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ofocus would shift to dysfunctional thoughts
humanistic
omay use interview techniques to uncover blocked/distorted personal growth
interpersonal
omay use personal confrontations and behavioural observations to pinpoint
difficulties in interpersonal relationships
Note: does not imply that clinicians of a particular orientation limit themselves to a
particular assessment method or a particular theoretical orientation
omerely shows that they place emphasis on some types of assessment
Trust and Rapport between the Clinician and the Client
in a clinical assessment the client must
ofeel that the testing will help the practitioner gain a clear understanding of
his/her probs
omust understand how the tests will be used and how the psychologist will
incorporate them into the clinical evaluation
oclinician should explain what will happen during assessment and how the info
gathered will help provide a clearer pic of the client’s probs
clients need to be assured that
ofeelings, beliefs, attitudes and personal history that they are disclosing will be
used appropriately, kept in strict confidence and made available only to
therapists or others involved in the case
otest results are generally released to 3rd party (ex. court) only if the client signs
an appropriate release form
in the case that the client is being tested for a 3rd party, it is the
referring source, not the client
likely to be less motivated to be tested in this situation
in a clinical setting, clients are usually highly motivated to be evaluated and like to
the know the results of the testing
oclinicians more likely to provide test feedback, which is imp for treatment
when ppl who were not provided psychological test feedback were
compared with those who were, the latter group showed a significant
decline in reported symptoms and an increase in measured self-esteem
as a result of having a clearer understanding of their own resources
ASSESSMENT OF THE PHYSICAL ORGANISM
The General Physical Examination
basically a “medical checkup”
otypically a medical history is obtained
omajor system of body are checked
important for disorders that entail physical probs such as somatoform, addictive and
organic brain syndromes
a variety of organic conditions including hormonal irregularities can produce
behavioural symptoms that closely mimic those of mental disorders usually
considered to have psychosocial origins
some long-lasting pain can be related to actual organic conditions, but others can
result from strictly emotional factors
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