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Chapter 4

Chapter 4

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Konstantine Zakzanis

Chapter 4: Clinical Assessment Procedures All clinical assessment procedures are more or less formal ways of finding out what is wrong with a person, what may have caused a problem or problem, and what steps may be taken to improve the individuals conditions Procedures also used to evaluate the effects of therapeutic interventions [Reliability and Validity in Assessment] Psychometrics: study of reliability and validity Reliability o Consistency of measurement o Inter-ratter reliability Degree to which two independent observers or judges agree o Test-retest reliability Measures extent to which people being observed twice or taking the same test twice, perhaps several weeks or months apart, score in generally the same way. Makes sense only when theory assumes that people will not chance appreciably b/w testing on the variable being measured i.e. intelligence tests o alternate-form reliability two forms of tests used rather than giving same test twice, perhaps when there is concern that people will remember their answers from the first test and aim merely to be consistent extent to which scores on the two forms of test are consistent o internal consistency reliability assesses whether the items on the test are related to one another correlation: measure of how closely two variables are related correlation calculated b/w raters or sets of items; higher the correlation, better the reliability Validity o Related to whether a measure fulfills its intended purpose o Unreliable measure will not have good validity because unreliable measure does not yield consistent results, it will not relate very strongly to other measures o Content validity Refers to whether a measure adequately samples the domain of interest o Criterion validity www.notesolution.com Evaluated by determining whether a measure is associated in an expected way with some other measure (the criterion) Concurrent validity: both variables are measured at the same point in time Predictive validity: evaluating the measures ability to predict some other variable that is measured in the future o Construct Validity: Relevant when we want to interpret a test as a measure of some characteristic or construct that is not simply defined Inferred attribute, such as anxiousness or distorted cognition, that a test is trying to measure Peoples responses to a questionnaire are determined by more variables than simply the construct being measured It is evaluated by looking at a wide variety of data from multiple sources Self report measure would achieve some construct validity of the people with anxiety disorders scored higher than a control group Self report measure could be related to other measure thought to suggest anxiety, such as observations of fidgeting, trembling or excessive sweating When related to observational one then its construct validity increases Studies may also examine change on self-report measure If the measure has construct validity, we would expect scores of patients with anxiety disorders to become lower after a course of therapy that is effective in reducing anxiety [PSYCHOLOGICAL ASSESSMENT] Designed to determine cognitive, emotional, personality and behavioural factors in psychopathological functioning Concentrates on measuring underlying personality structures and traits : obsessiveness, paranoia, coldness, aggressiveness Clinical Interviews o Interview: any interpersonal encounter, conversational in style, in which one person, the interviewer, uses language as the principal means of finding out about another, the Characteristics of Clinical Interviews: Interviewer pays attention to how the respondent answers-or does not answer- questions; attentive to any emotion accompanying the comments The paradigm within which an interviewer operates influences the type of information sought, how it is obtained and how it is interpreted www.notesolution.com Psychoanalyst: Persons childhood history; likely to remain sceptical of verbal reports because the paradigm holds that the most significant aspects of disturbed or normal Perons developmental history are repressed into the unconscious Behaviourally oriented clinician: focus on current environmental conditions that can be related to changes in the persons behaviour Clinical interview does not follow one prescribed course but varies with the paradigm adopted by the interviewer Find only the information for which they are looking Conducted with people who are under considerable stress Recognize importance of establishing rapport with the client Interviewer must obtain the trust of the person; it is naive to assume that a client will easily reveal information to another, even to an authority figure with the title doctor Psychodynamic clinicians assume that people entering therapy usually are not even aware of what is truly bothering them Behavioural clinicians: concentrate more on what can be observed, also appreciate the difficulties people have in sorting out the factors responsible for their distress Most clinicians emphasize with their clients in an effort to draw them out, to encourage them to elaborate on their concerns, and to examine different facets of a problem Humanistic therapists employ specific empathy techniques to accomplish these goals A simple summary statement of what the client has been saying can help sustain the momentum of talk about painful and possibly embarrassing events and feelings, and an accepting attitude toward personal disclosures dispels the fear that revealing secret of the heart to another human being will have disastrous consequences Clinicians tend to overlook situational factors of the interview that may exert strong influences on what the patient says or does Interviews vary in the degree to which they are structured Exactly how info is collected is left largely up to the particular interview and depends, too , on the responsiveness and responses of the interviewee Because overwhelming majority of clinical interviews are conducted within confidential relationships, it has been possible to establish either their reliability or their validity through systematic research The reliability for initial clinical interviews is low Both reliability and validity may be low for a single clinical interview that is conducted in an unstructured fashion; but they do more than one interview with a given patient, hence a self- corrective process is probably at work Structured Interviews: is one in which the questions are set out in a prescribed fashion for the interviewer www.notesolution.com
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