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Chapter 3

Chapter 3

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Psychology 2030A/B
Doug Hazlewood

CHAPTER 3 1/22/11 7:19 PM CLINICAL INTERVIEW Gathers information on current and past behaviour, attitudes, and emotions, as well as a detailed history of the individuals life in general and of the presenting problem Determine when the specific problem first started and identify other events that might have occurred about the same time To organize info obtained during an interview, many clinicians use a mental status exam When presenting one of these exams importance of PATIENTS TRUST and EMPATHY Mental Status Exam Involves the systematic observation of somebodys behaviour Organize info in sufficient way to see if psychological disorder is present The exam covers 5 categories: 1. Appearance and behaviour: Overt behaviour Attire (individuals dress) General appearance, posture, expression Ex. Frank persistent twitch, appearance appropriate 2. Thought process Rate of speech Continuity of speech Does person make sense Content of speech Ex. Flow and content of speech reasonable 3. Mood and affect Predominant feeling stat of the individual Normal reactions to situations o Laughing if mother dies Ex. Frank anxious mood, affect appropriate 4. Intellectual functioning Estimate of intelligence Type of vocabulary Use of abstractions and metaphors Ex. Frank intelligence within normal limits 5. Sensorium General awareness of our surroundings Do you know who you are? Where you are? Who they are> Self, time and place Ex. Frank ORIENTED times three Semi structured Clinical Interviews Unstructured interviews follow no systemic format Semi-structured interviews made up of questions that have been carefully phrased and tested to elicit useful information in a consistent manner, so clinicians can be sure they have inquired about the most important aspects of particular disorders BEHAVIOURAL ASSESSMENT AND OBSERVATION BA: measuring, observing, and systematically evaluating (rather than inferring) the clients thoughts, feelings, and behaviour in the actual problem situation or context Used for children who are no old enough or skilled enough to report their problems and experiences Target behaviours are identified and observed with the goal of determining the factors that seem to influence those behaviours Most clinicians assume that a complete picture of a persons problems requires DIRECT OBSERVATION in naturalistic environments The ABCs of Observation Observational assessment is usually focused on the here and now clinicians attention is usually directed to the IMMEDIATE behaviour, its ANTECEDENTS (or what happened just before the behaviour), and its consequences (what happened afterward) oAntecedents (exists before) oBehaviour (act) oConsequences (reaction) Ex. Boy 1) his mother asking him to put his glass in the sink (antecedent), 2) the boy throwing the glass (behaviour), 3) his mothers lack of response (consequence) oThis ABC sequence might suggest that the boy as being reinforced for his violence outburst by not having to clean up his mess - b/c there was no negative consequence for his behavior (mother didnt scold or reprimand him), he will probably act violent the next time he doesnt want to do something Ex of INFORMAL OBSERVATION problem with this is the observers recollection as well as his interpretation of the events FORMAL OBSERVATION involves identifying specific behaviours that are observable and measurable oTarget behaviour, observer writes down each time it occurs, along with what happened just before (antecedent) and just after (consequence) oGoal is to see if there are any obvious patterns of behaviour and then to design a treatment based on these patterns PSYCHOLOGICAL TESTING Must be reliable and valid Include specific tests to determine cognitive, emotional, or behaviour responses that might be associated with a specific disorder and more general tests that asses long-standing personality features Specialized areas include: oIntelligence testing to determine the structure and patterns of cognition oNeuropsychological testing determines the possible contribution of brain damage or dysfunction to the patients condition oNeurobiological procedures use imaging to assess brain structure and function Projective Testing Include a variety of methods in which ambiguous stimuli, such as pictures of people or things, are presented to a person who is asked to describe what he or she sees Theory: people PROJECT their own personality and unconscious fears onto other people and things in this case, the ambiguous stimuli and, without realizing it, reveal their unconscious thoughts to the therapist oRorschach inkblot test: oComprehensive System: this system specifies how the cards should be presented, what the examiner should say, and how the responses should be recorded oThematic Appercation Test (TAT) best known PT Consists of 31 cards: 30 picutres on them and one blank card, only only 20 cards are typically used the instructor tells the person to tell a dramatic story about the picture Based on the notion that people will reveal their unconscious mental processes in their stories about the pictures Personality Inventories NA Minnesota Multiphasic Personality Inventory oBased on an empirical approach collection and evaluation of data
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