Psychology 3301F/G Chapter Notes - Chapter 9: Clinical Formulation, Data Integration, Psych

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Chapter 9: Assessment: Integration and Clinical Decision Making
All assessments are conducted to address a question
The psychologist refers to the question that prompted the assessment as a framework to guide the
process of drawing together the various pieces of info available about the client
Integrating Assessment Data
Itegatio euies povidig a desiptive aout of the liet’s pesetig psh futioig
As comorbidity is common in clinical diagnoses, with many clients receiving more than one diagnosis, the
psychologist must indicate how these diagnoses are related to each other and to the persons overall
psychosocial functioning
Psych assessment requires an understanding of the person in his or her social and interpersonal env
In children really important to get info from multiple sources
Coo psh patie is to egi  eaiig the liet’s test responses at the most global level
Psychologists must be aware that data from other self report tests are interviews are not independent
sources of info that can be used to conform initial hypotheses
Case Formulation
Often the purpose of assessment is to provide directions for possible alleviation or remediation of
problems
Includes assessments to address educational concerns, vocational questions, rehabilitation services and
possible referrals
Psych needs to formulate hypotheses about how problems developed and factors that maintain them;
how they can function in the future; fuller perspective
Based on these hypotheses and conclusions the psychologist provides recommendations frequently but
not necessarily, include suggestions for psych services
o Other suggestions may include obtaining further assessment data from other health scare
specialists
Case formulation = description of patient that provides info on their life situation, current problems, and
set of hypotheses linking psychosocial factors with clinical condition
o Useful when patient has many problems, allows for informed decisions
Clinical psychologists of all theoretical orientations use assessment data to develop case formulations
Case formulations tended to include 4 major components:
o Symptoms and problems
o Events or stressors
o Predisposing life events or stressors
o Hypothesized mechanism that linked them together
Major challenge in formulation: detect patterns in wealth of data gathered during an assessment,
including patterns that may be primarily attributable to cultural factors
Theoretical orientation plays a central role in all aspects of assessment process, from the nature of the
initial hypotheses made about the client, to the selection of assessment tools
Premise of case formulation is tied to clinicians theoretical POV
Interpersonally oriented psychodynamic case formulations are likely to focus on dysfunctional
relationship styles (cyclical maladaptive patterns) as the premise for the formulations, whereas process
experiential formulations are likely to use info about clients emotional processing and insight into
emotional issues in developing the main premise
Given exactly the same clinician info, clinicians of differing orientations are likely to develop very diff
formulations
Very limited research on the validity of case formulations
Jacqueline Persons: effort to developing approach to formulation that clinical psych can easily learn and
use
CB Case Formulation: emphasizes importance of identifying the patients overt problems and long standing
beliefs (schemas)that, when activated by life events are believed to cause overt problems
Threats to Validity of Assessments and Case Formulations
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