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Chapter 10

Clinical Psychology Chapter 10.docx

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John Stephens

Chapter 10- Clinical Judgment The Theoretical Framework  By adopting a particular theoretical perspective, clinicians can evaluate interpretations and inferences according to their theoretical consistency and can also generate additional hypotheses Process and Accuracy • Clinical Interpretation (inference jump) – Influence of theoretical framework • This framework influences interpretation • Can also help to generate new hypotheses – Samples, Signs, and Correlates • Sample of general behaviour • Sign of underlying state or condition • behavioural, attitudinal, or emotional correlate Levels of Interpretation Level III (high inference) - Involves inference about individual in a particular situation (theory of the person) Level II - Involves inference about person in general o Descriptive generalization; hypothetical construct) Level I (low inference) - Descriptive data  prediction Process and Accuracy • Theory and Interpretation – Behavioural clinicians • Levels I and II • Typically seeks patient data based on personal observation or on direct reports from the patient or other observers – Psychometrically-oriented clinicians • Levels I and II • Empirical and objective- likely to use objective tests to predict to relatively specific criteria • Especially useful when the criteria being predicted are crisp and well articulated • Most concerned with standardized tests and their norms, regression equations, or actuarial tables – Psychodynamic clinicians • Level III • Strives to identify inner states or determinants Quantitative vs. Subjective Approach • Quantitative/Statistical Approach – Emphasizes objectivity and is presumably free from fuzzy thinking – Obtain scores for one or more relevant characteristics; use these to predict outcome • i.e. insurance companies predicting when you will die – “Mechanical” prediction – Must keep careful records of test data, observations, etc. so that interpretations/judgments can be quantified • Subjective/Clinical Approach – Adherents claim is the only method to offer truly useful interpretations and predictions – More subjective and intuitive – Integrate data from multiple sources – Summary of behaviours • The case for the Quantitative/Statistical Approach – More specificity – Predictions are “mechanical” – Large group application – Avoid Barnum effect • Why don’t clinicians use the quantitative approach? – Predictors seem short-term and not profound – Clinicians remember their successful predictions and forget their errors – Ethical arguments – While statistics and scientific findings may help to understand the relationships between variables in general, they do not offer an answer that is equally applicable to every situation, or every person • The case for the Subjective/Clinical Approach – Formulas are not available for all prediction situations – Judgment can add to prediction in some situations where statistical approach does not allow for flexibility – Clinician as data gatherer Clinical and Quantitative Approaches • Many comparison studies • Goldberg (19
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