Clinical psych from my notes for EPPP (from Beck and on)

Automatic thoughts-spontaneous thoughts
schemata-core beliefs underlying assumptions
cognitive distortions- systematic errors in reasoning that form link between dysfunctional schemas and automatic thoughts

drawing conclusions when there is no evidence to support it

perceiving something as more or less than it really is

focusing on negative of situation


Drawing general conclusions based on a single incident

attributing external events to oneself


all or nothing

negative thoughts about self, world and future

1- monitor neg. automatic thoughts
2-recgonize relat. b/w cog., affect, beh.
3-examine evidence of automatic thoughts
4-subsitute reality based interpretations
5-identify alternate belief system

eliciting thought
decatestrophizing
reatributting
redefining

Albert Ellis based on ABC Theory

A- people experience undesirable events
B-they have rational and irrational beliefs
C-they create appropriate emotional and behavioral consequences or inappropriate.... "MUSTERBATION)

1- RET irrational thoughts--> maladaptive behavior,vs CT- thoughts are dysfunctional when interfere with cog. process (not nec. irrational)
2-RET is more behavioral
3-RET-directly challenge irrationality vs. CT-encouraged to tests beliefs

Self monitoring
Stimulus control -
-narrowing
-cue strengthening
-competing responses

good for aggressive and impulsive anger
1- cognition preparation
2- skills aquisition

absorption, dissociation, suggestibility

-dissociation, phobias, PTSD, habits

contraindicated- psychosis, paranoid, obsessive compulsions

-warm up-identify group theme
-action-problem dramatized
-sharing-after perf. therapists leads discussion

EMG (electromyopgrah)-measures relaxation and tension in muscle
Skin temp feedback-skin temp and blood flow (thermal handwarming0 headaches)

main obstacle- ambivalence
goal-resolve ambivalence, make decision, build commitment
5 principals-
1-empathy thru reflective listening, 2-discrepeancy b/w goal and current behavior
3-avoid argument
4-roll with resistance
5-support self efficacy for change

1- precontemplation
2-contemplation
3-preparation
4-action
5-maintenance (maintained for 6 mo.)

prescriptive eclectic therapy- adjust therapeutic relationship to treatments of client by matching the theoretical approach and empirically supported guidelines

Therapy doesnt help--> only behavioral does

average client better off than 80% of controls, 2500 patients, (.8 effect size),

ALL TREATMENTS CREATED EQUAL

Gender and Age

age-weak association
ethnicity, self disclosure, orientation, gender-NONE
emotional well being- modest
COMPETENCE-MOST IMPORTANT

Therapeutic alliance- MOST IMPORTANT
type of Tx- best practices- most effective
duration- up to 26 sessions has a positive linear relationship

same with children and adults

-best with adolescent girls

1- re-moralization-focus on well being- improve hopelessness and desperation
2-remediation-symptom reduction (5-15 session)
3-rehabilitation- gradual improvement of various aspects of life functioning

MMPI-2-
-individual or group
-18 +
at least 8th grade education
(MMPI-A- (14 -18 yrs)
-empirical criterion key--> content analysis--> 4 scales

hypochondriasis- concern with bodily somatic
depression-helplessness
hysteria-awareness of problem
psychopathic deviant- respect for society
masculinity-femininity
paranoia-level of trust
psychathenia- neurotic, worry doubt
schizophrenia
hypomania
social introversion

Pattern analysis- used for scoring

mean- 50, SD=10
>65- clinical significant

cannot say
L, F, K
true

Lie scale- detect deliberate lying-
high-->cant admit shortcomings

Frequency scale-test taking attitude
low-lack of psychopathology
high-deviant, antisocial

Correction- defensiveness scale-indicated guardedness

high- doesnt review anything about conflict = FAKE GOOD --> Poor progress

Millon Clinical multi-axal inventory-IV
175 T-F questions,
21 scales that correlate to the DSM

symptom checklist, self report, 15 pt. likert scale

Measures big 5 -
1-extraversion
2-agreeableness
3-openess to experiences
4- conscientiousness
5-neuroticism

contam- "butterflower"
deviant verb- incorrect word
inapp. logic- strained reasoning

assess personal interest and compares to norms.
-more valid for occupational choice and satisfaction than success
1-general occupational theme
2-basic interest scale (more spec.)
3-scores for main body of SCII
empirical criterion keying

6 categories
1-general occupational
-2 basic interest scales
3-occupational scale
4-personal style
5-administrative indices

indicates interest in 10 broad vocational areas, based on content validity, forced choice, "most-least preferred"
-kids in grades 6-12
-ipsative score-convey relative strength

more recent, empirical criterion key, for High School junior and seniors
4 scales-
1- occupational
2-college major
3-vocational interest
4-dependability

Separate measure of several things (lateral dominance, pscyhomotor function, sensory-perceptual func., speech language...)

11 Subtests, 4-5 hrs, >.60- brain pathology

296 items, 11 subscales to measure specific functions, supplemental scales used to predict severity, acuteness,
scores 0-2 (injured)
faster and more thorough than H-R

measures visual motor memory, skills, defecits
-copy phase and recall phase, scores correlate with intelligence up 10 yrs old

used to identify brain damage in 8+
assess visual memory, visual motor skills, spatial perception, reproductive from memory one or more figures

3-18 yrs old

2-10 yrs., individual test, assess channels, processing, levels

measure ability to shift cognitive strategies in response to feedback,
6.5-80 yrs
impaired performance- autism, malingering, schizophrenia, depression, (sensitive to frontal lobe damage)

measures cognitive felxibility and selective attention
-prepotent response- habitual response on favor of unusual one

move disks 1x into specific configuration, measure higher order executive functioning

measure cog. functioning for older adults, 11 questions that assess-
-orientation, registration, attention, recall, language, visual construction
<23/24 out of 30 = impairment

assess level of consciousness following brain injury
rate individual based on- eye opening, best motor response, best verbal response
score-from 3-15, lower- severe brain damage

measure of cognitive recovery after brain injury
rates patient 1-10, 1-no response, 8-10-purposefull- appropriate

2002,
goal- protect public
no anonymous complaints unless already public
Sua Sponte- committee can act on its own less than one year after - felony, malpractice, deliscensure, expulsions or suspension

Dismiss charges
sanction
formal charges
stipulated resignation

-- no violation,
- trivial violation,
- insufficient evidence,
-educative letter

Reprimand no harm
-cease and desist,
-supervision requirement
-education training
Censure insignificant harm
-evaluation and Tx requirement
-probation

significant harm, formal hearing

in leu of other action

INTRODUCTION AND APPLIABILITY = intent and scope
PREAMBLE and GENERAL PRINCIPALS= aspirations
ETHICAL STANDARDS (=enforceable rules)

reasonable, appropriate, potentially
-allow for prof judgement
-eliminate injustice
-ensure applicability
-guard against rigidity

aspirational goals- committed to working ethically
Gen. Princ-
-Beneficence and nomalifecense- help not hurt
-fidelity and responsibility- try to do pro bono work
-integrity-accurate, honest, science
justice- equal and fair
respect for ppl- rights and dignity

(although sometimes beyond law you must meet it)
-Resolving- misuse of psychologist works
-conflict between law and ehtic
-conflict between ethic and organizational demands
-informal resolution and reporting of ethical violations
cooperating with ethics committee
improper complaints
unfair discrimination

boundaries of competence
in an emergency can provide
continue education
delegate employees-only what competent
can refuse case but 1-be fair, 2-refer client,3-must treat in an emergency
-if suspect personal problem is interfering- get consulation

Right of individual to make decision about how much should be shared with others

Standard of professional conduct
everything is confidential unless-
-patient waved rights
-identifying info is removed
3-breach is required or permitted by law (danger to self or others)

quality assurance- find out why insurance needs info, use cover letter stating it is confidential and who can see it

EAPS- tell if employee kept appt., does or does not need tx
accept or reject recommendations

Health insurance portability and accountability act of 1996, must follow as of 2003

all identifying data

1-determine if valid and demands disclosure
2-contact client and discuss implications of providing info
3-if client consents- provide info, if not-try to negotiate request
4-if requesting party continues to demand info--seek guidance informally from court

-When there is little or no harm
-studies of normal educational practices or job or organizational effectiveness and no harm

humane treatment (minimal pain and only of no alternative) , responsible tx
(care for and dispose of according to law)

scientific integrity- cant fabricate data
publication credit-must be commensurate with psychologists contribution to project

legal terms referring to persons ability to differentiate between right and wrong at time of crime

-must have professional relationship
-must have been negligent
some harm must have occurred to client

confidentiality

HMO, PPO, IPA, EAP

closed-can only get services from that HMO providers
cost containment- high, paid per capita

-less restrictive, practitioners join panels or networks, more autonomous, must lower fees to join

- independant group of practitioners join contract with an HMO to provide specific services within facility

manager provides minimal intervention , refers client to provider for brief therapy

requires 20 individual sessions/ yr.

cost containment, require treatment plan and discharge goals

assesses availability, adequacy, appropriateness of health care resources and activities through application of standards