-
What changes were made in the 20th century that now turned "helpers" into "clinicians"?
- Increased Education
- Increased Training
- Licensing Requirements
-
This helps to shed light on the importance of traditional healers
Cross-cultural psychology/transcultural psychology
-
These are gifted neighbors and community members to whom many people turn for advice, consolation, and concrete resources
indigenous helpers
-
What is a clinician's purpose and focus guided by?
assessment
-
What aspects of the client must a clinician intentionally focus on?
- their story
- their strengths
- their needs
- their goals
-
What type of goals should be created in clinical interviews?
Overall and individual session goals
-
How is clinical interviewing informed?
theory
-
What is a systematic set of principles used to understand and explain observable phenomena?
theory
-
What influences the goals and purpose of the interview, and how the clinician responds and listens to the client's story?
the theoretical stance of the clinician
-
What are some theory examples?
- Cognitive
- Behavioral
- Psychodynamic
- Family systems
- Crisis Intervention
- Person-centered
-
What is incorporating science into practice?
Scientist/practitioner model
-
What helps us to better understand the biological influences of mental and emotional states?
Brain imaging
-
What is demonstrated to be effective with particular problems and populations?
EST (Empirically Supported Treatments)
-
What practice is based on results of research, more than models or techniques?
EBP (Evidence-Based Practice)
-
What do clients bring to the process?
- their story
- their history
- their traditions
- their coping skills
- their strengths
-
What do clinicians bring to the process?
- Special knowledge of human behavior
- Psychology theory
- Communication skills
- The effects of sociopolitical issues on mental health
-
What are used to describe the participants in a clinical interview?
labels
-
What are four things labels may do?
- designate a discipline
- capture roles and tasks of particular groups of clinicians
- designate a specialization within a discipline
- designate people with whom clinicians work
-
What is the first task in a structered interview?
To develop and maintain a warm, trustful, and collaborative relationship in which clients feel comfortable sharing and elaborating their stories
-
What is a working agreement that specifies things such as participants, purpose, goals, roles, expectations, techniques, time, structure, and cost of care?
Contracts
-
Contracts should be...
- Mutually developed
- Tailored to a client's style, needs, and language
- Realistic/attainable
- Flexible/open to negotiation
-
What is mutuality?
When the interviews focus is not only on the client's need but also affected by the give-and-take of the relationship
-
Who is held accountable for the effectiveness of relationship?
Clinician
-
What is the paradox of clinical work?
Being genuine yet self-aware and deliberate at the same time
-
When should you share personal information?
If it forwards goals and after careful consideration of how it may affect the patient
-
What increases our self-knowledge?
Introspection
-
What may give us a clue into what emotions the client brings out in others?
Our reactions
-
What should be evaluated?
- The effectiveness of the specific focus, activities, techniques, and uses of self
- The relationship itself
- The progress and process note, audio, and video recordings
-
What stresses the obligation to the client?
Ethics
-
What is a system of values, beliefs and assumptions about how the universe operates and how people behave toward one another?
Worldview
-
What means "every member of an interaction influences and is influenced by the others"?
Reciprocal influence
-
What means "events in complex systems exist as both causes and effects of each other"?
Circular causality
-
What means "differing views about how things are, how they got that way, and how they ought to be"?
Multiple realities
-
What are aspects in the RE-VIEW Practice Method? Explain each one.
- Read
- Explore
- View
- Implement the skills
- Evaluate performance together
- Watch yourself
- Practice, practice, practice
-
What is the purpose of the RE-VIEW Practice Method?
to go from being an unprofessional natural helper into a professional clinician
-
What are the five main concepts to consider when trying to become a professional clinician?
- Spontaneous to Intentional
- Working under a microscope
- No one "right" answer
- Learning from mistakes
- Identify and appropriately deal with strong feelings
-
Explain what "Spontaneous to Intentional" means
Develop awareness of yourself, the client, the work, the environment. Observe, evaluate, and modify clinical actions & be client-centered and goal oriented.
-
Explain "Working under a microscope".
Being constantly observed by supervisors/teachers may cause worry and doubt in your abilities, but it is essential to ensuring effective service to clients
-
Explain "No one 'right' answer"
There is a lot of ambiguity and conflicting beliefs that you will encounter. Understand other methods and beliefs will help you cater to the diverse individual needs of each of your clients
-
Explain "Learning from mistakes"
mistakes happen! Use them as moments to reflect for improvement
-
What is central to effective intervention?
the clinical relationship
-
What are characteristics for developing effective clinical relationships?
- warm & caring
- a good listener
- accepting & nonjudgemental
- genuine
- empathetic
- compassionate
- respectful
- culturally sensitive
- self-aware
-
What theory states that people grow through their connection with others; relationships must be understood within the context of our social and cultural identities?
Relational Control Theory
-
What is the reciprocal caring and attending & feeling understood that leads to mutual empowerment?
mutual empathy
-
What is the quality and strength of the collaborative relationship?
Working alliance
-
How does the working alliance develop?
- Through partnership and mutuality
- Active participation in developing tasks, goals, methods, and evaluation of work together
-
What is spotting and verbally addressing our mistakes with patients and making amends?
Relational tending
-
These kinds of people believe that there is something essential/innate/biological about race and ethnicity? Give an example.
- Essentialists
- racial differences in intelligences
-
What is how we see ourselves and how people see us?
self-identity
-
What is acculturation?
which culture you identify with
-
What is an example of "salience of identity"?
when a minority may not feel like a minority when they are surrounded by people like them, but may feel like one when they are surrounded by white people
varies over time and circumstances
-
What are unearned advantages/benefits given to a person because of membership in a particular cultural group?
privilege
-
What is a fixed, oversimplified images of members of a group?
Stereotype
-
What is a positive or negative bias, poorly informed opinions, or unjustified assumptions about individuals who belong to a certain group or fit into a particular category?
Prejudice
-
What is an unfair treatment of people because of prejudice?
Discrimination
-
What is the difference between prejudice and discrimination?
prejudice is an attitude, whereas discrimination is a behavior
-
What are the multicultural guidelines we need to engage in as professionals?
- 1. Be aware of own ethnic, gender, and culture heritage - our negative & positive reactions to the values and traditions of other groups and how it affects our worldview
- 2. Acquire knowledge about the cultures and customs of the clients with whom we work
- 3. Use self-awareness and knowledge to create flexible strategies for intervention that are effective + congruent with patients values
-
What establishes principles and standards of conduct that elucidate the values of the profession?
Professional code of ethics
-
How many ethical violations does the APA have?
89
-
What are some ethical dilemmas?
- two sections of an ethical code are at odds
- agency/institutional policies conflict with the ethics code
- the law and ethical codes differ
- the clinician's moral values prevent compliance with an ethical code
-
What are multiple relationships?
- may involve professional or personal roles
- occurs when a clinician socializes with his/her patient
-
What are some of the dangers of multiple relationships?
it can harm and exploit patients and impair professional judgement
-
How long does the ACA and APA make clinicians technically wait before they are able to engage in sexual relations with a former patient?
- ACA - 5 years
- APA - 2 years
-
What helps patients disclose intimate, sensitive, and potentially shameful information?
confidentiality
-
When must clinicians breech confidentiality?
- to prevent serious foreseeable and imminent harm to the patient or another identifiable person
- Subpoena/court order
- insurance reporting
- abuse or neglect of vulnerable populations
-
What is the legal protection of confidentiality that protects against forced disclosure during a legal proceeding of confidential information?
Privileged information
-
What are 8 characteristics an interview environment should have?
- 1. Private and soundproof
- 2. Accessible to persons with disabilities
- 3. Flexible allowing for personal space
- 4. Should reflect equality and respect
- 5. Should have moveable, easily accessible furniture
- 6. Should be able to accommodate unexpected others
- 7. Should be analyzed from the client perspective
- 8. Should be considerate of other needs of clients
-
When should you ask the client about accommodations? Why?
At the point of intake because it shows that you are considering the needs of clients
-
What are some of the advantages and disadvantages of home visits?
- adv. - gives an expanded perspective of your client
- disadv. - its an unfamiliar environment for the clinician
- its not a controlled setting
- the clinician can be viewed as guest/outsider
- social rituals
-
What are services to clients using any Internet-based sources of communication, such as email, video conferencing, virtual reality platforms, and Internet-based tests or exercises?
online clinical services
-
What is the perception of the client based on the client's values, beliefs, and personal background in the larger social, cultural, and familial context?
clinician persona
-
Which experiment identified pseudo-psychiatric patients that faked schizophrenia?
David Rosenhan study (1973)
-
What is are negative assumptions/biases attached to people because of their membership to a particular group?
stigmas
-
What refers to the client's react to information about the clinician, and their reactions are affected by their values, beliefs, and background?
Clients persona
-
What is the ability to immerse oneself in another's experience and to imagine the feelings of that person in that situation?
Anticipatory Empathy
-
What are some of the influential factors?
location, people present, motivation of all participants, purpose of meeting, and time availability
-
What requires clinicians to provide clients with a notice of privacy practice about the use and disclosure of protected health information?
Health Insurance Portability and Accountability Act (HIPPA)
-
What are some of the client right and responsibility?
- they can see records
- receive information about available treatments
- treated with respect
- informed about procedures
- benefits
- risks
-
What are the different types of opening lines?
Focal and Nondirective
-
Which type of opening line offers an initial framework guideline that lend structure to the process
Focal opening lines
-
What opening line provides less information, giving the client a greater opportunity to set the agenda, pace, focus, and tone?
Nondirective opening lines
-
What should be discussed during the greeting/welcoming?
- 1. Introduction
- 2. Confidentiality and limits
- 3. Patient rights and responsibilities (HIPAA)
- 4. Begin gathering data
-
What should be included in your introduction?
- 1. How the patient would like to be addressed
- 2. Clarify your role
- 3. Deciding whether to use a formal or informal opening
- 4. Clarify the reason for meeting and time availability
-
When should a clinician use focal opening lines?
- 1. When the client is new to talking with a professional
- 2. When a client is confused, overwhelmed, or scattered
-
Why should a clinician use nondirective opening lines?
1. It allows you to assess the client's skills in organizing, communicating and relating to you and the tasks
-
What should you remember when utilizing "focused attending"?
- SOLER
- sit squarely
- open posture
- lean forward
- eye contact
- relax
-
What means "focused attention on everything going on in interview and relationship"?
Clinical listening
-
What are things to pay attention to in clinical listening?
- What is said
- How it is said
- How the client feels about what they say
- Themes
- Patterns
-
What can cause a clinician to misinterpret what is being said?
- Lack of experience
- Anxiety
- Distraction
- Countertransference
-
What part of nonverbal communication is associated with body posture?
Kinesics
-
What refers to the use of direct or indirect communication?
Proxemics
-
What kind of messages do low context cultures send? Give an example.
Direct messages, explicitly stated (Euro-Americans)
-
What kind of messages do high context cultures send? Give an example.
Indirect communication, implicit meanings (Asians)
-
What refers to nonverbal cues that affirm or negate what is said verbally?
Metacommunication
-
When listening to a client's story, what should you be listening for?
- Behaviors
- Feelings
- Context
- Meanings of the stories
- Thoughts and cognitive styles
-
What refers to remaining calm and reliable with a relaxed, open posture and gaze?
Clinical repose
-
What enlarges our perspective and allows us to see and appreciate other perspectives?
Clinical Work
-
What does it mean to endorse and appreciate the realities of the client's stories?
Validation
-
What undercuts a sense of isolation or differentness?
Universalizing
-
What increases the sense of belonging, mattering, and enhances personal efficacy?
affirmation
-
This is an example of ____.
"It's amazing how much you've got done with almost no support."
Affirmation
-
This is an example of ____.
"Who wouldn't be nervous in a dark parking lot late at night?"
Universalizing
-
This is an example of ____. "I think it's wonderful that things are working out for you now, and, frankly, I think you deserve a little more support for your successes than is out there for you right now."
Affirmation
-
What is defined as understanding beliefs, intentions, or desires resulting from reasoning?
Cognitive empathy
-
What is defined as sharing sensations or emotion of another, I feel?
Emotional empathy
-
What is defined as self-soothing, calming your distress about another's situation to maintain the perspective of an outside observer to engage in helpful behaviors?
Emotional regulation
-
What are some ways that one can communicate empathy?
- 1. Soothing sounds
- 2. Mirroring
- 3. Empathetic echo
- 4. Empathetic reflection of context
- 5. Empathetic reflection of affect
-
What refers to the use of careful reflection of a patient's behaviors, thoughts, affect, and meaning when trying to communicating empathy?
empathic echo
-
What refers to making statements that accurately reflect patient's statements when trying to communicate empathy?
Empathic reflection of context
-
What refers to making statements that may encompass a patient's feelings when trying to communicate empathy?
empathic reflection of affect
-
What are the two factors that contribute to diversity in America?
- 1. Differential birthrates
- 2.. Immigration
-
What refers to the mimicking of behaviors and facial expressions when trying to communicate empathy?
Mirroring
-
Why should a clinician use empathy?
- 1. It demonstrates support and caring
- 2. It encourages self-disclosure
- 3. It builds working alliance
- 4. It serves as a basis for clinical hunches
- 5. It can be used to help clients gain a new perspective
-
How can a clinician use empathy to help clients gain a new perspective?
The clinician can reflect the meaning beneath the client's awareness - seeing clearly what patients only half say/hint at; things the client is scarcely aware of
-
What is the meaning of multiple realities?
Differing views about how things are, how they got that way, and how they ought to be
-
What is the viewpoint or position one takes when envisioning oneself in relation to others and to the wider world.
Perspective
-
Which approach in psychology undergirds all effective clinical interventions and is concerned with well-being and optimal functioning, and aims to broaden the focus beyond suffering and its direct alleviation?
Strengths Perspective (aka. Positive Psychology)
-
Which approach in psychology emphasizes the centrality of client participation and self-determination; that clients should be directly involved in the processes and outcomes that they believe are the most empowering for themselves?
Empowerment Perspective
-
What approach in psychology informs our professional ethic of care; believes that we have the responsibility to work for a more equitable distribution of resources, rights, and opportunities for all people?
Social Justice Perspective
-
Which approach in psychology believes that clinicians must nourish structures and processes that encourage growth and development and oppose all forms of oppression and environmental degradation around the world?
Social Justice Perspective
-
What involves being familiar with various clinical theories; dividing theories into their conceptual constructs, assumptions, and hypothesis; understanding the history and context that inform these constructs; identifying common errors in reasoning; and evaluating their strengths, weaknesses, and practice implications?
Critical Thinking
-
What are some examples of empathic failures?
- Piling it on
- Boilerplate empathy
- Getting the facts wrong
- Trivializing via excessive universalizing
- Mistaking personal sharing for empathy
- Not responding enough
-
What does the term "boilerplate empathy" mean?
generic statements
-
What does "piling it on" refer to?
having too many comments, too childlike in tone, too repetitious
-
What is countertransference?
Seeing patients as a figure from the past and treating them as such
-
What is the gathering of initial information with questions, prompts, and probes?
Exploration
-
What means "encouraging the client to expand on and enrich the details of the story"?
Elaboration
-
What are the levels of exploration and elaboration?
- Outer circle
- Middle circle
- Inner circle
-
Describe the outer circle in exploration and elaboration.
Surface level conversation
-
Describe the middle circle in exploration and elaboration.
Deeper level content, conflicts, and feelings
-
Describe the inner level in exploration and elaboration.
feelings/content about frightening, taboo, or shame-bound areas
-
What level of exploration is this an example of? "What motivates you?"
Outer circle
-
What level of exploration is this an example of? "Can you tell me something about your work?"
Outer-level
-
What level of exploration is this an example of? "Where did you grow up?"
Outer circle
-
What level of exploration is this an example of? "What do you like to do on your free time?"
Outer circle
-
What level of exploration is this an example of? "It seems like this is difficult to talk about. What makes it so difficult?"
Middle circle talk
-
What level of exploration is this an example of? "You said that you were ashamed about your line of work. What about your work makes you feel ashamed?"
Inner circle talk
-
What level of exploration is this an example of? "Where do you think this hating to get after people comes from?"
Inner circle
-
What level of exploration is this an example of? "You mentioned things you like...are there things you don't like?"
Middle circle talk
-
What level of exploration is this an example of? "Can you tell me a bit more about that, I realized you started crying while we were discussing it."
Middle circle talk
-
What are the purposes of questioning?
- 1. To gather information and build relationship
- 2. To help the client have an intervention
-
What means "help clients gain new perspectives, cope with feelings, come up with solutions for problem behaviors"?
Intervention
-
What are some common mistakes with questioning?
- Delving too soon before establishing relationship or norms are clarified
- Use of too many questions
- Use of too few questions
- Use of a question with reluctant/mandated clients
-
Why shouldn't use ask questions before establishing relationship or norms?
It can come off as disrespectful or rude
-
What causes a clinician to use too many questions?
if they have mandatory forms to fill out or if they have lack of experience
-
What causes a clinician to use to few questions?
if the clinician is feeling intrusive or embarrassed
-
What are some general principles in questioning?
- 1. Wording matters
- 2. It should be intentional
- 3. It can be verbal and nonverbal
- 4. Needs to be flexible
- 5. Can serve many purposes
-
What are some problems with close-ended questions?
- it gives little opportunity and encouragement to elaborate
- reduces client to more of a respondent
- are often leading
- sets up expectation that given answers, clinician will be able to solve client's problems
- dis-empowers client, clinician keeps initiative, encourages passivity
-
What type of questions are actually directive or commands disguised?
Pseudoquestions
-
What type of questions involve asking the client to respond to more than one question at a time?
Double questions
-
What type of questions occur when a clinician is being nosy or does not have direction?
Tangential questions
-
What type of questioning involves rapid fire questioning?
Rat-a-tat questioning
-
Questioning technique that involves "considering other fruitful areas for further exploration"
Initiating new topics
-
Questioning technique that involves "returning client to desired topic by gently inserting it into the conversation again"
Refocusing
-
Questioning technique that involves "Reflecting content or affect to encourage continued discussion-usually one thing"
Reflection
-
Questioning technique that involves "Is sometimes the best way to encourage clients to tell their story ... use judiciously"
Silence
-
Questioning technique that involves "brief responses by clinician that encourage client to continue and elaborate"
Prompts
-
What are some important factors in questioning?
- Sensitive timing
- The state of the clinical relationship
- Client's readiness to Explore Charged areas Client's cognitive capacity and expressive style
- Informed and respectful process
- Maintaining a not-knowing person
- Sustaining techniques to cushion intensive exploration
- Appreciating and using resistance
- Recognize when enough is enough
-
What is it called when the clinician and the client work together to gather and analyze information about story and larger contextual or systems influences?
Collaborative assessment
-
When are formal clinical assessments typically used?
For diagnosis, treatment planning, or research to determine eligibility for specialized services
-
What do formal clinical assessments focus on?
What problems, needs, or issues are motivating the client to seek help
-
When do formal clinical assessments occur?
at the start, middle, and end of work
-
What are you assessing for in clinical assessments?
- Strengths
- Affect
- Relationships
- Context
- Cognition
- Barriers to growth and development
-
What are the methods of assessment?
- 1. Interviews
- 2. Observation
- 3. Tests
- 4. Life records
-
What type of interview follows the lead of client
Unstructured interviews
-
What type of interview lists content areas that should be covered?
Semi-structured interviews
-
What type of interview uses standardized questions that are to be asked in a specific order?
Structured interviews
-
What method entails observing interactions in a halfway house, classroom, or school yard?
Informal observation
-
What method is used when the clinician defines target behavior, antecedents, and consequences?
Formal observation
-
Intelligence tests, personality tests, symptom checklists, neuropsychological tests, and medical tests are all a part of which kind assessment method?
Tests
-
What are records of patient's previous treatments, school records, previous written test reports?
Life records
-
What are some guidelines for assessment interviewing?
- Discuss the assessment process
- Ask how the client perceives the problem
- Use basic counseling skills
- Recognize cultural/familial factors affecting self-disclosure
- Assess clients social identities and context
- Assess what's strong - not just whats wrong
- Integrate spiritual and religious questions into assessment process
-
What is the integration and analysis of assessment data?
Case conceptualization
-
What does SOAP notes stand for?
- Subjective
- Objective
- Assessment
- Plan
-
What are goals that patients want to stop doing referred to as?
Negative goals
-
What are goals that patients would like to achieve referred to as?
Positive goals
-
What is it called when major goals are broken down into components to make them seem more achievable?
Partialize goals
-
What is it called when goals are ranked in order of urgency or importance?
Prioritize goals
-
What means "selecting theoretical model that best explains assessment findings to identify covert and overt factors?
Clinical judgement
-
What are the different levels of inference? Explain each of them.
- Low levels - stay close to date
- Moderate levels - base hunches on correlations between one behavior and another
- High levels - interpret through theoretical models
-
The greater the ______, the higher level of inference.
Speculation
-
What is characterized by a deep and abiding belief in the capacity of human beings to grow and change in positive relationships and contexts that activate potentials and provide for the meeting of basic human needs?
perspective
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