TOPIC 4

• Clinical Assessment


  collecting information and drawing conclusions through the use of observation, psychological tests, neurological tests, and interviews to

  determine the person's problem and the presenting symptoms.

  - This collection of information involves learning about the client's skills, abilities, personality characteristics, cognitive and emotional functioning, the social context in terms of environmental stressors that are faced, and cultural factors particular to them

  such as their language or ethnicity.
• Three Critical Concerns


  Three Critical Concepts

  1. Reliable

  2.Validity

  3. Standardization

  ​
• Reliable


  we want the assessment to be consistent
• Interrater Reliability


  Ensuring

  that two different raters are consistent in their assessment of patients
• Test-Retest Reliability


  Another

  type of reliability occurs when a

  person takes a test one day, and then

  the same test on another day. We

  would expect the person's answers to

  be consistent.
• Validity


  we want to make sure the test measures what it says it measures
• Concurrent or Descriptive Validity

  If the new test measures

  depression, then the scores on it

  should be highly comparable to the

  ones obtained by the BDI.
• Predictive Validity


  It is when a tool

  accurately predicts what will happen in the future
• Standardization


  we want to make sure

  that the experience one patient has when

  taking a test or being assessed is the same as

  another patient taking the test the same day

  or on a different day, and with either the

  same tester or another tester. This is

  accomplished with the use of clearly laid out

  rules, norms, and/or procedures
• Observation


  Can be done in Naturalistic or laboratory method of behavior assessment
• naturalistic


  observing the

  person or animal in their environment
• laboratory


  observing the organism in a more controlled or artificial setting where

  the experimenter can use sophisticated

  equipment and videotape the session to

  examine it later.
• Reactivity


  A limitation of this

  method is that the process of

  recording a behavior causes the

  behavior to change
• Cross-Sectional Validity


  Another issue is that the behavior made in one situation may not be made in other situations, such as your significant other only acting out at the football game and not at home.
• Clinical Interview


  It is a face-to-face

  encounter between a mental health

  professional and a patient in which the

  former observes the latter and gathers data

  about the person's behavior, attitudes,

  current situation, personality, and life history
• Unstructured


  in which open-ended

  questions are asked
• Structured


  in which a specific set

  of questions according to an interview schedule are asked
• Semi-structured


  in which there is

  a pre-set list of questions, but

  clinicians can follow up on specific

  issues that catch their attention
• Mental Status Examination


  It is used to organize the information

  collected during the interview and

  systematically evaluates the patient

  through a series of questions

  assessing appearance and behavior
• Psychological Tests


  Assess personality, cognitive abilities, emotions
• Projective Tests


  consist of simple

  ambiguous stimuli that can elicit an

  unlimited number of responses.
• Thematic Apperception Test


  which asks the individual to write a complete story about each of 20

  cards shown to them and give details about what led up to the scene

  depicted, what the characters are

  thinking, what they are doing, and what the outcome will be. From the

  response, the clinician gains perspective on the patient's worries,

  needs, emotions, conflicts, and the individual always connects with one of the people on the card.
• Sentence Completion Test


  asks individuals to finish an incomplete sentence.
• Personality Inventories


  ask clients

  to state whether each item in a long

  list of statements applies to them,

  and could ask about feelings,

  behaviors, or beliefs
• Neurological Tests


  used to diagnose

  cognitive impairments caused by brain

  damage due to tumors, infections, or head

  injuries; or changes in brain activity
• Positron Emission Tomography or

  PET - is used to study the brain's

  chemistry.

  ● Magnetic Resonance Imaging or MRI - provides 3D images of the

  brain or other body structures using magnetic fields and computers.

  ● Computed Tomography or the CT scan - involves taking X-rays of the brain at different angles and is used to diagnose brain damage caused by

  head injuries or brain tumors
• Physical Examination


  Many mental

  health professionals recommend the patient

  see their family physician for a physical

  examination, which is much like a check-up
• Behavioral Assessment


  which is the

  measurement of a target behavior
• Target Behavior


  It is whatever

  behavior we want to change, and it

  can be in excess and needing to be

  reduced, or in a deficit state and

  needing to be increased
• Antecedents


  the environmental

  events or stimuli that trigger a behavior
• Behaviors


  what the person

  does, says, thinks/feels
• Consequences


  the outcome of a

  behavior that either encourages it to

  be made again in the future or

  discourages its future occurrence
• Self-monitoring


  the person does

  their own measuring and recording

  of the ABCs
• Intelligence Tests


  determines the patient's

  level of cognitive functioning and consists

  of a series of tasks asking the patient to use

  both verbal and nonverbal skills

  ● Stanford-Binet Intelligen
• Stanford-Binet Intelligence Test


  which assesses fluid reasoning,

  knowledge, quantitative reasoning,

  visual-spatial processing, and working memory
• Clinical Diagnosis


  It is the process of using

  assessment data to determine if the pattern of

  symptoms the person presents with is consistent

  with the diagnostic criteria for a specific mental

  disorder outlined in an established classification

  system such as the DSM-5-TR or ICD-11 (both will

  be described shortly)
• Clinical Utility


  meaning it aids the mental health

  professional in determining prognosis, the treatment

  plan, and possible outcomes of treatment
• Syndrome


  Symptoms that cluster together regularly
• Specific Disorder


  If they also follow the same, predictable course
• Classification Systems


  provide mental health professionals with an

  agreed-upon list of disorders falling into

  distinct categories for which there are clear

  descriptions and criteria for making a

  diagnosis

  - also permit the gathering of statistics to

  determine incidence and prevalence rates

  and conform to the requirements of

  insurance companies for the payment of

  claims