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Chapter 4,Clinical Assessment, Diagnosis, and Treatment,Slide 2,Clinical Assessment: How and Why Does the Client Behave Abnormally?,What is assessment?The collecting of relevant information in an effort to reach a conclusionClinical assessment is used to determine how and why a person is behaving abnormally and how that person may be helpedFocus is idiographic on an individual personAlso may be used to evaluate treatment progress,Slide 3,Clinical Assessment: How and Why Does the Client Behave Abnormally?,The specific tools used in an assessment depend on the clinicians theoretical orientationHundreds of clinical assessment tools have been developed and fall into three categories:Clinical interviewsTestsObservations,Slide 4,Characteristics of Assessment Tools,To be useful, assessment tools must be standardized and have clear reliability and validityStandardization is the process in which a test is administered to a large group whose performance serves as a common standard (norm) against which individual scores are judgedThe “standardization sample” must be representativeOne must standardize administration, scoring, and interpretation,Slide 5,Clinical Interviews,Conducting the interviewFocus depends on theoretical orientationCan be either structured or unstructured In unstructured interviews, clinicians ask open-ended questionsIn structured interviews, clinicians ask prepared questions, often from a published interview scheduleMay include a mental status exam,Slide 6,Clinical Interviews,Limitations:May lack validity or accuracyInterviewers may be biased or may make mistakes in judgmentInterviews, particularly unstructured ones, may lack reliability,Slide 7,Clinical Tests,Devices for gathering information about specific topics from which broader information can be inferredMore than 500 different tests are in useThey fall into six categories,Slide 8,Clinical Tests,Projective testsRequire that subjects interpret vague and ambiguous stimuli or follow open-ended instructionMainly used by psychodynamic practitionersMost popular:Rorschach inkblotsThematic Apperception TestSentence completionDrawings,Slide 9,Clinical Test: Rorschach Inkblot,Slide 10,Clinical Test:Thematic Apperception Test,Slide 11,Clinical Test: Sentence-Completion Test,“I wish _”“My father _”,Slide 12,Clinical Test: Drawings,Draw-a-Person (DAP) test:“Draw a person”“Draw another person of the opposite sex”,Slide 13,Clinical Tests,Projective testsStrengths and weaknesses:Helpful for providing “supplementary” informationHave rarely demonstrated much reliability or validityMay be biased against minority ethnic groups,Slide 14,Clinical Tests,Personality inventoriesDesigned to measure broad personality characteristicsFocus on behaviors, beliefs, and feelingsUsually based on self-reported responsesMost widely used: Minnesota Multiphasic Personality Inventory (MMPI),Slide 15,Clinical Test: MMPIMinnesota Multiphasic Personality Inventory,Consists of 550 self-statements that can be answered “true,” “false,” or “cannot say”Statements describe physical concerns; mood; morale; attitudes toward religion, sex, and social activities; and psychological symptomsAssesses careless responding & lying,Slide 16,Clinical Test: MMPIMinnesota Multiphasic Personality Inventory,Comprised of ten clinical scales:Hypochondriasis (HS)Depression (D)Conversion hysteria (Hy)Psychopathic deviate (PD)Masculinity-femininity (Mf)Scores range from 0 120Above 70 = deviantGraphed to create a “profile”,Paranoia (P)Psychasthenia (Pt)Schizophrenia (Sc)Hypomania (Ma)Social introversion (Si),Slide 17,Slide 18,Slide 19,Clinical Tests,Psychophysiological tests Measure physiological response as an indication of psychological problemsIncludes heart rate, blood pressure, body temperature, galvanic skin response, and muscle contractionMost popular is the polygraph (lie detector),Slide 20,Clinical Tests,Psychophysiological tests Strengths and weaknesses:Require expensive equipment that must be tuned and maintainedCan be inaccurate and unreliable (See Box 4-2),Slide 21,Clinical Tests,Neurological and neuropsychological testsNeurological tests directly assess brain function by assessing brain structure and activityExamples: EEG, PET scans, CAT scans, MRINeuropsychological tests indirectly assess brain function by assessing cognitive, perceptual, and motor functioningMost widely used is the Bender Visual-Motor Gestalt Test,Slide 22,Clinical Test: Bender Visual-Motor Gestalt Test,Slide 23,Clinical Tests,Neurological and neuropsychological testsStrengths and weaknesses:Can be very accurateBender-Gestalt can detect general organic impairment in 75% of casesAt best, though, these tests are rough and general screening devicesBest when used in a battery of tests, each targeting a specific skill area,Slide 24,Clinical Tests,Intelligence testsDesigned to measure intellectual abilityComprised of a series of tests assessing both verbal and non-verbal skillsGenerate an intelligence quotient (IQ)Most popular: Wechsler (WAIS, WISC),
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