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Ch. 5 and 6
PSY 275- Clinical Psych.
| Question | Answer |
|---|---|
| The APA published its first code of ethics in | 1953. -9 revised editions of the ethical code have been published |
| The current APA (2017) ethical code features 2 distinct sections: | 1. General principles 2. Ethical standards |
| General principles are | aspirational-they describe an ideal level of ethical functioning, or how psych. should strive to conduct themselves |
| 5 general principles | 1. Beneficence and Nonmaleficence 2. Fidelity and Responsibility 3. Integrity 4. Justice 5. Respect for People's Rights and Dignity |
| Ethical standards section of the ethical code includes | enforceable rules of conduct. Divided into 10 categories and include 89 individual standards |
| 10 ethical standards | 1. Resolving ethical issues, 2. competence, 3. human relations, 4. privacy and confidentiality, 5. advertising and other public statements, 6. record keeping and fees, 7. education and training, 8. research and publication, 9. assessment, 10. therapy |
| Celia Fisher "Decoding the Ethics Code" (2023) proposes a model for ethical decision making: | 1. make a commitment to doing what is ethical, 2. know the APA ethical code, 3. identify any laws that might apply, 4. understand the perspectives of various people who could be affected by the decision you make |
| Decoding the Ethics Code pt. 2 | 5. generate and evaluate your options and wisely choose one. 6. Monitor and evaluate the effectiveness of the option you choose |
| One of the characteristics most closely associated with the ethical practice is | confidentiality |
| "Therapists working with minor clients often | negotiate an arrangement with their clients and their caregivers whereby the caregivers will not expect to be informed of what the client discloses in therapy except under specified conditions" |
| Child abuse situations often | require the clinical psych. to make difficult judgement calls |
| Clients from diverse cultural groups, along with their relatives, may have | very different beliefs regarding confidentiality in mental health -make adjustments based on "cultural fit" |
| The informed consent process presents the clinical psych. the | chance to begin to establish a collaborative relationship with the client |
| Multiple Relationship | when a psych. is in a professional role with a person and at the same time is in another role with the same person, 2)is in a relationship with a person closely associated w/o related to the person, 3) promises to be in relationship in the future |
| The most flagrant and damaging are | sexual multiple relationships, in which the clinical psych. becomes a sexual partner of the client |
| Similar consequences can also come from nonsexual multiple relationships: | friendships, businesses, coworker, religious etc. |
| 2 things that make a multiple relationship unethical: | 1. impairment in the psychologist 2. exploitation or harm to the client |
| Competence | are those who are sufficiently capable, skilled, experienced, and expert to adequately complete the professional tasks they undertake |
| Boundaries of Competence | based on their training, education, supervised experience, consultation, study, or professional experience -remain competent--> CEUs -cultural competence |
| BurnOut | refers to a state of exhaustion that related to engaging continually in emotionally demanding work that exceeds the normal stresses or psych. "wear and tear" of the job |
| Test selection | should entail a number of factors, including the psych's competence; the client's culture, language, and age; and the test's reliability and validity |
| Test security | should make efforts to protect the security and integrity of the test materials they use. Psych. should prevent the questions, items, and other stimuli included in psych. tests from entering the public domain |
| Test data | refers to the raw data the client provided during the assessment- responses, answers, and other notes the psych. may have made |
| Ethics in Clinical Research | obligated to minimize harm to participants, steer of clear of plagiarism, and avoid fabrication of data, among other things |
| Efficacy of Psychotherapy | studies that test the success of a particular therapy in a controlled way with clients who were chose according to particular criteria |
| Managed Care companies can put clinical psych. in a position of divided loyalty | require that a DSM diagnosis be assigned to a client to quality for payment -false diagnosis--so insurance can pay -require that the clinical psych. share at least some clinical info. about the problem or its treatment with the company |
| Tech. and Ethics | make sure the tech. used is secure and sufficiently encrypted, develop and maintain competence in the tech. they use, devise and utilize a plan for handling client emergencies, navigate complexes related to licensing, services equitably available |
| Informed Consent to Research | Risks (physical and emotional), benefits, length of the study, compensation, right to decline to participant/ withdraw |
| Informed Consent to Clinical Practice | nature of the service, purpose, anticipated course, fee arrangement, involvement of other parties, your psych. training, limits of confidentiality |
| Therapy with Couples/Families | be clear about who the client is/are, discuss what kind of relationship you will have with each person, try to play only one role at a time (refer individual members out for individual therapy, don't start couples therapy with someone you already seen ) |
| Limits to Confidentiality Privilege | client is a risk to self or others, learns the client is abusing children or elderly, court-ordered evaluation, if client raises issue of their mental condition in a trial, client claims malpractice, children under 18 |
| Doctors Dilemma | therapy client if a private citizen who wants his/her privacy to be respected -society wants to be informed about certain acts or intentions on the part of individual citizens |
| Privilege is a legal right granted to citizens | protects them from having therapists disclose info. without their consent -other relationships with privilege communication: married couples, attorney and client, certain religious leaders |
| Civil Commitment | involuntary placement in a psych. hospital -Justification for commitment includes person is mentally ill, person is judged to be a danger to themselves or others -patient has a right to court hearing to judge appropriateness |
| Research on treatment outcome has rather extensive history with | Hans Eysenck's (1952) review of psychotherapy outcome serving as a landmark study and a catalyst for additional investigations on the subject |
| How should psychotherapy outcome be measured? | questionnaires are an efficient, convenient way to evaluate therapy outcome |
| What should be measured when assessing psychotherapy outcome? | observable behavior, thought patterns or cognitive processes, emotional responses, interpersonal tendencies, awareness of internal mental processes, relationship quality, and productivity outcome etc. |
| When should psychotherapy outcome be measured? | could occur immediately after therapy ends or follow-up after a week, month, year or any time period |
| Efficacy | the success of a particular therapy in a controlled study conducted with clients who were chosen -treatments that work in the form of books or websites -behavioral and cognitive therapies have accumulated larger amounts of data |
| Effectiveness | refers to the success of a therapy 8n actual clinical settings in which client problems span a wider range, and are not necessarily chosen -how well it works in the real world |
| When measuring the outcome of an efficacy or an effectiveness study, researchers must distinguish from | clinical significance from statistical significance -statistical tests can indicate whether a significant difference exists between 2 groups -clinical (or real-world) significance is measured more quantitively |
| Internal validity | refers to the extent to which the change in the dependent variable is due solely to the change in the independent variable |
| External validity | refers to the generalizability of the result-extent to which the same finding is valid for different settings and populations |
| When designing an efficacy study, they aim to minimize any element of the study that may bring into question the casual connection between the treatment and outcome | often respected for their high internal validity but criticized for their low external validity, opposite is true for effectiveness studies |
| Dissemination Strategies | efforts to promote therapies that have demonstrated effectiveness in treatment studies to large numbers of therapists -ex: in-person workshops and course; synchronous online training sessions; self-paced or asynchronous online training; consultation |
| Clinical psych. conduct research to evaluate and improve the assessment methods | involve the development, validation or expanded use of new instruments; establishment of normative data for specific populations; comparison of multiple assessment tools; or other research questions |
| Conduct research to explore issues of diagnosis and categorization | examine validity of existing or proposed diagnostic constructs, relationship between disorders, prevalence or course of disorders |
| Clinical psych. also examine elements of their own profession through empirical research | study clinical psych. activities, beliefs, practices |
| Clinical psych. also pursue research questions related to how to educate those entering the profession | training philosophies, specific coursework, opportunities for specialized training and outcome of particular training efforts |
| The Experimental Method: Clinical psych. adhere whenever possible, 4 steps: | 1. Observation of events 2. Develops a hypothesis 3. Empirical testing of the hypothesis 4. revising the hypothesis after testing |
| Independent variable | variables manipulated |
| Dependent variable | variables that are expected to change as a result of changes in the IV |
| The Experimental Method often take form of | randomized clinical trials (RCTs) -begins with recruitment and selection of participants who meet the criteria, then each participant is randomly assigned -maximize internal validity |
| Quasi-Experimental Design | used when truly experimental design is not feasible -may not be internally valid |
| Between-Group Design | participants in different conditions receive entirely different treatments, involve 2 conditions or groups -experimental group- receives treatment -control group-does not receive treatment |
| Within-Group Design | involves comparison of participants in a single condition to themselves at various points in time -all participants experience the same condition |
| Mixed-Group Design | combine between groups and within groups |
| Analogue Design | involves an approximation of the target client or situation as a substitute for the "real" thing |
| Correlational Methods | examine the relationship that exists between two or more variables, do not determine a causal relationship between them -do not identify variables as either independent or dependent -correlations between two variables can range from +1 to -1. |
| Case Studies | detailed exam of one person or situation, held in high regard by researchers who prefer the idiographic approach (emphasizing the unique qualities of each person) to the monothetic approach (determining similarities among people) -qualitative |
| Use some variation of an ABAB design (reversal) in which | a treatment is alternately applied and removed |
| Alternating treatments design: | involves 2 treatments alternating rather than a single treatment alternating with no treatment |
| Meta-Analysis | Most powerful tools used, is a statistical method of combining results of separate studies to create a summation of the findings -quantitative analysis |
| Meta-Analysis incorporate 5 steps | 1. formulate the research question 2. obtain a representative study sample 3. obtain info. from individual studies 4. conduct appropraite anlyses 5. reach conclusions and offer suggestions for future research |
| Cross-sectional | assess or compare a participant or group at one particular point in time |
| Longitudinal | emphasize change across time, often making within-group comparisons |
| Open science movement | promotes openness in all aspects of the research process, including announcing the plan for a research project ahead of time |
| Statistical significance is an | important concept in clinical psych. research |
| Inferential statistics are used to evaluate whether a | hypothesis is accepted or rejected (null) -usually consider a result significant if it would only occur by change less than 5 times out of 100 (p< .05) |
| P-values are affected by | size of the effect and sample |
| Systematic Reviews and Meta-Analysis | gather and summarize all relevant studies on a particular topic-lower chance of bias -strongest available evidence |
| RCT | identify population to study-split in two 2 random groups and measure effects (one exposed to treatment and other one not exposed) -can prove causation but keep in mind not to generalize too readily |
| Observational Research | use these to identify correlations and develop hypothesis for further testing (cohort, case-control studies, case series) -correlation does not mean causation and remember to communicate absolute risk |
| Animal and Cell studies | effects in humans and animals are not always the same, isolated cells in the lab. behave differently than cells in the body -limitations |
| Expert opinion and anecdotes | a single person's experience or opinion does not provide an objective picture -too weak to draw conclusions |
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