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Flashcards in Clinical And Counselling Psychology Deck (14):

Diagnosis - definition

A process of identifying a disorder by signs and symptoms


Diagnostic classification - definition

Develop categories based on shared attributes


Assessment vs Diagnosis

Assessment - idiographic approach
Focus on unique qualities of the individual. Not single label is assigned as the result of an assessment

Diagnosis - nomothetic approach
Focus on similarity of this case to other cases of the same disorder/condition. A label is assigned

both are important in formulation and intervention planning


Types of assessments

Assessment interview

Clinical interview

Objective tests

Projective tests

Behavioural observation

Medical/neurological examinations

Mental status examination


Trust and Rapport

Clients should understand the underlying rationale of the assessment


Motivation of client for being assessed

Importance of providing feedback to client

Assessment can work as therapy



Used to assess the person holistically in the context of their social environment

Best practice - get corroborating information

Structured interviews in which questions and sequence are predetermined

Unstructured interviews are usually free flowing and informal


Interviewing - Advantages and Disadvantages

Rapport with clients pace according to clients needs, observe non verbal behaviours

Client controls degree of disclosure, can be lengthy, prone to interviewer bias, clients can be difficult to work with


From assessment to diagnosis - Clinical interviews

Clinical interview - used to make DSM diagnosis
Most common clinical assessment method
Best are structured or semi structured
Collect info on past and present behaviour, attitudes emotions and history
Usually these interviews are based on DSM criteria and provide a systematic means of assigning diagnoses


Objective tests

used to gain information that is free as possible form bias

the value of the test depends on the interpretation and the competence of the interpreter

Questionnaires, self report, forced choice, problem solving

Can be more precise and reliable than interviews or some observational techniques


Objective tests - disadvantages

Social desirability biases, forced choice responses, misinterpretation of items


case formulation

Attempt to illustrate the relationships between different aspects of a clients presentation

To indicate where an intervention might be useful

To shed light on the most appropriate type of intervention


Case formulation - Benefits and Limitations

Allows understanding to be checked

Accessible to clients

Can be dis confirmed


Grounded in research

Facilitates the therapeutic alliance

Not always sensitive to cultural issues

Can be influenced by therapist bias

Can be overly influenced by clients perception of accuracy and these can vary with time

Doesn't untangle mediating influences

Focus is on problems rather than whole person


benefits and limitations of diagnosis

Shared language which eases communication and record keeping

May improve access to services for some

May improve access to insurance cover

May encourage developmental in research and treatment

Can provide an explanation of experiences for some and possibly comfort

A diagnosis is not a disorder

Lack of convincing evidence of distinct psychopathology d's for different disorders

Diagnostic concepts are unstable

May limit access to services

Artificial distinctions between normal and abnormal


May be used as an excuse for unacceptable behaviour by some

Poor predictor of prognosis and treatment outcome

May skew research efforts

Limits likelihood of prevention work


What is the definition of a clinical assessment?

The systematic evaluation and measurement of psychological, biological and social factors in an individual presenting with a possible psychological disorder.

May lead to diagnostic classification.