Clinical Psychology Year 1

Question 1

4 populations of clients a clinical psychologist works with

Answer 1

children and adolescents
working aged adults
older adults
people with learning disabilities

Question 2

2 divisions of settings clinical psychologists can choose to work in

Answer 2

setting by age group - children and adolescents, working aged adults or older adults
setting by presentation - EDs, learning disabilities, health psychology, etc

Question 3

training required to become a clinical psychologist

Answer 3

undergraduate degree with graduate basis for chartered membership (GBC)
work experience is required
doctoral training course is needed - this covers 4 key areas and a specialist placement
(total = minimum 7 years - with only one year of work experience)

Question 4

graduate basis for chartered membership (GBC)

Answer 4

GBC is a standard set by the BPS. it ensures that before anyone can start a clinical psychology course they have already studied psychology in enough breadth and depth
BPS uses a process called accreditation to assess whether degrees offered by UK unis cover enough psychology for GBC

Question 5

the clearing house

Answer 5

the organisation where applications are made for clinical psychology training

Question 6

british psychological society (BPS)

Answer 6

professional body that supports clinical psychologists - BPS holds the standard/ title of a chartered psychologist

Question 7

health & care professions council (HCPC)

Answer 7

this is the registered body for clinical psychologists
clinical psychologists can be members of the HCPC and not BPS
to be a practicing clinical psychologist you need to be a member of the HCPC

Question 8

2 main mental health classification systems

Answer 8

ICD-11 and DSM-5

Question 9

2 main models of mental health

Answer 9

biomedical model - psychiatry
biopsychosocial model (George Engell, 1977)

Question 10

biopsychosocial model - George Engell, 1977

Answer 10

more holistic approach to wellbeing
mental illness occurs due to biological + psychological + social factors
the biopsychosocial model is compatible with the ICD and DSM diagnostic tools

Question 11

4 types of interventions

Answer 11

-CBT
-psychodynamic therapy
-systemic therapy
-3rd wave CBT

Question 12

what therapies are included as part of ‘3rd wave CBT’

Answer 12

-dialectical behavioural therapy (DBT)
-acceptance and commitment therapy (ACT)
-interpersonal therapy (IPT)

Question 13

what are the IQ levels for the different severities of learning disabilities

Answer 13

IQ = 0-20 = profound
IQ = 20-34 = severe
IQ = 35-49 = moderate
IQ = 50-70 = mild

Question 14

B.F Skinner

Answer 14

behaviourist
known for reinforcement and operant conditioning
skinner box experiment (rats)

Question 15

Ivan Pavlov

Answer 15

known for classical conditioning
pavlov’s dog salivation experiment

Question 16

Sigmund Freud

Answer 16

founder of psychoanalysis
developed a theory of the unconscious with a model of psychic structure - id, ego, superego

Question 17

Hermann Rorschach

Answer 17

psychiatrist and psychoanalyst
developed artistic inkblots - used experimentally to measure various parts of the subject’s personality
commonly known ‘Rorschach test’
iterations of Rorschach test used today to identify personality, psychotic and neurological disorders

Question 18

David Wechsler

Answer 18

developed standardised intelligence assessments
intelligence/ memory tests

Question 19

John Bowlby

Answer 19

known for his work on attachment

Question 20

Aaron Beck

Answer 20

father of cognitive therapy + CBT
theories widely used in treatment of clinical depression and various anxiety disorders

Question 21

Michael White

Answer 21

social worker and family therapist
founder of narrative therapy

Question 22

Marsha Linehan

Answer 22

developed dialectical behavioural therapy (DBT) - seen as part of third wave CBT

Question 23

cognitive behavioural therapy (CBT)

Answer 23

founder = Aaron Beck
talking therapy
common for anxiety and depression
based on the concept that your thoughts, feelings, physical sensations and actions are interconnected, and that negative thoughts and feelings can trap you in a vicious cycle
CBT deals with your current problems, rather than your past issues

Question 24

psychodynamic psychotherapy

Answer 24

form of depth psychology
primary focus: to reveal the unconscious content of a client’s psyche, in an effort to alleviate tension

Question 25

systemic therapy

Answer 25

seeks to address people not only on the individual level, but also as people in relationships. dealing with the interactions of groups and their interactional patterns and dynamics systems can be family, school, residential settings, wider community networks, etc

Question 26

what is third wave CBT

Answer 26

third wave CBT refers to a group of emerging approaches to psychotherapy that represent both an extension of and deviation from traditional cognitive behavioural treatment approaches includes: -dialectical behavioural therapy (DBT) -interpersonal therapy (IPT) -acceptance and commitment therapy (ACT)

Question 27

dialectical behavioural therapy (DBT) - Marsha Linehan

Answer 27

evidence-based psychotherapy that began with efforts to treat emotionally unstable/ bordeline personality disorder (EUPD/BPD) there is evidence that DBT can be useful in treating mood disorders, suicical ideation, and for change in behavioural pattern, e.g. self harm or substance misuse DBT evolved into a process in which the therapist and client work with acceptance and change-oriented strategies, and ultimately balance and synthesise them

Question 28

acceptance and commitment therapy (ACT) - Hayes

Answer 28

form of counselling and a branch of clinical behaviour analysis it is an empirically based psychological intervention that uses acceptance and mindfulness strategies mixed in different ways with commitment and behaviour-change strategies, to increase psychological flexibility developed by Hayes

Question 29

interpersonal therapy (IPT)

Answer 29

a talking treatment that helps people with depression identify and address problems in their relationships with family, partners and friends the idea is that poor relationships with people in your life can leave a person feeling depressed depression in turn can make relationships with others worsen IPT is usually 16-20 sessions long

Question 30

primary types of psychological assessment

Answer 30

-clinical interview -assessment of intellectual or other domains of functioning (e.g. IQ or memory) -personality assessment -behavioural assessment

Question 31

assessment process

Answer 31

begins with a referral question clinicians must ensure the q is clarified and clear and select the best assessment type data/ info is gathered from a range of sources, including historical, interview, observation and tests using clinical judgement, the practitioner ensures the right assessment process is utilised, most relevant data is gathered and analysed, and appropriate assessment tools used integration of all of the info from the sources results in a coherent assessment lastly, the clinician communicates the conclusions and provides recommendations in a manner that is clear and helpful to the referrer

Question 32

the question (for clinical assessment)

Answer 32

the question being asked will lead to the type of assessment and also indicate if any tests are needed clarifying the referral question is needed before an assessment can be undertaken broad q (e.g. what type of psychological distress does the person experience, if any?) = more open clinical assessment specific q (e.g. does the individual have learning disabilities?) = a targeted assessment with tests would be needed

Question 33

confidentiality in the assessment process

Answer 33

at the start of the assessment process or therapeutic intervention, confidentiality needs to be explained, and the limitations of it limitations: need to discuss info with the team you are part of (e.g. concerns about risk or safeguarding)

Question 34

clinical interview aims

Answer 34

to obtain relevant info and arrive at a decision, such as a diagnosis, and/or intervention needed to cover specific content areas that can include developmental history, history of the presenting problem, current risk concerns, things that have worked/ not worked in the past, etc

Question 35

how long does a clinical interview usually last

Answer 35

usually takes place in one or two sessions any longer becomes an extended assessment

Question 36

psychological tests

Answer 36

formal tests, e.g. questionnaires or checklists these can be described as norm-referenced tests, meaning the tests have been standardised so that test-takers are evaluated in the same way, no matter where they live, or who administered the test norm-referenced tests have been developed and evaluated by researchers and proven to be effective for measuring a particular trait or disorder

Question 37

formulation

Answer 37

'formulation is the tool used by clinicians to relate theory to practice' - Bulter, 1998 formulation = hypotheses to be tested

Question 38

formulation and diagnosis

Answer 38

can be complementary to one another definitions differ: -diagnosis - is descriptive and non-theoretical, provide discrete clusters of symptoms -formulation - provides psychological description and explanation of presenting difficulties at a given point in time formulation is more detailed and comprehensive formulation - what has happened to you rather than what is wrong with you

Question 39

principles of formulation - Johnstone, 2018

Answer 39

clinician takes a reflective stance to reduce the risk of using formulation in an insensitive, non-consenting or disempowering way clinician should consider the possible role of trauma and abuse. a trauma-informed formulation can be a powerful way of integrating this knowledge into interventions

Question 40

the 5 P model of formulation

Answer 40

provides a structure for formulation 5 P's: -predisposing -precipitating -presenting -perpetuating -protective

Question 41

predisposing factors

Answer 41

factors which make the individuals vulnerable to the problem could be biological factors, past life events, etc

Question 42

precipitating factors

Answer 42

factors which triggered the problem

Question 43

presenting factors

Answer 43

what difficulties is the person reporting - or what are the systems around them identifying as a problem

Question 44

perpetuating factors

Answer 44

factors such as mechanisms which keep a problem going, or unintended consequences of an attempt to cope with the problem

Question 45

protective factors

Answer 45

factors that help with resilience, and indicate the person has other strengths or interests that can help to overcome the presenting difficulties

Question 46

types of individual CBT formulation

Answer 46

-the 5P model -hot cross bun model -vicious flower model

Question 47

hot cross bun model of individual CBT formulation

Answer 47

concept that thoughts, emotions, behaviour and physical factors are all interlinked and all contribute to an individuals formulation

Question 48

vicious flower model of individual CBT formulation

Answer 48

the vicious flower model is a flower where different components interact to cause a psychological problem. the centre is the psychological problem. the petals surrounding it are comprised of: -automatic negative thinking -ruminations and self-attacking -mood/emotion -withdrawal and avoidance -unhelpful behaviours -motivation and physical symptoms

Question 49

systemic formulation

Answer 49

formulation is not seen as something a therapist does to a family, but as something they do WITH the family. it is a co-constructional process

Question 50

compassion focused therapy (CFT)

Answer 50

compassion focused therapy (CFT) has been described as integrating concepts from evolutionary, social and developmental psychology alongside neuroscience findings and Buddhist teachings

Question 51

formulation within compassion focused therapy (CFT)

Answer 51

-developing insight into how early life experiences created safety strategies, drive-based strategies and soothing strategies -how each strategy is externally (how we interact with the outside world) and internally (how we manage our own thoughts and feelings) directed -formulation of sense of self, based on core memories

Question 52

antecedent, behaviour and consequence (ABC)

Answer 52

in applied behaviour analysis (ABA), the antecedent, behaviour, consequence (ABC) provides building blocks in understanding, analysing and potentially changing how an individual acts ABC charts can be used to provide 'snapshots' into the situation, potentially enabling further comprehension of the behaviour the individual can be observed to help provide 'snapshots' about the emotional reasons why they are behaving in a certain way an analysis of behaviour via an ABC chart can be included in a comprehensive functional assessment of the behaviour

Question 53

antecedent

Answer 53

event/environment that occurs before a behaviour, and serves as a trigger/cue for it

Question 54

features of an effective therapist

Answer 54

therapy is an interpersonal activity thus the therapist needs to have strong interpersonal skills - this includes skills related to communication, relationship building and self-monitoring therapists who can recognise differences and intensities in client's emotional experiences = more effective communication and understanding with clients

Question 55

key to therapeutic process

Answer 55

therapeutic relationship building skills

Question 56

relationship building skills

Answer 56

communicating with sincerity and warmth supporting individuals without judgement ^whilst simultaneously having the skill to remind the individual of their capacity and responsiblity for making beneficial changes in their life

Question 57

Rogerian qualities - Carl Rogers

Answer 57

clinical skills - genuineness, empathy and unconditional positive regard Carl Rogers argued that these are the necessary and sufficient conditions for bringing about therapeutic change

Question 58

which types of interventions typically DO NOT stress the importance of the therapeutic alliance as a major role in the therapeutic process

Answer 58

CBT psychodynamic therapy

Question 59

which branch of psychology highlights the importance of the therapeutic alliance as part of the therapeutic process

Answer 59

behaviourism behavioural therapists see the therapeutic relationship playing a larger role, seeing it as a crucial element in bringing about behavioural change because it gives the therapist the opportunity to model new skills and reinforce improvements in the clients behaviour

Question 60

what attitudinal qualities in a therapist contribute to more effective therapy

Answer 60

therapists that convey warmth, acceptance and who hold a positive, hopeful orientation are more effective when compared with therapists who hold a challenging or overly confrontational stance

Question 61

reflective practitioner

Answer 61

self reflection is important for a practitioner it is when a clinician engages in an active process of thinking about their work and experience and learning from it

Question 62

goals of individual therapy

Answer 62

-to reduce emotional suffering -fostering the clients insight -psychoeducation -assigning homework tasks -developing hope and expectations for change

Question 63

group dynamics

Answer 63

term coined by Kurt Lewin describes the positive and negative forces within groups of people the attitudinal and behavioural characteristics of a group - concerns how groups form, their structure and how they function

Question 64

principle of universality - Ivan Yalom

Answer 64

sharing our experience with those that have similar experience is often itself therapeutic

Question 65

health psychology

Answer 65

the study of psychological and behavioural processes in health, illness and health care concerned with understanding how psychology, behavioural and cultural factors contribute to physical health and illness

Question 66

approach of a health psychologist

Answer 66

health psychologists take a biopsychosocial approach, understanding health to be the product of biological factors (e.g. a virus/ tumour/ etc) but also psychological factors (e.g. thoughts and beliefs), behavioural factors (e.g. habits like smoking) and social processes (e.g. socioeconomic status/ ethnicity/ etc)

Question 67

historical clinical risk management (HCR-20 V3)

Answer 67

used to help inform the assessment of risk HCR-20 V3 - a comprehensive set of professional guidelines for the assessment and management of violence risk embodies and exemplifies the structured professional judgement (SPJ) model of violence risk assessment applicable for 18+ people who may pose a risk of violence includes historical, clinical and risk management factors

Question 68

consultation objectives

Answer 68

-to provide practitioners with consultation on their work with clients -to enhance the quality and competence of practice offered to all clients -in line with BPS practice guidelines

Question 69

why is research important for clients

Answer 69

-to receive effective care and support -to improve current care and support provision -to monitor and maintain standards

Question 70

why is research important for practitioners

Answer 70

-to consume research and apply to practice -to advance their knowledge of the field -to understand process issues -for quality improvement

Question 71

scientist-practitioner model

Answer 71

occurred as a result of the Boulder conference 1949 views developed seeing research and practice as co-existing and complementary useful for: -scientific protocols for assessment and support -integration of scientific findings into practice - empirically supported therapies -hypothesis testing in practice -quality improvement

Question 72

evidence-based practice

Answer 72

complementary to scientist-practitioner model, NOT the same -use of current best evidence in decision making and care provision -systematic review and randomised controlled trials (RCTs) are the best methods according to evidence-based practice -ensures quality and accountability best research evidence + clinical expertise + client preferences

Question 73

mental capacity act (MCA)

Answer 73

designed to protect and empower people who may lack the mental capacity to make their own decisions about their care and treatment applies to age 16+

Question 74

ethics and code of conduct

Answer 74

code - provided by the BPS ethics committee focuses on 4 main ethical principles: -respect -competence -responsibility -integrity`