Karli, 8% 4SAQ

Question 1

What are the origins of the S-P model?

From Boulder conference 1949.

Answer 1

• Bring order to psychologist training
• context of working with ww2 vets (needed extra support from psychologists)
• Agreed training should include research and proactice
• Deveop interst and motivation in both science and proactice
• designed to improve practices adn legitimise profession

Question 2

Explain how is the S-P model a reciprocal process?

Answer 2

• scientific evidence should always inform practice
• our experiences in practice shoulds always be the basis of forming new hypiotheses to be tested by sicence

Question 3

What deos the S-P model mean for psychology as an industry?

Answer 3

• The basic principals of psychology should be derived from science
• Psychologist (opractitioner) is a data gatherer and hypothesis tester
• Works in tandem with clinical skills

Question 4

Critique 1 of the S-P model?

The changing view in Science

Answer 4

• When the model was first proposed, there was a belief that there were concrete facts in pschy (like physics)
• then we moved from behaviourism to cognitivism
• Our construction of the world is consturcted and influenced by culture and experience (not concrete) - cognitivism so psychology as a science becomes debateable

REBUT:

• Even though thisngs arent’ concrete we approach them in a scientific way ewith prediction and rigorous testing of concepts, ideas and interventions

Question 5

Critique 2 of the S-P model

The Role of Tacit Knowledge

Answer 5

• The pure science model seems to claim that only knowledge the pratitioner has comes thorugh science
• Model appears to reject implicit knowledge that comes from practive, theraputic alliance (interpersonal skills, ethical behaviour, cultural understanding)

REBUT

• We do use our theraputic alliance and interpersonal communication skills in tandem with a scientific approach to acihve great outcomes fro clients

Question 6

Critique 3 of the S-P model

Practitioners don’t do research

Answer 6

• clin psychs don’t actually do that much research
• academic v service focused environments

REBUT:

• Even if you are a clin psych that doesnt do research that is peer reviewed, you can research eveidence based techniques for the best outcome for patients and disseminate best practices amongst your peers

Question 7

What was strickers re-conceptualisation of the S-P model?

Answer 7

• Science is defined by attitudes - how you approach your practice - so you don’t have to be publishing papers to adhere to the S-P model.
  
  • critical thinking
  • imagination
  • rigor
  • sceptical
  • openess to change when evidence tells you otherwise
• All of the above are required to be a good practitioner and stay up to date as a threrapist regarding new ideas

Question 8

What is the Local Clinical Science MOdel

Answer 8

• Raising hypo in the consulting room: individual treatments
• Seeking confirmatory or disconfirmitory evidence to respond to a patient needs
• apply a reaserach finding to directly to a patient
• assess if it works and be flexible where required

So if we have good evidence - we alter our clincial practice.

Question 9

How to apply the Local clinical Science model to treatment and practice?

Answer 9

• TRETMENT
• try to find the effective parts of the treatment
• draw on efficacy research
• apply techniques and how to apply flexibly
• use quantative assesment to test if treatment works (questionairres or assessments)
• PRACTICE
• Not all clinicians will be good at evidence based techniques
• clinicians have diff preferences for approaches to therapy
• reflection is key to figuring out where skills liw and preferences for treatment

Question 10

Why is there an increasing demand for Evidence Based Prac?

Answer 10

• makes practitioners more accountable:
  
  • professions demand you meet certain criteria
  • Registration beards protect public
  • Funding sources want evidence you are doin a a good job
  • consumers want confidence that they are getting the best therapy
  • Insurers and services want practice that doesnt cause hard

Question 11

Evidence based practice, how does it tie in ethically to what a therapist must do?

Answer 11

• Act to offer the client the best treatment available (empirically supported therapy)
• Not diminish its effectiveness
• ensure the client is not harmed

Question 12

What is evidence based practice? DEFINITION

Answer 12

• A process that involves the conscious, explicit use of the current best evidence in making decisions about the care of the client.
• INtegrating evidence with clinical expertise - this is the crux

Question 13

Evidence based practice model to learn:

synthesiser, researcher, patient, clinician

->

best evidence, patient values, cliniical expertise

->

decision making

Answer 13

Question 14

What is the McMAster 5 step EBM process?

5A’s

Answer 14

• Ask (formulate Q)
• Acquire (search for answers by finding evidence)
• Appraise (evaluate the evidnce for quality trustworthiness)
• Apply results
• Assess the outcome (continually evaluate and re-assess)

Question 15

What are the 4 NHMRC levels of evidence?

Answer 15

• Level 1
  
  • Evidence obtained from a systematic review of all RCTs
• Level 2
  
  • Evidence obtained from at least one properly designed RCT
• Level 3 (I)
  
  • Evidence from well designed pseudo-RCTs (alternate allocation, quasi exp)
• Level 3 (II)
  
  • Evidemce obtained from comparitive studies with no random allocation. (caxse control studies or time series with a control group)
• Level 3 (III)
  
  • Eveidence obtained from comparitive studies without concurrent controls
• Level 4
  
  • Evidence obtained from case series ewither post or pre and post test

Question 16

What is a RCT?

Answer 16

• The closest we can get to a true experiement in an applied setting
• involves:
  
  • manipulate a single IV (treatment)
  • cause change in the DV (some aspect of health)
  • While holding everything constant (randomisation)

Question 17

RCTs - Efficacy v effectiveness?

Answer 17

• Efficacy
  
  • The trials and experiemtns you do - in experimental setting in research studies:
  • Do we see the effect we want to see
• Effectiveness
  
  • Real world setting
  • trial in service context or just provideing a treatment to the client
  • e.g. practicality: cost effectiveness

Question 18

What are the facts surrounding resistance to RCTs?

Answer 18

• Focus on RCT can promote over the top strict adherace to scienctific discourse
• They can block the consideration of other legitimate, essential methodologies lower on the ladder
• They are the gold standard but far from perfect, often their limitations are overlooked.

Question 19

What is the cochrane collaboration?

Answer 19

• produces and publishes sys reviews of healthcare interventions and provides a platform for clinicians to search for up to date info

Question 20

What is the PICO acroynom?

Answer 20

• Population: general public
• Intervention: Empathy condition
• Comparison: stigma toward drug users
• Outcomes: increased empathy and stigma reduction in experimental condition.