NPE - Chegg Flashcards

Question

Effect Sizes

Answer 1

**Effect size** – way to quantify the difference between two groups; a difference in means between two groups. It tells you how well an intervention works, as opposed to just statistical significance (which just tells you whether something works or not). - .06 - .07 – medium effect size - .80 + - good effect size. When the blurb indicates two types of therapy, and you cant decide which you would choose (due to similar effect sizes), you would look at the client’s preferences.

Answer 2

What is the most common single-subject design? * ABA design * Baseline \> intervention \> baseline (hard to do with psychological interventions) * Main issue – we aim for psych interventions to have an effect even when we have ceased intervening - Validity and reliability for this is not as high for these studies - E.g., with meds, you can measure the effect of the medicine on blood sugar, and then take the medicine away and measure the baseline again (to assess whether the results are due to the medicine). With psychological interventions, you can’t remove a psychological intervention

Answer 3

1. Grief and loss 2. Interpersonal disputes 3. Role transitions 4. Interpersonal sensitivities Biggest evidence base with depression (newer research shows it can also be helpful for substance abuse, eating disorders, etc.) Not recommended for: very complex presentations: psychosis, PD’s, acute suicide risk, chronic substance use. You decide from the beginning which area you will focus on(e.g., grief and loss, disputes, etc.).

Answer 4

When a client hyperventilates when anxious, they can be taught to “re-breathe” or engage in general breathing retraining. This may include: * cupping hands over mouth and breathing into hands * breathing into a paper bag

Answer 5

Firstly, who is issuing the referral? A GP? Psychiatrist? Self-referral? Secondly, what does the referral seek to ascertain? Does it indicate the need for a psychological assessment? * clinical assessment * cognitive assessment * personality assessment * work capacity assessment * workers comp assessment * victims of crime assistance tribunal (VOCAT) * transport accident commission (TAC) Does it indicate the need for a forensic assessment? * risk of violence assessment * forensic psychological assessment Does it indicate the need for an educational assessment? * full scale cognitive (IQ) assessment * education/achievement assessment

Answer 6

General plan for anxiety and depression. Every treatment plan: * Starts with assessment and diagnosis * Socialisation to treatment (Psychoeducation) * Specific interventions (cognitive and behavioural) Need to know the order of intervention (don’t jump straight into intervention because there can be other things before that). — In terms of anxiety, you may set behavioural goals before moving into cognitive techniques. * With depression, behavioural intervention is typically first (behavioural activation, pleasurable activities)

Answer 7

What to include in a treatment report for court? Many psychologists make big mistakes here. In a treatment report, **only include:** * Reasons for writing report (e.g., who asked you to) * The date they presented for the first time and who referred * How many sessions you have had * Presenting issues * Any test results and assessment * Findings (i.e., problems and possible diagnosis) * Treatment that has been recommended * The progress that has been made (if any) * Any information about the continuation of treatment/further referrals You cannot include an opinion!

Answer 8

With communication – if they ask you about choosing the content of what you need to present – look at the target audience first before deciding. The other thing to know is that in a report, as a treating psych, you would never include an opinion or a prognosis about what might happen (e.g., if they would re-offend) – you would only include how many times you’ve seen client, what the diagnosis is, whether they are attending – keep it factual, no opinions. Only expert witnesses will give opinions. So for any court reports as treating psych, you need to keep it short and focused.

Answer 9

* Age * Cultural background * English proficiency * Presenting problem * Physical/developmental restrictions * Reason for referral * Available time * Intended outcome - or what the client hopes to achieve from psychological intervention

Answer 10

Assessment – test selection, interpretation, application, norms, and administration. * Understanding of issues in test selection, use, interpretation, acceptability, and appropriateness, including: * the application and limitations of tests and their psychometric and normative basis, including test reliability, validity, utility, and standardization * the ability to identify and choose appropriate assessment instruments * cultural responsiveness in testing diverse groups * the ability to score tests and interpret results, and * understanding the limitations of computerized interpretive reports. Knowledge and understanding of the application of forms of assessment including: * interview techniques (structured and unstructured) * systematic behavioural observation * psychometric assessments * self-monitoring (including diaries), and * goalsetting based on needs analysis. Candidates will be asked detailed questions to demonstrate competence in the administration, scoring, and interpretation of six selected tests: * WAIS (Wechsler Adult Intelligence Scale) * WISC (Wechsler Intelligence Scale for Children) * PAI (Personality Assessment Inventory) * DASS (Depression, Anxiety and Stress Scale) * K10 (Kessler Psychological Distress Scale), and * SDQ (Strengths and Difficulties Questionnaire). Knowledge and application of interview assessments * a systematic history-taking approach * the Mental Status Examination * risk assessment of suicide, self-harm, and harm to others (acute and chronic) * diagnostic classification systems (including current versions of DSM and ICD) * setting and monitoring goals measures (including goal attainment scaling)

Answer 11

Overall you need to understand Statistics – Classical test theory (CTT) is a body of related [psychometric](https://en.wikipedia.org/wiki/Psychometric) theory that predicts outcomes of psychological [testing](https://en.wikipedia.org/wiki/Test_(assessment)) such as the difficulty of items or the ability of test-takers. It is a theory of testing based on the idea that a person's observed or obtained score on a test is the sum of a true score (error-free score) and an error score. Generally speaking, the aim of classical test theory is to understand and improve the [reliability](https://en.wikipedia.org/wiki/Reliability_(psychometric)) of psychological tests. Classical test theory assumes that each person has a true score, T, that would be obtained if there were no errors in measurement. A person's true score is defined as the expected number-correct score over an infinite number of independent administrations of the test. Unfortunately, test users never observe a person's true score, only an observed score, X. It is assumed that observed score = true score plus some error: Item response theory (ITT) is a paradigm for the design, analysis, and scoring of [tests](https://en.wikipedia.org/wiki/Test_(student_assessment)), [questionnaires](https://en.wikipedia.org/wiki/Questionnaire), and similar instruments [measuring](https://en.wikipedia.org/wiki/Measurement) abilities, attitudes, or other variables. It is a theory of testing based on the relationship between individuals' performances on a test item and the test takers' levels of performance on an overall measure of the ability that item was designed to measure. Item response Theory does not assume that each item is equally difficult. item response theory treats the difficulty of each item as information to be incorporated in scaling items. Descriptive Mean, median, and mode – They are three types of averages. The mean is the average you are sued to. Add all numbers and divide by the quantity of numbers to find the mean. The median is the middle number. Write all values in numerical order and then find the middle number. For odd numbers +1 then divide 2. Mode is the most frequently occurring number. Range- the distance between the lowest and highest score. Bell curve – Is a normal distribution. The mean median and mode are all equal. Exactly half the data is below the mean and half above the mean. The majority of the data is closer to the mean and the least amount of data is furthest from the mean. SD- In statistics, the standard deviation is a measure of the amount of variation or dispersion of a set of values. A low standard deviation indicates that the values tend to be close to the mean of the set, while a high standard deviation indicates that the values are spread out over a wider range. Scaling Standardize Score- The standard score is the signed fractional number of standard deviations by which the value of an observation or data point is above the mean value of what is being observed or measured. Percentile- Percentile is a measure indicating the value below which a given percentage of observations in a group of observations falls. For example, the 20th percentile is the value below which 20% of the observations may be found. Tells where one stands in relation to everyone else as opposed to the mean. Allows for fair evaluation of data sets that have different means and SD’s. Percentiles are not evenly spaced/standardized. Percentile rank- The percentile rank of a score is the percentage of scores in its frequency distribution that are equal to or lower than it. For example, a test score that is greater than 75% of the scores of people taking the test is said to be at the 75th percentile, where 75 is the percentile rank. Percentile ranks help in clarifying the interpretation of scores on standardized tests. In the case of test theory, the interpretation of the percentile rank of a raw score is as the percentage of examinees in the norm group. Also, these examinees scored below or at the score of interest. Percentile rank clarifies the interpretation on standardized tests. They are evenly spaced. Stanine – Standard Nine which is a method for scaling test scores on a 9 point scale with a SD of 2 and a mean of 5. Other Ipsative and normative scores- Generally used in personality/organizational psych testing. Normative assessment compares quantifiable personality characteristics on each scale and provides a final score which is then compared to patterns of normality e.g other test takers representing the population. Generally, likert scales are used for normative tests. Ipsative tests are also known as forced choice. Test takers are forced to choose between equally desirable choices. Hence scores indicate individual characteristics within however cannot be compared between individuals. **Confidence interval** - A confidence interval is a type of interval estimate, computed from the statistics of the observed data, that might contain the true value of an unknown population parameter. **Alpha level** - The alpha level is the probability of rejecting the null hypothesis when the null hypothesis is true. It's the probability of making a wrong decision. **Reliability** - The extent to which the results can be reproduced when the research is repeated under the same conditions. **Validity** - The extent to which the results really measure what they are supposed to measure.

Answer 12

They provide a valid benchmark for comparing the efficacy of interventions. What is a systematic review or meta-analysis? A systematic review answers a defined research question by collecting and summarising all empirical evidence that fits pre-specified eligibility criteria. A meta-analysis is the use of statistical methods to summarise the results of these studies. Systematic reviews, just like other research articles, can be of varying quality. They are a significant piece of work (the Centre for Reviews and Dissemination at York estimates that a team will take 9-24 months), and to be useful to other researchers and practitioners they should have: * clearly stated objectives with pre-defined eligibility criteria for studies * explicit, reproducible methodology * a systematic search that attempts to identify all studies * assessment of the validity of the findings of the included studies (e.g. risk of bias) * systematic presentation, and synthesis, of the characteristics and findings of the included studies It is essential that each review is approached rigorously and with careful attention to detail. Plan carefully, and document everything. The consensus reporting guidelines for different study designs proposed by EQUATOR ([http://www.equator-network.org/](http://www.equator-network.org/)) are a useful starting point. PRISMA provides guidance on what you should include when reporting a systematic review. Step 1: Why do a systematic review? Step 2: Who will be involved? Step 3: Formulate the problem. Has it been done before? Registering your review. Step 4: Perform your search. Step 5: Data extraction. Step 6: Critical appraisal of studies (quality assessment). Step 7 Data synthesis. Step 8: Presenting results (writing the report). Step 9: Archiving and updating. Why do a systematic review? The massive expansion of research output, both in peer-reviewed publications, and unpublished, e.g. in conference presentations or symposia, mean it is difficult to establish what work has been done in your area already and to ensure that clinical practice keeps up to date with the best research evidence. See this presentation by Susan Shenkin for an [Introduction to Systematic Reviews](https://www.ccace.ed.ac.uk/sites/default/files/introduction%20to%20systematic%20reviews%20powerpoint.ppt?phpMyAdmin=UlK8xfSbayFQJAV7hgjO-sdYkp3). A systematic review is often required as part of undergraduate or postgraduate theses, grant proposals, and establishing research agendas. It will be most useful where: * there is a substantive research question * several empirical studies have been published * there is uncertainty about the results Systematic reviews can be of interventions (i.e. randomized controlled trials) or observations (i.e. case-control or cohort studies). The type of study to be included will depend on your research question. Although sociology and psychology have been performing systematic reviews of observational studies for decades, many of the recent resources have been developed within a medical framework using randomized controlled trials (RCTs) to assess whether a treatment is effective or not. In psychology and related disciplines, observational studies are more common (as RCTs may not be feasible or ethical, e.g. it would not be possible to randomize children to poor or enriched social environments to assess the impact on cognition), and systematic reviews have a very important role to play.

Answer 13

Assessment Interview (9 Steps to the interview CBT approach): 1. Explaining the purpose 2. Discussing concerns 3. Identifying importance 4. Understand – behaviours 5. Explore these concerns and antecedents 6. Identify consequences 7. Explore previous approaches 8. Explore coping skills 9. Explore clients perception

Answer 14

Assessment: Most questions will relate to interpretation. You will need to know: - The order of interpretation - How scores dictate what, and how, you will interpret - Mean and standard scores for subscales and FSIQ - Mean = 100; SD = 15 What it means to have scores that are 2 SD’s above/below the mean (e.g., scores above 2 SD’s [130] are signs of giftedness, and scores below [70] indicate intellectual delay)

Answer 15

There are **6 Main Assessments** that you are supposed to know: * **WAIS** (Wechsler Adult Intelligence Scale) * **WISC** (Wechsler Intelligence Scale for Children) - know block design well * **PAI** (Personality Assessment Inventory) * **DASS** (Depression, Anxiety and Stress Scale) * **K10** (Kessler Psychological Distress Scale) * **SDQ** (Strengths and Difficulties Questionnaire) - behaviour & emotional screener **SDQ,** **DASS**, and **K10** are screeners and not assessments. You cannot diagnose anything on those tests Primary Index Scales, Sub-tests Information to know: * - its use (1) * - the age ranges (2) * - target population, (3) * - whether it's a screener, a diagnostic, or a measure, or an information-gathering tool (4) * - Whether or not it has Australian norms (5) * - whether or not it's culturally appropriate (6)

Answer 16

The measure of intelligence and cognitive ability, including cognitive delay, learning difficulties, giftedness, examination of cognitive strengths and weaknesses or challenges in cognitive functioning. * The administration manual contains guidelines for the assessment of some examinees with special needs, such as people who are hard of hearing. * It includes 13 special group studies providing tables of scores for people with intellectual disability, traumatic brain injury, dementia, and autism spectrum disorders. **_WAIS_** is the Wechsler Adult Intelligence Scale, **Its Use:** it's cognitive **its age range:** 16 to 90 years, 11 months, and 30 days (16 - 90:11:30) **Screener, diagnostic, repeated measure, or data-gathering tool**: It is a diagnostic, **Does it have Australian norms or not:** it does **_not_** have Australian norms, **Is it culturally appropriate**: and it is not culturally appropriate. **Reliability:** is good **Validity:** is satisfactory **Time:** ~60-70 mins (for core) * **4 domains** (VCI, PRI, PSI, WM) = FSIQ * VCI – Verbal Comprehension Index * PRI - Perceptual Reasoning Index * PSI - Processing Speed Index * WMI - Working Memory Index * FSIQ – Full-Scale IQ * FSIQ is calculated using VCI, PRI, WMI, and PSI * GAI = VCI & PRI * CPI = VMI & PSI * 10 core subtests, 5 supplementary (15 subtests in total) * Five Supplemental subtests are available to replace core subtests or provide optional additional cognitive functioning information Individually administered intelligence test, designed for use for clients * Age: 16-90yr 11m. Used for: * investigation of cognitive delay * learning difficulties * giftedness * cognitive strengths & weaknesses * changes in cognitive functioning Comprises of 15 subtests, with 10 core subtests. Subtest raw scores are converted to scaled scores, which are combined to give index scores. WAIS4 used standard scores (M=100, SD=15) for: * verbal reasoning * perceptual reasoning * working memory * processing speed index scores * full-scale IQ score Raw subtests scores are converted to scaled scores (M=10, SD=3) for 15 subtests. IQ: Range from: * \< 70: Extremely Low / Intellectual Deficient * 70-80: Borderline * 80-90: Low Average * 90-110: Average * 110-120: High Average * 120-130: Superior * \> 130: Extremely Superior Administration takes approximately 60-70min. Australian norms are not available.

Answer 17

* Measure intelligence and cognitive ability of children * Used in education, welfare, mental health, hospitals, community health, and private practice **_WISC_** is the Wechsler Intelligence Scale for children, **Its Use:** It's a cognitive, **Its age range:** it's for 6 to 16, and eleven months, (6:0–16:11) * So, there's a crossover between WISC and WAIS, **Screener, diagnostic, repeated measure, or data-gathering tool**: It is diagnostic. **Does it have Australian norms or not:** It does have the Australian norms, **Is it culturally appropriate**: and it's not culturally appropriate, **Reliability:** is good **Validity:** is satisfactory **Time:** ~65 mins (for core) * **5 domains (VCI, VSI, FRI, WMI, PSI) = FSIQ** * VCI, VSI, FRI = GAI * VSI: measures visual details (organization, integration, part-whole relationships) * FRI: conceptual thinking, inductive reasoning – ability to learn new things * 10 core subtests, 6 supplementary (16 tasks in total) **WISC (Wechsler Intelligence Scale for Children)** FSIQ (Full-Scale IQ): VCI (Verbal Comprehension Index) * Vocabulary, Similarities, Comprehension, (Information) (Word Processing) PRI (Perceptual Reasoning Index) * Block Design, Matrix Reasoning, Picture Concepts (Picture Completion) WMI (Working Memory Index) * Digit Span, Letter-Number Sequencing, (Arithmetic) PSI (Processing Speed Index) * Coding, Symbol Search, (Cancellation) **10 primary subtests** (**16 subtests** in total) are used to calculate full-scale IQ, which represents a child’s overall cognitive ability, Five primary index scales: * verbal comprehension, * visual-spatial, * fluid reasoning, * working memory & * processing speed. Information, Comprehension, Visual Puzzles, Picture Concepts, Arithmetic, Picture Span, Letter Number Sequencing, Symbol Search, Cancellation Supplementary tests: Similarities, Vocabulary, Block Design, Matrix Reasoning, Figure Weights, Digit Span, Coding Can you diagnose intellectual disability from the WISC? No. A diagnosis of intellectual disability requires an additional assessment of adaptive behaviour.

Answer 18

The only questions about administration relate to block design. You will not get questions about how to discontinue, etc. Q’s about block design will be basic. Look at the manual for block design. For example: • You need to know what happens when someone gets 1 of the first two trails wrong, etc. Answer: if they get a 1 (not a 2), you need to reverse anyway. • What happens if someone produces a correct design 2 seconds after the time period has passed? Answer: Score it as an incorrect response and make a note that they did it correctly. Anything passed the time limit is an invalid response. Testing someone using a WISC even though they fit the age range for a WAIS, based on the grounds of suspected intellectual ability? Answer: No! Because then there are no norms. The only way to determine an intellectual disability is based on age-matched norms

Answer 19

The WISC is a specialized test for children - Used for people aged 6 to 16y 11m. You should use the WAIS if you are administering it to someone aged between 16-90. **WISC and WAIS** * WISC and WAIS are very similar in construction, procedure, and scoring. * They have Australian norms * When they get 5 wrongs it's out * **Crystallized IQ** is from _verbal reasoning_ - More dependent on learning and background * **Fluid IQ** is more dependent on prior learning and prior knowledge. Tested via perceptual reasoning. * WISC can be done at 6,6 - 16,11, the age for WAIS is done from 16 – 89, based on this you can choose either test. So, number 3 and 4 is out * Kids who fall into the 16-year-old age - If they are struggling academically, you would use the WISC but if you think they are gifted use the WAIS. * However, you cannot use WISC on a 17-year-old. * The same thing is the argument for WPSSI or WISC. A 6-year-old can be done for WPPSI or WISC. WPPSI is done from the ages (2:5 – 7:3) * and the **_unitary rules_** have changed for the WISC, but they have not changed for the WAIS.

Answer 20

No. A diagnosis of intellectual disability requires an additional assessment of **Adaptive Behaviour.**

Answer 21

* **PAI is a multi-scale self-report test of personality** * **It is designed to provide information which is relevant to clinical diagnosis, treatment planning and screening for psychopathology** * **A 4^th grade reading is required** * **Has 344 questions/items** * **There are 3 different PAI’s** - there's the **_PAI_** - then the **_PAI-CS_**, which is the correctional settings, - and the **_PAI-A_**, which is the adolescent version. **-** can **_administer_** _it even_ **individually or in a group**, **PAI - Personality Assessment Inventory** **It's Use:** It is a clinically diagnostic for the DSM-5 **its age range**: It is for 18 + plus **Screener, diagnostic, repeated measure or data gathering tool**: It’s a screener and a clinically diagnostic for the DSM-5 **Does it have Australian norms or not**: no Australian norms but it is used extensively in Australia **Is it culturally appropriate**: and culturally appropriate **Time:** ~up to 40 mins **The PAI has 22 non-overlapping scales of four varieties:** **1)** **validity scales - 4 items** **2) clinical scales, - 11 items** **3) treatment consideration scales, - 5 items** **4) interpersonal scales. - 2 items** **_4 Validity Scale_** * **Inconsistency (ICN):** assesses consistency of the respondent’s answers throughout the inventory. * **infrequency (INF):** assesses careless or random responding. * **Negative Impression (NIM):** assess presentation of negative experiences. * **and Positive Impression (PIM) Scales:** assess presentation of exaggerated presentation of very favourable impression respectively. * There are also supplemental validity indicators for malingering, defensiveness and under-reporting of substance abuse. **_11 Clinical scales:_** * provide diagnostic features of those within the neurotic spectrum, those within the psychotic spectrum, and those with behaviour disorder/impulse control problems **1. Somatic Complaints (SOM):** Focuses on preoccupation with health matters and somatic complaints associated with somatization or conversion disorders. - [conversion (sensory/motor), physical functioning, preoccupation with health status] **2. Anxiety (ANX):** Focuses on phenomenology and observable signs of anxiety, with an emphasis on assessment across different response modalities. - [degree of tension and negative affect, involvement of anxiety: cog (ruminative worry), affective (tension, difficulty relaxing), physiological (somatic symptoms)] * So, the next scale that breaks down is **anxiety** and we have **anxiety C** which is cognitive **Anxiety A,** which is an effective, and then **anxiety P** which is physiological * and cognitive, affective, and physiological are kind of like three main areas that we look for in psychological distress and mood disorders and so forth. * **Anxiety-related disorders** also has the: **ARD-O**, O is for obsessive-compulsive **ARD-P**, P is for phobias. **ARD-T**, T is for traumatic stress. **3. Anxiety-Related Disorders (ARD)**: Focuses on symptoms and behaviors related to specific anxiety disorders—particularly phobias, traumatic stress, and obsessive-compulsive symptoms. - [extent of behavioural expression of anxiety: OCD, phobias/fears, traumatic stress] **4. Depression (DEP)**: Focuses on symptoms and phenomenology of depressive disorders. - [unhappiness, distress, suicidal ideation, indication of MDD: affective (feelings of sadness), cog (thoughts of worthlessness), physiological (loss of enjoyment in activity/energy/sleep/appetite/weight] * for **depression**, we have: **DPC** which is cognitive **DPA** which is effective **DPP** which is the physiological **5. Mania (MAN):** Focuses on affective, cognitive, and behavioral symptoms of mania and hypomania. - [disruptions in mood, cognition, behaviour: activity (accelerated thought processes, over-involvement), grandiosity (inflated self-esteem, superior/unique skills), irritability (strained relationships b/c others can’t keep up with them] * **mania** so we're talking about: **MAN-A**, A is activity level, **MAN-G** which is grandiosity. **MAN-I,** which is irritability, * so, as you can see the irritability, grandiosity, inactivity level of all components of the DSM criteria for manic states. **6. Paranoia (PAR)**: Focuses on symptoms of paranoid disorders and on more enduring characteristics of the paranoid personality. - [interpersonal mistrust and hostility: hypervigilance (suspicious), persecution (been treated inequitably, other people undermining them), resentment (bitter, cynical)] * **paranoia** and it breaks down to: **PAR-H,** H being hyper vigilance **PAR-P**, P which is the persecution **PAR-A,** which is the resentment, * so, hyper vigilance, persecution and resentment, are the three major criteria for paranoia in the DSM-5. **7. Schizophrenia (SCZ)**: Focuses on symptoms relevant to the broad spectrum of schizophrenic disorders. - (psychotic (delusional beliefs, unusual perceptions, magical thinking), social detachment, thought (confusion, []) * we have **schizophrenia**, SCZ and it breaks down to **SCZ-P** p which is psychotic experiences **SCZ-S**, s which is social detachment, **SCZ-T** which is thought disorder, * again, the three major components of the DSM criteria. **8. Borderline Features (BOR)**: Focuses on attributes indicative of a borderline level of personality functioning, including unstable and fluctuating interpersonal relations, impulsivity, affective lability and instability, and uncontrolled anger. - (affective instability (emotional responsiveness), identity problems (uncertain about life goals), negative relationships (misunderstood by others, intense relationships), self-harm (impulsivity  potential for–ve consequences) * we have **borderline** now this is the one that breaks down to four and it's the only one that breaks down to four **BOR-A,** which is affect instability. **BOR-I,** I which is identity problems, **BOR-N**, in which is negative relationships **BOR-S,** s which is self-harm. * **a**nd of course, again four of the major areas from the DSM five. **9. Antisocial Features (ANT)**: Focuses on the history of illegal acts and authority problems, egocentrism, lack of empathy and loyalty, instability, and excitement-seeking. antisocial behaviours - (illegal), egocentricity (lack of empathy/remorse), stimulus-seeking (craving for excitement, low tolerance for boredom) * we have **antisocial features** ANT * , which is antisocial behaviors **ANT-E** which is egocentricity * which is stimulus seeking again three major criteria from the DSM. **10. Alcohol Problems (ALC)**: Focuses on problematic consequences of alcohol use and features of alcohol dependence. **11. Drug Problems (DRG)**: Focuses on problematic consequences of drug use (both prescription and illicit) and features of drug dependence. - Some clinical scales comprise three or four smaller facet scales. For example, the MAN scale is made up of Activity level, Grandiosity and Irritability. **_5 Treatment scales:_** **1. Aggression (AGG)** measures the respondent's different kinds of aggressive behaviour’s toward others. - [(aggressive attitude (poor control, hostility, think they should utilize aggression), verbal aggression (assertiveness to abusiveness, readiness to express anger), physical aggression (fights, violence)] * we go into **aggression**: **ARG-A**, which is attitude **ARG-V** which is verbal **ARG-P** which is physical * and of course, if we've got a client that's scoring highly on that, * what we want to know is, is there some physical level involved here, * what are we looking at what type of aggression? * so that we know how to manage how to put strategies in place. **2. Suicidal ideation (SUI)** measures a respondent's frequency and severity of suicidal thoughts and plans. - [(thoughts of suicide, behaviours, disguise suicidal ideation)] **3. Non-support (NON)** measures how socially isolated a respondent feels, and how little support the respondent reports having. - [level of stress (family, finances, employment, major changes)] **4. Stress (STR)** measures the controllable and uncontrollable hassles and stressors reported by the respondent. **5. Treatment rejection (RXR)** measures certain attributes of the respondent that are known to be related to psychological treatment adherence, including motivation, willingness to accept responsibility, and openness to change and new ideas. - [(attitudes towards Tx)] - (risk for Tx, non-compliance and early termination – acknowledge need for change? Resist efforts to change?): * potential complications in Tx like harm of self/others, * environmental circumstances, * motivation for tv **_2 interpersonal scales_** **1.** **Dominance (DOM)** measures the degree to which a respondent acts dominant, assertive, and in control in social situations. **2. Warmth (WRM)** measures the degree to which a respondent acts kind, empathic, and engaging in social situations. (how people interact with others): * relationships and interactions such as warm * **WRM:** empathetic, engaging * **vs** * **cold rejection:** withdrawn, mistrustful style; dominating (DOM)/controlling vs submissive * **2 pathology scales:** * **Borderline features scale,** * **antisocial features** * **Inconsistency scale:** * **pair responses that are similar** (it should result in similar item scores for the paired items) * The other one is **_Suicide Potential Index_** _(**SPI)**_**,** * It has a raw score between zero and 20, which then converts to a to a T score and you basically evaluate that by the distance from the mean. * so, the further above the mean it is, the more likely they are to commit suicide, meaning that I have a lot of a known risk factors, and the further below the mean they are, the less likely they are and the more you're looking at them, you know that those rooms are depression, so depressed that they can't get off the couch to do anything. * The other one we have is **_violence potential index_** _(**VPI)**_, * and it's used to indicate obviously the potential for someone being violent, it is the same as the SPI score between zero and 20, which is then converted to a T score. * The higher the T score above the main, the more likely they are to be violent, the lower the T score the lower that mean the less likely they are to be violent, the more passive, that they are. **Personality Assessment Inventory (PAI)** is a multi-scale, self-report test for adults 18 and over. Provides information for clinical diagnosis, treatment planning, screening for psychopathology. 4th-grade reading level required. PAI has 344 items which form 22 non-overlapping scales. Respondents answer on a 4-point Likert scale (false - true). **Scales:** Validity: * inconsistency (consistency) * infrequency (careless or random) * negative impression (exaggerated negative) * positive impression (exaggerated positive) Clinical: * Somatic Complaints * Anxiety * Anxiety-related * Depressive * Manic * Schizophrenic * Paranoid & Personality Dis * Borderline * Illegal/Authority * Alcohol & Drug Treatment: * Aggression * Suicidal Ideation * Recent Stressors * Nonsupport * Treatment Rejection Interpersonal: * Dominance * Warmth

Answer 22

PERSONALITY ASSESSMENT INVENTORY (PAI) The PAI is a comprehensive personality assessment of psychopathology. Assesses for personality disorders, mood, anxiety, somatic concerns, drugs, alcohol. For vocational counselling, you would use 16PF or NEO (5 factors of personality). PAI is used often for forensics, court reports. PAI has 4 types of scales. Validity, clinical, treatment considerations, and interpersonal scales. The board focuses on general interpretation and not on specific scales. We may need to know cut-offs for clinical scales (but not for validity scales). Scored in T scores – mean of 50, SD of 10. E.g., normal/average is 41-59. Reading level is Grade 4. Has 344 questions. 18yrs+ (there is an adolescent one which we do not need to know) Interpersonal scales - dominance and warmth. Clinical scales - somatic, anxiety and related disorders, depression, mania, BPD, anti-social PD, alcohol, drugs, paranoia, schizophrenia. Scores with 60-69 (1 SD) is considered mild/transient. Any scores 70+ (2 SD) is in clinical range. Need to know clinical scales most comprehensively. Validity scales – inconsistency, positive impression management (faking good), negative impression management (faking bad), infrequency (e.g., the degree to which some people respond to bizarre questions is true). High scores in validity scales indicate you need to be careful in interpreting the profile. In MMPI there is a LIE scale (validity scale) – the principle is the same as with the PAI validity scales – if they tell you the T score is 50 or below, you know they are not lying/malingering. If they ask you about any validity scale and the score is below 50, you can be sure that is OK. MMPI is longer than PAI, very similar to the PAI. Treatment consideration scales – factors that may impact on treatment or other risk factors – aggression, suicide, non-support (social isolation), stress, treatment rejection (how much they want to have the treatment and how motivated they are to change and respond to treatment). In treatment, 70+ t scores are also used to indicate clinical ranges. If 18 or more items have not been responded to, they need to review and complete if possible. Uninterpretable if 18 or more questions (5%) have not been answered. If more than 20% of a specific scale question has not been answered you need to interpret with caution. In terms of community and clinical norms – in the community – the average is 50, 1SD is 60, Need to know what is the clinical skyline – which is 2SD above the clinical population (80). When would you compare your scores to the clinical skyline? If your client scored above 70 in any of the clinical or treatment scales, you would then compare your client to the clinical population. Clinical skyline – is 2 SD above the mean for clinical population. Above 70 is the clinical range. To decide whether a score is clinical or not, you need to look at community norms and whether the score is 2 SDs or more above the mean (which is 50). Community norms and clinical norms are the important ones to know. The validity Scale needs to be above 60 for this to be invalid. Clinical Scales and Treatment Scales need to be above 70 for a problem to exist. The clinical skyline is a comparison to the community. Above 70 is still a problem but above the skyline is a serious problem.

Answer 23

Scores on the PAI are presented as T scores, with a mean of 50T, and an SD of 10T. T scores can be referenced against general and clinical populations. PAI includes 4 kinds of scales: * Validity - respondents' approach to test, incl. faking good or bad, exaggerating, defensiveness. * Clinical - Psychiatric diagnostic categories. * Treatment - Relate to the treatment of clinical disorders. * Interpersonal - Personality functioning.

Answer 24

**Its Use:** its uses for mood, **Its age range:** essentially age ranges 14 + Plus, **Screener, diagnostic, repeated measure, or data-gathering tool**: it's a screener and a repeated measure, **Does it have Australian norms or not:** It does have Australian norms, **Is it culturally appropriate**: not culturally appropriate, * Used with adults * Used with care when used with younger people * 3 domains: Depression, anxiety, stress * Full DASS is 42 items of 3 domains * A shortened version is 21 items (takes half the time) * **Depression:** - dysphoria, - homelessness, - devaluation of life, - self-depreciation, - lack of involvement, - anhedonia (don’t find anything enjoyable), - inertia (remain unchanged) * **Anxiety:** - autonomic arousal, - muscular effects, - situational anxiety, - subjective experience of anxiety * **Stress:** - difficulty being able to wind down, - nervous arousal, - easily upset/agitated, - irritable/over-reactive, impatient = measures responses to a stressor IMP: * The anxiety scale on **DASS correlates with panicky symptoms, phobias, other anxiety disorders.** * Stress scale correlates more to **G.A.D.** * Depression scale correlates with **Mood disorders** * Generally done above 16 years Measures levels of severity of depression, anxiety, and stress. Not a diagnostic measure and will not replace a clinical interview. Gives client and clinician important feedback and monitor progress. • **Two forms** * Long: 14 items for each of the three scales * Short: 7 items for each of the three scales • Instructions: How much each statement applied to you over the past week – I.e., state measure. **Norms** • Manual Scoring (sum all items within the scale) * Depression: 3, 5, 10, 13, 16, 17, 21 * Anxiety: 2, 4, 7, 9, 15, 19, 20 * Stress: 1, 6, 8, 11, 12, 14, 18 • N.B: Scores on the DASS-21 will need to be multiplied by 2 to calculate the final score (range is 0-42)) **Domains of depression**: * Dysphoria, Hopelessness, Devaluation of Life, Self-Deprecation, Lack of Involvement Anhedonia and Inertia **Domains of anxiety:** * Autonomic arousal, muscular effects, situational anxiety, subjective experience of anxiety. **Domains of stress:** * Difficulty in winding down, nervous arousal, easily upset/agitated, irritable/overreactive, impatience. **DASS 21:** Meaning Depression Anxiety Stress Normal 0-9 0-7 0-14 Mild 10-13 8-9 15-18 Moderate 14-20 10-14 19-25 Severe 21-27 15-19 26-33 Extremely severe 28+ 20+ 34+

Answer 25

**It’s a global measure of nonspecific psychological distress** **It's Use:** Its use is for psychological distress, which has its own conceptual definition. **its age range**: It's from 13 + plus, **Screener, diagnostic, repeated measure, or data-gathering tool**: it's a screener and a repeated measure, **Australian norms or not:** It does have Australian norms, **culturally appropriate**: it's not culturally appropriate, * **It** **has 10 items** * it's a nonspecific psychological distress scale that is indicating need for further assistance, * 10 - items about emotional states - identifies levels of distress * Psychometric assessments – not a diagnostic tool * psychological distress (those experiencing a wide range of mental health disorders have high scores of non-specified distress) * Usually when GP’s want referrals to psychologists in a mental health plan * Queried K-10 stability over time * it's a **Likert scale**: all the time, most of the time, some of the time, a little of the time, none of the time * Score: one to five you sum the scores to get a total K-10 score, * **the lowest possible score is 10, because even if you say it doesn't relate to you that's scores one, so, 10 and the highest is 50.** * The relationship between psychological the K-10 score and psychological distress is linear. * So, the lower the score the less distress, the higher the score, the more distress. **K-10** **Is not a diagnostic tool. It is a screener** It cannot tell you specific mental disorders. E.g., depression Moderate levels is significant Below 20 is fine 20 - 24 is a mild mental disorder 25 - 29 is a moderate mental disorder 30 and up is severe The interpretation so the score categories * 10 to 15 is low _remember 10 means that events have none of the time_, all of them, so that within itself is a little bit strange that you score 10 when nothing relates to you, so they didn't have the first month, * or zero it actually starts of one. * 16 to 21 is moderate * 22 to 29 is high * **The total score of 10-50** 1 = none of the time 2 = a little of the time 3 = some of the time 4 = most of the time 5 = all of the time **30 to 50 is very high.** **Kessler Psychological Distress Scale** * Screening instrument – Predictive of anxiety and affective disorders * Used extensively in population surveys. **K-10 Norms Category Score/Band** Normal: Under 20 Likely to have a mild mental disorder: 20-24 Likely to have a moderate mental disorder: 25-29 Likely to have a severe mental disorder: 30+ * 13% of the adult population will score 20 and over * About 1 in 4 patients seen in primary care will score 20 and over * Manual scoring: Simply sum the response to all 10 items * Scores range from 10-50

Answer 26

**SDQ** **SDQ (Strengths and Difficulties Questionnaire)** **It's Use:** It's a behavioural tool **its age range**: It's from 2 + plus, **Screener, diagnostic, repeated measure or data-gathering tool**: it's a screener, **Australian norms or not:** It does have Australian norms, **culturally appropriate**: it's not culturally appropriate, * This can be done for younger and older kids * Emotional problem scale; conduct problem scale; hyperactivity scale and peer problem scale – **looks at problems** * Prosocial scale - **looks at strengths** * Emotional problem scale and peer problem - **make up internalizing problems** * Conduct and hyperactivity - **make up externalizing scales** * Total difficulty scale = is the sum of all problem scores * Don’t have to know the scoring * Need to know usually when people report on the scoring they report in percentiles and the way you score it is adding up raw scores * If a child scores on the 90% for total problem scores this means they have more problems than 90% of the child population. * [http://www.sdqinfo.com/](http://www.sdqinfo.com/) * You can do a 1 sided or 2 sided - the reverse of the page is an impact statement. Impact statement looks at how much the problems the child has impact their home life, friendship, classroom learning, and leisure activities. * You get a score from 0 - 10 on this. with 10 being severe. * There are different versions of the SDQ's * There's the parent report measures, there's teacher report measures and then there's the youth self-report measures * Assessment of emotional and behavioural problems in children and adolescents * used as an initial assessment * internalizing behaviours (emotional, peers), externalizing (conduct, hyperactivity), prosocial behaviours **SDQ is a behavioral screening questionnaire of strengths and difficulties** **It's Use:** it's a brief screening questionnaire assessing emotional and behavioural problems in children and adolescents, **its age range:** the age range goes from 2 + plus ( * for parents and teachers 4 to 17-year-olds) * (modified version for parents and preschool teachers of 2 to 4-year-olds) * and (self-report version for completion by young aged 11 to 17-year-olds) **Screener, diagnostic, repeated measure or data-gathering tool**: it's a screener. **Australian norms or not:** It does have Australian norms, **culturally appropriate**: and it's not culturally appropriate, - There are several versions depending on the needs of the user - Components include a 25-item questionnaire - there are _three components_, depending on which version that you're using - the **_first component_** is psychological attributes and there's 25 of them, * it asks about is **five different categories** asks about: * conduct problems * hyperactivity * emotional problems, * peer problems * prosocial behaviour * Each subscale consists of five items. **- SDQ** can be used for clinical assessment _- It can be used as a **pre** and **post measure,** and it can also be used as **screening** as well,_ 1) 25-item SDQ 2) impact supplement (parent/teacher/self; does the respondent think they have a problem? Assess the level of impact on themselves and to others/friends/home life/leisure activities) 3) follow-up questions: has the intervention reduced the problem or made problem more bearable? * 25-item, 5 subscales: emotional problems (happy/sad), peer problems (has friends or solitude), conduct problems (temper tantrums, fights), hyperactivity (restless, overactive), prosocial (helpful, considerate of others) There's the parent report measures, there's teacher report measures and then there's the youth self-report measures * Some of them have, children are four to 10 children 11 to 17 or youth 11 to 17 etc. * So, there's different age groups but they all work off the same principles. Each version includes between one and three of the following components: A) 25 items on psychological attributes. All versions of the SDQ ask about 25 attributes, some positive and others negative. These 25 items are divided between 5 scales: 1) emotional symptoms (5 items) } 1) to 4) added together to generate a total difficulties score (based on 20 items) 2) conduct problems (5 items) 3) hyperactivity/inattention (5 items) 4) peer relationship problems (5 items) 5) prosocial behaviour (5 items) * The same 25 items are included in questionnaires for completion by the parents or teachers of 4-16 year old’s ([Goodman, 1997](http://www.sdqinfo.org/py/sdqinfo/GetAbstract.py?id=Goodman1997&n=1)). * A slightly modified informant-rated version for the parents or nursery teachers of 3 (and 4) year old’s. 22 items are identical, the item on reflectiveness is softened, and 2 items on antisocial behaviour are replaced by items on oppositionality. * Questionnaires for self-completion by adolescents ask about the same 25 traits, though the wording is slightly different ([Goodman et al, 1998](http://www.sdqinfo.org/py/sdqinfo/GetAbstract.py?id=GoodmanEtAl1998&n=1)). This self-report version is suitable for young people aged around 11-16, depending on their level of understanding and literacy. - In low-risk or general population samples, it may be better to use an alternative three-subscale division of the SDQ into 'internalising problems' (emotional + peer symptoms, 10 items), 'externalizing problems' (conduct + hyperactivity symptoms, 10 items) and the prosocial scale (5 items) ([Goodman et al, 2010](http://www.sdqinfo.org/py/sdqinfo/GetAbstract.py?id=GoodmanEtAl2010&n=1)). B) An impact supplement Several two-sided versions of the SDQ are available with the 25 items on strengths and difficulties on the front of the page and an impact supplement on the back. These extended versions of the SDQ ask whether the respondent thinks the young person has a problem, and if so, enquire further about chronicity, distress, social impairment, and burden to others. This provides useful additional information for clinicians and researchers with an interest in psychiatric caseness and the determinants of service use ([Goodman, 1999](http://www.sdqinfo.org/py/sdqinfo/GetAbstract.py?id=Goodman1999&n=1)). C) Follow-up questions The follow-up versions of the SDQ include not only the 25 basic items and the impact question, but also two additional follow-up questions for use after an intervention. Has the intervention reduced problems? Has the intervention helped in other ways, e.g. making the problems more bearable? To increase the chance of detecting change, the follow-up versions of the SDQ ask about 'the last month', as opposed to 'the last six months or this school year', which is the reference period for the standard versions. Follow-up versions also omit the question about the chronicity of problems. **SDQ Overview** * The Strengths and Difficulties Questionnaire (SDQ) is a **_brief emotional and behavioural screening questionnaire_** for children and young people. The tool can capture the perspective of children and young people, their parents, and teachers. * There are currently three versions of the SDQ: a short form, a longer form with an impact supplement (which assesses the impact of difficulties on the child’s life), and a follow-up form. * The 25 items in the SDQ comprise _5 scales of 5 items each_. * The scales include: 1) Emotional symptoms subscale 2) Conduct problems subscale 3) Hyperactivity/inattention subscale 4) Peer relationships problem subscale 5) Prosocial behaviour subscale * The SDQ can be used for various purposes, including clinical assessment, evaluation of outcomes, research and screening. **Property** **Definition** **SDQ** Internal consistency *The degree to which similar items within a scale correlate with each other.* Research on the reliability of the SDQ has produced mixed results**.** Some articles say the SDQ exhibits strong internal consistency (Yao et al., 2009), some say the SDQ shows satisfactory internal consistency (Goodman, 2001) and others say there are concerns regarding the reliability of the subscales, with most subscales showing low internal consistency. It has been suggested that the SDQ total difficulties score should just be used for screening purposes (Mieloo et al., 2012). Test-retest reliability *The degree to which the same respondents have the same score after a period of time when trait shouldn't have changed.* SDQ showed moderate test-retest reliability (Yao et al., 2009). Concurrent validity *Correlation of the measure with others measuring same concept.* SDQ shows good concurrent validity (Muris, Meesters & van den Berg, 2003). Discriminant validity *Lack of correlation with opposite concepts.* SDQ showed good discriminant validity (Lundh, Wangby-Lundh & Bjarehed, 2008). **Populations** * The SDQ can be completed by children and young people aged 11-17 years old, and a separate version can be completed by those aged 18 and over. The parent and teacher SDQ can be completed by the parent or teacher of CYP aged between 2 and 17 years old. * Clinical experience indicates that the SDQ may be appropriate to use with CYP with mild learning difficulties, but not with more severe learning difficulties (Law & Wolpert, 2014). **Administration** * The questionnaire takes between five and ten minutes to complete. All versions of the questionnaire can be given to the appropriate respondent to complete themselves. The questionnaire can be completed on paper or online and can all be found on the [**Youth In Mind website**](https://sdqinfo.org/)**.** * Alternatively, in order to ensure that each item is understood by the respondent, or to gain additional information about each response, the questionnaires can be administered directly by the clinician who can ask follow-up questions. **Scoring** * Assisted Scoring: If CYP, parents or teachers fill out the SDQ online, the Youth in Mind website produces a technical and readable report with a description of the scores for a small cost. * Manual Scoring: Paper versions of the SDQ can be scored by following the instructions found on the [**SDQ website**](https://sdqinfo.org/). **Interpretation** * **Assisted:** After entering paper versions of the SDQ on the SDQ website, a report designed for professionals will then be generated. * If CYP, parents or teachers fill out the SDQ online, the Youth in Mind website produces instant feedback reports including a technical report designed for professionals as well as a readable report with a description of the scores, the level of concern, an overall impression as well as suggestions about what to do if the child or young person, their parent/teacher still has concerns. * **Manual:** Instructions for scoring the SDQ manually can be found on the SDQ scoring website and instructions for interpreting the SDQ when scored by hand can be found here. Instructions in other languages are also available here. **Translation** * The SDQ is one of the most widely and internationally used measure of child mental health and has been translated into more than 80 languages. [**The English and translated versions are available here**](https://sdqinfo.org/py/sdqinfo/b0.py). Information on normative SDQ data from the United Kingdom, Australia, Denmark, Finland, Italy, Germany, Japan, Spain, Sweden and the United States can be [**found here**.](https://sdqinfo.org/g0.html) A widely used, brief-screening questionnaire with 25 core questions, assessing emotional and behavioral problems in children and adolescents, between 4-17yrs. Scores contribute to five subscales: * conduct problems * hyperactivity * emotional problems * peer problems * prosocial behavior The second component is the impact supplement which asks respondents whether they think the young person has a problem and the perceived impact of the problem. _How would you use the results of an SDQ in further assessment planning?_ These results help identify young people who should be referred for further assessment and or/intervention, as well as evaluating treatment outcomes.

Answer 27

Peer Problem Subscale

Answer 28

Assessment - Candidates must demonstrate familiarity with the use and purpose of the following tests: **Intelligence Scales** * WPPSI (Wechsler Preschool and Primary Scale of Intelligence) * Stanford-Binet (Stanford-Binet Intelligence Scales) - SB-5 * WASI Wechsler Abbreviated Scale of Intelligence * Woodcock-Johnson Test of Cognitive Abilities * Raven's Standard Progressive Matrices **Adaptive & Educational Assessments** * WIAT (Wechsler Individual Achievement Test) * ABAS (Adaptive Behaviour Assessment System) **Memory** * WMS (Wechsler Memory Scale) * WRAML (Wide Range Assessment of Memory and Learning) **Vocational** * SDS (Self Directed Search) * Strong (Strong Interest Inventory) **Personality** * 16PF (Sixteen Personality Factor Questionnaire) * NEO (NEO Personality Inventory) **Clinical & Mental Health Tests** * BDI (Beck Depression Inventory) * GAF (Global Assessment of Functioning) * STAI (State-Trait Anxiety Inventory) * WHO-DAS (World Health Organisation Disability Assessment Scale) * WHO-QOL (World Health Organisation Quality of Life Scale) * ORS (Outcome Rating Scale) * MMPI (Minnesota Multiphasic Personality Inventory) * PHQ-9 (Patient Health Questionnaire 9 Item) * CBCL (Achenbach Child Behaviour Checklist and Teacher/Youth reports - ASEBA) * Structured Clinical Interview for DSM (SCID) Primary Index Scales, Sub-tests Information to know: * - its use (1) * - the age ranges (2) * - target population, (3) * - whether it's a screener, a diagnostic, or a measure, or an information-gathering tool (4) * - Whether or not it has Australian norms (5) * - whether or not it's culturally appropriate (6)

Answer 29

(Intelligence) Individually administered instrument for assessing pre-school and early primary school children (aged 2yr 6m, to 7y 7m). Is used to assess children referred for cognitive delays, intellectual disabilities, intellectual giftedness, and informing educational intervention and placement decisions. **WPPSI is an Intelligence Scales** * Measure intelligence and cognitive ability * **Time:** ~60 mins for all primary subtests **WPPSI assesses the intelligence of preschool and early primary school-aged children, the current version is the WPPSI-4** **Its use:** A measure of Cognitive Development **The age:** 2 years 6 months to 7 years 7 months (2:6-7:7) **Screener, diagnostic, repeated measure or data-gathering tool**: It's a diagnostic **Does it have Australian norms:** It has Australian Norm **Is it culturally appropriate:** It's not culturally appropriate, (although it is not a match for Aboriginal status, because Australian indigenous various from continent to continent but does match the NZ indigenous community), however, these are the assessments that we use with our indigenous population, **so, we interpret with caution,** * It's - gender age-appropriate but has not been done for the indigenous population or **caveat is a must** **Reliability:** Excellent **Validity:** Good **Ages:** 2:6 – 3:11 **Full Scale:** 3 domains (VCI, VSP, WMI) **Ages:** 4:7 – 7:12 **Full Scale**: 5 Domains (VCI, VSI, FRI, WMI, PSI) **Consist of:** - 15 subtests - 10 core subtests, 5 supplementary (15 tasks in total) - Subtest batteries differ for younger (2:6-3:11) and older (4:0-7:7) children. - Verbal Comprehension Index (Information; Similarities; Vocabulary; Comprehension) - Visual-Spatial index (Block Design; Object Assembly) - Fluid Reasoning Index (Matrix Reasoning; Picture Concepts) - Processing Speed Index (Bug Search; Cancellation; Animal Coding) - WPPSI is used in the assessment of children referred for cognitive delays, intellectual disabilities, and intellectual giftedness, and for informing educational intervention and placement decisions.

Answer 30

(Intelligence) Can be used for people between 2 and 85+ years in a range of contexts, including clinical and neuropsychological assessment, early childhood assessment, psychoeducational evaluations for placements, compensation evaluations, career assessment, selection, forensics ad research. Takes 45-60min to administer. SB5 identifies individuals of low intellectual functioning as well as those with gifted intellectual functioning. SB5 measures individual performance on complex tasks of memory, judgment, and comprehension. SB5 measures five factors of genitive ability: * Fluid Reasoning * Knowledge * Quantitative Reasoning * Visual-Spatial Processing * Working memory Each factor includes a verbal and non-verbal counterpart. **SB5 is an Intelligence Scales** * Measures low intellectual functioning and gifted * **Time:** ~45-60 mins * ~15-20 min after the full-scale batter **ABIQ** can be administered **Current version is SB-5** **Its use:** identifies individuals of low intellectual functioning as well as those of gifted intellectual functioning. It measures individual’s performance on complex tasks of memory, judgment, and comprehension. **The age:** It has a range of 2-year-olds - 85-year-old (2:0 – 85:0) **Screener, diagnostic, repeated measure or data-gathering tool**: It's a diagnostic * It's normed with **VIQ** - Vocal Intelligence Quotient **NVIQ** (Nonverbal IQ) * **FSIQ** – Full-Scale IQ **Does it have Australian norms:** It is not an Australian Norm but a US norm **Is it culturally appropriate**: It's not culturally appropriate **Reliability:** Very high **Validity:** has good concurrent and criterion validity - It's not widely used in private settings * - If we need to use another after the Weschler we go to* ***C-Tony -**2* *(comprehensive Test of Nonverbal Intelligence) it is asked by Centrelink etc.* - It identifies both positive and negative cognitive processes **5 domains:** * Fluid Reasoning, * Knowledge, * Quantitative Reasoning, * Visual-Spatial Processing, * Working Memory * For each of the five-factor indexes, there are verbal and nonverbal counterparts (e.g., nonverbal fluid reasoning and verbal fluid reasoning). * The nonverbal subtests require minimal linguistic skills and rely mostly on nonverbal responses (e.g., pointing and/or moving pieces). * The verbal subtests require competency with words and printed material (e.g., reading and/or speaking). * The 10 subtests comprise the Full-Scale IQ (FSIQ). * The five verbal subtests combine to form the Verbal IQ (VIQ), and the Nonverbal IQ (NVIQ) combines the five nonverbal subtests. * An Abbreviated Battery IQ (ABIQ) can be used when time is limited. * The ABIQ provides a global estimate of overall cognitive functioning level and can be used as a screening tool. * The SB-5 can be used in a variety of contexts for different purposes, including clinical and neuropsychological assessment, early childhood assessment, psychoeducational evaluations for special education placements, compensation evaluations, career assessment, selection, forensics, and research. **IQ Range** **IQ Classification** \<130 Giftedness 120-129 Extremely High 110-119 High average 90-109 Average 80-89 Low average 70-79 Borderline impaired or delayed \>69 Mildly impaired or intellectual delayed Used in the US from 1908 • Binet’s work with Lewis Terman at Stanford was crucial – Translated and expanded the test – Developed norms • First test to – Provide detailed instructions on administration and scoring – Use the concept of IQ – Provide alternate items • Application: Ages 2-89+ • Norms: Deviation IQ – Normed on nearly 5,000 people with complex sampling used – Matches norms to 2000 U.S. Census – Age norms • Tries to balance language-based and non-language skills • Around an hour to administer • Individually administered • Requires training to administer • Testing begins with an item from a routing test (object series or vocabulary) – Optimises difficulty of items to participant – Improves rapport – Reduces time required to administer the test • Facilitates adaptive testing: Testing at a level appropriate for the test taker. Don’t want items that are too hard or too easy. Why? – More efficient – Helps with rapport – Means that test taker is not asked too many items, causing fatigue • Structure: Ten subtests – As well as full-scale IQ, you can calculate a Quantitative IQ, Knowledge IQ, and others

Answer 31

**(Intelligence)** A brief measure of cognitive ability, suitable for ages 6-91yrs. Takes approx 45min to administer. It is used in clinical, educational & research settings to estimate IQ when a comprehensive test is unnecessary or to determine if a full test is warranted or as a re-test measure. Not intended for diagnosis or education support. **WASI is an Intelligence Scales** * **A Measure of Intelligence and Cognitive Abilities** * Conducted when a comprehensive test is unnecessary; to determine if a full test is warranted; as a re-test measure * **Time: ~** FSIQ4 (30 mins) **Four-Subtest form, 30 minutes,** * **~** FSIQ2 (15 mins) **Two-subtest form, 15 minutes** * **Latest is WASI-II** **Its use**: in clinical, educational, and research settings to estimate IQ when a comprehensive test is unnecessary, to determine if a full test is warranted or as a re-test measure. **The age**: 6-90 years old **Target population:** WASI delivers an estimation of a student’s general intellectual ability by measuring the verbal, nonverbal, and general cognition of individuals from 6 to 89 years of age. **Screener, diagnostic, repeated measure or data gathering tool**: It’s a diagnostic **Does it have Australian norms**: It does have Australian norms for WASI- 4 but not for WASI-2 **Is it culturally appropriate:** It's not culturally appropriate **Reliability:** Good with adults and children **Validity:** demonstrating adequate concurrent validity - All subtests form the **FSIQ-4**, and Vocabulary and Matrix Reasoning combined form the FSIQ-2. - While WASI-II has unique test items and norms, its subtests can substitute corresponding WAIS-IV and WISC-IV subtests if full assessment is required. **Block Design, Matrix Reasoning = FSIQ4** **Vocab, Matrix Reasoning = FSIQ2** * VCI (Vocabulary, Similarities, Information, Comprehension) = VIQ * PRI (Digit Symbol Coding, Symbol Search) = PIQ * FSIQ - the short form is used in incidents where it's not appropriate to use the full WAIS - the person that may have an impairment that could be a physical impairment that prevents them from being able to sit through the longer test * - we would use it on the indigenous population because there has been the ability to sustain attention and for the rested sub-tests applicability.* - You get an FSIQ, and it's an estimate of general cognitive ability. * The VCI is going to give you crystallized abilities * and the PRI is going to give you fluid ability, * so, **VCI - Crystallized intelligence and PRI = Fluid intelligence.** * So, from the form theory of intelligence, * there is a two sub-tests form, which is **vocabulary and matrix reasoning**. * obviously, the short form is used in incidents where it's not appropriate to use the full WAIS **“Superior”** Performance: 130 and beyond. Individuals who score in this range are considered to be in the superior or “gifted” range. **“Very High”** Performance: 120-129. Individuals who score in this range as classified as performing at a high level. **“Bright Normal”** Performance: 110-119. **“Average”**: 90-109 **“Low Average”**: 80-89 **“Borderline Mental Functioning”**: 70-79

Answer 32

Suitable for ages 2-90 yrs. Based on Cattell-Horn-Carroll's theory of cognitive abilities. Comprised of 10 tests and 10 extended tests. Has Australian norms. **WJ is an Intelligence Scales** * The **Woodcock**-**Johnson** Tests of **Cognitive Abilities** is an intelligence **test** series (often referred to as IQ **test**). ... The comprehensive series of exams is designed to measure general intellectual **ability**, as well as academic achievement, scholastic aptitude, **cognitive abilities** and oral language. * The WJ IV comprehensive system offers the ease of use and flexibility examiners need to accurately evaluate learning problems and improve instructional outcomes for children and adults in a way that no other assessment can. * Manual provides suggestions for assessing clients with hearing and visual impairments **The latest is:** **WJ-IV** (Fourth Edition) **Its use:** It’s a measure of both **cognitive** abilities and achievement among children and adults. **The age:** 2 years to 90 plus year-olds (2:0 – 90:0) **Target population:** children and adults **Screener/diagnostic/repeated measure/info gathering tool:** It’s a diagnostic **Does it have Australian norms:** there are Australian norms for the standard batteries, but not for the extended battery as yet, **Is it culturally appropriate:** not appropriate **Time:** ~ 40 mins (extended version is ~2 hours) * 10 subtests and additional 10 extended subtests * Measures: word knowledge, meaningful memory, visual-spatial ability, synthesis sounds, inductive and fluid reasoning, visual perceptual speed, short-term auditory memory, auditory analysis, short term auditory memory span, delayed recall * Not very popularly used The WJ IV consists of three independent and co-normed batteries, which may be used separately or in any combination, emphasising the identification of individual strengths and weaknesses by providing comparisons both within each battery and across batteries: * **WJ IV Tests of Cognitive Abilities** * **WJ IV Tests of Achievement** * **WJ IV Tests of Oral Language** – NEW! **Features** * Patterns of strengths and weaknesses identified through an easy-to-use test and cluster comparison procedure. * Australian norms (Standard Batteries) * Updated and expanded interpretive model. * New domain-specific scholastic aptitude clusters that allow for efficient and valid predictions of academic achievement. * WJ IV Australian Adaptation Scoring Software (PC only) allows examiners to easily enter raw scores, assessment data, and test session observations for any test in the WJ IV suite of assessments on their computer to quality and easily generate reports. **Benefits** * New! WJ IV Tests of Oral Language battery which supplements the Cognitive and Achievement batteries to provide measures of oral language, phonetic coding, and speed of lexical access for a more comprehensive evaluation of cognitive abilities or achievement. * Patterns of strengths and weaknesses are a readily obtainable component of any evaluation. * Yields a new Gf-Gc Composite for comparison to measures of cognitive processing, oral language and achievement. * Increased diagnostic sensitivity. * Utilizes the most diagnostically useful system for current and future assessment needs. * Provides the most efficient use of testing time. * Offers greater administration flexibility and interpretive clarity. * Supports multidisciplinary evaluation with three distinct, independent batteries. * Pinpoints cognitive and language correlates of learning problems, allowing professionals to more accurately target interventions. **Score Range** **Percentile Rank** **Range Classification** 131 and above 98 to 99.9 Very Superior 121 to 130 92 to 97 Superior 111 to 120 76 to 91 High Average 90 to 110 25 to 75 Average 80 to 89 9 to 24 Low Average 70 to 79 3 to 8 Low 69 and below 0.1 to 2 Very Low

Answer 33

**RPM is an Intelligence Scales** **Time:** 20-45 min **Type:** Individual or group **Its use:** A nonverbal group test typically used in educational settings **The age:** 6 to 80 years **Target population**: ethnically diverse population **Screener/diagnostic/repeated measure/info gathering tool**: diagnostic **Does it have Australian norms:** has Australian norms **Is it culturally appropriate:** culturally appropriate Raven’s Progressive Matrices is a leading global non-verbal measure of mental ability, helping to identify individuals with advanced observation and clear-thinking skills who can handle the complexity and ambiguity of the modern workplace. The SPM was designed to assess non-verbal reasoning in the general population and is used widely in clinical, educational, occupational, and research settings. The SPM score indicates a candidate’s potential for success in professional, management and high-level technical positions that require: * Clear thinking * Problem identification * Holistic situation assessment * Monitoring of tentative solutions for consistency with all available information * It is usually a 60-item test used in measuring abstract reasoning and regarded as a non-verbal estimate of fluid intelligence. * It is the most common and popular test administered to groups ranging from 5-year-olds to the elderly. * It is made of 60 multiple choice questions, listed in order of difficulty. * This format is designed to measure the test taker's reasoning ability, the **eductive** (“meaning making”) component of Spearman’s ***g*** (***g*** is often referred to as general intelligence. * All of the questions on the Raven's progressives consist of visual geometric design with a missing piece. The test taker is given six to eight choices to pick from and fill in the missing piece. * Raven thought that the tests commonly in use at that time were cumbersome to administer and the results difficult to interpret. * Accordingly, he set about developing simple measures of the two main components of Spearman's g: the ability to think clearly and make sense of complexity (known as eductive ability) and the ability to store and reproduce information (known as reproductive ability). * Raven's tests of both were developed with the aid of what later became known as item response theory. * Many patterns are presented in the form of a 6×6, 4×4, 3×3, or 2×2 matrix, giving the test its name. * The tests were originally developed by John C. Raven in 1936. * In each test item, the subject is asked to identify the missing element that completes a pattern. Another test that might be considered to be culture-fair or culturally reduced is the Raven’s Progressive Matrices (Raven, 1941, 1981; Raven, Court, & Raven, 1983, 1985). Versions The matrices are posed in **three different** forms for participants of different ability: * **Standard Progressive Matrices:** The booklet comprises five sets (A to E) of 12 items each (e.g., A1 through A12), with items within a set becoming increasingly difficult, requiring ever greater cognitive capacity to encode and analyse information. * **Coloured Progressive Matrices****:** Designed for younger children, the elderly, and people with moderate or severe learning difficulties, this test contains sets A and B from the standard matrices, with a further set of 12 items inserted between the two, as set Ab. Most items are presented on a coloured background to make the test visually stimulating for participants. However, the very last few items in set B are presented as black on white; in this way, if a subject exceeds the tester's expectations, transition to sets C, D, and E of the standard matrices is eased. * **Advanced Progressive Matrices:** The advanced form of the matrices contains 48 items, presented as one set of 12 (set I), and another of 36 (set II). Items are again presented in black ink on a white background and become increasingly difficult as progress is made through each set. These items are appropriate for adults and adolescents of above-average intelligence. * The test was introduced in 1938 and has gone through many revisions, because it is nonverbal, and in most situations requires little more than having the examinee point to the correct item, it is often used in situations where examiners want a measure of ability that is not biased by educational background or by cultural or linguistic deficiencies. * All of the test items are composed of geometric figures that require the test taker to select among a series of designs the one that most accurately represents or resembles the one shown in the stimulus material. * The test items are presented in graded levels of difficulty and there are test booklets for different age levels. Validity measures involving the correlation of the Raven Matrices with the Stanford-Binet and the Wechsler Scales range from .54 to .86. * The authors indicate that “the scales can be described as ‘tests of observation and clear thinking,…By themselves they are not tests of ‘general intelligence’…They should be used in conjunction with a vocabulary test”. * Despite this caution, the Progressive Matrices have been viewed as measures of intelligence and have been widely used in many countries to test military groups because they are considered to be independent of prior learning. **Scoring:** 90-100 Well above average (90^th percentile and above) 0-10 well below average (10^th percentile and below) 10-30 below average (11^th to 30^th percentile) 30-70 average (31^st – 70^th percentile) 70-90 Above average (71^st – 90^th percentile)

Answer 34

**Raven's Progressive Matrices** (often referred to simply as Raven's Matrices) or RPM is a nonverbal test typically used to measure general human intelligence and abstract reasoning and is regarded as a non-verbal estimate of fluid intelligence. It is one of the most common tests administered to both groups and individuals ranging from 5-year-olds to the elderly. It comprises 60 multiple choice questions, listed in order of increasing difficulty. This format is designed to measure the test taker's reasoning ability, the eductive ("meaning-making") component of Spearman's **g (g** is often referred to as general intelligence).

Answer 35

Designed to assess achievement in individuals ages 4-85. Academic achievement is assessed either in a broad range of skills or in particular areas of interest. Comprised of 9 subtests that make up 4 composites: * Reading * Maths * Written Language * Oral Language May be used in school settings to assist in dx of specific learning disability, academic strengths, eligibility for educational services & intervention designs. The WIAT is often used in schools or clinic settings to assist with the diagnosis of a specific learning disability, identification of students' academic strengths and weaknesses, eligibility for educational services, and/or intervention designs. The WIAT is not used to measure academic giftedness in adults or older adolescents. It is important to remember that most assessments, including the WIAT scores, should be considered alongside qualitative behaviour observations and skills analysis of the examiner. This may be included in the question by mentioning “what would the next best step for the psychologist be” …if there is an option **WIAT is an Adaptive & Educational Assessments** **Time:** ~45-120 mins **WIAT – Wechsler Individual Achievement Test, latest version 3** **Its use:** Academic achievement (Educational) in a broad range of skills/specific area of interest and giftedness in adults or older adolescent. **The age:** It goes from 4 years to 50 years, 11 months (4:00 – 50:11) **Target population:** is really important when we're considering that we're using in an educational setting and is used in clinical settings too **Screener/diagnostic/repeated measure/info gathering tool:** It is a diagnostic **Does it have Australian norms:** Yes, it has Australian norms **Is it culturally appropriate**: it's not culturally appropriate * There is no normative data specific to the indigenous population, however, we do use it, and we interpret with caution **Reliability:** subtests and composites indicates adequate stability across time, ages and grades. **Validity:** has moderate to high correlations with other achievement test scores which are consistent across various individual and group administered tests. **4 domains:** * Reading, * mathematics, * written language, * oral language For standard scores, each number given shows the level at which the child is performing: - Very superior scores are scores over 130. - Superior scores range from 120-129. - High Average scores range from 110-119. - Average scores range from 90-109. - Low scores range from 80-89. - Borderline scores range from 70-79. - Extremely Low scores are scores under 69.

Answer 36

Used to evaluate adaptive behavior skills which are important to everyday functioning. Useful in identifying strengths and weaknesses. Can be useful in establishing a baseline to compare the effectiveness of interventions. Suitable for any age. **ABAS is an Adaptive & Educational Assessments** **ABAS – Adaptive Behaviour Assessment System, the latest version is 3** **Its use:** used to evaluate adaptive behaviour skills which are important to everyday functioning. **I**t's giving us a picture of adaptive skills across the lifespan **The age:** from birth all the way through to 89 years (0-85) **Target population****:** **Screener/diagnostic/repeated measure/info gathering tool:** a measure of ability and a repeated measure **Does it have Australian norms**: there are Australian norms **Is it culturally appropriate**: not necessarily **Time**: ~15-20 mins **3 domains: Conceptual, Social, Practical = General Adaptive Composite** * Conceptual: Communication (speech, listening), functional academics (basic reading, writing), self-direction (independence) * Social: Leisure (recreational), social * Practical: Community use (shopping), home/school living (cleaning), health & safety (protection), self-care (groom), motor (fine & motor), work (for adults and youth) Adaptive behavior assessment system is really important in our diagnostics for intellectual impairment * and **it's actually a DSM-criteria that intellectual functioning and adaptive skills are paired together when doing a diagnosi**s. ABAS and adaptive functioning there are other forms of adaptive functioning assessments but an ABAS in particular is really useful for the assessment of * people with developmental delays, * autism spectrum disorder, * intellectual disability, * learning disabilities, * neuropsychological disorders, * and sensory or physical impairments, because these are all of the things that if you're going to restrict us from being able to successfully function in our environment, * so adaptive skills are really important in understanding how an impairment impacts a person. * so, in the beginning when we're talking about measures, * and **when we're talking about, genotype, phenotype, state, trade,** etc. * This is obviously on the side of a dynamic factor that can change over time, * **IQ is something that is considered a static factor**. * So, in the early years, it's still developing, etc. * **Whereas adaptive behaviors are dynamic**. * **well, it's a measure of ability and it can be a repeated measure because this is looking at dynamic factors or phenotypes, that can change over time**. * So, they're the two that are in our category for adaptive and educational assessments.

Answer 37

* How antidepressant medications work * Why complying with the regimen is critical * How long it takes to reach therapeutic windows (when enough medication is in the bloodstream to be effective) * Potential side effects that might arise * Which side effects to be concerned about and which to endure * How to talk with the prescribing doctor about symptoms

Answer 38

**(Memory)** Comprehensive & current battery assessing a range of memory abilities in adults aged 16 - 90. The adult battery comprises seven subtests: * Logical Memory * Verbal Paired Associated * Visual Reproduction and four new tests * Brief Cognitive Status Exam * Designs * Spatial Addition * Symbol Span **WMS is a Memory Scale** * Measures memory abilities and deficits **WMS** **Measures memory abilities and deficits and** **Current version VMS-4** **Its use:** assesses visual memory is used to assess dementia and assess brain dysfunction **The age:** 16-90:11 months **Target population:** **Screener/diagnostic/repeated measure/info gathering tool:** Its diagnostic and we can assess memory impairment **Does it have Australian norms:** It does have Au norms **Is it culturally appropriate:** Not culturally appropriate for it doesn't have a version for the aboriginal population but widely used **Time:** ~45-60 min * It's the most difficult to learn within the Weschler scales * You can combine the scores WMS and WAIS are used for Neurological * 5 domains: Auditory memory, visual memory, visual working memory, immediate memory, delayed memory * 7 subtests: Logical memory, verbal paired associated, visual reproduction, general cognitive screener, design memory, spatial addition, symbol span Optional: brief cognitive status exam (for those suspected memory deficits or those with neurodevelopmental disorders (learning difficulties, dementia) * Usually want you to choose to do a WMS when people are having problems with because the WAIS does not measure visual memory. and their scoring, in working off the bell curve, * so, it makes a little bit easier to learn to deliver.

Answer 39

**(Memory)** Assesses memory ability in a range of contexts, including: * memory deficits among people with brain injury * dementia * developmental disabilities Assesses range of memory from childhood to older adulthood (5-90yr). It had a Screening Memory Index that enables a brief but reliable assessment of memory. **WRAML is a Memory Test** * WRAML is measuring memory abilities and deficits **WRAML’s latest version is 2** **Its use:** is a standardized test of memory and learning battery, so not as depth as the WMS **The age:** It’s from 5 to 90 years old (5:0-90:0) (with the WMS starts at 16, whereas a WRAML starts at 5) **Target population:** was based on developments in cognitive, developmental, and neuropsychology. It is designed to assess memory ability in a range of contexts including assessments of memory deficits among people with brain injury, dementia, and learning and other developmental disability. **Screener/diagnostic/repeated measure/info gathering tool:** It’s a diagnostic, even though it’s broad still diagnostic **Does it have Australian norms:** doesn’t have Australian norms **Is it culturally appropriate:** not culturally appropriate * Time: ~28 min * Its strength lies in the ability to assess a range of aspects of memory from childhood through to older adulthood (5–90 years). * The WRAML2 consists of six core subtests that contribute to three core indexes: Verbal Memory, Visual Memory, and Attention-Concentration. * These combine to provide a General Memory Index. * Optional subtests enable the assessment of working memory, delayed recall, and recognition memory. * A Screening Memory Index can also be administered to establish whether a more in-depth assessment is indicated. * The WRAML2 is designed to be used in a range of clinical settings including schools, rehabilitation services, vocational counselling, hospitals, and private practice as well as in the research. * 3 domains: Verbal memory, visual memory, attention-concentration = General Memory Index * 6 subtests * so, we have the three indexes verbal, visual and attention, and concentration.

Answer 40

**(Vocational)** Self-assessment career inventory designed to assist ppl 15yr + to identify career interests and match them to suitable occupations or career fields. Classified into six different categories: * Realistic * Investigative * Artistic * Social * Enterprising * Conventional More congruent an individual’s personality is with the characteristics of the occupation, the greater the individual's vocational satisfaction. **SDS is a Vocational Assessment** * Vocational psychometric tests: Career inventory * identify their career interests and match them with suitable occupations * the more congruent with the characteristics of occupation, the more satisfaction **The latest version is 5** **Its use:** to identify their career interests and match them to suitable occupations or career fields based on the theory that people and occupations can be classified into six different categories: **RIASEC -** Rational, Investigative, Artistic, Social, Enterprising, Conventional, **The age:** 11 years to 70 years **Target population:** Assesses career interests, it matches aspirations - vocational **Screener/diagnostic/repeated measure/info gathering tool:** it's really just a measuring tool, **Does it have Australian norms:** it does have Australian norms **Is it culturally appropriate:** it's not necessarily culturally appropriate **Time:** 25-35 minutes **Reliability:** demonstrates sound reliability with Cronbach’s alpha coefficients for the activities, competencies and occupations scales. **Validity:** demonstrates acceptable concurrent and predictive validity. - based on the theory that people and occupations can be classified into six different categories, including * Realistic (R), * Investigative (I), * Artistic (A), * Social (S), * Enterprising (E), * Conventional (C). * **RIASEC -** Rational, Investigative, Artistic, Social, Enterprising, Conventional, - The more congruent an individual’s personality is with the characteristics of the occupation, the greater the individual’s vocational satisfaction. - The SDS consists of five sections: * Occupational * Daydreams (respondents can list up to five occupations), * Activities (66 items rated Like/Dislike), * Competencies (66 items rated Yes/No), * Occupations (84 items rated Yes/No), * and Self-Estimates of abilities and skills (12 items rated on a scale from 1 = Low to 7 = High).

Answer 41

(Vocational) Suitable for 16+ Used to aid career decision-making by helping people understand their interests across a broad range of categories and to match them with compatible occupational, educational, and leisure pursuits. Also used for employee engagement, leadership & executive coaching & employee reintegration. **Strong Interest in a Vocational Test** * Vocational psychometric tests: Career assessment instrument * Aids career decision-making **Its use**: its similar to SDS **The age:** is 16 Plus **Target population:** Assesses career interests, it matches aspirations – vocational, it **Screener/diagnostic/repeated measure/info gathering tool:** we don't consider it diagnostic or screening or any of those, it's not aimed at coming up with a diagnosis etc., gathering tool **Does it have Australian norms:** don't really have norms **Is it culturally appropriate:** it's not necessarily culturally appropriate **Time:** 35-40 minutes * The **SII** is often used to aid career decision making by assisting individuals to gain an in depth understanding of their interests across a broad range of categories and to match them with compatible occupational, educational, and leisure pursuits. * Apart from career exploration and development, the SII is also used for employee engagement, leadership and executive coaching, and employment reintegration. The 2012 updated version of the SII consists of five scales: * **General Occupational Themes (GOTs)** based on Holland’s six personality types of Realistic (R), Investigative (I), Artistic (A), Social (S), Enterprising (E), and Conventional (C) * **30 Basic Interest Scales (BIS),** which measure specific areas such as art, science, athletics, social sciences, sales, and office management * **260 Occupational Scales (OSS),** which are based on occupations in the United States * **5 Personal Style Scales (PSS)** including Work Style, Learning Environment, Leadership Style, Risk Taking, and Team Orientation * **3 Administrative Indices** used to identify test errors or unusual profiles.

Answer 42

(Personality) Standardized, self-report that assesses a broad range of personality factors. Appropriate for 16+ years. **16PF is a Personality Assessment** * Personality psychometric tests that helps with vocational and occupational preferences and suitability * Can be good for knowing personality, good to know coping styles, help inform psychiatric diagnosis **Latest version 5^th edition** **Its use:** is a standardized self-report measure that assesses a broad range of personality factors. It is generally used to assist with identifying vocational and occupational preferences and suitability. **The age:** 16+ **Target population:** Adults - is used in occupations - or organisations use it if you have the desirable personality that Provides a measure of personality that fits in with providing us with a measurement of anxiety, adjustment, emotional stability and behavioral problems **Screener/diagnostic/repeated measure/info gathering tool:** It’s not diagnostic in line with DSM-5. **Does it have Australian norms:** It doesn’tt have Australian norms however it is constructed to worldwide personality type **Is it culturally appropriate:** no it’s not culturally appropriate **Reliability:** It has adequate reliability (internal consistency and test retest) **Validity:** Convergent and discriminant. So, the true false on this makes it an ipsative test * So, Ipsative test makes it a forced choice I've been talking about last week, - the false choices kind of like in making them go from one extreme to the other.* * *There's no middle ground like on a Likert scale.* 16 PF looks at 16 primary personality scales and 5 global personality scales, they are all bipolar scales. The **five primary global scales** it's talking about relate to * **The Big Five Personality Theory** that we have, * **OCEAN**, which most of you would have learnt about it at university, it can have some diagnostic meaningfulness, but essentially, it assists us with looking at * **psychiatric disorders,** * **Or with therapy planning** * **Or with prognosis** * but then also can be used in a career in occupational setting as well and that's what makes the 16 PF popular, because of its ability across settings. The **16PF-5** comprises 185 multiple-choice items, resulting in scores on 16 scales of primary personality factors: * Warmth, * Reasoning, * Emotional Stability, * Dominance, * Liveliness, * Rule-Consciousness, * Social Boldness, * Sensitivity, * Vigilance, * Abstractedness, * Privateness, * Apprehension, * Openness to Change, * Self-Reliance, * Perfectionism, * and Tension. The measure also assesses * social desirably expressed through an Impression Management Index, * and generates scores (through combining related primary scales) * for five global personality factors (i.e., Extraversion, Anxiety, Tough-Mindedness, Independence, and Self-Control).

Answer 43

(Personality) Based on the 5-factor model of personality, assessing: * Neuroticism, * Extraversion, * Openness, * Agreeableness & * Conscientiousness. **NEO-PI is a Personality Battery** * Personality psychometric tests **Latest is the revised version** (**NEO PI-R**) **Its use:** Provides a detailed assessment of normal personality, NEO stands for neuroticism, extraversion and openness, **The age:** 12+ _revised version_ 17 years to 89 years **Target population:** personality inventory **Screener/diagnostic/repeated measure/info gathering tool:** Not diagnostic **Does it have Australian norms:** there are no Australian norms **Is it culturally appropriate:** not culturally appropriate **Reliability:** has adequate reliability (internal consistency and test-retest) **Validity:** convergent and discriminant validity **Time:** ~ 30-40 minutes * **NEO** stands for **neuroticism, extraversion and openness** which is the three of the five for the Big Five Personality Factors and the other two are agreeableness and conscientiousness – so it’s basically a Five Factor Model * **In** addition, the NEO PI-R also reports on six subcategories of each Big Five personality trait (called facets) The **NEO PI**, **NEO PI-R** (or Revised NEO PI), and **NEO PI-3**, respectively The inventories have both longer and shorter versions with the full NEO PI-R * consisting of 240 items and providing detailed facet scores, * whereas the shorter **NEO-FFI** (NEO Five-Factor Inventory) has only 60 items (12 per domain). * The test was originally developed for use with adult men and women without overt psychopathology. * It has also been found to be valid for use with children. In the most recent publication, there are two forms for the NEO, self-report (form S) and observer-report (form R) versions The NEO PI-R is self-administered and is available in two parallel versions. Each version contains 240 items and three validity items and requires a 6th-grade reading level. * Form S, designed for self-reports, is appropriate for use with adults, including individuals of college age. * Form R, designed for observer reports, is written in the third person for peer, spouse, or expert ratings. It can be used as an alternative measure or as a supplement to self-reports from adult clients. * Each item is rated on a 5-point scale. the big five personality factors **OCEAN**, * Neuroticism (mood/emotional instability, highly stress/anxious), * extraversion, * conscientiousness (goal-directed behaviours, executive functioning), * openness to experience, * agreeable (altruism, prosocial behaviours)

Answer 44

**Special Note:** * So, that's the only thing you need to really be careful of in the exam is not choosing the **_PAI**_ when you should be choosing _**16 PF_ or _NEO_** and vice versa as well. * So, the **_PAI_** you just really need to remember that that is a very clinical instrument based on the major sections in the DSM five * and is not used in any type of vocations setting, whereas **_16 PF**_ and _**NEO_** are based on the personality theory used in vocational settings. * The difference between that **_NEO**_ has Agreeableness _**16 PF_** doesn’t * Also remember that the **_MMPI_** does provide valuable insight on a range of different areas, not just In terms of **clinic diagnostic measures,** it has 500 questions and is most widely used within the personality tests. **Difference between** Higher-level dimensions 5 global scales 5 domains Lower-level dimensions or traits 16 primary factors 30 facet scales Bottom-up Top-down

Answer 45

(Depression) A self-report measure of the severity of depression. 21 items. **BDI is a Clinical & Mental Health Tests** * clinical and mental health tests * this self-report measures severity of depression **The latest version is 2** **Its use:** self-report measure of the severity of depression **The age:** 13 yrs. and older **Target population:** **Screener/diagnostic/repeated measure/info gathering tool:** diagnostic and repeated measure **Does it have Australian norms:** doesn’t have Australian norms but is widely used in Australia **Is it culturally appropriate:** not culturally appropriate **Reliability:** noted as sound **Validity:** it’s designed to validate DSM-IV **Time:** 5-10 minutes * It very much is like A DASS or like a K-10 * Has 21 items * Respondents select one of four statements for each item that best represents how they have been feeling over the preceding **fortnight**

Answer 46

Measures a person's overall psychosocial functioning - * psychological symptom severity * social functioning * occupational impairment * current functioning due to mental health * self-care * danger to self/others **GAF is a Clinical & Mental Health Test** * Clinical and mental health tests * psychosocial functioning * not supported by DSM-V b/c GAF follows the multi-axial structure and has been designed for DSM-IV * WHODAS is more recommended **Its use:** GAF measures a person’s overall psychosocial functioning and **The age:** Adults and school-aged children, however, Children’s Global Assessment Scale is also available **Target population:** Adults and school-aged children to gather information **Screener/diagnostic/repeated measure/info gathering tool:** a gathering tool **Does it have Australian norms:** no Australian norms **Is it culturally appropriate:** not culturally appropriate * **3 domains:** 1. Psychological symptom severity, s= 2. Social functioning, 3. Occupational impairment * APA recommends standardized scales and risk assessment instead of one single score rating covering 3 domains * Has normative samples The GAF measures a person’s overall psychosocial functioning and forms Axis V of the DSM-IV-TR. The GAF summarizes, in a single score, three function domains: psychological symptom severity, social functioning, and occupational impairment. * Current functioning due to mental health is rated, with self-care and danger to self/others also informing scoring. The GAF is not included in the DSM-5, which also no longer uses a multiaxial structure. * **Instead, the WHODAS 2.0** is recommended and provided in Section III; APA recommends the use of standardized scales and risk assessments rather than a single-score rating for the domains covered by the GAF. So, in DSM-4 we used to have axes one for clinical disorders, axes to two for personality disorders and intellectual impairment, axes three was social. So, anything in the social, educational, occupational, you know, like recently divorced or recently lost a job or etc. * The next one was a general medical condition. So, if the person has cancer or diabetes, or something that could impact as well, and then the last scale was the GAF, but we don't actually do that anymore. GAF score of 1-100 With higher score indicates healthier functioning. it can be 98, it can be 2, it could be 7. So, within each of those anchor points, there's descriptives as to how you define where the person sits in that anchor point.

Answer 47

(Anxiety) One of the most commonly used measures of anxiety in adults. Provides measures of Trait Anxiety and State Anxiety. **STAI is a Clinical & Mental Health Tests** State Trait Anxiety: how you are predisposed to respond to stressors across life situations; individual differences, how you generally feel * State anxiety: fluctuating anxiety based on immediate, threatening stimuli/temporary conditions * **State Trait Anxiety Inventor** * differentiates between **state anxiety and trait anxiety.** * State Anxiety - something temporary. Looks at anxiety in a particular situation. This is panic attacks * Anxiety trait - is anxiety all the time in a person. This is constant anxiety and may be avoidant personality. * It can also distinguish between depression and anxiety. * It is very often used when people present with somatic symptoms **Its use:** it measures two types of anxiety, State and Trait there is also a STAI for children (STAIC) with the same number of items **The age:** It is used with Adults 18+ but there is a children's version 9–12 **Target population:** **Screener/diagnostic/repeated measure/info gathering tool:** it’s diagnostic and a repeated measure on STATE ONLY **Does it have Australian norms:** there's no Australian norms, **Is it culturally appropriate:** not culturally appropriate **Reliability:** Internal consistency is high for the anxiety component **Validity:** convergent and discriminant validity **Time:** ∼10 minutes to complete * 40 items in total: 20 items for trait, 20 items for state * STAI FORM Y-1: State Anxiety (how you feel right in this moment) * STAI FORM Y-2: Trait Anxiety (how you generally feel) **Phenotype (dynamic) genotype (static)** _static (not changeable_), _dynamic (changeable),_ **etc.** **So, state and trait:** * **state -** refers to the **phenotype -** the **dynamic side of the equation**, * and the **state** is basically how you're responding to what's happening around you at that particular time. * whereas **trait -** refers to the **genotype -** like your **inherent side of the equation** is your inherent **traits**, that is going to show through regardless of what's happening around you. It's almost like two separate question is there's a state one, and there's a trait one, and you come up with two scores, and then **there's a formula** that combines those two scores to gives you an overall score. So, there's a **Form X and there is a Form Y** consists of 40 questions on a self-report basis original STAI‐X, the STAI was revised in 1983 (STAI‐Y) and has been used extensively in a number of chronic medical conditions including rheumatic conditions such as rheumatoid arthritis, systemic lupus erythematosus, fibromyalgia, and other musculoskeletal conditions. Different other versions exist: - State-Trait Anxiety Inventory for Children (STAIC) - Test Anxiety Inventory (TAI) - State-Trait Anger Expression Inventory-2 (STAXI-2) STAI for children (STAIC) with the same number of items STAI FORM Y-1 scoring 1-4: 1 = not at all; 1 2 = somewhat; 3 = moderately so; 4 = very much so STAI FORM Y-2 scoring 1-4: 1 = almost never; 2 = sometimes; 3 = often; 4 = almost always four-point Likert scale. 1) not at all, 2) somewhat, 3) moderately so, and 4) very much so Using a cut score of 8 overall provided sensitivities and specificities at ∼80% and reaching 90% in a community cohort for the HADS‐A for detecting anxiety disorders. In primary care populations, cut scores of ≥9 for the HADS‐A yielded moderate sensitivity (0.66) and high specificity (0.93)

Answer 48

World Health Organization - Disability Assessment Scale **Clinical & Mental Health Tests** World Health Organisation Disability Assessment Schedule 2.0 * Assessment for health and disability * mental, neurological, and addictive disorders **Current version 2.0** (previous one was II roman numeral) **Its use:** it's basically a generic assessment instrument, for health and disability. **The age:** 18+ **Target population:** **f**or health and disability **Screener/diagnostic/repeated measure/info gathering tool:** not diagnostic a measure of function **Does it have Australian norms:** It doesn’t have Australian norms **Is it culturally appropriate**: has cultural norms, WHO is cross cultural **Time:** ~5-20 minutes * 12 item OR 36 items * WHO - Internationally recognised organization. * Cognitive (understand and communication), mobility (moving/getting around), self-care (hygiene), getting along (interacting with other people), life activities (leisure, work, school), participation (community) * Scores are summed to get 0-100 disability **WHO-DAS** is an instrument that basically **covers 6 domains of functioning**. the functioning domains that it covers are * cognition, * mobility, * self-care, * getting along (which is kind of like your social skills interacting with other people) * life activities (like your domestic responsibilities, leisure work, etc.) * and participation (joining in community activities) * they are going to change across time but cognition and mobility, not necessarily, or mobility may or may not change, but cognition you know their understanding and communicating abilities are not likely to change. **WHO-DAS** are both available online. * There are recently added to the curriculum. They are screeners. * WHODAS is the impact on mental health issues in people's day-to-day functioning. * NDIS is accepting the WHODAS as it is a measure of disability caused by health or mental health issues.. * 2 versions one for the client and one for the parents or friends. Can be used for kids as well. * If the question includes disability due to mental health issues - the answer could be WHODAS * Look at: American Psychiatric Online Assessment Measures, look under disability for WHODAS

Answer 49

World Health Organization- Quality of Life scale **Clinical & Mental Health Tests** **Its use:** WHOQOL measures of quality of life, is based on an individual's perception, so it's self-report **The age:** 18 plus **Target population:** it's a measure of quality but perceived quality **Screener/diagnostic/repeated measure/info gathering tool**: it’s a screener **Does it have Australian norms**: It has Australian norms **Is it culturally appropriate:** It is culturally appropriate * **it's a measure of quality but perceived quality,** _that's really important_ * **s**o, a person's perception can be impacted by a number of different variables obviously, * their own mental health at that point in time. * depression * it can be impacted by personality disorders etc. * and I guess the important factor there we need to realize is that the person's perception is real to them

Answer 50

Brief measure of client functioning, for use in clinical, counseling and community settings. Was developed as regular monitoring of client progress has significant positive effect on client outcomes from treatment. High scores may indicate that the client is experiencing sustained improvement in their overall well-being over the course of therapy. Note that this measure does not assess therapeutic relationship or psychological intervention. **ORS is a Clinical & Mental Health Tests** * measures client functioning (wellbeing) and therapy outcomes (regularly monitor whether there are treatment outcomes/effects) * Scale to see whether the client is happy with the therapeutic process. * It is about client outcomes. It is about whether the client is seeing benefit in his life outside therapy. **Its use:** a brief measure of client functioning, developed for use in clinical counselling and community settings **The age:** 13 + **Target population:** The ORS is a simple, four-item session-by-session measure designed to assess areas of life functioning known to change as a result of therapeutic intervention. **Screener/diagnostic/repeated measure/info gathering tool:** just a measure **Does it have Australian norms:** doesn’t have norms **Is it culturally appropriate**: not appropriate **Reliability and Reliability:** ORS demonstrated adequate validity and moderate reliability for participants from both clinical and nonclinical samples when compared with extensive measures **Time:** ~ 1 min - The ORS is a simple, four-item session-by-session measure designed to assess areas of life functioning known to change as a result of therapeutic intervention. * The **ORS** and **CORS** they do have psychometric properties, * but the **YCORS** doesn't but it's a useful way of engaging children. * **CORS** was developed for children aged 6 to 12 Four dimensions of client functioning that are widely considered to be valid indicators of successful outcome. 1. Personal or symptom distress (measuring individual well-being). 2. Interpersonal well-being (measuring how well the client is getting along in intimate relationships) 3. Social role (measuring satisfaction with work/school and relationships outside of the home). 4. Overall well-being. * The ORS translates these four dimensions of functioning into four visual analogue scales which are l0cm lines, with instructions to place a mark on each line with low estimate to the left and high to the right. * The ORS is designed to be accessible to a **child with a 13-year-old’s reading level****,** making it feasible for adolescents and adults. * The **CORS** was developed for children age 6–12. It has the same format as the ORS but with more child friendly language and smiley and frowny faces to facilitate the child’s understanding when completing the scales (Duncan et al., 2003). * For children 5 or under there is also the Young Child Outcome Rating Scale (**YCORS**), which has no psychometric properties, but can be a useful way of engaging young children regarding their assessment of how they are doing. * The development of the ORS came in response to a growing area of research demonstrating that regular monitoring of client progress had significant positive effects on clients’ outcomes from treatment. * Its design was also in response to a need for **a briefer, cost-efficient, and less complex tool** to assess client functioning than what was available to practitioners at the time. * The ORS was designed to measure clients’ functioning irrespective of any particular type of treatment model being applied by the practitioner and is in alignment with evidence-based practice to include eliciting feedback on clients’ progress in treatment. * **ORS (13+ years)** * **CORS (6-12 years)** * **YCORS ( \<5 years)** The ORS (ages 13 and over) * *The cut-off scores are:** - Cut off for 13–17-year-olds = 28 - Cut off for 18 and over = 25 * *The CORS** (ages 12 and under) cut-off scores are: - Child Self Reporting = 32 - Carer Reporting on Child = 28 **The ORS/CORS** cut off scores between the clinical population and the non-clinical population are different depending on the age of the client: - 13-17-year-olds (self-reporting & carer reporting on teen) = 28 - 18 and over = 25 The CORS (ages 12 and under) cut off scores are: - Child Self Reporting = 32 - Carer Reporting on Child = 28 It is important to explain these cut-off scores to young people and carers. the **YCORS** is just a page form of phases which is full of faces and expressions * Quantify by using a ruler ![]()

Answer 51

(Personality) Most widely used, clinical assessments in personality assessment, which also assesses dimensions of psychopathology. **MMPI is a Clinical & Mental Health Tests – Personality Assessment** * Another Personality assessment is the MMPI. * It also has validity scales, T scores but it is just longer, it has **500 questions** **Current version is**: 2 **Its use:** MMPI is used quite a lot in Queensland for emergency services, screening of personnel **The age:** 18+ **Target population:** is a standardized psychometric test of adult personality and psychopathology. Psychologists and other mental health professional use various versions of MMPI to help develop treatment plans, assist with differential diagnosis help answer legal questions (forensic psychology) screen job candidates during the personal selection process **Screener/diagnostic/repeated measure/info gathering tool:** It is a diagnostic **Does it have Australian norms:** don't have Australian norms, norms of US only **Is it culturally appropriate:** definitely not culturally appropriate. * MMPI does provide valuable insight on a range of different areas, not just In terms of **clinic diagnostic measures** * 567 items of True/False responses of abnormal behaviour and personality **clinical scales:** * 1 Hypochondriasis (Hs) * 2 Depression (D) * 3 Hysteria (Hy) * 4 Psychopathic Deviate (Pd) * 5 Masculinity-‐Femininity (Mf) * 6 Paranoia (Pa) * 7 Psychasthenia (Pt) - (phobia, obsessions, compulsions), schizophrenia, hypos mania, social introversion) * 8 Schizophrenia (Sc) * 9 Hypomania (Ma) * 0 Social Introversion (Si) **What are code types:** Code-‐type groups are more homogeneous * Greater likelihood that descriptors will fit individual with the code type * More focused descriptors Highest clinical scales in a profile * High-‐point codes/One-‐point code types; highest clinical scale in profile * Two-‐point code types; two highest clinical scales in profile * Three-‐point code types; three highest clinical scales in profile **Guidelines for Interpreting Code Types** Excluding scales * Do not include scales 5 and 0 in determining code types. These scales are different in nature from the other eight clinical scales. * Most previous code‐type research has not included them. Order of scales * Except when interpretive materials specifically indicate otherwise, order of scales in two-and three‐point code types is not important (e.g., 13 code and 31 code have same interpretation). **Guidelines for Interpreting Code Types** Definition * Interpret only defined code types - at least 5 T-score points between lowest scale in code type and next highest clinical scale in profile (excluding 5 and 0). * For profiles that do not have defined code types, interpretation should focus on individual scales. Elevation * When scales in defined code types are elevated (T \> 65), include both symptoms and personality descriptors in interpretation. * When scales in defined code types are not elevated (T \< 65), include personality descriptors but not symptoms in interpretation. it is definite ipsative and its forced choice. So, it's true or false, there is no in-between and quite often you get quite a lot of **false positives or false negatives** because they're being forced to one direction or the other

Answer 52

(Depression) 9-item depression module of full Primary Care Evaluation of Mental Disorders PHQ. The full PHQ is a screener & diagnostic tool for mental health disorders such as depression, anxiety, alcohol, somatoform, and eating disorders. **PHQ-9 is a Clinical & Mental Health Tests** * **PHQ-9: screens, measures, monitor severity of depression** * **Item 9 on PHQ-9 screens for suicide ideation** (risk assessment) * **FULL PHQ measures:** depression, anxiety, alcohol, somatoform, eating disorders * It is a self-report **This is the current version** **Its use:** used to measure change in quality of life over the course of treatment **The age:** ≥15 years **Target population:** homogeneous populations (same kind) **Screener/diagnostic/repeated measure/info gathering tool:** it is used as a screener but as a diagnostic and for monitoring as well, so it's a multipurpose screening, diagnosing, monitoring and measuring the severity of depression **Does it have Australian norms:** no Australian norms **Is it culturally appropriate:** not culturally appropriate **Time:** ~5:10 min * **PHQ-9** actually has nine items. * **But based on the DSM and depression only** * it really is a depression assessment * But not used anywhere near as much as DASS or as BDI * It actually relates to DSM four, however, as we know the constructs of depression in DSM four and DSM five did not change a great deal. * Shorter than other depression rating scales * Can be administered in person by a clinician, by telephone, or self-administered * Facilitates diagnosis of major depression * Provides assessment of symptom severity * Is well validated and documented in a variety of populations * Can be used in adolescents as young as 12 years of age * PHQ-9 has 9-items, * item 10 is the impact scale (how difficult have these problems made it for you to do work/home life/get along with other people): * Not difficult at all; somewhat difficult; very difficult; extremely difficult. Scoring (from the non-adapted **PHQ**-**9**): \<5 = minimal; 5–**9** = mild; 10–14 = moderate; 15–19 = moderately severe; 20–27 = severe. * Over the last 2 weeks * 0-3: 0= not at all; 1 = several days, 2 = more than half the days, 3 = nearly every day

Answer 53

A group of assessment tools that include parent, self and teacher reports of adaptive and maladaptive functioning in children and adolescents aged 6-18. **CBCL is a Clinical & Mental Health Tests** * assessment of emotional and behavioural functioning in children (completed by parent form, OR teachers, OR youth self-report) * CBCL is PART OF Achenbach System of Empirically Based Assessment (ASEBA) * ASEBA collection of questionnaires to **measure adaptive and maladaptive behaviors of child/adolescent** **This is the current version** **-** It belongs to a large family of ASEBA **Its use:** it's widely used questionnaire to assess behavioral and emotional problems **The age:** 1-5; 6-18; Teacher, Parent & Self-report forms for youth (CBCL 1-5 CBCL – youth) **Target population:** **Screener/diagnostic/repeated measure/info gathering tool:** It is often used as a screener however does not include Autism ABAS does **Does it have Australian norms:** it doesn't have norms available **Is it culturally appropriate:** but obviously compared with constructs that is consistently various cultures, * **Time** ~10-15 min by parents and 6-18-year-old. * 18m – 5-year-old; 6-19-year-old * There are 113 questions * Have self-, parent, teacher reports * It belongs to a large family of ASEBA * It is often used as **a diagnostic screener,** however, the important thing here is that or it **does not include autism spectrum disorders**. * **ABAS** does include autism but **CBCL** does not include autism. * So, that's a really important distinction. * **CBCL** child behavior checklist, emotional behavioral problems - **minus ASD** * you can compare what the behavior and emotions across the different settings * and it's not unusual for us to get vastly different reports from the teacher to what we do from a home setting * **if there's anything in the vignette about ASD CBCL is not your answer.** * **If there's anything in the vignette to ASD ABAS is your answer** * is basically what this one comes down to, in a very rudimentary (immature, undeveloped) way. **Assessment:** a) Internalizing behaviours (anxious/depression, withdraw/depression, somatic complains) b) Externalizing Behaviours (aggressive, rule-breaking) c) Social, Thought and Attention problems d) competency and adaptive functioning are assessed. 0-2: absent = 0, occurs sometimes = 1, occurs often = 2

Answer 54

Structured Clinical Interview for DSM **SCID is a Clinical & Mental Health Tests** **Current version SKID CV & SKID PD** **Its use:** Semi structured to making a diagnostic tree of DSM-5, it’s also a differential diagnosis for diagnosis, and it’s used in clinical intake procedures or in comprehensive forensic diagnostic evaluation **The age:** 18 and over **Target population:** To improve interviewing skills of students in the mental health professions, including psychiatry, psychology, social work, and psychiatric nursing, Through repeated administrations of the SCID, students will become familiar with the DSM-5 criteria and at the same time will incorporate useful questions into their own interviewing repertoire. **Screener/diagnostic/repeated measure/info gathering tool:** it’s a diagnosis **Does it have Australian norms:** it has Australian norms **Is it culturally appropriate:** Culturally appropriate YES and NO for it does not have Aboriginal data * **It's a semi structured interview guide for making the major DSM-5 diagnosis**. You need to be familiar with **DSM-5** in order to deliver it, * So, we have a couple of versions we have * **SCID-CV,** which is the **Clinical Version.** * **SCID-PD**, which is the **Personality Disorder** version. * So, there's two PD ones * one as a screener because as you know it personality disorders there's a general diagnostic-criteria, for personality disorders _that must be met_ before you then go into specific criteria for a specific personality disorder in one of the clusters of the personality disorders * So, the screener will tell you whether or not you need to move on to the full **SCID-PD** * If they don't meet that general criteria which is short and sharp, then don't continue on if they do meet then you continue on, but you still may not in any of the criterion which is said then you will come up with a mixed * **most likely a mix personality disorder**

Answer 55

The AUDIT (Alcohol Use Disorders Identification Test) **The AUDIT (Alcohol Use Disorders Identification Test)** **Its use:** It’s a screening for detecting risky and harmful drinking patterns **The age:** 18 and over **Target population:** Adults and Adolescents **Screener/diagnostic/repeated measure/info gathering tool**: it’s a screener **Does it have Australian norms:** it has Australian norms **Is it culturally appropriate:** Culturally appropriate YES * (AUDIT) is a 10-item screening tool developed by the World Health Organization (WHO) * to assess alcohol consumption, drinking behaviours, and alcohol-related problems. * to assess whether your drinking is putting you at risk of alcohol-related harm * questions about your alcohol use during the past 12 months. 0 – Recommended- provide positive reinforcement and offer relevant literature (may be helpful to others) 1 – 7 Low Risk 8 – 12 Risky 13+ High Risk

Answer 56

MINI MSE (MMSE) allows you to screen for neurocognitive disorders for dementia (not diagnostic). Don’t get this confused with MSE.The MSE is not to be confused with the Mini-Mental State Examination (MMSE), which is a brief neuropsychological screening test for cognitive impairment and suspected dementia. However, the MMSE can be used for more detailed testing in the cognitive section of this MSE The MMSE can be used to assess several mental abilities, including: * short and long-term memory * attention span * concentration * language and communication skills * ability to plan * ability to understand instructions Scores on MMSE – look at this and do it yourself. If the score is below 25, the result is usually considered to be abnormal (indicating possible cognitive impairment). Impairment may be classified as follows: * mild — MMSE score of between 21 and 24 * moderate — MMSE score of between 10 and 20 * severe — MMSE score of less than 10 * The maximum score for the MMSE is 30. * So 27 is very likely not diagnosed with dementia. * A score of 25 or higher is classed as normal.

Answer 57

Is the psychiatric equivalent of the physical medical exam. Involves psychologist observing and talking with a client seeking a dx. Systematic behavioural observation of the client Psychologists use MSE to assess suitability for formal psychological testing or to guide case management in clients with the possibility of severe psychological impairment. • Level of consciousness / awareness(person / time / place) normal; clouded, inattentive, distracted; delirious; stuporous; coma * Appearance and Behavior (dress, grooming, non-verbal) * Speech / motor activity (slow; halting, tics, restlessness) * Thought and perception (coherent, tangential, delusional, hallucinations) • Mood(how the person generally feels) and affect (immediate expression of emotion); affect: appropriate/innappropriate, broad, restricted, labile, flat * Attitudes and insight * Intellectual functioning (may be assessed with tests, but vocab, memory….) The mental status exam is the psychologist observing and talking with the client seeking a diagnosis. * MSE you need to remember the major components. **Acronym - ABC Stamp Licker** * **A**ppearance, * **B**ehaviour, * **C**ooperation * **S**peech * **T**hought - **form** and **content** * **A**ffect - moment to moment variation in emotion * **M**ood - the subjective emotional tone throughout the interview * **P**erception - in all sensory modalities * **L**evel of consciousness * **I**nsight & Judgment * **C**ognitive functioning & Sensorium * **O**rientation * **M**emory * **A**ttention & Concentration **R**eading & Writing * **K**nowledge base * **E**ndings - suicidal and/or homicidal ideation * **R**eliability of the information *

Answer 58

**(Intelligence)** Measures intelligence & problem-solving skills, for ages 11-85+. Strengths include: * a good indication of overall intelligence, less influenced by culture, opportunity, or education * both visual and auditory formats are used to measure intelligence across different contexts KAIT computes Composite IQ & separate IQ for Crystallized and Fluid Scales.

Answer 59

Self Directed Search (SDS) Strong Interest Inventory (SII)

Answer 60

**Setting and monitoring goals measures (including goal attainment scaling)** * The Five Principles of Successful Goal Setting * Commitment – attachment to the goal * Clarity – Specify the goal * Challenge – degree of goal’s difficulty * Complexity – degree of goals demands * Complexity – degree of goals demands Feedback – the presence of progress reporting

Answer 61

According to the updated 2018 version of Evidence-Based Psychological Interventions in the Treatment of Mental Disorders: A Literature Review (4th edition) Posttraumatic Stress Disorder (309.81 (F43.10)) interventions include: * Trauma-focused Cognitive Behavioural, * Hypnotherapy, * Eye Movement Desensitisation and Reprocessing (EMDR), * Dialectical Behavioural Therapy, * emotion-focused therapy, * metacognitive therapy, * mindfulness-based stressed reduction. It does not include Solution-focused brief therapy (SFBT) as an evidence-based treatment for PTSD. This document is a systematic review undertaken to update the APS document Evidence-Based Psychological Interventions in the Treatment of Mental Disorders: A Literature Review (3rd edition). This review was first conducted in 2003 in the context of the Australian government’s Better Outcomes in Mental Health Care initiative. It was updated in 2006 and again in 2010 with consideration of the introduction of primary healthcare services through the Access to Allied Psychological Services (ATAPS) and Better Outcomes to Mental Health Care initiative.

Answer 62

Previous attempts (where nature of ideation, outcome & reaction are considered) Present thinking (has the method been chosen? Is such a method available? Frequency, intensity & duration of thoughts, and reasons for harm. Protective Factors (social support & religious beliefs) other risk factors

Answer 63

Psychologists fully inform clients regarding the psychological services they intend to provide, unless an explicit exception has been agreed upon in advance, or it is not reasonably possible to obtain informed consent.

Answer 64

* Diagnostic classification systems (including current versions of DSM and ICD) * You need to know: * The diagnostic features * The functional consequences * The key criteria * You need to know the following disorders: * From Anxiety Disorders, you need to know * GAD, * Panic Disorder, * Separation Disorder, * Social Anxiety Disorder * From Trauma and Stress, you need to know * PTSD * Adjustment Disorder * From Personality Disorder you need to know * Antisocial * Borderline * From the Obsessive compulsive and related Disorder, you need to know * Obsessive Compulsive Disorder (OCD) * From Somatic symptom and related Disorder, you need to know * Somatic Symptom Disorder, * From Neurodevelopmental Disorders you need to know * Autism spectrum * ADHD, * From Schizophrenia Spectrum and Other Related Disorder, you need to know * Schizophrenia. * From Disruptive Disorders you need to know * Oppositional Defiance Disorder (ODD) * Conduct Disorder * From Bipolar and related Disorder, you need to know * Bipolar 1 * Bipolar 2 * Depressive Disorder you need to know * Major Depressive Disorder * From Feeding and Eating Disorders you need to know * Pica, * Rumination Disorder, * Avoidant Restrictive Food Intake Disorder, * Anorexia, * Bulimia, * Binge eating * Other Specified Feeding or Eating Disorder * Neurocognitive Disorder you need to know * Delirium, * Mild NCD (NCD is Neuro Cognitive Disorder), * Major NCD, but then there's specifiers: * Alzheimer's Disease, * Frontotemporal Lobe, * Lewy bodies, * Vascular, * TBI, * Substance induced, * HIV infection, * Parkinson's, * Huntington * Unspecified * From the Substance Related and Addictive Disorders you need to know * Alcohol * Cannabis * Hallucinogen * Opioids * Sedative * Hypnotic * Stimulant related * Caffeine – does not have USE criteria * Inhalants – does not have a WITHDRAWAL * Tobacco – does not have an INTOXOCATION * Other unknown substance induced disorders * Other unspecified disorders Look for: * Use * intoxication * Withdrawal * Other * Unspecified Then with each one: * Intensity * Duration * Frequency

Answer 65

* Separation Anxiety Disorder * Selective Mutism * Generalised anxiety disorder * Panic disorder * Agoraphobia * Specific phobia * Social Anxiety Disorder (social phobia) * Substance /Medication-Induced Anxiety Disorder * Anxiety due to another medical condition * Other specified AD * Unspecified AD * Panic specifier “Anxiety is a negative mood state characterized by bodily symptoms of physical tension, and apprehension about the future”

Answer 66

Symptoms must be present for at least 6-months. Excessive exaggerated anxiety and worry about everyday life events with no obvious reasons for worry. – Worry about everything – Prepared for the worst – Worry feels out of control Generalized Anxiety Disorder (GAD): Statistics from DSM-5 (2013) • One of the most common anxiety disorders • US 2.9% general adult samples (12 months prevalence) • 9.0% (lifetime prevalence) • 12 month prevalence ranges 0.4% - 3.6% internationally • High comorbidity with depression • Female : Male = 2 : 1 • Median age of onset is 30 years, but most report feeling “anxious & tense all my life, as long as I can remember” • Chronic course **Causes of GAD** • Much less physiological reactivity (HR, BP, GSR) in response to stressors than other anxiety disorders (Roemer & Orsillo, 2013) – Except muscle tension • Very much a ‘cognitive’ disorder – Sensitive to threat/danger and worry about threat/danger – Avoid images associated with the threat (cognitive avoidance) so don’t process information completely • Cognitive mediators: intolerance of uncertainty • Metacognition: – “if I am alert to the threat I will be ready” (+ve) – “I can’t control my worry, my worries control me” (-ve) • Avoidance, reassurance-seeking, and distraction -\> never dispel beliefs **Psychological Treatments** • CBT: • Exposure to worry process • Identify and challenge underlying beliefs • Confronting anxiety-provoking images • Coping strategies • Similar benefits to pharmacotherapy (ST) and better long-term results

Answer 67

A panic attack is a sudden surge of overwhelming anxiety and fear. Your heart pounds and you can't breathe. You may even feel like you're dying or going crazy Panic Disorder (DSM-IV, with agoraphobia (PDA) and without agoraphobia (PD)) DSM-5, just PD – Unexpected panic attacks – Anxiety, worry, or fear of another attack * – Persists for 1 month or more – Fear or avoidance of situations/events – Interoceptive avoidance * – avoid internal physical sensations that might resemble onset of a panic attack – With / without agoraphobia Panic Disorder Statistics from DSM-5 (2013) • 2%-3% (12 months) • 4.7% (lifetime) • Female: male = 2:1 • Acute onset, ages 20-24 • Associated with drug and alcohol use (hangovers, fatigue, smoking increase likelihood of panic) • Prevalence decreases with age Nocturnal Panic – 60% with panic disorder experience nocturnal attacks * – non-REM sleep (not nightmares) * – Delta wave – Caused by deep relaxation, sensations of “letting go”? – Children: sleep terrors – Isolated sleep paralysis * – “the witch is riding you” (transition between sleeping & waking) Agoraphobia Statistics from DSM-5 (2013) * ~2%(12 months); \>=65 -\> 0.4% * Female: male = 2:1 * Mean age of onset ~ 17 years (variable) * DSM-5 reports agoraphobia has the strongest / most specific heritability of the anxiety disorders (61%) * Social/gender roles? ~75% of those with agoraphobia are female **Treatment** – Psychological * – Exposure-based-\> reality testing * – Relaxation – Breathing – Panic Control Treatment * – Exposure to interoceptive cues * – Cognitive therapy * – Relaxation/breathing – High degree of efficacy

Answer 68

Separation anxiety is a normal stage of development for infants and toddlers. Young children often experience a period of separation anxiety, but most children outgrow separation anxiety by about 3 years of age. In some children, separation anxiety is a sign of a more serious condition known as separation anxiety disorder, starting as early as preschool age. If your child's separation anxiety seems intense or prolonged — especially if it interferes with school or other daily activities or includes panic attacks or other problems — he or she may have separation anxiety disorder. Most frequently this relates to the child's anxiety about his or her parents, but it could relate to another close caregiver. Less often, a separation anxiety disorder can also occur in teenagers and adults, causing significant problems leaving home or going to work. But treatment can help. **Symptoms** Separation anxiety disorder is diagnosed when symptoms are excessive for the developmental age and cause significant distress in daily functioning. Symptoms may include: * Recurrent and excessive distress about anticipating or being away from home or loved ones * Constant, excessive worry about losing a parent or other loved one to an illness or a disaster * Constant worry that something bad will happen, such as being lost or kidnapped, causing separation from parents or other loved ones * Refusing to be away from home because of fear of separation * Not wanting to be home alone and without a parent or other loved one in the house * Reluctance or refusing to sleep away from home without a parent or other loved one nearby * Repeated nightmares about separation * Frequent complaints of headaches, stomachaches or other symptoms when separation from a parent or other loved one is anticipated A separation anxiety disorder may be associated with panic disorder and panic attacks ― repeated episodes of sudden feelings of intense anxiety and fear or terror that reach a peak within minutes.

Answer 69

Feelings of awkwardness, concern, tension, and discomfort when confronted with strangers or casual acquaintances. ***Characteristics***: Marked and persistent fear of one or more social or performance situations in which the person is exposed to possible scrutiny by others. The individual fears that he or she will act in a way (or show anxiety symptoms) that will be humiliating or embarrassing. The individual often fears that they will be judged negatively by others. **_Social Phobia: DSM-5 Statistics_** * US: ~7% (12 months); Europe: ~2.3% (12 months) * • Female : Male ~ 1.5:1.0 * • Onset = adolescence: (75% onset 8-15 years) ***Causes*** *Inherited vulnerability* Temperament, genetics, arousal system *Environmental causes* Relationships, observational learning, negative childhood experiences *Traumatic causes* Bullying, traumatic social experience **Pharmacotherapy for SAD** *Performance only* * Beta-blockers that block NE at the receptor eg. propanolol / inderal -\> Antihypertensive meds * Reduce physical anxiety signs (eg sweating, tremor, increased heart rate) but not emotional * Side effects -\> low blood pressure, depression *General SAD* * more often ‘seen’ than performance only -\> more problems, higher comorbidity * SSRIs: sertraline / zoloft, paroxetine / paxil (placebo controlled studies) * SNRI: Venlafaxine / effexor * BZD: alprazalam / xanax, clonazepam / klonopin (side-effects as before) Treatment: * CBT * Video feedback * Exposure * Behavioural experiments * Role-play * Group settings * Highly effective

Answer 70

Exposure to a traumatic event coupled with intrusive recollections, avoidant behaviours, changes to thoughts & mood, and increased reactivity that last more than 1-month after the event or its consequences. * The traumatic event itself * Intrusive symptoms * Behavioural avoidance * Negative changes in thoughts or mood * Evidence of reactivity **Criterion A**: stressor (one required) The person was exposed to: death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence, in the following way(s): * Direct exposure * Witnessing the trauma * Learning that a relative or close friend was exposed to a trauma * Indirect exposure to aversive details of the trauma, usually in the course of professional duties (e.g., first responders, medics) **Criterion B**: intrusion symptoms (one required) The traumatic event is persistently re-experienced in the following way(s): * Unwanted upsetting memories * Nightmares * Flashbacks * Emotional distress after exposure to traumatic reminders * Physical reactivity after exposure to traumatic reminders **Criterion C**: avoidance (one required) Avoidance of trauma-related stimuli after the trauma, in the following way(s): * Trauma-related thoughts or feelings * Trauma-related external reminders **Criterion D**: negative alterations in cognitions and mood (two required) Negative thoughts or feelings that began or worsened after the trauma, in the following way(s): * Inability to recall key features of the trauma * Overly negative thoughts and assumptions about oneself or the world * Exaggerated blame of self or others for causing the trauma * Negative affect * Decreased interest in activities * Feeling isolated * Difficulty experiencing positive affect **Criterion E**: alterations in arousal and reactivity Trauma-related arousal and reactivity that began or worsened after the trauma, in the following way(s): * Irritability or aggression * Risky or destructive behavior * Hypervigilance * Heightened startle reaction * Difficulty concentrating * Difficulty sleeping **Criterion F**: duration (required) * Symptoms last for more than 1 month. **Criterion G**: functional significance (required) * Symptoms create distress or functional impairment (e.g., social, occupational). **Criterion H**: exclusion (required) * Symptoms are not due to medication, substance use, or other illness.

Answer 71

• Classified under Trauma and Stressor-Related Disorders in DSM-5 * Clinical description * Trauma exposure * Extreme fear, helplessness, or horror * Continued re-experiencing (e.g., memories, nightmares, flashbacks) * Avoidance * Emotional numbing * Reckless or self-destructive behavior * Interpersonal problems * Dysfunction * For 1 month Posttraumatic Stress Disorder (PTSD): Statistics • 6.8% (lifetime); 3.5% (year) • Prevalence varies – Type of trauma – Proximity • Sexual assault: 32% met PTSD criteria at some point • Accidents: 15-20% • Combat: 18.7% for Vietnam veterans, correlation with amount of combat exposure Treatment Some of the most effective treatments for PTSD include: • CBT • Exposure • Imaginal exposure • Cognitive challenging of negative thoughts and appraisals • Increase positive coping skills • Increase social support • Highly effective • Cognitive Processing Therapy • Eye movement desensitization and reprocessing therapy (EMDR) • Aims to reduce the distress associated with a traumatic event • Client thinks about the emotionally distressing events while focusing on external stimulus • EDMR appears to weaken the impact of negative emotion

Answer 72

Must be at least 18yrs at time of dx. History prior to 15yrs must support Conduct Disorder. Noncompliance with social norms -“Social Predators” * Violate rights of others * Irresponsible * Impulsive * Deceitful * Lack conscience, empathy, remorse * High rates of substance abuse (60%) * Many movies feature antisocial PD Antisocial -\> ‘moral insanity; ‘sociopathy’; ‘psychopathy’ ASPD captures many of the deviant or abnormal behaviors associated with psychopathy but does not capture many of the psychopathic personality traits classified as interpersonal traits or affective traits E.g. the Hare Psychopathy Checklist-Revised (PCL-R) Hare criteria (PCL-R) for psychopathy include: Glibness/superficial charm Grandiose sense of self-worth Proneness to boredom/need for stimulation Pathological lying Conning/manipulative Lack of remorse Theory of mind Psychopathy based on personality traits rather than observable behaviour (DSM) Overlap with criminality: Original PCL-R normative data: male prison inmates Overlap with ASPD, criminality (esp violent crime) Intelligence separates criminal and non-criminal ASPD Successful psychopaths? **Causes** * Early histories of behavioral problems * DSM-5 Conduct disorder -\> essentially a behavioural description (see p. 455 B&D, 2015) Families history of: * Inconsistent parental discipline * Variable support * Criminality * Violence DSM-5: general pop ~= 3.3% (US data) ASPD & criminality? Family, twin, adoptee studies Environmental triggers (Crowe, 1974) * Cross fostering analysis: rates of arrests, convictions and ASPD in adopted bio offspring of felons \> in adopted offspring of non-felons * But adopted bio offspring of felons who committed crimes -\> longer time in institutions (orphanages) than (a) non-criminal offspring of felons (b) offspring of non-felons -\> Gene-environment interaction * Arousal hypotheses * Underarousal – risk-taking behaviours to increase stimulation * Fearlessness – opposite of attent bias – don’t respond to danger cues **Treatment** * Unlikely to seek help * Mental health stigma * High recidivism * Early intervention * Parent training concerning discipline * Prevention * Rewards for pro-social behaviors * Skills training * Improve social competence

Answer 73

Highly stigmatized diagnosis (laypeople and health professionals * Used to be associated with psychoanalytic view of trauma * BORDERLINE- associated with psychotic behaviour, clients can be hard to characterize * Most prevalent PD in clinical populations * Often misdiagnosed as bipolar (emotions reactive and volatile rather than cyclical) * Also misdiagnosed as schizophrenia - brief psychotic breaks (2-4 hours) **Characteristics** * Low/unstable sense of self * Heavily dependent on other people’s evaluation * May have a very poor self-image * Sense of emptiness * Labile, intense moods – often intense anger * Intense fear of abandonment (real or perceived) * Volatile and unstable relationships * Suicide attempts, self-harm behaviours, impulsivity and risk-taking * Often low insight into own emotional reactions and behaviours **Comorbitiy** * DSM-5: general pop ~= 1.6%-5.9% * Common in males but less frequent in clinical samples * Males often end up in forensic settings or using substances * Males - impulsivity, Females - emotionality * High comorbidity with other disorders: * Depression – 20% (completed suicide – 6%) * Bipolar – 40% * Substance abuse – 67% * Eating disorders - 25% of those with bulimia nervosa **Borderline PD: Treatment** * Very likely to seek treatment * Antidepressant medications often prescribed are not effective for BPD * Need stability and predictability- don’t like uncertainty * Marsha Linehan: For women with BPD, CBT has 3 major problems: * Focus on change invalidating (withdrawal, anger) -\> high drop out * Clients unintentionally reinforced therapists for ineffective treatment (interpersonal warmth/engagement -\> change the topic of the session) while punishing effective therapy (therapists would “back off” when client’s emotional) * Too many problems! (suicide attempts, self-harm, urges to quit treatment, noncompliance with homework, dep, anxiety)

Answer 74

Obsessions: Intrusive and mostly nonsensical thoughts, images, urges, or irrational beliefs that the individual tries to resist or eliminate. • Common obsessions : – repeated thoughts about contamination (e.g., becoming contaminated by shaking hands) – repeated doubts (e.g., wondering whether one has performed some act such as having hurt someone in a traffic accident or having left a door unlocked) – a need to have things in a particular order (e.g., intense distress when objects are disordered or asymmetrical) – aggressive or horrific impulses (e.g., to hurt one’s child or to shout obscenity in church) Compulsions: Behaviours (or mental rituals) designed to suppress or neutralize the thoughts and provide relief • The individual with obsessions usually attempts to ignore or suppress such thoughts or impulses or to neutralize them with some other thought or action (a compulsion) • E.g., – “I’m getting contaminated by germs” -\> washing – “Did I turn the stove off?” -\> checking stove – “I might commit blasphemy” -\> hail Mary’s

Answer 75

Somatic symptom disorder (SSD) occurs when a person feels extreme anxiety about physical symptoms such as pain or fatigue. The person has intense thoughts, feelings, and behaviors related to the symptoms that interfere with daily life - typically more than 6months. A person with SSD is not faking his or her symptoms. The pain and other problems are real. They may be caused by a medical problem. Often, no physical cause can be found. But it's the extreme reaction and behaviors about the symptoms that are the main problem. * Statistics (including in DSM-5) based on DSM-IV Somatization Disorder. DSM-5: * Prevalence “not known” (DSM-5, p.312) * Prevalence likely to increase with less restrictive criteria in DSM-5 * General adult population “maybe around 5%-7%” (DSM-5, p. 312) * Likely to be higher rates in females than males * Older adults: * Likely to be underdiagnosed * DSM-5 recommends focusing on Criterion B * Comorbid depression common Somatic Symptom Disorder * Associated with: * Personality trait of negative affectivity/neuroticism * Recent life stressor * More common in: * Females * Lower SES * Fewer years of education * Higher unemployment * Run in families and associated with Antisocial PD (ASPD mainly males) -\> biological basis disinhibition/impulsiveness? Expression (ASPD or SSD -\> depend on gender roles)

Answer 76

Autism spectrum disorder (ASD) is a complex developmental condition that involves persistent challenges in social interaction, speech and nonverbal communication, and restricted/repetitive behaviors. The effects of ASD and the severity of symptoms are different in each person. ASD is usually first diagnosed in childhood with many of the most-obvious signs presenting around 2-3 years old, but some children with autism develop normally until toddlerhood when they stop acquiring or lose previously gained skills. According to the CDC, one in 59 children is estimated to have autism. Autism spectrum disorder is also three to four times more common in boys than in girls, and many girls with ASD exhibit less obvious signs compared to boys. Autism is a lifelong condition. However, many children diagnosed with ASD go on to live independent, productive, and fulfilling lives. The information here focuses primarily on children and adolescents. Characteristics of autism spectrum disorder fall into two categories: Social interaction and communication problems: including difficulties in normal back-and-forth conversation, reduced sharing of interests or emotions, challenges in understanding or responding to social cues such as eye contact and facial expressions, deficits in developing/maintaining/understanding relationships (trouble making friends), and others. Restricted and repetitive patterns of behaviors, interests or activities: hand-flapping and toe-walking, playing with toys in an uncommon way (such as lining up cars or flipping objects), speaking in a unique way (such as using odd patterns or pitches in speaking or “scripting” from favorite shows), having the significant need for a predictable routine or structure, exhibiting intense interests in activities that are uncommon for a similarly aged child, experiencing the sensory aspects of the world in an unusual or extreme way (such as indifference to pain/temperature, excessive smelling/touching of objects, fascination with lights and movement, being overwhelmed with loud noises, etc), and others.

Answer 77

ADHD is one of the most common neurodevelopmental disorders of childhood. It is usually first diagnosed in childhood and often lasts into adulthood. Children with ADHD may have trouble paying attention, controlling impulsive behaviors (may act without thinking about what the result will be), or be overly active. Must persist for at least 6months. Ppl under 17 must have 6 or more symptoms, over 17rs must have 5 or more. There are three different types of ADHD, depending on which types of symptoms are strongest in the individual: * Predominantly Inattentive Presentation: It is hard for the individual to organize or finish a task, to pay attention to details, or to follow instructions or conversations. The person is easily distracted or forgets details of daily routines. * Predominantly Hyperactive-Impulsive Presentation: The person fidgets and talks a lot. It is hard to sit still for long (e.g., for a meal or while doing homework). Smaller children may run, jump or climb constantly. The individual feels restless and has trouble with impulsivity. Someone who is impulsive may interrupt others a lot, grab things from people, or speak at inappropriate times. It is hard for the person to wait their turn or listen to directions. A person with impulsiveness may have more accidents and injuries than others. * Combined Presentation: Symptoms of the above two types are equally present in the person.

Answer 78

Schizophrenia is a psychosis, a type of mental illness characterized by distortions in thinking, perception, emotions, language, sense of self and behaviour. Common experiences include: * hallucination: hearing, seeing or feeling things that are not there; * delusion: fixed false beliefs or suspicions not shared by others in the person’s culture and that are firmly held even when there is evidence to the contrary; * abnormal behaviour: disorganised behaviour such as wandering aimlessly, mumbling or laughing to self, strange appearance, self-neglect or appearing unkempt; * disorganised speech: incoherent or irrelevant speech; and/or * disturbances of emotions: marked apathy or disconnect between reported emotion and what is observed such as facial expression or body language.

Answer 79

Even the best-behaved children can be difficult and challenging at times. But if your child or teenager has a frequent and persistent pattern of anger, irritability, arguing, defiance or vindictiveness toward you and other authority figures, he or she may have oppositional defiant disorder (ODD). The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, lists criteria for diagnosing ODD. The DSM-5 criteria include emotional and behavioral symptoms that last at least six months. Angry and irritable mood: * Often and easily loses temper * Is frequently touchy and easily annoyed by others * Is often angry and resentful Argumentative and defiant behavior: * Often argues with adults or people in authority * Often actively defies or refuses to comply with adults' requests or rules * Often deliberately annoys or upsets people * Often blames others for his or her mistakes or misbehavior Vindictiveness: * Is often spiteful or vindictive * Has shown spiteful or vindictive behavior at least twice in the past six months ODD can vary in severity: * **Mild.** Symptoms occur only in one setting, such as only at home, school, work, or with peers. * **Moderate**. Some symptoms occur in at least two settings. * **Severe**. Some symptoms occur in three or more settings.

Answer 80

Conduct disorder is a severe condition characterized by hostile and sometimes physically violent behavior and a disregard for others. At least three symptoms must be present in the past 12 months, with at least one in the last 6 months. Children with CD exhibit cruelty, from early pushing, hitting and biting to, later, more than normal teasing and bullying, hurting animals, picking fights, theft, vandalism, and arson. Since childhood and adolescent conduct disorder often develops into the adult antisocial personality disorder, it should be addressed with treatment as early as possible.

Answer 81

**Bipolar 1:** Presence of at least a single manic episode. Recurrent. Symptom-free for 2 months. **Bipolar 2:** Presence of at least a single hypomanic episode & past major depressive episode. —- Onset 15-18 years onset usually more acute than in MDD. Typically chronic course.

Answer 82

Good to know the difference between *hypomanic* (Bipolar II) versus *manic*(Bipolar I) Remember, **depressive episodes in Bipolar are equally severe in both I and II**, but the manic episodes are less severe in B II than B I. People are high but ability to function in everyday life is not as severely affected in Bipolar II. E.g., sleep might be lessened, rapid speech, not eating much (or over-eating lots), seem high, but don’t seem psychotic, etc., but they are still able to go to work (hypomanic, B II). **With full mania**, they can’t go to work, they are *severely impaired*. Hypomania is harder to diagnose because it is a bit more on the borderline. You cannot diagnose B II until they have had a depressive episode because that’s when you know that is not just their personality type. With Bipolar I – you can diagnose with only a manic episode because it is so much more extreme. Depressive episodes for people with Bipolar are a lot more severe – and the depressive episodes of people with Bipolar II are especially severe. So Bipolar I is at least one manic episode, and Bipolar II is at least one depressive episode to get the diagnosis. The only context/diagnosis in which you can have a (full) manic episode is with Bipolar I.

Answer 83

Major Depressive Disorder: Key criterion: No evidence of mania or hypomania episodes. DSM-IV: single episode / recurrent with symptoms present for 2-week period Single episode rare: ~85% single episode -\> second episode DSM-IV MDD, recurrent More than 2 episodes separated by more than 2 months when not depressed. 4 Episodes (lifetime) = median DSM-5 does not distinguish between single & recurrent, notes “A diagnosis based on a single episode is possible, although the disorder is a recurrent one in the majority of cases” (p. 155)

Answer 84

• Severe disturbances in eating behaviour. **Anorexia Nervosa** – refusal to maintain minimal body weight (BMI \< 17.5 [DSM-IV]; changed to significantly low in DSM 5) **Pica** – eating nonfood items at an inappropriate developmental level **Bulimia Nervosa** – repeated binges followed by compensatory behaviours **Eating Disorder Not Otherwise Specified** – don’t meet criteria for AN or BN • DSM-5 – added Binge Eating Disorder • Obesity: not in the DSM 5, in ICD classified as a general medical condition

Answer 85

The neurocognitive disorder is a general term that describes decreased mental function due to a medical disease other than a psychiatric illness. It is often used synonymously (but incorrectly) with dementia. **Causes** Listed below are conditions associated with neurocognitive disorder. **BRAIN INJURY CAUSED BY TRAUMA** * Bleeding into the brain (intracerebral hemorrhage) * Bleeding into the space around the brain (subarachnoid hemorrhage) * Blood clot inside the skull causing pressure on the brain (subdural or epidural hematoma) * Concussion **BREATHING CONDITIONS** * Low oxygen in the body (hypoxia) * High carbon dioxide level in the body (hypercapnia) **CARDIOVASCULAR DISORDERS** * Dementia due to many strokes (multi-infarct dementia) * Heart infections (endocarditis, myocarditis) * Stroke * Transient ischemic attack (TIA) **DEGENERATIVE DISORDERS** * Alzheimer disease (also called senile dementia, Alzheimer type) * Creutzfeldt-Jakob disease * Diffuse Lewy body disease * Huntington disease * Multiple sclerosis * Normal-pressure hydrocephalus * Parkinson disease * Pick disease **DEMENTIA DUE TO METABOLIC CAUSES** * Kidney disease * Liver disease * Thyroid disease (hyperthyroidism or hypothyroidism) * Vitamin deficiency (B1, B12, or folate) **DRUG AND ALCOHOL-RELATED CONDITIONS** * Alcohol withdrawal state * Intoxication from drug or alcohol use * Wernicke-Korsakoff syndrome (a long-term effect of deficiency of thiamine (vitamin B1)) * Withdrawal from drugs (such as sedative-hypnotics and corticosteroids) **INFECTIONS** * Any sudden onset (acute) or long-term (chronic) infection * Blood poisoning (septicemia) * Brain infection (encephalitis) * Meningitis (infection of the lining of the brain and spinal cord) * Prion infections, such as mad cow disease * Late-stage syphilis Complications of cancer and cancer treatment with chemotherapy can also lead to neurocognitive disorder. Other conditions that may mimic organic brain syndrome include: * Depression * Neurosis * Psychosis

Answer 86

Is not a DSM5 diagnostic criteria. Is a major neurocognitive disorder. Substantial cognitive decline and demonstrated by concern from the individual or a clinician. Performance on objective assessment shows decline from previous (usually 2SDs from norm). Interferes with independence and functioning.

Answer 87

The mood will improve within 1-3 weeks, sleep is usually the first to improve. It is important to provide psychoeducation that may not have been provided by his psychiatrist. You may start by explaining to the client that his mood will likely improve within 1-3 weeks, and provide reassurance that sleep is usually the first to improve. You would never encourage the client to cease medication immediately. You may refer the client to the GP for review of medication if you felt after a reasonable period of time the medication was not helpful.

Answer 88

In communication, a client’s words are only a fraction of his/her efforts. The pitch and tone of his/her voice, the speed and rhythm of the spoken word, and the pauses between those words may express more than what is being communicated by words alone. 55% (general body language and facial expression), 38% (voice tone), and 7% (spoken words).

Answer 89

Confidential Client File: sensitive information about clients. May include psychological testing. Identifies client and documents the nature, delivery, progress, results, or recommendations of psychological services. Includes appointment diary entries, working notes, assessment, needs to be managed with the strictest confidence. Client Service Record: administrative component such as dates and times of services, formal correspondence. Less sensitive but also needs to remain confidential.

Answer 90

13 rules associated with regulation of health information. As they are legislative requirements, the APP must be kept.

Answer 91

Psychs are supposed to leave a professional will – a contingency plan in case we die. If they have not done so, the executor of the will is responsible for all the files and it is recommended they appoint a psych to ensure everything that needs to be done is done – speak to the clients, refer on to other psychs, return the files to the client, keep those files if the client cannot be contacted in their own office. The executor of the professional will must be a psychologist (or other medical/health professional regulated by AHPRA).

Answer 92

What is not allowed in advertising of psych services? TESTIMONIALS or to say you’re the best psych in the world, cannot lie about your memberships

Answer 93

Adequacy of psychologists records has two components: The legal purpose and service Provision. “There should be sufficient detail to permit planning for continuity in the delivery of psych services in the event that another psychologist takes over that responsibility, including event of death, disability or retirement. In addition, psychologists need to maintain records in sufficient detail to allow for review of psych service delivery.” If someone can pick up the file and continue psych services, one can assume the records stand a reasonable chance of being deemed adequate. Case notes should have observations and opinions

Answer 94

Minimum of 7 years since last client contact, unleaded legal or organizational requirements state otherwise. Where a child is younger than 18 yrs, psychs should keep records until the client turns at least 25yrs. Careful consideration should be given to not destroying records where there may be criminal or other investigation outside 7 years as certain crimes have no statute of limitations.

Answer 95

a) clarify with colleagues the need to safeguard the confidentiality of psychological assessment data b ) clarify the nature of the information to be shared c) discuss how that information will be shared

Answer 96

To explore reasons for ambivalence to help assess specific issues. Maintaining a good therapeutic relationship alliance is critical to strengthening client engagement and positive outcomes.

Answer 97

The processes of absorption, transport, distribution, metabolism, and excretion Pharmacokinetics is the study of what the body does to medicine. Specifically, it studies the * absorption, * distribution, * metabolism, * and excretion of the medicine (ADME), as well as bioavailability. These pharmacokinetic processes often referred to as ADME, determine the concentration of the medicine in the body, and the onset, duration, and intensity of a medicine’s effect.

Answer 98

a) Clorpromazine

Answer 99

Lithium is a mood stabilizer medication commonly used in the treatment of bipolar disorders. Its side effects include but are not limited to: Excessive thirst and tremor, progressive effects on cognition with risk of death, risk times include dehydration which is more problematic in the elderly who have reduced thirst when dehydrated. Due to the risks, it is important clients on this medication have their blood tested regularly. * Headache * Nausea or vomiting * Diarrhea * Dizziness or drowsiness * Changes in appetite * Hand tremors * Dry mouth * Increased thirst * Increased urination * Thinning of hair or hair loss * Acne-like rash

Answer 100

The way a psychotropic agent impacts on the body

Answer 101

A pattern of observable behaviours that is the expression of a subjectively experienced feeling state (emotion).

Answer 102

Although there is a scarcity of data on specific child mental health conditions for Aboriginal and Torres Strait Islander children and youth, there is evidence of: greater risk for emotional and behavioural difficulties; greater exposure to risk factors and stressful life events; higher rates of suicide; higher rates of hospital admissions for mental health problems; higher rates of incarceration; and higher numbers of removal of children under child protection compared with the general population. This suggests the need to consider a comprehensive approach when considering mental health disorders in Aboriginal and Torres Strait Islander children and young people. Indigenous Therapies Engaging clients in a narrative approach may help them to understand the historical burden they carry, provide the opportunity for an empathetic response by the clinician to their present predicament, promote strengths and create a new story for the future. Dowling and Vetere (2005) describe ‘narrative approaches as inviting self-disclosure in the form of story-telling thereby allowing the child to explore their own life with the clinician. Narrative approaches allow the child and therapist to reflect on what has happened over time, including over generations, from both the difficulties and strengths perspectives, in order to develop a cohesive sense of self. There is also a goodness of fit, with cultural norms using storytelling to convey important lessons in life. Courtney will be better able to assist her family if she is re-engaged with school and achieves a good education.

Answer 103

A maladaptive pattern of use leading to clinically significant impairment/distress, \>1 of the following within 12-months : Recurrent substance use -\> failure to fulfill major role obligations (work, school, home). Recurrent substance use despite physical danger (driving). Recurrent substance-related legal problems (driving, assaults…) Continued use despite persistent/recurrent social or interpersonal problems caused or exacerbated by the substance (e.g., arguments, physical fights….). Doesn’t include tolerance, withdrawal, the pattern of compulsive use, mainly harmful consequences of repeated use. A maladaptive pattern of substance use, clinically significant impairment/distress, 3 (or more) of the following, in the same 12-month period: **Tolerance**, as defined by either of the following: Markedly increased amounts to achieve intoxication or desired effect Markedly diminished effect with continued use of the same amount **Withdrawal**, as manifested by either of the following: Characteristic withdrawal syndrome for the substance. Same (or closely related) substance taken to relieve/avoid withdrawal symptoms.

Answer 104

Need to know the *severity of symptoms* for SUD (DSM5) * I.e., depending on how many symptoms one has, they will be diagnosed with a different severity of substance use disorder * Looking at alcohol use disorder * There is a number of criteria you need to be familiar with when looking at any SUD, as well as the severity of substance use: 👉 2-3 mild 👉 4-5 moderate 👉 6+ severe

Answer 105

2:6 to 3:11 and 4:0 to 7:11

Answer 106

If side effects appear to be getting out of hand, talk with the client and perhaps encouraging him or her to ask the prescribing physician to reassess the medication or dosage. Sometimes, too many side effects mean the dosage of the antidepressant is too high. Other side effects may lead a physician to prescribe an additional medication to alleviate the unwanted effect. The psychologists role in medication monitoring is to check in weekly with the client. It is important for you to ask your clients if they are noticing anything unusual physically or mentally. You need to be knowledgeable about what may be expected during the course of treatment. For example, some individuals report increased anxiety when they begin taking an antidepressant, but the anxiety subsides after a few weeks of treatment. It is important for you to know if certain side effects are transient.

Answer 107

**EVIDENCE-BASED INTERVENTIONS:** * We need to know a bit about each one like * How they operate * How they are used * So, the board exam curriculum, wants you to have _knowledge of the application_ of specific focus therapy techniques for the common psychological problems listed in the assessment section You specifically need knowledge of: * **psychoeducation,** * **interpersonal and psychodynamic approaches,** * **solution focused techniques** * **motivational interviewing** * **and narrative therapy** **Thus:** * Psychoeducation * Cognitive and behavioural * Psychodynamic and Interpersonal * Family systems * Humanistic * Narrative * Solution-focused * Motivational interviewing * And skills training (a wide range of skills training) _Under Cognitive Behavioural Approaches_ * **Exposure** * In vivo * and Imaginal exposure (IE), * **behavioural activation,** * **cognitive interventions,** * **acceptance strategies,** * **self-management,** * **relapse prevention** * **progressive muscle relaxation breathing techniques** **In the skills training they would like you to have**: * skills training, ability in problem-solving, * anger management, * social skills, * assertiveness, * stress management, * Mindfulness [they (the board) consider mindfulness as a skill not a standalone intervention] and parenting **_Note_:** if you know the: * **frameworks**, * **main components** of it * and to relate that to a **diagnosis** * and a **case formulation** * then that is **_the key_** _to answering the intervention questions on the exam._

Answer 108

Involves the presentation of various techniques that can be used to control symptoms and manage various psychological conditions relevant to particular client topics or illnesses. Psychoeducation o The practice of educating those with mental health conditions and their families to help empower and support them with their condition is referred to as psychoeducation. - Psychoeducation is a strong tool against the stigmatization of mental health conditions and those who face those challenges on a day-to-day basis. Psychoeducation is defined with four broad goals in mind: * transfer of information * medication and treatment support * training and support in self-help * an available a safe place to vent * People underrate it and don't see it as intervention, * but it's actually an important part of the intervention, * and certainly, is the first phase in any intervention that I deliver * * So, psychoeducation basically refers to * the process of providing education and information to those seeking or receiving mental health services * So, the information * can be on the intervention itself or on the presenting issues or on the diagnosis * So basically, giving them * some contexts around, * basically, your case formulation, * but also, to - if they have a diagnosis what is that and what does that mean… * Also, a particular intervention you chose * what is the theory and research behind that what does it look like? * Psychoeducation basically: * has a goal to help people better understand their mental condition, * generally, help them understand the challenges they're facing * as well as gaining knowledge of their own abilities, * their internal their external resources, * their own areas of strength and difficulties, * give them knowledge and understanding of the intervention that you're proposing * and what that looks like to reduce the fear associated with such, * and basically, to give them a greater capacity to work towards mental and emotional wellbeing * So, _psychoeducation is the extremely important initial phase_

Answer 109

IPT uses an interpersonal variant of psychodynamic therapy, however, the focus is more on the client’s immediate psychosocial environment rather than their internal experiences and previous environments. Is traditionally comprised of three stages: - Therapist evaluates the client and their environment - Uses strategies to correct interpersonal problems experienced by the client - Collaboratively plans for the end of therapy and forward client growth IPT problem areas: * Grief and loss * Interpersonal disputes * Role transitions * Interpersonal sensitivities - Biggest evidence base with depression (newer research shows it can also be helpful for substance abuse, eating disorders, etc.) Techniques used to address interpersonal conflict within IPT framework: Problem-solving and communication analysis. IPT is very structured, and intervention is decided early on and stayed with! If extending in IPT, it is because goals have not been met and there is a continuation of an original symptoms/problem, etc. IPT is an attachment-based approach. Remember, IPT isn’t very bothered about transference. It is also a very structured approach, so at the very start, you determine what the treatment will be and what the focus of the sessions will be. Because it is so structured, even when you extend, the focus stays on current issues. It’s not a very open-ended/flexible approach. **Key Points:** * **Attachment focused therapy**, * **Interpersonal relationships**, * it's about that person's perceptions and expectations around those r**elationships**, * and it focuses on **interpersonal disputes**, **role transitions**, **grief**, and **interpersonal deficits** * intended to be completed within **12 to 16 weeks** * **its** **interpersonal psychotherapy** has evidence-based behind it for the effective treatment of: * eating disorders, * postpartum depression, * major depressive disorder, * cyclothymia (is a mental disorder that involves numerous periods of symptoms of depression and periods of symptoms of hypomania. These symptoms, however, are not sufficient to be a major depressive episode or a hypomanic episode), * mood-based disorders * and even bipolar disorder

Answer 110

Recognizes conscious and unconscious drives as important determinants of psychological state, emphasizes client-practitioner relationship as a key therapeutic factor, and works to interpret patterns in clients expression of emotions and thoughts. **Key Points:** * Psychodynamic and/or interpersonal applications * not structured and not time-limited * Psychodynamic and interpersonal interventions include those focusing upon subconscious motivation and improving healthy interpersonal connection with others, * Focuses on the **unconscious processes** as they manifested in a person's present behaviour * Fraud’s psychoanalysis kind of like is a very early format we **review certain life factors** with the person and where you're viewing * their **emotions**, * their **thoughts**, * their **early life experiences**, * and their **beliefs**. * Psychodynamic and Interpersonal Intervention Psychodynamic and interpersonal interventions include those focusing upon subconscious motivation and improving the healthy interpersonal connection. with others.

Answer 111

Look out for words: * Preferred future * Things that have worked in the past and can work in the future * Preferred outcomes * Miracle question * Again - Solution-focused interventions is: * - Focus on goals, future, what can be done here and now * - SMART goal setting * - Miracle question in the first session * - Look for exceptions to the problems The goal is for clients to establish and visualize the goals that they aim to achieve, and with a continuous focus on those future goals, the client and therapist work together to evaluate the client's strengths and weaknesses and establish more efficacious problem-solving strategies.

Answer 112

**Humanistic Model of Treatment are:** * Gestalt Therapy * Client-Centered Therapy * Existential Therapy

Answer 113

**Humanistic Model of Treatment are: Gestalt Therapy** Gestalt Therapy is another type of counseling that is based upon the existential framework. Key elements include: – 1. A Phenomenological Basis—You are seeking to focus on the client’s perception of reality – 2. Experiential—The client is being asked to come to understand what and how they are thinking, feeling, and doing as they interact with the therapist and the other people in the world - 3. Existential—The person is to take responsibility for their destiny and identity • The client is also encouraged to work in the “here and now,” not in the “there and then” – 4. Awareness—A key element in this theory is helping the client come to an awareness of what he or she is doing and experiencing • This involves dropping those behaviors and barriers that would stop someone from experiencing one’s self A Gestalt View of Human Nature * people can deal with their problems, especially if they become fully aware * Change happens in a person’s life when he or she can reintegrate a disowned part of the self back into the mix of identity * more a person tries to be who they are not, the more they stay the same Existential & Phenomenological – it is grounded in the client’s “here and now” • Initial goal is for clients to gain awareness of what they are experiencing & doing now – Promotes direct experiencing rather than the abstractness of talking about situations – Rather than talk about a childhood trauma the client is encouraged to become the hurt child Therapeutic Process • Client's Experience in Therapy – They are active participants who make their own interpretations & meaning – Discovery: a new view of an old situation – Accommodation: clients recognize that they have a choice – Assimilation: clients learning how to influence their environment • Relationship Between Therapist and Client – Therapists need to allow themselves to be affected by their clients – Therapists share experiences in the here and now – Therapists do not manipulate clients – Therapists give feedback – The I/thou relationship, a dialog relationship **Therapeutic Techniques** * The Experiment in Gestalt Therapy * Preparing Clients for Experiments * Role of Confrontation * Specific Techniques: * – Internal dialogue exercise * – Making the rounds * – “I take responsibility for” * – Playing the projection * – Rehearsal exercise * – Reversal technique * – Exaggeration exercise * – Staying with feeling * – Guided fantasy * – Empty Chair * – Gestalt Approach to Dream Work **These Specific Techniques** • Internal dialogue exercise – the "top dog" and the "under dog" • Making the rounds – go to each person in the group and talk to them • “I take responsibility for” – can be added to one of the client's statements • Rehearsal exercise – to rehearse with the therapist out loud. • Reversal technique – asking the client to do the opposite of their behaviors • Staying with feeling – so that you can work through the fears • Empty-Chair Technique: – When client speaks to an empty chair as if it were another person or another part of the client – Used to help the client get in touch with other views or other aspects of self • Exaggeration Exercise: – Counsellor exaggerates mannerism of client or asks client to exaggerate mannerism in order to make client aware of true feelings • Guided Fantasy: – Client is encouraged to visualize here & now experiences • Playing the Projection: – Client is asked to play the role of the person who they are not connecting with Gestalt Approach to Dream Work • Does not interpret & analyse dreams • Instead intent is to bring back to life & relive them as though they were happening now • Dream is acted out in the present & dreamer becomes a part of his or her dream • Suggested format: – Making a list of all the details of dream – Remembering each person, event, & mood in it – Then becoming each of these parts by transforming oneself, acting as fully as possible & inventing dialogue

Answer 114

**Humanistic Model of Treatment -** Client-Centered Therapy Client-centered therapy operates according to three basic principles that reflect the attitude of the therapist to the client: 1. The therapist is **congruent** with the client. 2. The therapist provides the client with **unconditional positive regard**. 3. The therapist shows an **empathetic** understanding to the client Ten Tips for Client-Centred Counsellors 1. Set clear boundaries For example, when and how long you want the session to last. You may also want to rule out certain topics of conversation. 2. The client knows best The client is the expert on his/her own difficulties. It’s better to let the client explain what is wrong. Don’t fall into the trap of telling them what their problem is or how they should solve it. 3. Act as a sounding board One useful technique is to listen carefully to what the client is saying and then try to explain to him/her what you think he/she is telling you in your own words. This can not only help you clarify the client’s point of view, it can also help the client understand his/her feelings better and begin to look for a constructive way forward. 4. Don’t be judgmental Some clients may feel that their personal problems mean that they fall short of the ‘ideal’. They may need to feel reassured that they will be accepted for the person that they are and not face rejection or disapproval. 5. Don’t make decisions for them Remember advice is a dangerous gift. Also, some clients will not want to take responsibility for making their own decisions. They may need to be reminded that nobody else can or should be allowed to choose for them. Of course you can still help them explore the consequences of the options open to them. 6. Concentrate on what they are really saying Sometimes this will not be clear at the outset. Often a client will not tell you what is really bothering him/her until he/she feels sure of you. Listen carefully – the problem you are initially presented with may not be the real problem at all. 7. Be genuine If you simply present yourself in your official role the client is unlikely to want to reveal personal details about themselves. This may mean disclosing things about yourself – not necessarily facts, but feelings as well. Don’t be afraid to do this – bearing in mind that you are under no obligation to disclose anything you do not want to. 8. Accept negative emotions Some clients may have negative feelings about themselves, their family or even you. Try to work through their aggression without taking offense, but do not put up with personal abuse. 9. How you speak can be more important than what you say It is possible to convey a great deal through your tone of voice. Often it will be found helpful to slow down the pace of the conversation. Short pauses where the client (and you) have time to reflect on the direction of the session can also be useful. 10. I may not be the best person to help Knowing yourself and your own limitations can be just as important as understanding the client’s point of view. No person centred counsellor succeeds all the time. Sometimes you will be able to help but you will never know. Remember the purpose of a counseling session is not to make you feel good about yourself.

Answer 115

**Humanistic Model of Treatment -** Existential Therapy Existential therapy focuses on free will, self-determination, and the search for meaning—often centering on you rather than on the symptom. The approach emphasizes your capacity to make rational choices and to develop to your maximum potential. The existential approach stresses that: * All people have the capacity for self-awareness. * Each person has a unique identity that can be known only through relationships with others. * People must continually re-create themselves because life’s meaning constantly changes. * Anxiety is part of the human condition. When It's Used What else is existential therapy recommended for? Psychological problems—like **substance abuse** —result from an inhibited ability to make authentic, meaningful, and self-directed choices about how to live, according to the existential approach. Interventions often aim to increase self-awareness and self-understanding. Existential psychotherapists try to comprehend and alleviate a variety of symptoms, including excessive anxiety, apathy, alienation, nihilism, avoidance, shame, addiction, despair, depression, guilt, anger, rage, resentment, embitterment, purposelessness, psychosis, and violence. They also focus on life-enhancing experiences like relationships, love, caring, commitment, courage, creativity, power, will, presence, spirituality, individuation, self-actualization, authenticity, acceptance, transcendence, and awe

Answer 116

These are based on the principle that our perceptions of reality and self-concept are organized through personal narratives, and working with these narratives in a therapy context is useful for exploring and healing the client's psychological state. A primary goal is to replace dominant, maladaptive narratives with preferred alternatives. Narrative therapy has excellent multicultural applications, particularly for Indigenous Australians. Aligned with the practice of “yarning” - a significant method of sharing and handing down information. **Key Points:** * Narrative Therapy is a **standalone therapy**, it does have an evidence base behind it, as well. * but again, not for high-level _psychiatric disorders_, * you _would not use it as a standalone, but you would use it to increase the quality of life_. * So, Narrative Therapy is one that's _certainly is beneficial_ to us _as an adjunct_ (supplementary rather than an essential) _therapy as well, in combination with CBT or IPT_, etc. * and **essentially** the quality of life is increased when somebody has a far more positive sense of self, their identity their values, and their strengths, * and when they view their past, generally when they come to you, they view it in a very negative way, * because of all these things that have happened to them or difficulties that they face, they _lose sight of their strengths_ that they had throughout that time. * *Narrative Therapy a lot of people kind of like get this one slightly wrong.* * They actually think it's about the person writing a narrative of what's happening for them, but it's actually about seeking to identify the skills that they do have the values that they do have, it’s a process of showing them that they can actually confront whatever problems they're facing and then it's about **co-authoring a new narrative**, a more positive narrative with those skills. * Narrative interventions * - Clients describe their problems in a story fashion * - Problem is externalized * - Re-authoring can redirect a client's story * - Identity is shaped by new meaning or stories * - Story meanings can be created by the client however they wish

Answer 117

You specifically need knowledge of: * **psychoeducation,** * **interpersonal and psychodynamic approaches,** * **solution focused techniques** * **motivational interviewing** * **and narrative therapy** _Under Cognitive Behavioural Approaches_ * **Exposure** * In vivo * and Imaginal exposure (IE), * **behavioural activation,** * **cognitive interventions,** * **acceptance strategies,** * **self-management,** * **relapse prevention** * **progressive muscle relaxation breathing techniques** In the skills training they would like you to have: * skills training, ability in problem-solving, * anger management, * social skills, * assertiveness, * stress management, * Mindfulness [they (the board) consider mindfulness as a skill not a stand-alone intervention] and parenting Theories and models of treatment Psychopharmacology Specific Therapeutic techniques **Dialectical Behaviour Therapy** * Marsha Linehan * Addresses 'both sides of the fence' * Equal balance of boundaries/rules/consequences and empathy/understanding/support * Focus on emotion regulation and managing emotional 'waves' **Humanistic Therapy** * Emphasizes people’s capacity to make rational choices and develop to their maximum potential * Involves themes of concern and respect for others **Person Cantered Therapy** * Carl Rogers * Form of talk-psychotherapy * Provide clients with the opportunity to develop a sense of self whereby they realise their attitudes, feelings and behaviours are being affected * Focus on problem over person, self-actualisation

Answer 118

Cognitive behaviour therapy (CBT) is a type of psychotherapy. * It may help you to change unhelpful or unhealthy ways of thinking, feeling and behaving. * CBT uses practical self-help strategies. These are designed to immediately improve your quality of life. * CBT can be as effective as medication to treat depression and anxiety. CBT combines cognitive therapy and behaviour therapy Treatment with CBT The details of treatment will vary according to the person’s problem. However, CBT typically includes the following: * **assessment** – this may include filling out questionnaires to help you describe your particular problem and pinpoint distressing symptoms. You will be asked to complete forms from time to time so that you and your therapist can plot your progress and identify problems or symptoms that need extra attention * **personal education** – your therapist provides written materials (such as brochures or books) to help you learn more about your particular problem. The saying ‘knowledge is power’ is a cornerstone of CBT. A good understanding of your particular psychological problem will help you to dismiss unfounded fears, which will help to ease your anxiety and other negative feelings * **goal setting** – your therapist helps you to draw up a list of goals you wish to achieve from therapy (for example, you may want to overcome your shyness in social settings). You and your therapist work out practical strategies to help fulfil these goals * **practise of strategies** – you practise your new strategies with the therapist. For example, you may role-play difficult social situations or realistic self-talk (how you talk to yourself in your head) to replace unhealthy or negative self-talk * **homework** – you will be expected to actively participate in your own therapy. You are encouraged to use the practical strategies you have practised during the course of your daily life and report the results to the therapist. For example, the therapist may ask you to keep a diary.

Answer 119

**Alcohol** Obviously, with **ALCOHOL** there are slightly different symptoms to the other substances: * So generally, with ALCOHOL WITHDRAWAL, it develops around 4 to 12 hours after reduction of intake * So, withdrawal is unpleasant and intense, so these people have underlying USE DISORDERs * The substances people can actually die from going Cold Turkey from Alcohol withdrawal, * so, when there has been a prolonged heavy use over many years to suddenly withdrawal people can actually die from that * So, the alcohol withdrawal is, people often talk about the shakes and the DT's and those sorts of things, it's quite a real issue in the withdrawal process because that’s obviously what's driving them to re-administer the substance because they want to stop those shakes * so that's when you know that you’re in a withdrawal state * The intoxication state is the slurred speech, the lack of motor control, the inability to cognitively function at a normal process, and a normal -rect (guide; rule; right; straight). Note: * The use criterion, quite a common feature of alcohol use is a denial of there being a problem and this is quite prevalent so there is absolutely no insight what so ever and the amounts they consume are well above what is recommended for the consumption of standard drinks to remain under 0.05 driving limit that we have here in Australia, so use is all about the prolonged use, the denial, the inability to cut down * Withdrawal is all about those physiological symptoms and that craving or that urge to re-administer * And intoxication is obviously their impairment in being able to communicate and being able to function So, when to think about it in those senses it's actually not that hard to distinguish each of them

Answer 120

Hallucinogens In our **HALLUCINOGENS** related disorders, there's quite a lot in this category We phencyclidines (PCP), we have other hallucinogens, we have unspecified etc. **_Phencyclidines (PCP)_** is a synthetic compound * it comes under all different names on the market essentially i.e., LSD, Speed etc. Angel Dust, Special K, Ketamine (all sorts of things come under this category) * For the **use disorde**r there's quite a long-term affect with * cognition, * memory, * Speech * and these can last for quite a number of months * Use disorder again meets all those, seeking it out, excessive time in seeking it out, * Intoxication obviously is magical in they're quite magical in their thinking, they're reporting things like, see, hear, feel, hallucinations across all of the sensory modalities * Withdrawal is that desperate seeking to re-administer in order to reduce the withdrawal symptoms, they get what's called shakes and the horrors that sweating that inability of motor function and it's quite obvious The **_INHALANT_** related disorders * These are Hydrocarbon based inhalants * they are toxic gases from: * fuel, * glue, * paint, * any sort of volatile compounds * So basically, it's the inhalation of nitroso cite * those sorts of disorder arising from that nitroso cite * they are things like * laughing gas, * balloons are some of the things he used * they should be classed as unknown or other substance use disorder * So, anything that is under nitroso cite are the substance use disorder * _but the hydrocarbon inhalant so standard drug screens don't detect inhalants_, * so, it makes it really difficult sometimes to be able to get the common source * but essentially what we are looking for in inhalant a diagnostic marker, * for breath, * urine * and the saliva and there are _some diagnostic markers that are shown to denote the use of inhalant but there is no clear test_ * So inhalant use gives us a lot of similar features, you know our use disorder criteria that ongoing seeking it out etc. * the intoxication phase of that, they seem to be quite phased out, airy fairy, non-commitment, non-compliant * but then can't follow through with the actions associated with what they are agreeing to, complying to so cognitive functioning just completely slows down, * you actually see a lot less withdrawal symptoms with Inhalant use, * there is more around headaches and dizziness, and inability to function * but on a different level they just can't gather thoughts together to make decision to sequence events essentially

Answer 121

**CANNABIS** related disorders, CANNABIS USE DISORDER, CANNABIS INTOXICATION, CANNABIS WITHDRAWAL, OTHER and UNSPECIFIED * So, cannabis comes with a lot of different names, weed, pot, herd, hash, grass, rifa, dope, Yandi (for our indigenous clients) is a popular one * Mostly smoked, some people do eat it, but mostly it is inhaled in the form of smoke * So basically, an abruptly station will result in _Withdrawal_, so people that use it on daily basis and then suddenly stop, will get increased symptoms, * and those symptoms are * anxiety, * anger, * irritation, * aggression, * restlessness, * sleep disturbances, * decreased appetite, * weight loss * And they are quite significant as well and that prolonged intense use and then that sudden sensation will create those symptoms quite quickly * So, the withdrawal can be a difficult stage, * So, _intoxication_ of cannabis use that's easy to detect, * people are: * overly relaxed, * overly calm, * appetite tends to increase, * cognitive functioning starts to deteriorate * but also, there tends to be some sort of * magical thinking that goes along with it as well, so it's like a bit of grandiosity * So, intoxication and withdrawal they are easy to identify

Answer 122

**_OPIOIDs_** Related Disorders * Use, intoxication and withdrawal, * we are talking about heroin, morphine, oxycodone, fentanyl, methadone, suboxone all of those drugs * Suboxone and methadone are used to withdraw people from opioids, * obviously, the dosage decrease, because essentially what those drugs do is control the withdrawal side effects but don't give them the effect of actually taking heroin or morphine it doesn't give them the high that they are looking for. * So intoxication, morphine and heroin and things like that are very similar to the other disorders that we've been discussing but generally this is one of the ones where they develop a high tolerance very very quickly, needing more and more and more, in order to be able to get the same amount of benefit they did before. Note: ***_Ice_*** *falls under the hallucinogens that floating around the market at the market, is one of the ones to induce a mental disorder, we've seen quite severe psychotic mental disorder as a result of that. A man in Victoria killed his father, his father was one of the AFL football coaches, while he was under the influence of ice.* * Opioids - for pain medications and so forth, that's where all the opioids come from, so abrupt withdrawal from opioids will create a lot of * aggression, * anger * and frustration * so, the tolerance to the drug increases as that increases, * _tolerance for not having the drug rapidly decreases and this is the key to opioids_

Answer 123

**_SEDATIVE and HYPNOTIC_** based drugs * These are your benzodiazepines, barbiturates, sleep medications, and some of the anti-psychotic drugs will fall into this category as well. * Intoxication is that really * distinct slowing down, * not wanting to do anything, * not caring about anything, * being overly relaxed, * overly aggregable, * overly present until they start to withdraw * When they start to withdraw of course you get the increase in anxiety and agitation and low tolerance very frustrated at the smallest thing * Stimulant related disorder these are more like your amphetamines like Cocaine * Cocaine usually, orally or nasally ingested * Withdrawal symptoms are different with amphetamines because these people become quite hyposomnia, unable to sleep at all, they have incisively increased appetite, they are kind of in a manic state on the withdrawal side of things, so * Intoxication as their tolerance builds, they actually function really well and it's a little bit harder to detect the intoxication, but withdrawal is extremely obvious

Answer 124

* Stimulant related * Caffeine – does not have USE criteria * Inhalants – does not have a WITHDRAWAL * Tobacco – does not have an INTOXOCATION * Other unknown substance induced disorders * Other unspecified disorders

Answer 125

Stimulant Related – Caffeine **CAFFEINE** related disorder: * We don't have a use criterion, but we have an intoxication and withdrawal and other and unspecified * We talk about anything that has caffeine, tea, coffee, soft drinks, energy drinks (these are a huge one), weight loss aids tend to have caffeine in them as well, some vitamins do and so do some food products like chocolate and so forth * So, when we talk about Caffeine intoxication or withdrawal, not just coffee as most people suspect * Approximately 85% of the population consumes some form of caffeine regularly, so that's quite high * Intoxication - when you are intoxicated, there is a * restlessness, * nervousness, * excitement insomnia, * flushed face, * gastrointestinal complaints, * so that's what we are looking for when we talking about caffeine intoxication and it does occur and people just don't realize and in order to make themselves feel better, * generally, they drink another cup of coffee or they eat that go to food or the chocolate or they have another one of those energy drinks or diet pills or something along those lines which clearly doesn't assist the situation, * so basically, you only need 1 gram in your blood to form muscle twitching, rambling flow of thoughts and speech, cardiac arrythmia and all those things to start occurring * So, withdrawal can actually last 2 to 9 days * People report generally headaches, for up to 21 days, cognitive and motor performance issues, it can affect work and exercise and care for children * Those are quite easy to distinguish however, you need to be aware of the various sources of caffeine, * so when you ask you client "how many cups of coffee do you drink a day" that's not going to give you the whole picture, you need to ask "are they drinking any energy drinks, are they taking any supplement pills, do they also drink tea etc." to actually get a good understanding of the caffeine intake, * so essentially caffeine intake can be a little bit insidious and people can be less aware of how much they are actually taking in

Answer 126

The **INHALANT** related disorders * These are Hydrocarbon based inhalants * they are toxic gases from: * fuel, * glue, * paint, * any sort of volatile compounds * So basically, it's the inhalation of nitroso cite * those sorts of disorder arising from that nitroso cite * they are things like * laughing gas, * balloons are some of the things he used * they should be classed as unknown or other substance use disorder * So, anything that is under nitroso cite are the substance use disorder * _but the hydrocarbon inhalant so standard drug screens don't detect inhalants_, * so, it makes it really difficult sometimes to be able to get the common source * but essentially what we are looking for in inhalant a diagnostic marker, * for breath, * urine * and the saliva and there are _some diagnostic markers that are shown to denote the use of inhalant but there is no clear test_ * So inhalant use gives us a lot of similar features, you know our use disorder criteria that ongoing seeking it out etc. * the intoxication phase of that, they seem to be quite phased out, airy fairy, non-commitment, non-compliant * but then can't follow through with the actions associated with what they are agreeing to, complying to so cognitive functioning just completely slows down, * you actually see a lot less withdrawal symptoms with Inhalant use, * there is more around headaches and dizziness, and inability to function * but on a different level they just can't gather thoughts together to make decision to sequence events essentially

Answer 127

**Tobacco-related** Disorders * Obviously, _tobacco as is alcohol are both legal substances_, * However, tolerance of tobacco very quickly increases and some of the intoxication signs and symptoms, loss of smell and loss of taste most when you know that it's a very serious based disorder is when people generally smoke while they're walking smoke or they're talking smoke or they're eating smoke while they are doing activity what so ever * When the disappearance, most people if they are smokers, if they have a couple of _cigarettes_ in a row will actually feel nauseous and sick, people who have quite a high tolerance will not feel nauseous or sick just by smoking after the other after the other. * The _intoxication_ is actually quite obvious, because they can't put a cigarette down, so it's kind of like weird that we have these categories that sort of "well if a person smokes 1 cigarette an hour or 1 in half an hour that's okay" we know it's not because of the health implications as such, however it's still legal, when it becomes a severe problem is when they can't do without a cigarette in their hand and withdrawal creates a great deal of initiation and intolerance So, they are our different categories of substance related disorders, but you really need to distinguish use withdrawal and intoxication Note: * *The vignettes generally on the exam are quite obvious and it's rare that no one has every reported to me that they have to identify outside of alcohol, cannabis are the two common ones that everyone comes and tells about on the exam.* * *The other types of questions are about the person most likely has a substance use disorder or is currently in substance withdrawal or in substance intoxication* * *The nuance between the difference don't seem to be as important on the exam* * *Essentially, your client even in prison, they quite happily tell you what substance they use and how frequently they use, because they know that they are going to go into withdrawals and they know they need to get onto one of the programs pretty quickly, and if client is coming to you willingly for assistance it's very easy for them to tell you what the substance is, that they will underreport their use of that substance*

Answer 128

Helps modify a pathological fear structure by providing corrective information that is incompatible with the fear. Thus, the clients are encouraged to confront feared and avoided situations or objects. The confronting of feared objects can be both in-vivo (actual/real-life) or imaginal. Has four main steps: - Preparation - Creation of an exposure hierarchy - Initial exposure - Repeated exposure Fears are assessed using the Subjective Units of Distress scale (SUDS) Exposure therapy * Imaginal exposure (imagining) * In vivo Exposure (real-life exposure) * Virtual reality exposure (both imaginal and real exposure) Using techniques: Systematic desensitization * SUDS 1-100 includes relaxation etc Graded Exposure * Not including relaxation techniques Flooding * In vivo and imaginal * Flooding for a prolonged period Prolonged Exposure * Same as flooding but includes psycho-education and cognitive processing Exposure and Response Prevention (ERP) * Works to weaken obsessions and compulsion link between Interoceptive Exposure - Physical sensation – habituation (over time) i.e., imaginal - e.g., panic disorder

Answer 129

Marital and couple interventions designed to improve the quality of relationships and satisfaction Family communication exercises Education about dysfunctional family relationships and how to create functional family relationships **Family Systems Therapy:** Family systems therapy draws on systems thinking in its view of the family as an emotional unit. When systems thinking—which evaluates the parts of a system in relation to the whole—is applied to families, it suggests behaviour is both often informed by and inseparable from the functioning of one’s family of origin. Families experiencing conflict within the unit and seeking professional assistance to address it may find family systems therapy a helpful approach. **Three types – Structural, Strategic and Intergenerational** Structural – looks at the structure within the family i.e., parental or sibling structure Strategic – looks at the function and how change can occur Uses: * Reframing * Redefining * Paradoxical intervention Intergenerational behaviour pattern – patterns within multigenerations’

Answer 130

Family therapy remember: * Patterns of behaviour * Patterns of relationships * Structure * Function within the system \*\* Discard any option that has to do with individual member

Answer 131

Bowen’s 8 explanation 1. Emotional triangle – 2 sides in conflict, 1 side stable i.e., parents and child example 2. Differentiation of self – the amount the person is able to separate thoughts, feelings, self and other family members 3. Family projection process – family projecting anxiety on to the child 4. Multigenerational transmission – differentiation 5. Emotional cut-off – cutting the relationship with other family members 6. Sibling position – 7. Societal emotion process 8. Nuclear family emotion – minor family emotion system

Answer 132

Client confidentiality must be protected. The psychologist should proactively address all issues if there are foreseeable risks of breaches of confidentiality and seek appropriate solutions. Discussion of this matter should happen before commencing psychological consulting by email and can include both data security and the privacy provisions with regards to who may have access to the emails.

Answer 133

* Empathetic responding * Reflection & summarization * Questioning

Answer 134

- The development of an empathetic relationship - Helping the client explore their story & strengths - Setting goals mutually - Re-story including working and exploring alternatives & conflicts - action involving applying changes to one's life, generalization of learning, and eventually, termination

Answer 135

Subtle client observation (i.e. client verbal and non-verbal presentations & possible conflicts) Process & outcome measures Overtly assessing behaviour, thought, and emotional changes

Answer 136

* *Ruptures:** A misunderstanding or personal conflict between client and therapist * *Resistance:** Resistance or ambivalence to therapy & intervention. * *Re-enactments:** Same time of problem client is having in life is being played out within the therapy room

Answer 137

Conceptualising and discerning what clients core difficulties are. How they developed. How the difficulties are currently being displayed and their consequences.

Answer 138

Assists therapist by providing an over-arching structure to their thoughts about the client and guides their interaction and focus with the client.

Answer 139

— Therapist creates a supportive atmosphere reducing anxiety through their mannerism & suggestion - Clients beliefs and assumptions are drawn out through Socratic dialogue, thoughtful questioning designed to lead a client to more logical conclusions - Clients are encouraged to test their beliefs and assumptions - Finally, clients are assisted in modifying their thoughts through guided discovery involving more adaptive thoughts, which can, in turn, be tested. Guided discovery involves helping clients uncover important information which might be outside of their awareness.

Answer 140

* Activating event * Beliefs * Consequences * Disputing the thoughts * Effect of the changed thinking * Feelings associated with changed feeling

Answer 141

- Labelling emotions, which may regulate amygdala activation - Distraction (external or internal) of attention from the negative aspects of a situation to more neutral aspects - Reappraisal of the meaning of an emotion eliciting situation

Answer 142

Also known as functional analysis, chain analysis is a technique designed to help a person understand the function of a particular behavior. During a chain analysis of particular problem behavior (for example, deliberate self-harm), a person tries to uncover all the factors that led up to that behavior. A full chain analysis includes * vulnerability factors * activating events * thoughts * feelings * behaviours * responses in a timeline fashion related to a specific event

Answer 143

A collection of applied techniques designed to move clients towards greater levels of readiness to change. Generally applies to the treatment of alcohol or other substance dependence difficulties. Involves change stages of: - pre-contemplation - contemplation - determination - action - maintenance (and movement to abstinence or relapse) Techniques include: - giving advice - removing barriers - providing choice - decreasing desirability - providing feedback Involves three fundamental components: collaboration, evocation, and autonomy.

Answer 144

Skills training is when clients need support to gain skills that are absent or underdeveloped. These may include problem-solving, stress management, anger management, emotional self-regulation, parenting ability, speaking and listening skills, and basic self-care.

Answer 145

* Defining the problem * Setting goals * Brainstorming Solutions * Evaluating possible solutions * Selecting a solution * Identifying the steps to attempt the chosen solution * Cognitive rehearsal of the steps for the chosen solution * Actually implementing the solution * Evaluating the outcome

Answer 146

Need to know medications: * Methylphenidate (Ritalin) * SSRI’s – for depression (very linear with this) - Lovan - Zoloft - Lexapro * Benzodiazepines (Xanax, Valium) anxiety, and panic attacks – people need to be under medical supervision when taking these. *Extremely dangerous to cease taking Benzo’s suddenly.* If someone reports they have stopped taking all of the sudden, need to report straight to GP. * No meds for PD’s * Schizophrenia/psychosis – olanzapine, clozapine, * Bipolar – mood stabilisers, lithium * SNRI – Serotonin and nonrepinephrine reuptake inhibitory * Seroquel (atypical antipsychotic – used to augment action of antidepressant in small doses, also used for sleep)

Answer 147

The means by which a psychotropic agent has an impact (on receptors, enzymes, ion channels, and chemical transporter systems), either by activation or inhibition - is referred to as pharmacodynamics.

Answer 148

The process by which psychotropic agent is passed through the body. Can be influenced by age, weight, gender, physiological function, nutrition, etc.

Answer 149

There is no single test to determine if a person is ‘competent to provide informed consent. Generally, there is an assumption that people aged 18 and over have the capacity to provide informed consent. In cases where this is questionable, a psychologist must make a judgment based on an assessment of the client. A formal, structured assessment of capacity is recommended, which may require referral to a psychologist experienced in this type of assessment. In order for a person to provide informed consent he or she must: Understand the information that is provided, including the benefits and risks of proceeding or not with the service. Understand the limits to confidentiality. Be able to retain and consider the information and make a decision whether to consent or refuse. Be able to communicate his or her consent.

Answer 150

Drugs that affect mood, perception, or behaviour, impacting the central nervous system. Antidepressants, antipsychotics, and mood stabilizers are all psychotropics medications.

Answer 151

Acetylcholine: Thought to be involved with memory, learning, and attention. Epinephrine: Secreted by endocrine glands above the kidneys, adrenal glands. Regulates our flight-fight-freeze response. Often mentioned when anxiety is discussed. Norepinephrine: Related to wakefulness and alertness. Dopamine: Related to behavioural regulation, movement, learning, mood, and attention and can be both excitatory and inhibitory. Discussed in relation to schizophrenia. Receptors are activated by amphetamines and cocaine. Serotonin: Related to inhibition of activity and behaviour. Discussed in relation to mood regulation, appetite, and sleep. GABA: Is inhibitory in action and relates to stability by decreasing neural transmission and thus preventing overexcitation. Barbituates and benzodiazepines increase GABA.

Answer 152

The APS ethical guidelines on record keeping state in Standard 10: Psychologists are aware of relevant Federal, State, and Territory laws and regulations governing record retention. Such laws and regulations supersede the requirements of these Guidelines. In the absence of such laws and regulations, records or a summary are maintained for seven years before disposal. If the client is a minor, the record period is extended until seven years after the age of majority. Keeping records beyond the minimum requirements is a matter of professional judgment for psychologists. In making such a judgment, psychologists take into account the nature of the psychological services, the source of the information recorded, the intended use of the record, and his or her professional obligations. All records, active and inactive, are maintained safely and securely, with properly limited access, and from which timely retrieval is possible.

Answer 153

This is a substantive record of the psychological service, which may include sensitive client information. Access to such information should be restricted to professional and clinical staff directly involved in the care of the client. The exact nature of what information to include will vary depending on the organisation and type of service provided. The following information would typically be stored in this part of the file, and not in the client service record/summary section: • detailed client history, • detailed descriptions of assessments and interventions provided (may include test responses and scores [test pro formas] test profiles and interpretations • detailed Mental Status Examination • risk and protective factors • diagnoses and case formulation, working hypotheses, clinical impressions • verbatim comments by the client and others, such as family members, delineated by quotation marks • documents provided by other parties such as other treating professionals • reports and letters • consent forms.

Answer 154

The base-level information stored here is concise but includes sufficient detail to enable other members of the multi-disciplinary team who have a need to know such information about a client in order to provide their services to the client. This record may take the form of a basic registration or intake page or screen. Typically it may include: • client demographics including, if appropriate, a next of kin contact for emergencies • billing information • date and time the psychological service took place • who was involved • purpose and type of psychological service provided • how the psychological service was provided, such as face-to-face, via telecommunications • the setting in which the service took place, such as community clinic, home visit, inpatient ward • a summary mental state examination (MSE) if appropriate • a summary risk assessment and plan for intervention including emergency contact numbers for this if appropriate • alerts • date of next appointment. There may be organizational variations in the composition of this record. Access to this part of the record may be required by additional staff, such as administration, in order to complete their duties.

Answer 155

When a third party is involved it is important to clarify the nature of the relationship with all individuals and organizations involved before providing services. This process includes determining who the client is, the service being provided, reporting requirements, and any limits to confidentiality. This is essential in determining from whom to obtain informed consent as well as to whom you may provide any confidential information. The psychologist must discuss this information with all parties to ensure full understanding and agreement with the conditions under which the service will be provided, and have documentation outlining consent to the arrangement.

Answer 156

Psychologists may provide services to a young person without parental consent as long as the young person is deemed to have the capacity to give informed consent. A young person is considered capable of giving informed consent when he or she achieves a sufficient understanding and intelligence to enable full understanding of what is proposed. Sometimes the age at which a young person can provide consent independently is clarified in legislation. For example, under Medicare, there are specific requirements regarding the management of information and the age at which a young person can make decisions. For a young person aged 14 or 15, Medicare information can only be disclosed to a parent or others with the young person’s signed authority, although a parent or guardian can dispute this until their child is 16 years old.

Answer 157

The client’s return appears to signal a new episode of service rather than a continuation of your previous work, so it would be prudent to review informed consent. Essentially, a client’s consent remains until the end of the agreed service unless consent is withdrawn.

Answer 158

Consent for services is essentially an agreement between the psychologist and the client, and, while there is no legal requirement to document the provision of consent, the APS Code of Ethics instructs psychologists to document a client’s consent prior to the provision of a service. Although it is preferable to have a signed agreement from the client, there are times when this may not be possible or necessary, for example, if the client provides verbal consent by phone or as part of a regular checking in with the client to confirm agreement for continuation of services. In this instance a file note outlining the discussion and the provision of consent may suffice, although that will not provide the psychologist or the client with the same protection in a legal context as a signed consent form.

Answer 159

In all States and Territories (except South Australia and the Northern Territory where there are mandatory reporting requirements) a health professional should notify the State or territory Commissioner of Police if a patient has made threats to harm themselves or others and who the practitioner believes to be a risk to themselves or the public if they possess a firearm. As outlined in the table below, there is legislative protection in all jurisdictions from any criminal and civil liability that may arise when a health professional breaches a patient’s privacy by disclosing information in good faith to the police.

Answer 160

Where a psychologist believes that a person does not have the capacity to provide informed consent, consent needs to be obtained from an authorized person. In particular situations, there may be applicable legislation that specifies who the authorized adult might be (e.g., Guardianship and Administration Acts). An authorized person may be: * A parent or guardian in the case of a young child * A person’s spouse or partner * A person appointed under a medical treatment act * A person appointed under a guardianship order * An enduring guardian appointed by the person while competent * A person appointed in writing by the patient with power to make such decisions * The nearest relative.

Answer 161

You should always obtain client consent before disclosing any information with third parties. However, confidentiality can be broken under exceptional circumstances (e.g., risk of harm to client or others, responding to a subpoena or warrant – see Section A.5.2 of the Code of Ethics for details).

Answer 162

It is a natural inclination to do what is perceived as ‘the right thing' when being made aware of criminal activity, and many psychologists struggle with their obligations in this area. **Without a legal obligation to report a crime**, the question becomes one for the judgment of the psychologist. **There is no requirement in the Code of Ethics for a psychologist to report a crime**. When receiving information about a crime a psychologist should consider: * The client's best interests * Whether there is an immediate risk of harm to a person, the disclosure of which would be allowed under the Code of Ethics * The ongoing therapeutic relationship. * If the psychologist feels that it is in the best interests of the client to report the crime, the client should be encouraged to make a confession to the police or the client's permission should be sought for the psychologist to make the report.

Answer 163

Only in New South Wales does a psychologist have a legal obligation to report a crime disclosed to them by a client (Crimes Act 1901 [NSW]), and that obligation only applies to serious crimes which, if proven, could attract a penalty of five years or more jail time.

Answer 164

A broad screening test for emotional & behavioral strengths and difficulties which commonly occur in childhood (3-16yr old). Five scales include: * Emotional symptoms. * Conduct Problems. * Hyperactivity/Inattention * Peer Relationship Problems. * Prosocial behavior. A more comprehensive assessment is required to inform treatment options.

Answer 165

The psychologist must release all information that is required as there is no professional privilege. This is a case where a legal obligation overrides the normal protection of confidentiality of client records.

Answer 166

The National Law is the Health Practitioner Regulation National Law, as in force in each state and territory. The National Law is a state and territory-based legislation; it is not a commonwealth law.

Answer 167

The psychologist must release all information that is requested as there is no professional privilege. This is one of the cases where legal obligation overrides normal protection of confidentiality of client records. The psychologist is at liberty to communicate their concerns about releasing such information to the court or relevant authorities but nevertheless is required to act on a valid subpoena.

Answer 168

Explore reasons for clients ambivalence in order to maintain a good therapeutic alliance, as it is critical to strengthening client engagement and good outcomes and is even more critical when a client is ambivalent.

Answer 169

Discuss the issue of confidentiality before engaging in email or digital consulting. client confidentiality must be protected and the psychologist should proactively address all issues if there are foreseeable risks of breaches of confidentiality and seek appropriate solutions. Discussion of this matter should happen before digital services are rendered and can include both data security and privacy provisions with regards to who may have access to the emails.

Answer 170

A boundary crossing is a “decision to deviate from an established boundary for a specific purpose- a brief excursion with a return to the established limits of a professional relationship”(Peternelj-Taylor, 2003). * A boundary crossing is also “any activity that moves the clinician from a strictly objective position…” (Guthriel and Gabbard, 1993). * Boundary crossings may be minor and may even be therapeutic * A boundary-crossing becomes a violation when it becomes harmful to the patient. It can be difficult to assess when harm is caused. **Boundary Crossings** • Taking phone calls between sessions (if not an emergency or previously agreed upon) • Small gifts (giving and accepting) • Special fee arrangements or bartering • Allowing patients to run a large balance • Excessive therapist self-disclosure/disclosure of personal information • Extending time beyond what was initially agreed • Saying “yes” rather than “no” • Making special allowances for a patient • Non-emergency meetings outside of the office or after office hours **Boundary Violations** • Avoidable dual or multiple relationships • Sexual relationships An important consideration of what causes harm to the patient is not the clinician’s intent or even necessarily the clinician’s behavior, but the meaning of the behavior to the patient.

Answer 171

* Complex Attention * Executive Function * Learning and Memory * Language * Perceptual-Motor * Social Cognition

Answer 172

A disturbance of attention or awareness that is accompanied by a change in baseline cognition that cannot be better explained by a pre-existing or evolving neurocognitive disorder

Answer 173

Psychologists only consider the use of a therapeutic aversive procedure as a last resort, when there is evidence as to its effectiveness, and they are trained in its use and/or have access to relevant supervision and expertise. In instances where psychologists believe the use of therapeutic aversive procedures is indicated, the psychologist considers the risks and benefits. Psychologists provide a therapeutic aversive procedure with the client’s or guardian’s consent, and only when the benefits outweigh the risks. The overarching goal and challenge for psychologists is to minimize any physical, emotional, and psychological harm in the process of eliminating the targeted problem behaviour(s) of clients. This approach requires comprehensive documentation involving the rationale for and selection of procedure, goals of treatment, provision of informed consent, and constant monitoring of the effectiveness of the procedure.

Answer 174

If clients have outstanding accounts or are unlikely to pay their accounts, psychologists engage with clients to find an acceptable process to settle the account. These may include: * adjusting the frequency, nature or extent of services to match the client’s budget or their ability to pay; * payment by installments over an agreed period of time; * informing the client about lower-cost options available through alternative providers of similar or other relevant services; * terminating or withdrawing the service in an appropriate manner to minimize harm to the client.

Answer 175

Psychologists understand that abuse and/or neglect is reported on the basis of reasonable belief or suspicion. Psychologists are aware that reasonable belief or suspicion that a child is in need of protection is more likely formed when: • a child states that they have been physically injured or sexually abused; • a parent or other relative, friend, acquaintance or sibling of the child states that the child has been physically injured or sexually abused; • the psychologist has knowledge that a child is exposed to family violence; or • professional observations of the child’s behaviour or development lead the psychologist to form a belief that: • the child has been physically injured or sexually abused; and/or • there has been a failure to provide for the shelter, safety, supervision or nutritional needs of the child.

Answer 176

Psychologists work with a wide range of clients in many different contexts. When faced with a potentially harmful situation, psychologists balance a client’s right to confidentiality with the psychologist’s responsibility to reduce the likelihood of harm to the client and/or others. Psychologists understand the different thresholds for disclosing information to avert risk depending on whether or not their work falls under the jurisdiction of the Privacy Act (1988). If psychologists work with children, they obtain the relevant state or territory Working with Children Check. Psychologists are aware of the specific roles, settings or occupational groups that are subject to mandatory reporting of child abuse and neglect in the state or territory in which they practise. Because legislation regarding mandatory reporting of child abuse and neglect is regularly amended, psychologists maintain up-to-date knowledge of such developments. Psychologists are aware of the behaviours and circumstances that are more likely to contribute to a reasonable belief or suspicion that a child or other vulnerable person is in need of protection. Psychologists are mindful of the primary role they undertake when providing a psychological service to a client, and if making a decision about whether to act on information received from a client about a crime committed or intended to be committed by the client, psychologists consider a range of factors which address reporting requirements and safety issues.

Answer 177

* the code itself has **3 principles and the principles have standards,** * each of the principles has multiple standards, and that's the overarching card, * and then attached to the card are **29 guidelines**. And then I'm sure you guys haven't heard of these * but then in addition to that, there are **13 different ethical considerations**. Again, the Ethical code: * has **3 general principles** * Each of the principals has multiple standards, which is the overarching code * and attached to the code there are **29 guidelines** * and there are **13 ethical considerations**

Answer 178

1. **Ethical Guidelines** 1. Aboriginal and Torres Strait Islander people/s 2. Ethical guidelines for the use of therapeutic aversive procedures 3. Ethical guidelines on confidentiality 4. Ethical guidelines on providing psychological services in response to disasters 5. Ethical guidelines regarding financial dealings and fair trading. 6. Ethical guidelines for psychological practice in forensic contexts 7. Ethical guidelines for working with people when there is a risk of serious harm to others 8. Ethical guidelines on the teaching and use of hypnosis, and related practices 9. Ethical guidelines for psychological practice with clients with an intellectual disability 10. Ethical guidelines for providing psychological services and products using the internet and telecommunications technologies 11. Ethical guidelines for psychological practice with lesbian, gay, and bisexual client’s guidelines for psychological practice with men and boys 12. Ethical guidelines for psychological practice with clients with previously unreported traumatic memories 13. Ethical guidelines for psychological practice with men and boys 14. Ethical guidelines for psychological services involving multiple clients 15. Ethical guidelines for managing professional boundaries and multiple relationships 16. Ethical guidelines for working with older adults 17. Ethical guidelines relating to procedures/assessments that involve psychologist-client physical contact 18. Ethical guidelines on providing pro bono or voluntary psychological services 19. Ethical guidelines for psychological assessment and the use of psychological tests 20. Ethical guidelines on record keeping 21. Ethical guidelines on reporting abuse and neglect, and criminal activity 22. Ethical guidelines for psychological practice in rural and remote settings 23. Ethical guidelines on the prohibition of sexual activity with clients 24. Ethical guidelines on supervision 25. Ethical guidelines for working with and in the media 26. Ethical guidelines for working with young people 27. Ethical guidelines for psychological practice with women and girls 28. Ethical guidelines on working with sex and/or gender diverse clients 29. Ethical guidelines relating clients at risk of suicide

Answer 179

Aboriginal and Torres Strait Islander people/s * Be sensitive to: * Value systems and authority structures * Sensitive to both cultural and contextual factors - associated with health and wellbeing that will change depending on the areas that you’re working in, i.e., they have a high incidence of diabetes in general * Ensuring that informed consent is validly given and understood - we need to understand those language barriers * Understanding of providing a culturally competent and respectful service - if working with this community get appropriate training or recognize it's outside of your competence and refer on. * Selecting the appropriate test or instruments when assessing - there's only a few so put a CAVEAT on your report and interpret with caution * When researching - make sure you are mindful and disseminating in a culturally appropriate way. ----------------------- Again: * When working with Indigenous clients, psychologists respect the value systems and authority structures that operate in Indigenous communities. * They are sensitive to both cultural and contextual factors associated with Indigenous health and wellbeing. * Psychologists ensure that informed consent is validly given and understood. * They understand the importance of providing a culturally competent and respectful service, and where practical and/or requested they involve an appropriate Indigenous cultural consultant. * When assessing * Indigenous clients, psychologists select an appropriate test or instrument. * When the reliability and validity of individual and group test results for Indigenous test takers are limited, psychologists note any necessary caveats on the interpretation of the test results. * When conducting research and disseminating information related to Indigenous people, psychologists complete the process in collaboration, or after due consultation with Indigenous persons or people who could reasonably be expected to have either expertise and/or interest in such research and information.

Answer 180

**29 guidelines - 2. Aversive Procedures** - cause strong dislike or disinclination. - relating to or denoting aversion therapy, a type of behaviour therapy designed to make patients give up an undesirable habit by causing them to associate it with an unpleasant effect **The key areas to know:** * one you need to occasionally to know is that you need to carefully decide, * is it indicated in is it appropriate in your case formulation should do that for you? * Consider the risks and benefits. * And then, obviously, do it with consent. * Informed consent, * parents, * guardians * and usually, there are parents or guardians involved when you open using averse procedures * and minimizing any physical, emotional, and psychological harm in the process is really important. * There are points that you need to remember.

Answer 181

29 guidelines - 3. Confidentiality So, the point you need to remember on confidentiality is: * to establishing maintain confidentiality, * understand the context in which you know confidentiality is being given * inform your clients that, you know, confidentiality is utmost but it's not absolute * the informed consent process, and being aware of multiple clients, \< \>you know, in a private practice setting you know we get referrals through EAP, Work Cover, like I said involuntary situations, * and we have other people that we report to so we must be very clear and open to the client in front of us * that there's actually another point involving wave motion is going back to that person. * So that's what you need to remember, and I think most of you really do understand confidentiality * but maybe not with the multiple components of that.

Answer 182

**29 guidelines - 4. Disasters:** * the things you need to be aware of with this one * is clarifying obviously from the outset, * and then providing contextually and culturally appropriate services, * seeking adequate supervision, * and liaising with a local organization, * and make suitable referrals, * are the key points that you need to remember on the sidelines. ------------------ Again: At the outset, psychologists who are involved in the delivery of psychological services in response to disasters clarify with clients and agencies the nature of their role. Psychologists provide contextually and culturally appropriate psychological services and seek adequate supervision and support. Where possible, psychologists liaise with local organizations so that interventions and support may be implemented by local staff. As the need for an emergency response diminishes, psychologists make suitable referrals for clients’ ongoing needs.

Answer 183

29 guidelines - 5. Financial Dealings and Fair Trading Financial dealings and Fair Trading This one's pretty short and sharp: * with financial dealings, we need to be really clear from the outset, what our fees and charges are, * we need to consider the interest of the client first, * when we're looking at, you know, referring or engaging other services in addition to one can see the client’s financial position. * And we cannot under any circumstances receive any sort of commission for referring on or passing on, referring on, it's not okay. * Yeah, no arrangements whatsoever.

Answer 184

29 guidelines - 6. Forensic * the things you need to remember is: * that you really need to explain for forensic client * who has contracted your services to see? * why * and where the information is going, * and you need to make it really clear because it's very very different in those situations, * and you need to keep your boundaries, very difficult. ---------------------- Again: Psychologists involved in forensic contexts may work in many different roles. They understand the differing requirements of each role and clearly inform their clients of their role in the psychological services they are providing to the client. Psychologists inform clients how their reports may be used, and who may have access to the reports. They aim to obtain the best possible privacy conditions within the limitations of the forensic setting and the role they are performing. Psychologists maintain proper professional boundaries with their clients. They are aware of the potential for multiple relationships to emerge and take steps to address them when they do appear.

Answer 185

**29 guidelines - 7. Risk of Serious Harm to Others** * These are the key things to remember: * In accordance with these guidelines, * if you conduct a thorough risk assessment, * you monitor the ongoing risk, * you're seeking professional input and support from others so you're not doing this on your own, * you weigh up that responsibility that you have in deciding whether or not outweighs the therapeutic benefit of the relationship which needs to be a constant balancing act. * And, obviously, that management, you need to involve other professionals, outside of yourself to manage that it's really not something you should or need to do on your own. * And people that are in that situation, I will see them multiple times a week to manage that, that risk. * Okay, sounds a bit heavy made hard. * Hopefully, you don't come across that too often, people that choose to hack it some of the areas that I choose to and like I said generally these people are in securement facilities or in prison facility facilities, and then we're just moving on looking that facility to a more secure area within that facility and managing the risk from there. --------------------- Again: When psychologists work with clients where there is a risk of serious harm to others, they conduct thorough risk assessments and monitor the ongoing risk of serious harm. Where necessary, they seek professional support from experienced colleagues. When deciding whether to disclose client information, psychologists carefully weigh up their responsibility to others with the importance of an effective professional relationship. When delivering psychological services to this client group, psychologists maintain clear professional boundaries and attend to their own safety. Psychologists involve other professionals in the management and containment of individuals who are considered to be at risk of committing seriously harmful or violent acts.

Answer 186

**29 guidelines - 8. Teaching and use of Hypnosis, and Related Practices** So, the point you need to remember here obviously is: * fully describe the nature and purpose of the procedures * but like I said most clients come asking for it * the limitations that are involved for people do have very unrealistic expectations of hypnosis * your qualifications and experience. * Any foreseeable adverse effects. * And that they can withdraw at any time. * And you as a clinician, need to be vigilant that hypnosis does not compromise the dignity, \< \>or the wellbeing of the client at any time as well, because sometimes clients when they go into a hypnotic trance, can start to do some things that are inappropriate * so, you need to bring them out of that trance as quickly as possible. -------------------- Again: The ethical issues related to hypnosis are similar to the ethical issues arising from the provision of any other psychological service. However, because clients who experience hypnosis may be particularly focused and involved in the experience of the hypnotic process, psychologists are vigilant about ensuring that their use of hypnosis does not compromise the dignity and wellbeing of the client. Before clients are offered hypnosis services, psychologists fully inform them about the nature and purpose of the procedures they intend to use; * the limitations and risks involved in hypnosis; * the psychologist’s qualifications and experience in conducting hypnosis; * the reasonably foreseeable risks, adverse effects, and possible disadvantages of the procedures they intend using; * and the client’s option to participate, to decline to participate, or withdraw from the proposed procedures at any stage

Answer 187

**29 guidelines - 9. Clients with an Intellectual Disability** the main points to remember is that: * you need to be aware of is that just being aware that they still have rights they still need to be treated with respect and dignity. * We need to try and uphold their autonomy, * and be mindful of age and psychosocial development and therefore deliver material at that level. * We need to include carers, guardians, and so forth. * We need to be familiar with any state or territory legislation regarding disability for that person. * And essentially, if they're engaging in therapy, they have some level of capacity. * So, include them in that choice. --------------------- Again: Intellectual disability: Psychologists are aware that people with an intellectual disability are entitled to the rights, dignity, and respect due to all members of the community, regardless of the type or degree of impairment. Psychologists provide psychological services in ways that respect and uphold the autonomy of the client, taking into account their age and psycho-social development, and particular vulnerabilities. Psychologists also ensure that clients with an intellectual disability have an opportunity to participate in decisions about the type of psychological services provided to them. Where necessary, psychologists adapt their communication approach to meet the needs of the client with an intellectual disability, including oral and written communication. Where appropriate psychologists adapt their consent procedures to enable clients with an intellectual disability to understand, to the maximum extent they are able, what is proposed, the options available to them, the consequences of their decisions, any risks or benefits, and their opportunities to withdraw consent. When clients with an intellectual disability can’t give consent, psychologists consult with legal guardians or those who hold legal authority for the client. Psychologists are familiar with and work within state, territory, and Commonwealth legislation pertaining to people with a disability, which includes, but is not limited to legislation pertaining to discrimination, guardianship, and testamentary capacity. When providing psychological services to clients with an intellectual disability, and those who support them, psychologists work in ways consistent with the United Nations Convention on the Rights of Persons with Disability (2006) and the Disability Discrimination Act (1992). This approach extends to all aspects of their work including research, assessment, education/training, and therapy.

Answer 188

29 guidelines - 10. Services and Products using the Internet and Telecommunications Technologies * the ethical guidelines for basically internet telecommunications is * make sure that you're using a Secure Gateway, * and that you're meeting the standards that the board lays down, * and that you're practicing with the scope that telecommunication allows you to there are some therapies, you can deliver across a service, * and then also to that, you're keeping up to date with the field. ------------------ Again: The use of internet and telecommunications media in therapeutic, psychological assessment, research, and educational contexts is growing rapidly. While research supporting the use of the internet and other telecommunications technologies are emerging, in many instances, the research base remains behind the practice. Psychologists providing psychological services on the internet and via other telecommunications technologies are aware of the strengths, limitations, scope, and appropriate use of these modes of service delivery. They maintain their competence in the use of these methods of service delivery, client management, and practice management, and are aware of the ethical issues associated with the delivery of services via electronic media. Psychologists ensure that they evaluate the effectiveness of their interventions and the other uses they make of such technologies, and keep up-to-date with developments in a rapidly moving field.

Answer 189

**29 guidelines - 11. Practice with lesbian, gay, and bisexual client’s guidelines for psychological practice with men and boy** * the two main things you need to know is * that the professional development in that area you need to be up to date with,\< \>even some of the legislation which we spoke about last week as well surrounding that and gender identity, * And also providing services in a respectful manner * and referring on if you don't feel that you're competent in that area. ----------------- Again: Psychologists are aware of the diversity of identity and experience among men and boys, and the diversity of expression of maleness and masculinity across the lifespan. They are aware of the potential impact of social constructions of masculinities as well as gender role conflict on men and boys. Psychologists are aware of and address their own gender-related biases, stereotypes, or prejudices, and they take steps to minimize the impact of such factors on the effectiveness of the psychological services they provide. They are aware of male-specific concerns that relate to the provision of psychological services. Psychologists understand the barriers that male clients frequently face regarding help-seeking, and are alert to males’ heightened risk of suicide. Where necessary they work with male clients to identify appropriate referral pathways and support options, and address any risk factors.

Answer 190

**29 guidelines - 12. Practice with Clients with Previously Unreported Traumatic Memories** the point that you really need to remember is * Acknowledging that memory is complex and it's one of the things that the guidelines tell you to do with your client. * Focus on the welfare of the client do not focus on recovery as a goal for the client, * but focus on distress tolerance of the ambiguity basically is what it comes down to * Difficult one, very difficult one, * but you do get any practice, people do come to you and they say * oh, you know I keep having these dreams I don't know whether it really happened to me or whether or didn't happen to me, * And that can be difficult to work with. ------------------- Again: Psychologists assist their clients to tolerate uncertainty and ambiguity regarding their traumatic experiences. The psychologist and client may both have to accept that total clarity around the details of a traumatic experience may not be possible. The goals of therapy may include assisting the client to: * address current symptoms; * work towards an acceptance of incomplete memories; and * process the event/s with the aim of the client feeling ‘safe’. Psychologists are aware that what is remembered about an event may be an accurate or distorted memory of the events the client experienced and can be shaped by: * how that event was perceived at the time (McNally, 2005); * the individual psychological response at the time and the possible presence of dissociative or high‑affect states (Ozer, Best, Lipsey & Weiss, 2003); * the impact of organic factors such as an acquired brain injury (Bryant, 2008) prior to or during the event; * the prevailing environmental, personal, interpersonal, and social context during attempts to remember; and * events occurring before the experience, and between the experience and the attempted remembering. Where appropriate, psychologists convey information about the nature of memory to clients. For example, a psychologist may explain that memory is a constructive and reconstructive process and that encoding, storage, and retrieval of experiences are complex.

Answer 191

**29 guidelines - 13. Psychological practice with men and boys** * the guidelines, actually direct us to focus on that * That males are more likely to commit suicide. * Males face a lot more difficulty seeking treatment * so, you need to work a little bit harder with the engagement and with the rapport building with men and boys. * And you know, be aware of stereotypes * and your own prejudices that may come into play.

Answer 192

essentially for multiple clients, * it's about making sure all parties know they've answered responsibility. * Informed Consent is explained, \< \>so that the actual person that you're working with understand who's involved, * why they're involved in * what information they will get, * and why they will get that information. * So that's sort of multiple files

Answer 193

a) the ethical requirement for confidentiality of psychological assessment data; b) the type and extent of client information that will be shared; and c) how that information sharing will take place.

Answer 194

**29 guidelines - 15. Managing Professional Boundaries and Multiple Relationships** * Where managing the professional boundaries managing that far outweighs disclosing information to another practice. * So, it's not always unethical. * But you need to manage it. * And you need to understand that you need to constantly, weigh up, whether or not that is the cost-benefit ratio to the client is there. * And in small towns is the other place that you'll often see it as well and I mean really small towns in a larger city you don't often see it, * so, there are usually strange circumstances. ---------------- Again: While some multiple relationships may be inevitable and are not necessarily unethical, they can potentially lead to impaired judgment, and sometimes inferior or harmful service delivery. Therefore, if multiple relationships are necessary or have arisen, psychologists manage the relationship so that the benefits to the client(s) are maintained and the potential for harm is diminished. The responsibility for maintaining professional boundaries rests with the psychologist, not the client.

Answer 195

**29 guidelines 16. Working with Older Adults** Ethical guidelines to working with older adults: - obviously, you need to understand the aging process, * you need to be aware, their own attitudes and values towards older adults and be aware of your attitudes and values. * And don't assume that their problems are attributable to old age. * So, be aware that potential cognitive sensory and physical deficits are the natural part of the aging process and not necessarily an indication of the disorder * they are the things that you need to remember, * understanding the aging process, your own days and attitudes towards older people, not assuming their problem is related to age, but also, being aware that there are cognitive sensory physical deficits that are going to be there but likely to be age-related.

Answer 196

**29 guidelines - 17. Procedures/assessments that involve psychologist-client physical contact** the only look at guidelines that involve psychologist client contact. * So, you need to obtain conform informed consent. * Fully documenting the service, * maintaining your clients confidentially confidentiality and privacy * and respecting clients, social, cultural conventions * and adapt their own practices when necessary, * there are very few procedures that involve physical contact between the psychologist, and the client * EFT is one of them, not incredibly widely used, * but there are very, very few that involve that actual contact but it's all about just the documentation. * So really, that's all you need to remember is that the documentation and maintaining privacy throughout.

Answer 197

**29 guidelines - 18. providing pro bono or voluntary psychological services** * when looking at providing pro bono or voluntary Psychological Services. * Even if they are voluntary, * they are still entitled to receive a professional service that's consistent with the standard of a client that is paying, * there is no difference between the two. * So, it's not like you can say I'm doing it for free so I'm only going to do this factor I'm only going to give them this amount if you commit to a preservice that service must be full psychological service. * you need to be aware that possibly the insurance claim may not pay out for one reason or another, * and then you may not pay for all the services. * So basically, that was just saying just because it's pro bono voluntary the quality and standard of the service do not change. * And you still need to follow all of the same processes, procedures, etc.

Answer 198

**29 guidelines - 19. Psychological assessment and the use of psychological tests** * choosing the assessment instruments appropriately. * you can only purchase them only certain qualifications * they need to be held securely * interpretation psychological test in appropriate manner * communicate assessment and results to clients is done in a manner that has meaning and make sense to the client * assessing culturally and linguistically diverse client * need to be really careful about the data Psychologists understand that psychological assessment is a core competency for psychologists. Psychologists conduct psychological assessments for a wide range of purposes across a broad range of contexts, and often with a growing range of assessment methods, including those emerging through the use of internet and media technologies. When conducting psychological assessments, psychologists ensure that they obtain informed consent; outline the limits of confidentiality, and manage client relationships respectfully. Psychologists are qualified and competent in the selection, administration, interpretation, integration, and reporting of the results of psychological assessments, and are aware of the risks associated with unsupervised or blind testing. They are aware that clients’ test performance can be adversely affected by language barriers, cultural background, and physical or mental conditions, and they consider assessment data in the context of other relevant information about the client and the circumstances in which the assessment was conducted. Psychologists maintain the security of psychological tests and other assessment materials and limit access to those who have the appropriate qualifications and training. They are also responsible for the use of psychological tests by their students or those to whom they delegate test administration. Psychologists keep themselves up-to-date with developments in assessment and testing which relate to their area of work.

Answer 199

Psychologists understand that the release of test results to clients may be sought under Privacy or Freedom of Information legislation, depending on the psychologist’s work context. Psychologists are aware that the conditions of application and grounds for release of documents vary, and that these requirements are available from the relevant authorities. Test materials may be deemed exempt documents on the grounds that disclosure would be contrary to the public interest, where disclosure would: * a) invalidate the utility of the test or tests in the practice of psychology; * b) impair the ability of psychologists to perform their duties properly; * c) constitute a breach of the contractual arrangements under which psychologists are supplied with test materials.

Answer 200

2**9 guidelines - 20. Ethical guidelines on record keeping** Psychologists make and keep records that accurately document their psychological services, administration, and other practice operations. They understand that client records may contain sensitive and private client information. Psychologists ensure that their client records include notes which accurately reflect their professional practice, were created at the time of client contact, or immediately following contact, and give clear reasons for any interventions and decisions taken at that time. They ensure that the notes reflect client respect and dignity, and meet psychologists’ responsibilities for maintaining client confidentiality. Psychologists are aware that their record management systems incorporate all paper files, notes, and documents as well as electronic records. They ensure client records are readily accessible and stored in conditions appropriate to their format, that appropriate risk management has been applied to all records, and that the records are accessible for at least as long as required by law.

Answer 201

29 guidelines - 21. Reporting abuse and neglect, and Criminal Activity ethical guidelines on reporting abuse and neglect and criminal activity. * So, you need to be aware of your state or territory legislation. * So, as we discussed last week, New South Wales is the only one that has mandatory reporting. * So, you need to assess whether or not. * The other thing you need to be careful of is, * is the imminent risk of harm to your client or to someone else? * And if so, then that's a whole different area that you come under * as to when you breach confidentiality * and it doesn't matter whether the activity is criminal or not criminal, * if it's imminently about to occur * Then you need to do something about that. * You need to know whether or not you're under mandatory reporting criteria * for abuse to children in the case, it is a criminal activity regarding a child. * and basically, essentially, what that one comes down to is, * unless you're in New South Wales, * really, you just follow that is someone imminently going to be harmed, is there harm to others.

Answer 202

**29 guidelines - 22. psychological practice in rural and remote settings** * So that one is really about monitoring, professional boundaries, and seeking peer support and supervision. Psychologists who work in rural and remote areas are aware of the need and time required to build trust and respect within a community as well as with individual clients. They familiarise themselves with and develop a sound knowledge of the professional and community networks, resources, and services available in the region. Psychologists are aware of the limits to their competence in psychological practice and, if a psychologist with the necessary experience is not available, seek supervision or peer support if it is appropriate to offer the psychological service themselves. They carefully monitor their professional boundaries and develop strategies to anticipate and manage any multiple relationships that may emerge. Psychologists protect their clients’ confidentiality from inadvertent disclosures and proactively discuss with their clients mutually acceptable ways of handling everyday encounters outside of the consultation room.

Answer 203

29 guidelines - 23. Sexual Relationships with Clients: Psychologists understand that if the psychologist/client professional relationship becomes sexualized, it is likely to be detrimental to the client. Psychologists are aware that sexual activity with clients is not a legitimate part of psychological service and does not constitute an appropriate intervention or any other service by a psychologist. Psychologists recognize the possible existence of intense emotions between themselves and clients and ensure they manage the professional relationship ethically and appropriately. Psychologists understand that they are responsible for recognizing and maintaining appropriate professional boundaries with their clients. Psychologists are aware that clients and former clients may be vulnerable to exploitation in the context of a therapeutic, teaching, consulting, or supervisory relationship, and psychologists ensure that they maintain relationships of trust.

Answer 204

29 guidelines - 24. Supervision: Psychologists understand that supervision is an activity typically undertaken by psychologists to ensure appropriate learning and development of professional skills by their supervisees as well as to maintain standards of the profession via: * (a) a national registration board * (b) professional membership and affiliation with a peak professional body, or * (c) course or training accreditation (Bernard & Goodyear, 2014). They are aware that the various purposes, methods, and theoretical models influence the nature, mechanism, and processes that comprise this professional activity. Supervisors and supervisees act in a responsible, competent, and professional manner to ensure that no harm is done to clients and that supervisees are not exploited. Psychologists give careful consideration to due process, informed consent, management of multiple relationships, and confidentiality and privacy.

Answer 205

29 guidelines - 25. working with and in the media Psychologists work in a range of ways within media settings. They understand the distinct demands of working with and in the media, and adapt their practice accordingly. Psychologists are aware of their limited capacity to influence the final version put to air or print but still seek the opportunity to make amendments where possible. Psychologists involved in the psychological screening process for reality TV shows check that participants comprehend what they have consented to, and inform participants that there may be occasions when they may be seen in an unfavorable light that is beyond the psychologist’s control. When in on-camera roles on reality TV shows psychologists attempt to establish that the participants comprehend what they have consented to, and ensure that any comments they make about the participants are respectful. Psychologists are alert to the possibility that participants in a program may be adversely affected by their experiences in the media. Where indicated, psychologists recommend to the media organization or production company to provide immediate and ongoing support to the relevant participants. Whatever media role psychologists are involved in, they uphold the standing of the profession and discipline of psychology.

Answer 206

29 guidelines - 26. Young People Psychologists who provide psychological services to young people regard the wellbeing of the young person as paramount. Working with young people can be complex. In providing psychological services to young people, psychologists consider many issues, which include, but are not limited to: • the legislation applicable to their work; • the policies of the organisation in which they work; • assessing the young person’s capacity to provide informed consent; • clarifying and identifying the level of involvement of each parent; • clarifying the respective roles of all parties to the psychological service; • any Family Court orders that may apply; • clarifying whether the young person is to be seen on his or her own, or in conjunction with the accompanying parent and/or the non-accompanying parent; • clarifying the limits to confidentiality; • establishing what information a parent may have a legal right to access in relation to the young person, regardless of whether they are accompanying the young person; and • clarifying under what circumstances client information may be disclosed and to whom. Psychologists review their practice procedures for working with young people, clarify consent issues at the outset of providing a psychological service, and further clarify issues of consent if the contract for the psychological service changes.

Answer 207

29 guidelines - 27. psychological practice with Women & Girls Psychologists who provide psychological services to female clients understand the gendered dimensions of health and wellbeing and the influences and implications of social determinants of health. They recognise a female client’s right to develop as an autonomous and psychologically healthy person, and seek to foster such development. Psychologists acknowledge the inherent power differentials between client and psychologist, and the ways in which gender may amplify such differentials. They are clear about their own values and philosophical underpinnings related to providing psychological services to female clients. Psychologists acknowledge that sexual harassment, psychological, sexual and physical abuse, and all forms of violence are the responsibility of the perpetrator. The safety of clients and associated parties is paramount. In their interactions with female clients, including students and supervisees, psychologists establish, maintain and communicate an understanding of appropriate professional and personal boundaries.

Answer 208

29 guidelines - 28. Sex & Gender Diverse Psychologists who provide psychological services to sex and/or gender diverse clients do so in an inclusive, non-discriminatory, sensitive, respectful, and competent manner that is informed by the challenges of identity, language, and terminology, the limitations of the extant research, and the experiences of stigma, discrimination, harassment and threats to physical safety that this client group confronts. Psychologists are aware of the ethical implications of providing psychological services that cover the roles of “assessor” and “treatment provider”. They are clear about the professional relationship and role agreed to with sex and/or gender-diverse clients.

Answer 209

29 guidelines - 29. Risk of Suicide There are diverse and interacting client factors associated with an increase in the likelihood of people making suicide attempts, such as intoxication, previous history of self-harm, significant loss (e.g., spouse/partner, financial, health status), and availability and access to lethal means. Some personality and familial traits may also increase the risk of suicidal behaviour such as impulsivity, hopelessness, anger, or a family history of depression. Furthermore, an increased risk of suicide may be associated with some psychological conditions and mental disorders, such as substance abuse, depression, borderline personality disorder, post-traumatic stress disorder, acquired brain injury, and some neurological impairments.

Answer 210

Psychologists consider factors related to the immediate level of risk including a history of suicidal behaviour, suicide plans, access to means, evidence of impulsive behaviour, and the client’s use of alcohol or drugs. Psychologists act with care and skill in responding to a client’s current and ongoing signs of suicide, which may include: i) taking steps to attend to the client’s immediate safety; ii) undertaking or arranging for a thorough and specific assessment of suicide risk; and iii) arranging appropriate psychological, medical, psychiatric and/or social care, and community response. While psychologists’ focus with clients who are experiencing suicidal thoughts is on those clients’ immediate safety, psychologists also recognise and address factors that may pose a risk to others (e.g., where suicide might be attempted by firearms, weapons, arson or motor accident, or involve a potential homicide-suicide). Where a client who is at risk of suicide has dependent children, psychologists are aware of, and if necessary, address protective issues for those children.

Answer 211

The immediate safety of the person at risk is paramount. In the case of young persons, psychologists typically advise at least one relevant caregiver (e.g., parent, guardian, next of kin). In circumstances where advising a relevant caregiver is not appropriate, psychologists work with the client to identify one or more appropriate person/s or services (e.g., medical practitioner, Crisis Assessment and Treatment Team, or police) to contact.

Answer 212

When psychologists choose to disclose client information, they have to decide who will be informed. For example, with clients at risk of suicide, options at a professional level might include a GP, Crisis Assessment and Treatment team, or police. For clients’ personal support, options might include their parents, partner or close friend.

Answer 213

Psychologists are aware of, and avoid, the potential to over-attribute a client’s symptoms to a particular disability, which is known as the concept of diagnostic overshadowing.

Answer 214

Psychologists who provide psychological services to clients at risk of suicide ensure that they attain and maintain relevant competence, understand and accept the responsibility for the decisions and actions they take, and where necessary disclose confidential information in order to reduce the risk of harm to the client and relevant others. When working with clients at risk of suicide, psychologists weigh up the competing principles of respecting the client’s autonomy and confidentiality against the likelihood of risk of harm to the client. In such situations, psychologists consider the extent to which they consult with a professional of established competence in managing the suicide risk.

Answer 215

When delivering psychological services, psychologists take reasonable steps to provide an environment that facilitates personal safety, including the safety of other clients, children and other vulnerable people. Such steps may include: the use of duress alarms; ensuring other people are present, or nearby if needed; monitoring waiting rooms; and ensuring alternate avenues of exit. In cases of family violence, such steps might include holding separate interviews or having separate waiting rooms.

Answer 216

For purposes other than treatment, such as in a forensic context, where the role of psychologists may be to assist in recalling details of a specific event(s), psychologists restrict themselves to procedures such as a cognitive interview that enhance reliability (Holliday, Brainerd & Reyna, 2008; Middleton & Brown, 2005; Wells, Memon & Penrod, 2006), and avoid techniques known to reduce reliability, such as leading questions, hypnosis, guided imagery and dream interpretation (Geraerts et al., 2009

Answer 217

Psychologists ensure that they are competent to deal with the complex issues involved in providing services to clients who disclose memories related to traumatic experiences. Psychologists conduct a comprehensive client assessment relevant to the presenting problem, including screening for a history of trauma or family violence where indicated. They avoid drawing premature conclusions about the accuracy or occurrence of any previously unreported memory and assist their clients to manage their presenting symptoms. Psychologists do not have as a goal of treatment the recovery of memories of traumatic experiences where the client previously had no recollection of any trauma. In particular, psychologists are aware of the complex nature of such experiences, including the complexity of human memory and traumatic responses, the potential impact on the client and others of the psychological service, and any legal action that might be taken. They recognize that the disclosure of traumatic experiences is multidimensional, is often a process rather than a single event, and maybe emotionally challenging for both the client and the psychologist. Given the complexities of working with clients who disclose traumatic memories, psychologists ensure that they maintain a focus both on the client’s wellbeing, as well as monitoring and managing any impact that the disclosure may have on their own professional capacity to assist the client.

Answer 218

Psychologists understand that psychological services such as assessment, treatment, and writing reports for court-related purposes are each distinct services. Psychologists obtain informed consent for each of these services.

Answer 219

**Ethical guidelines young people** Gillick: [https://www.yac.net.au/wp-content/uploads/2012/10/Can-YP-make-their-own-decisions.pdf](https://www.yac.net.au/wp-content/uploads/2012/10/Can-YP-make-their-own-decisions.pdf) * 16 and under with those children who do not have a mental disorder * We have 10 and under we have a separate consent * Gillick Competence [https://www.anzctr.org.au/AnzctrAttachments/372256-Appendix%20C%20-%20Gillick%20Competency%20Test.pdf](https://www.anzctr.org.au/AnzctrAttachments/372256-Appendix%20C%20-%20Gillick%20Competency%20Test.pdf) * Read the information * Smooth sailing questionnaire Guardianship [https://www.justice.qld.gov.au/\_\_data/assets/pdf\_file/0006/249405/Decision-making-support-for-Queenslanders-with-impaired-capacity-A-targeted-overview-of-guardianship-legislation-in-Australia-March-2014.pdf](https://www.justice.qld.gov.au/__data/assets/pdf_file/0006/249405/Decision-making-support-for-Queenslanders-with-impaired-capacity-A-targeted-overview-of-guardianship-legislation-in-Australia-March-2014.pdf)

Answer 220

APS Code of Ethics - Three general principles: * RESPECT (for the rights & dignity of people) * PROPRIETY * INTEGRITY \*Domain 1: Ethics Three general principles: * *RESPECT for the rights and dignity of people* - General Principal A: (the key point - **Everybody else**) * *PROPRIETY* - General Principal B: (the key point - **how do we do businesses**) * *INTEGRITY* - General Principal C: (the key point - **Us**) Each of these _principles_ has an explanatory _statement_, and then several standards attached to it.

Answer 221

Respect for the rights and dignity of people/s - General Principal A (the key point - Everybody else) The standards are: * Justice - * Respect - * Informed consent - * Privacy - * Confidentiality - in the collection, recording, accessing, and storage of information * Release of information to clients - * Collection of client information from associated parties - (these are the standards) *gnomic* - JCRCPIR

Answer 222

Propriety - General Principal B: (the key point - how do we do businesses) * Competence - maintain your professional competence through your ongoing professional development * Record keeping - make and keep adequate records, 7 years since the last contact unless legal or organizational requirements specified otherwise, but children after the age of 18 + 7 = 25, however Criminal Law for certain crimes i.e. sexual abuse, various crimes a careful consideration need to be given to not to destroy records, where they may be later criminal or other investigation outside of 7 years. * Professional responsibility - have regard to the actual nature * Provision of psychological services at the request of a third party - * Provision of psychological services to multiple clients - * Delegation of professional tasks - * Use of interpreters - * Collaborating with others for the benefit of clients - * Accepting clients of other professionals - * Suspension of psychological services - * Termination of psychological services - * Conflicting demands - * Psychological assessments - * Research - (these are the standards) gnomic - CPR CPPPR DUCAST

Answer 223

Integrity - General Principal C: (the key point - Us) * Reputable behaviour - * Communication - * Conflict of interest - * Non-exploitation - * Authorship - * Financial arrangements - * Ethics investigations and concerns - (these are the standards) gnomic - RCC-NAFE

Answer 224

**12 Considerations:** 1. Assessing risk of harm to others 2. Client suicide: Considerations for Psychologists 3. Contracts and ethical concerns 4. Establishing and maintaining boundaries 5. Ethical considerations when providing pro bono services 6. Ethical considerations when providing second opinions 7. Ethical issues in rural practice 8. Making sound ethical decisions 9. Managing clients at risk of suicide 10. Managing multiple relationships 11. Psychologists clients’ rights 12. Record keeping templates

Answer 225

To get this item number added to your Medicare provider number: * you have to show evidence of completing the certain qualification * for eating disorders, the requirements are additional specialized eating disorder training, (whereas for the other ones like obviously: - if you're a clinically registered psychologist, you apply for a clinical provider number, - If generally registered psychologist you apply for a general Medicare, you'll automatically get CDM, and those sorts of things, * Similarly, for the pregnancies, there is a short course that you have to do to get those items added to your provider number, * the eating disorder category is much larger (40 sessions), so that’s quite an extensive one the eating disorder one * obviously, they’re taking into consideration the long term the basic nature of eating disorders,

Answer 226

DIS - The National Disability Insurance Scheme - Aged 65 under * *The NDIS exists to support Australians between the age of 7 and 65 living with disabilities. It aims to support people to live in the community or other settings that are suitable for their age.* You've heard of **NDIS** - From a Provider perspective - as a psychologist how do we fit into that, * This is nationally based * You firstly have to be registered under NDIS - it's a long process * The accreditation process is a long process * It's different from Medicare etc. * **NDIS works under a plan** the - plan has a **budget** and a **capacity**-building * A plan manager works out the plan * The number of sessions and the length of sessions * How many months weekly etc. * The sessions need to be targeting sessions * There is a reporting back to NDIS * There is a review every year for the funding is **reallocated every 12 months**

Answer 227

This one is difficult because it's different across all states and territories * Different/various different Victims of Crime compensation programs but they all work in a similar procedure * Eligibility requirement: A crime being committed against you, * and a report to police made, the application for VOC relies on the police * Generally, eligibility relies on the police report * the other eligibility is slightly different from state to state Basically, to compensate for Physical loss of items, medical expenses, pay for safety items, etc. money to compensate any sort of difficulty the person is going through, * they will also fund psychological intervention * we bill to the VOC association (they are a third party - they just pay the bill and determine how much they are willing to provide) there is nobody oversees them

Answer 228

**My Aged Care - Aged 65+** My Aged Care provides access to a range of government-funded services that are designed to help you live independently. These include: * home modifications, to make it easier and safer for you to move around * aids to make everyday tasks easier * personal care at home to help with grooming, hygiene, and self-care * physio, podiatry, and other therapies to keep you healthy * transportation, so that you can attend appointments and keep social * nursing, so that medical needs and other healthcare is supported in your home.

Answer 229

* PDD - Pervasive Development Disorder * Done by a pediatrician or a psychiatrist * **24 sessions, 20 sessions, and 4 assessment sessions for assessment** * The plan must be given to the child **by the age of 13 and must be used by the age of 15** * PDM is once in a lifetime * Whereas a CDM they can have every year. * PDD plan is multi-discipline It can be used for Speech, OT, Psych, Physio, etc. all of the disciplines, * So, it's not exclusive to psychologists, a CDM is not exclusive to psychologists, whereas mental health care plans the pregnancy support is exclusive to psychologists.

Answer 230

* MHCP - Mental Health Care Plan (which is the one you're most familiar with * It enables **10 sessions a year** * The first initial is **6 sessions**’ and the psychologist needs to write back to the GP and get further **4 sessions** in total of 10 sessions * This is available to the child and the adult once every 12 months period

Answer 231

* CDM - Chronic Disease Management Plan * **5 sessions** available to multiple practitioners * A psychologist, a dietician, an OT, a speech pathologist, a diabetes educator * The person who manages that team is the GP

Answer 232

**Referral Pathway - Pregnancy Support Counselling (PSC)** * So, another type of Medicare referral that you can have is Pregnancy Support Counselling (PSC). * Now this sits separately from Mental Health Care Plans or CDM’s. * So, you have to have done a course to be eligible to provide these services and you have to have it added once you've shown evidence that you've done the Pregnancy Support Counselling course, * Then they will add it to your provider number. * So, it's available for clients with a current or recent pregnancy within the last 12 months, * So, if they've got any concerns about decisions adjustments pest natal depression etc. they can access that. * So That's in addition to a minute health care plan in addition to a Chronic Disease Management Plan * So, only covers 3 sessions, but of course, the client can continue on under a mental health care plan or any other fall and of course and yes, you need to write back to the GP

Answer 233

ATSI dissents: * So, then another type that we also have is for people of Aboriginal and Torres Strait Islander descent and they have obviously different health Issues and more prolific health issues than the average Caucasian Australian has, * So, this one is for up to **5 Allied Health Service In total the calendar year,** * So, It's similar to the CDM but it's specifically for ATSI people of ATSI descent. * So, again you have to have that added to your Medicare provider number two eligible to deliver those services. * So, it's kind of like a CDM but it's only for ATSI people.

Answer 234

Referral Pathway - Better Start for Children Program: * So, then we also have what is now known as the Better Start for children with disabilities. * So, it's a transition process to NDIS, the aim of it is to assist people to transition to NDIS, and once they've transferred from the Better Start Program onto NDIS, * then that's it, no more eligibility.

Answer 235

Another one we have is **eating disorders,** * so, we have a very specific one for eating disorders, and under the eating disorder ones, this one is quite large, for eating disorders they can **access up to 40, four zero sessions a year,** however, for the eating disorders one, you must be trained in eating disorders and there is actually a Medicare item numbers, * to get this item number added to your Medicare provider number, you have to show evidence of completing certain requirements for eating disorder training, whereas for the other ones like obviously if you're a clinically registered psychologist, you apply for a clinical provider number, * If you're a general psychologist you apply for a general Medicare, you'll automatically get CDM, and those sorts of things, and I should have mentioned to you for the pregnancies for on this short course that you have to do to get those items added to your provider number, * the eating disorder category is much larger, * obviously, they're taking into consideration the long term the basic nature of eating disorders, * and hence why there are 40 sessions available, * so that's quite an extensive one the eating disorder one,

Answer 236

Referral Pathway - DVA: DVA - Department of Veterans' Affairs * Is available for ex-serving military members only * It has changed to 12 sessions cycle * The preference is one 12 session cycle every 12 months, however, the GP can approve for a second cycle * Questions have previously popped up about Medicare and DVA - they were about referrals and entitlements * To see medicare or a DVA client as prov. psychologist you can't see them for you need a Medicare and DVA number * It's interesting that these questions are based on evidence-based interventions - brief solution focused, his used up 6 sessions and has 4 sessions left for example

Answer 237

**Traffic Accident Commission** * is for accident injuries. * have to have a TAC claim number * a doctor or other health professional recommends it, and * **six psychology** or neuropsychology sessions in the first **90 days** after your accident, * psychologist to send us a **mental health treatment plan.** * This plan outlines your progress, treatment goals, and the need for more sessions. * The plan will be reviewed and decided what further treatment you need how many more sessions we will pay for.

Answer 238

**Referral Pathway - EAP** * Employee Assistance Program * under EAP usually get a lot of, * also, under EAP's will also have critical incidents, * whereas in a psychology field now we prefer to call it disaster response and disaster management, * so that also comes on to EAP as well, now with EAP, EAP is a third party, obviously, and there's a lot of different national EAP providers, * * the referral from the EAP generally this is brief intervention, * so, a brief intervention that will generally get three sessions, and then possibly another two, * most government organizations give their employees, six sessions straight up, but it's really important that you know what the parameters are,

Answer 239

Subpoena - do a lot of report for family court - not something to be fearful of We have a large contract with forensic working areas and do a lot of work to family court - it's not something to be fearful about We are constantly writing reports to the court and other various areas and so on Expert witnesses - court deems anybody other than a lawyer as an expert Expert witnesses need to familiar with Evidence Act and Federal Court Rules and the code of conduct is same as the APS's legal code of conduct - you can find it on their website * Most of the time it's out document that is called and not like it's going to be crosschecked When expert witnesses are expected to put caveats on their reports and in their information * Express that the opinions that are stated within the report are based upon the relied upon material then if any further material was provided to us this could change our opinions or our outcomes. You are basically saying "Based on the information that I had during this time, this is the conclusion I've come to, if more information was to come to me it could change my opinion…

Answer 240

**Writing the report:** * We are required to act upon the scope of our profession * We are required to rely on the pieces of information that we rely upon * All of the documentation we were given to read for background information * Reports that were previously written * Any psychometrics that we did * Anything else that we relied upon during writing the report, where we concluded whether that can be journal articles, textbooks we read or information that we just know like the information we are using how we got to our hypothesis or theories know can be put into that report - i.e., two psychologist need to get to be in the similar thinking outcome * We are basically needed to outline how we've come to our conclusion * So basically, we are drawing a picture of how we got to where we go to * What information we used to get to where we got to and what information we are relying on * The other thing is that we have to make a statement saying that "in the best of our ability abided by aware of duty to the court, to the best of our knowledge we have not breeched this in any form" so we are basically saying that I haven't lied, I haven't made false statement etc. in the report [https://www.fedcourt.gov.au/law-and-practice/guides/expert-evidence](https://www.fedcourt.gov.au/law-and-practice/guides/expert-evidence)

Answer 241

The APS Code of Ethics (Standard B.2.) states: B.2.2. Psychologists keep records for a minimum of seven years since last client contact unless legal or their organizational requirements specify otherwise. B.2.3. In the case of records collected while the client was less than 18 years old, psychologists retain the records at least until the client attains the age of 25 years.

Answer 242

* the Mandatory Notification: * \< \>those areas that kind of like warrant that immediately notifiable conduct if someone's practicing intoxicated, whether it be alcohol or drugs, any sort of sexual misconduct, any contact conduct that's going to place the public at substantial risk of harm, because of impairment and impairments can be in a range of ways, and practice it constitutes a significant departure from professional standards. * So, as I said, it's not an offense to not report, but however, it's possible that action can be taken against you, but you know warnings, etc. If you, if you don't report.

Answer 243

Provisional questions under: * 1 hour of supervision every 17 hours of practice * Minimum hours you can complete 88 weeks * 8 case reports (2 assessments and 2 interventions) * 60 hours of PD every year * 120 in total or pro-rata, if you take more than 2 years - you continue your PD Generally registered * 30 PD every year and continue every pro-rata (I hour = 1 point) - Cycle goes 1st of November - You need to record these (if you get audited you need to hand in this information) * If you have an endorsement - extra 10 points for the endorsement area, in addition to your other 30 * If you have a Medicare Number and you can only have this if you’re in private practice and to maintain your medicare number, then * 10 points must be in psychological strategies, * 10 in peer review of your own work * 10 in anything you want them to be in Note: * The LEGAL things that we need to know. * So that we practice safety within our profession. * One of the things that we also need to know about, is * PRIVACY and FREEDOM OF INFORMATION, and the MAINTENANCE OF HEALTH RECORDS. * The Privacy Act or Privacy Act, 1988

Answer 244

Part 7 (Registration)- talks about regulation and registration

Answer 245

Note: The Privacy Act 1988 (Privacy Act) was introduced to promote and protect the privacy of individuals and to regulate how Australian Government agencies and organizations with an annual turnover of more than $3 million, and some other organizations, handle personal information. The Privacy Act includes 13 Australian Privacy Principles (APPs), which apply to some private sector organizations, as well as most Australian Government agencies. These are collectively referred to as ‘APP entities. The Privacy Act also regulates the privacy component of the consumer credit reporting system, tax file numbers, and health and medical research.

Answer 246

**13 Principles of Practice** **APP 1 — Open and transparent management of personal information** * Ensures that APP entities manage personal information in an open and transparent way. This includes having a clearly expressed and up-to-date APP privacy policy. Open and transparent management of personal and transparent information **APP 2 — Anonymity and pseudonymity** * Requires APP entities to give individuals the option of not identifying themselves, or of using a pseudonym. Limited exceptions apply. Anonymity and Pseudonymity **APP 3 — Collection of solicited personal information** * Outlines when an APP entity can collect personal information that is solicited (try to obtain something from someone). It applies higher standards to the collection of ‘sensitive’ information. Collection of solicited and personal information **APP 4 — Dealing with unsolicited personal information** * Outlines how APP entities must deal with unsolicited personal information. Unsolicited personal information **APP 5 — Notification of the collection of personal information** * Outlines when and in what circumstances an APP entity that collects personal information must notify an individual of certain matters. Notification of collection of information collected **APP 6 — Use or disclosure of personal information** * Outlines the circumstances in which an APP entity may use or disclose personal information that it holds. Use of disclosure of personal information **APP 7 — Direct marketing** * An organization may only use or disclose personal information for direct marketing purposes if certain conditions are met. Direct marketing **APP 8 — Cross-border disclosure of personal information** * Outlines the steps an APP entity must take to protect personal information before it is disclosed overseas. Cross-border disclosure of personal information **APP 9 — Adoption, use, or disclosure of government related identifiers** * Outlines the limited circumstances when an organization may adopt a government-related identifier of an individual as its own identifier or use or disclose a government-related identifier of an individual. Adoption, use, or disclosure of government related identifiers **APP 10 — Quality of personal information** * An APP entity must take reasonable steps to ensure the personal information it collects is accurate, up to date, and complete. * An entity must also take reasonable steps to ensure the personal information it uses or discloses is accurate, up to date, complete and relevant, having regard to the purpose of the use or disclosure. Quality of personal information **APP 11 — Security of personal information** * An APP entity must take reasonable steps to protect the personal information * it holds from misuse, interference, and loss, and from unauthorized access, modification, or disclosure. An entity has obligations to destroy or de-identify personal information in certain circumstances. Security of personal information **APP 12 — Access to personal information** * Outlines an APP entity’s obligations when an individual requests to be given access to personal information held about them by the entity. This includes a requirement to provide access unless a specific exception applies. Access to personal information **APP 13 — Correction of personal information** * Outlines an APP entity’s obligations in relation to correcting the personal information it holds about individuals. Correction of personal information **NOTE:** * The most important ones are Anonymity and Pseudonymity (where people don't have to disclose their actual name) * and Access to personal information are the most that have previously seen questions asked about previously * Are the two that most are talked about and questions are about, so know the principals and what they are about but don't tie too much time about them * Adoption, use, or disclosure of government related identifiers

Answer 247

rivacy, freedom of information and maintenance of health records: * Freedom of Information Act. came about in 1982 * Most freedom of information request their personal information - but people can request access their personal information * * Basically, most freedom of information request involves people that are seeking to access documents that contain their own personal information, * but people can actually request to access information about government policies, programs and decision-making procedures etc. * There are some exemptions, and it's generally the exemptions that you need to be aware of. I've given a link to the exceptions, rather than going through the document freedom of information which I don't think you need to know exceptions are far more realistic. The exemptional are far more realistic. So, the exemptions are important to know.

Answer 248

Exemptions If a document is exempt under the defence, security, law enforcement, patent laws, Freedom of Information (FOI) Act, an agency or minister can refuse to disclosure it. Exemptions may apply to a document: * Basically, anything that affects national security defense or international relations, they're not going to release that. * Okay, so if you try and ask for a document that's around Australia's terrorism strategy, probably not going to be released to you. * Yeah, or around Australia's defense capabilities capability, it's probably not going to be, you know, released. * that anything that affects national security, defence or international relations * of the Federal Cabinet * that affects Law Enforcement and Public Safety (i.e., patent laws, people have to right to protect their intellectual property) * where The Secrecy Rules of a Law Applies (for example, information collected under taxation, child support, gene technology and patent laws) * where Legal Professional Privilege Applies * that has Material Collected in Confidence * whose disclosure would be in Contempt of Parliament of in Contempt of Court * disclosing Trade Secrets or Commercially Valuable Information * Electoral Rolls and Related Documents - (as a psychologist you can opt to be silent numbers) * However, an agency or minister may decide to disclose a document even if an exemption applies. * If you do a document that meets conditional exemption they have to disclose, they cannot say no but must meet the public interest * i.e. information that would damage Australian economy. if you’re going to defence, law enforcement, defence, security, law enforcement, patent laws (i.e., intellectual property - a new idea, product or way of doing something? Our patent attorneys can process to protect and commercialise your invention)., FOI Act * Under freedom of information - e If you did some work under a third party - i.e., the court for an assessment, essentially the court is your client not the person, you explain that to the client , they engage in the assessment process, * you can put a CAVEAT to say that that information could damage the client if not given to them in a safe environment or by a suitability qualified person, or not explained to them in an appropriate etc. or they are mentally suitable to understand therefore they can decompensate or decline * You can put that forward and have that considered it doesn't necessarily mean that they won't be given access to it. * It just means that that will be considered. * My experience is that the majority of the time that document will not be released to that person, particularly if they're mentally unwell. It won't be released to them. * If you look at the freedom of exemptions it will give you a blurb - which will be enough to know

Answer 249

Conditional Exemptions If a document meets a conditional exemption, the agency or minister must also decide if disclosing the document would be against the public interest. * They can’t refuse access to a document solely because it meets a conditional exemption, it must also be against the public interest. * so, posting information that would be unreasonable to disclose or information. * You know that would damage the Australian economy. * So that sometimes is those exemptions that they make on a case by case basis. * So, they're conditionally exemptions. Conditional exemptions may apply to a document that has: * personal information that would be unreasonable to disclose * information about certain operations of the agency (such as an agency’s operations, audit, examination or employee management) * information about the deliberative processes relating to an agency or minister’s functions * information that could damage federal and state government relations * information that may damage the Australian economy * information about the Australian Government’s financial or property interests

Answer 250

Antidiscrimination & Equal opportunity * In Australia it is unlawful or Illegal to discriminate on the basis of protected attributes which are: * age * disability, * race, * sex act * gender identity * Sexual orientation * the talk about different areas * which these acts apply * - Majority of times it's talking about employment and education * Disability Act 1992 - buildings, education - this is national legislation - equal opportunity but they all have the same thread Australian guidelines - Latest introduced are sex discrimination: * Sex and Gender - gender identity and intersex status - are the later additions * Individuals may identify as gender other than they are assigned to, or may not identify - gives evidence to change about to change their sex or gender (male or female) * Equal opportunity * APS - brought up guidelines to working with gender fluid population to psychologists - Gender fluid and other terms used.

Answer 251

* We don't have a national mental health act * It’s quite different for all territories and states Involuntary Treatment and Consent * Although it's a bit different within each state, generally * You can be hospitalised involuntarily if you have a mental illness, you can be treated in one or more of the following criteria: * A-Does the person have a mental illness * B-You need Treatment * C-You can't make decision for yourself * You are considered to be a danger to your own safety or considered to be a danger to other person/people’s safety, and/or imminent touch with reality * So, it comes down to is the person able to make decision for themselves and is the person a danger to themselves or others. * These are common within all states but there is no national mental health act. There are questions in the exam about involuntary treatment order, but the questions are very overt like "are they in touch with reality, or are they are at risk of harming themselves or someone else"

Answer 252

Informed Consent * 4 elements that are important for informed consent, psychologists * (1) provide an appropriate explanation - (It must be delivered in a language that the client understands and consents to) * (2) seek the individual's assent (approval or agreement) - (Providing comprehensive information about the service and basically, they agree to take part in that service, no cohesion and is able to make decision by themselves nor a threat) * (3) consider such persons' preferences and best interests - (What the scope of the client is consenting to and understands - i.e., 50-minute session, EAP provider etc.) * (4) obtain appropriate permission from a legally authorized person - (The client needs to be competent and the client needs to be voluntary (can't be impaired in any way, they need to overt and freely made the decision to be treated) * if such substitute consent is permitted or required by law.

Answer 253

Duty to protect, duty to report/inform - Mandatory notification, elder abuse, child abuse What are our legal requirements and obligations? * Legal responsibility on child abuse and neglect * Depending on the type of work and how the information was obtained and where in Australia you work: * Mandatory requirements have different responsibility on this one - (you have to have justifiable reasons for reporting, can't rely on your gut feeling) * Mandatory reporting elder abuse, child abuse - we have to think several things about what a mandatory reporting is

Answer 254

* Must have reasonable grounds that this information and decision was formed - need to look at the legislation within states - There are a lot of grey areas within the legislation according to the state * NT, TAS & South Australia: All registered psychologist is required to report all suspected physical, sexual, emotional and psychological abuse and neglect of children * In addition, NT and TAS are required to reporting of suspected exposure to family violence, * no other state or territory has legislation to reporting of psychologists * In Canberra and NSW: Psychologists working in school settings must report suspected physical and sexual abuse * Victorian Psychologist should be aware of Victorian crimes Act in the offence of failure to disclosure about sexual offence against a child under 16 years of age by someone over 18 years of age * In NSW provisional or psychologist who are employed to work with children health care services * In ACT extends to emotional and psychological abuse and neglect and exposure the family violence * Working in a school or working within community care must report * In QLD are mandated to report if they are working within school or if you’re working within a community care yes but private no * In any state anybody working for the family court - Working for the federal court yes you have to report * Working in a school yes but not you don't need to * Only in NSW - you have to report crime act no other state has this - this came in in 1901 - if the crime has occurred and the child is older than 18 you don't need to report * The psychologist must consider the clients security as paramount * E.g., a must read is the example - TARASOFF - American case occurred - an Indian guy fell in love and he disclosed that he was going to kill the girl and did kill the girl which was not reported (the psychologist was prosecuted for not breeching confidentiality) [https://en.wikipedia.org/wiki/Tarasoff\_v.\_Regents\_of\_the\_University\_of\_California](https://en.wikipedia.org/wiki/Tarasoff_v._Regents_of_the_University_of_California) * There are no requirements in the code of ethics for a psychologist to report a crime only in the state NSW

NPE - Chegg Flashcards

(281 cards)