Quiz 1

Question 1

*What is the structure of a CBT session (6 parts)?

Answer 1

1. mood check
2. review HW
3. agenda setting
4. session content
5. assign HW
6. Elicit feedback

Question 2

*What are the three components of EBP?

Answer 2

1. Best available research evidence
2. Patient preference and values
3. Clinical expertise

Question 3

*Ways to make CBT child friendly (7)

Answer 3

1. Developmentally, culturally sensitive
2. Collaborative empiricism, guided discovery
3. Beliefs: hypotheses to test in experiments
4. Playful applications of cognitions, emotions, and behavior
5. Teaching the identification of feelings
6. Thought diaries, thought digging, bubbles
7. Games, puppets, videos, workbooks

Question 4

*Key points in CBT psychoed with adolescents

Answer 4

• Disorders, symptoms, problems
  
  • Decrease self-blame
  • Not your fault
  • Emphasize strengths
  • Rationale for family involvement
• CBT model and rationale
  
  • Start to monitor feelings, thoughts, BEH
  • Set goals collaboratively
• Alternative Tx, combining meds?
  
  • Elicit and clarify explanations (e.g., takes work)
  • Been in therapy before?
  • Place value on their POV
  • Will learn skills
  • Invite questions

Question 5

Name two mood monitoring tools

Answer 5

1. Emotional thermometor
2. Daily rating of mood

Question 6

*How do mood monitoring tools work?

Answer 6

• links mood an events/situations
• pay attn to mood overtime and see what factors influence mood
• looks at connections in the thought triangle

Question 7

What is the ‘best available research evidence’ part of the 3 Legged Stool or EBP tripartide model?

Answer 7

• Clinicians use best available research when making Tx decisions. RCT is still the gold standard.
• Relevant abilities:
  
  • Adopt a scientific view of clinical psychology
  • Knowledge of applied research design and methods
  • Strategies for accessing best available research
  • Ability to evaluate relevant evidence

Question 8

What is the ‘patient preference and values’ part of the 3 Legged Stool or EBP tripartide model?

Answer 8

• Considering Pt’s individual characteristics in Tx; includes: diversity issues as well as the need to involve the patient fully in treatment planning including analysis of the chances they will benefit or not from the evidence-based approach (using quantitative presentations when possible).
• Relevant abilities:
  
  • Understand role and limits of clinical judgment
  • Skills in relationship building
  • Assessment and diagnostic skills
  • Skills to implement EST’s (e.g., specific therapeutic techniques)
  • Integration of EST with client characteristics

Question 9

What is the ‘clinical expertise’ part of the 3 Legged Stool or EBP tripartide model?

Answer 9

• Advanced clinical skills to Dx, assess, and Tx clients. Translate best available research evidence for the average or a prototypical client
• Relevant abilities:
  
  • View psychological interventions as a collaborative endeavor
  • Knowledge of specific culturally diverse groups
  • Ability to ascertain client/patient values and preferences
  • Respond effectively to client/patient preferences and value

Question 10

What are the 5 EBP Steps or Competencies?

Answer 10

• 1. Ask: formulate the question
• 2. Acquire: evidence - search for answers
• 3. Appraise: the evidence for quality of intervention and relevance to specific client/problem
     * Appraise both quality of the evidence and relevance to the pt at hand
     * The question must have 4 parts:
     1) pt or problem being addressed; 2) the intervention being considered;
     3) the comparison intervention; and 4) the clinical outcomes of interest
• 4. Apply the results
• 5. Assess the outcome

Question 11

*Key components of CBT psychoeducation with adolescents

Answer 11

• Disorders, symptoms, problems
  
  • Decrease self-blame
  • Not your fault
  • Emphasize strengths
  • Rationale for family involvement
• CBT model and rationale
  
  • Start to monitor feelings, thoughts, BEH
  • Set goals collaboratively
• Alternative Tx, combining meds?
  
  • Elicit and clarify explanations (e.g., takes work)
  • Been in therapy before?
  • Place value on their point of view
  • Will learn skills
  • Invite questions

Question 12

*Goal Setting

Answer 12

• Find a goal parent and child can agree on
• Prioritize where to start: problems à goals à intervention
• Write goal list actively engaging the child – include short and long-term goals:
  
  • Break into smaller, concrete parts:
• HW should be part of a goal
• Client may need new skills to meet the goal
• Objectives = strategies to obtain goals

Question 13

*Philosphy of STIC task

Answer 13

• Homework: Show that I can
  
  • Present as an opportunity for the child to show what they learned
  • Explain not like academic homework: no right or wrong answer, spelling/grammar does not count, no grades
• Purpose:
  
  • Allow therapist to gauge how well the child understands content of therapy
  • Allows child to practice what they know, and for skills to generalize and be maintained
• Link homework to presenting problem
• Collaborate with client and be flexible to change to make more effective -> but make sure maintaining fidelity to evidence based treatment
• Start simple and practice in session first
  
  • Assess potential obstacles and solutions
• Do uncompleted tasks in session
  
  • Learn from noncompliance
• Reward completion/effort (can involve parents but depends on the child)

Question 14

*RIBEYE

Answer 14

• Relax
• Identify the problem
• Brainstorm (no evaluation)
• Evaluate each possible solution
• Yes to one (choose one solution)
• Encourage yourself

Question 15

*BEH Activation

Answer 15

• BAdisrupts the cycle of avoidance/distress loop that maintains depression (contingencies maintaining depression)
• BA goal:
  
  • Increase pleasure and mastery in order to reduce avoidance -> goal is to have balance of both pleasure and mastery -> clients may have one or the other already but try to help them achieve both
• BA involves the client doing before they feel motivation -> change behavior to improve feeling

Question 16

*IPT

Answer 16

• Main goals: decrease depressive symptomatology and to improve interpersonal functioning.
• Clinical depression in the IPT framework is conceptualized as having three components: symptom formation, social functioning and personality.
• Phases:
  
  • Inital: focuses on depression diagnosis, psychoeducation about the illness and limited sick role, exploration of the patient’s significant interpersonal relations, and the identification of the problem area that will be the focus of the entire Tx. therapist conducts the “Interpersonal Inventory,”
  • middle: therapist teaches adolescent specific strategies that can help him deal with his interpersonal difficulties within one or two problem areas
  • termination: clarification of the adolescent’s warning Sx of future depressive episodes, ID of successful strategies used in the therapy, generalization of skills to future situations, emphasis on mastery of new interpersonal skills and discussion of the need for further Tx.