Clinical Psychology for Trainees: Foundations of Science-Informed Practice

✍ Scribed by Andrew C. Page, Werner G. K. Stritzke

• Publisher: Cambridge University Press
• Year: 2006
• Tongue: English
• Leaves: 301
• Edition: 1
• Category: Library

✦ Synopsis

This book describes the practice of clinical psychology with special emphasis on providing trainee therapists with the skills and strategies to achieve the core competencies required for a science-informed clinical practice. It will support the reader in making the transition from the lecture theater to the consulting room. The approach incorporates a contemporary perspective on the multiple roles of clinical psychologists within a competitive healthcare market, where professional psychologists not only need to be accountable for their outcomes and efficient in achieving them, but also need to be conscious of the social and political context in which psychology is practiced. Chapters are organized around the acquisition of key competencies and linked within an evidence-based, science-informed framework. Case studies, handouts, graphics and worksheets are employed to encourage the implementation of the skills described. This book should be read by all those enrolled in, or contemplating, postgraduate studies in clinical psychology.

✦ Table of Contents

0521615402......Page 1
Half-title......Page 3
Title......Page 5
Copyright......Page 6
Dedication......Page 7
Contents......Page 9
Preface......Page 11
1 A science-informed model of clinical psychology practice......Page 13
The scientist-practitioner model......Page 14
The aim of this book......Page 15
A science-informed model of clinical psychology practice......Page 16
Stakeholders in the practice of clinical psychology......Page 18
Presenting evidence to stakeholders......Page 20
2 Relating with clients......Page 23
Empirical foundations of the therapeutic relationship......Page 24
Building a therapeutic alliance......Page 26
Relating with a client to build an alliance......Page 27
Encouraging, restating and paraphrasing......Page 32
Troubleshooting......Page 35
Summary......Page 38
3 Assessing clients......Page 39
What is a mental disorder?......Page 40
The DSM-IV......Page 41
Axis I: clinical disorders......Page 42
Axis III: general medical conditions......Page 43
Axis V: global assessment of functioning (GAF)......Page 44
The ICD-10......Page 45
Conducting a diagnostic interview......Page 46
Adapting diagnostic interviews for different client groups (children and the elderly)......Page 51
SCL-90-R and BSI......Page 53
Hamilton anxiety scale (HAS) and the Hamilton rating scale for depression (HAM-D)......Page 54
Structured and semi-structured diagnostic interviews: adults......Page 55
Diagnostic interview schedule (DIS) and the composite international diagnostic interview (CIDI)......Page 56
Schedule for affective disorders and schizophrenia (SADS)......Page 57
Diagnostic interview schedule for children (DISC)......Page 58
Structured and semi-structured diagnostic interviews: older adults......Page 59
Mental status examination (MSE)......Page 60
Emotional......Page 61
Orientation......Page 62
Thought - form and content......Page 63
Perception......Page 64
Speech and language......Page 65
Limitations of diagnosis and future directions......Page 66
Additional assessment and testing......Page 68
4 Linking assessment to treatment: case formulation......Page 72
Behavioural case formulation: functional analysis......Page 73
A case example......Page 78
Core beliefs......Page 79
Predicted obstacles to treatment......Page 80
Presenting problems......Page 81
Precipitating variables......Page 83
Perpetuating cognitions and consequences......Page 85
Predisposing factors......Page 87
Provisional conceptualization......Page 88
Prescribed interventions......Page 91
A case example......Page 92
Deal with the depression......Page 94
Assess the interpersonal problems......Page 98
Negotiate a therapeutic contract......Page 101
Summary and contrast with CBT......Page 102
5 Treating clients......Page 105
Behaviour therapy......Page 107
Contingency management......Page 108
Increasing desired behaviours......Page 109
Decreasing problem behaviours......Page 110
Differential reinforcement......Page 112
Variables that influence performance......Page 113
Introducing new behaviours......Page 114
Maintenance of behaviours......Page 115
Self management......Page 116
Use behavioural contracting......Page 117
Modelling......Page 119
Dialectical behaviour therapy (DBT)......Page 121
Cognitive therapy......Page 123
Presenting a rationale for cognitive therapy......Page 126
Basics of interpersonal psychotherapy (IPT)......Page 129
Example 1: exposure to feared stimuli......Page 132
Example 2: relaxation......Page 137
Summary......Page 144
6 Group treatment......Page 146
Selecting a treatment programme......Page 147
Assessment and pre-group orientation......Page 149
Clarify format and duration of the programme......Page 151
Instil faith in the programme and optimism about the outcome......Page 152
Getting the group under way......Page 153
Monitoring and evaluating progress and outcomes......Page 154
7 Programme evaluation......Page 159
1 Asking the right questions......Page 161
2 Developing an evaluation plan......Page 163
3 Collecting and analyzing data to produce findings......Page 164
4 Translating findings into recommendations for action......Page 165
5 Advocating and promoting change......Page 167
Keeping good records......Page 169
Maintaining confidentiality......Page 172
Talking about confidentiality with patients......Page 173
Negotiating confidentiality when working with minors......Page 174
Controlling the scope of disclosure......Page 175
Securing patient information......Page 176
Getting treatment under way......Page 178
Presenting and documenting case information......Page 179
Assessing and managing risk......Page 181
Documenting progress toward goal attainment......Page 186
Initiating termination planning......Page 187
Tasks associated with the evaluation and termination phase......Page 190
Goals of supervision for science-informed practice......Page 193
A competency-based approach to supervision......Page 196
Following the trigger event......Page 198
During subsequent session with client......Page 199
Setting an agenda......Page 200
Learning from (audio-) videotapes......Page 201
Setting the stage......Page 202
Accounting for supervisory activities and outcomes......Page 203
The challenge to advance beyond the familiar......Page 205
Formative and summative evaluation......Page 206
Learning supervisory skills......Page 207
Reflective strategies......Page 208
Prescriptive strategies......Page 209
A model of resistance and non-compliance......Page 211
What is therapeutic resistance?......Page 213
During the assessment phase......Page 214
During the implementation phase......Page 215
During the termination phase......Page 217
Managing resistance by enhancing motivation......Page 218
Expressing empathy......Page 219
Developing discrepancies......Page 221
Avoiding argumentation......Page 222
Rolling with resistance......Page 223
Supporting self-efficacy......Page 224
Managing homework non-compliance......Page 226
11 Respecting the humanity of clients: cross-cultural and ethical aspects of practice......Page 229
Culture-sensitive practice of clinical psychology......Page 231
Parameters of culture-sensitive practice......Page 232
Applying structured problem-solving to culture-sensitive practice......Page 234
Applying structured problem-solving to ethical decision-making......Page 236
Dual relationships......Page 240
Mental health services in rural communities......Page 242
Maintaining professional boundaries in the rural fishbowl......Page 243
Strategies for managing multiple relationships in rural practice......Page 245
Coping with professional isolation......Page 247
Incorporating natural support networks and multidisciplinary care......Page 248
13 Psychologists as health care providers......Page 252
Psychologists compete for health care resources......Page 253
Psychologists add value to integrated care......Page 256
1. Psychologists need to provide effective interventions expeditiously......Page 258
3. Psychologists need to gain familiarity with all things medical......Page 261
4. Psychologists need to be accountable for outcomes......Page 262
5. Psychologists need to attend to ethical issues......Page 263
References......Page 264
Using the empirical and theoretical literature......Page 289
Assessment and case formulation......Page 290
Measurement, monitoring, evaluation and accountability......Page 291
Index......Page 293