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Evidence-based medical learning
Advanced Clinical Psychology: Assessment, Case Formulation & Evidence-Based Treatment — Flashcards
Flashcards for Advanced Clinical Psychology: Assessment, Case Formulation & Evidence-Based Treatment
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1
QUESTION
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What’s a practical rule if there’s little improvement by sessions 4–6?
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1
ANSWER
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Re-check formulation, barriers, adherence, confounders, and adjust the plan (targets/interventions/measurement).
outcomes
planning
adjustment
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2
QUESTION
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What’s the difference between mood and affect in the MSE?
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2
ANSWER
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Mood is the client’s reported internal emotional state (“sad,” “anxious”). Affect is the clinician’s observed emotional expression (range, intensity, congruence, stability).
MSE
assessment
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3
QUESTION
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What does “integration” of CBT/ACT/DBT mean in best practice?
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3
ANSWER
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Sequencing and combining approaches based on readiness, risk, and formulation—never random mixing.
integrative
sequencing
formulation
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4
QUESTION
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Name the key domains of the Mental Status Exam (MSE).
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4
ANSWER
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Appearance/behavior, speech, mood/affect, thought process, thought content, perception, cognition, insight/judgment.
MSE
assessment
documentation
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5
QUESTION
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What are the “Big Three” confounders to rule out in differential diagnosis?
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5
ANSWER
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Medical contributors, substance effects (intoxication/withdrawal), and sleep disruption.
differential
diagnosis
screening
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6
QUESTION
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Why do safety behaviors weaken exposure learning?
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6
ANSWER
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They teach “I survived because of my ritual/safety behavior,” preventing new learning that the feared outcome is tolerable or less likely.
exposure
safety behaviors
learning
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7
QUESTION
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What is a defensible way to document diagnostic uncertainty?
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7
ANSWER
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Use provisional language plus a testing plan: “Most consistent with X; continue to assess Y; rule out substances/medical; measures/collateral pending.”
documentation
diagnosis
ethics
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8
QUESTION
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What makes a treatment goal “measurable”?
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8
ANSWER
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It specifies behavior, frequency/intensity, time frame, and success criteria (e.g., “attend 2 social events/month without leaving early due to anxiety within 6 weeks”).
goals
documentation
planning
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9
QUESTION
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What is the purpose of case formulation compared with diagnosis?
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9
ANSWER
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Diagnosis labels symptom clusters; formulation explains why the problem developed and what maintains it, guiding what to target first and which interventions fit best.
formulation
diagnosis
treatment planning
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10
QUESTION
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What’s the differential diagnosis workflow taught in Lesson 2?
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10
ANSWER
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Timeline → functional impairment → rule out confounders (medical/substances/sleep) → check danger flags → compare hypotheses → build a testing plan with targeted questions/measures.
differential
clinical reasoning
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11
QUESTION
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How do OCD obsessions differ from generalized worry?
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11
ANSWER
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OCD obsessions are intrusive, unwanted thoughts often neutralized by compulsions/rituals; generalized worry is broader, future-oriented, often tied to reassurance seeking and tension rather than rituals.
OCD
anxiety
differential
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12
QUESTION
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When are DBT skills especially useful early in treatment?
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12
ANSWER
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When the client has severe emotion dysregulation, impulsivity, self-harm risk, or needs stabilization before exposure or deep cognitive work.
DBT
regulation
stabilization
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13
QUESTION
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In a maintaining cycle, what question often reveals the key target?
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13
ANSWER
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“What does the client do that makes sense short-term but makes the problem worse long-term?”
formulation
targets
behavior
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14
QUESTION
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What should be measured in MBC? (3 categories)
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14
ANSWER
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Symptoms, functioning, and process variables (e.g., avoidance, substance use, skills practice, exposure completion).
MBC
monitoring
outcomes
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15
QUESTION
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What’s the difference between goals and targets in treatment planning?
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15
ANSWER
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Goals are desired outcomes (e.g., “less anxiety”). Targets are mechanisms to change to reach goals (e.g., reduce avoidance, reduce safety behaviors, increase exposure).
treatment planning
goals
targets
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16
QUESTION
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What distinguishes mania/hypomania from simple sleep deprivation?
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16
ANSWER
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Mania/hypomania involves reduced need for sleep without feeling tired plus increased goal-directed activity and impairment/risk; sleep deprivation typically involves fatigue, irritability, and cognitive fog without classic manic pattern.
bipolar
differential
sleep
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17
QUESTION
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When is exposure-based treatment especially indicated?
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17
ANSWER
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When avoidance and safety behaviors maintain fear (phobias, panic, OCD, social anxiety, trauma-related avoidance when appropriate and paced).
exposure
anxiety
OCD
panic
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18
QUESTION
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What is a “provisional diagnosis”?
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18
ANSWER
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A best-fit working hypothesis based on current evidence that remains open to revision as more data (collateral, measures, observation over time) is gathered.
diagnosis
documentation
ethics
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19
QUESTION
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What is “mechanism matching” in evidence-based treatment selection?
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19
ANSWER
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Choosing interventions based on maintaining mechanisms (avoidance, safety behaviors, rumination, dysregulation) rather than relying only on diagnostic labels.
evidence-based
mechanisms
selection
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20
QUESTION
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What is a maintaining cycle (loop) in formulation?
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20
ANSWER
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A repeating pattern: trigger → interpretation → emotion/body → behavior → short-term payoff → long-term cost that sustains distress.
formulation
maintaining factors
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21
QUESTION
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What is the priority rule for sequencing treatment targets?
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21
ANSWER
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Safety first → stabilization (sleep/substances/crisis) → core maintaining cycles → growth/relapse prevention.
sequencing
safety
planning
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22
QUESTION
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Define measurement-based care (MBC).
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22
ANSWER
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Using brief standardized measures (symptom + function + process) at regular intervals to guide clinical decisions, monitor progress, and adjust treatment.
MBC
outcomes
evidence-based
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23
QUESTION
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What are the 5Ps in the case formulation model?
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23
ANSWER
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Presenting, Predisposing, Precipitating, Perpetuating, Protective factors.
formulation
5P
case conceptualization
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24
QUESTION
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CBT cognitive restructuring vs behavioral experiments—when to use each?
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24
ANSWER
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Restructuring helps evaluate distorted beliefs through evidence and alternatives; experiments test sticky beliefs in real-world conditions to produce disconfirming learning.
CBT
experiments
cognition
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25
QUESTION
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What is the core aim of ACT in clinical work?
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25
ANSWER
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Change the relationship to internal experiences (thoughts/feelings) using acceptance/defusion and promote values-driven committed action.
ACT
defusion
values
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26
QUESTION
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What are the three core goals of a clinical intake?
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26
ANSWER
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(1) Clarify the presenting problem in measurable terms, (2) assess safety/acuity, (3) gather enough context to form and test initial clinical hypotheses and plan next assessment steps.
intake
assessment
fundamentals
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27
QUESTION
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What is the difference between a presenting complaint and a symptom?
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27
ANSWER
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A presenting complaint is the client’s narrative (“I can’t sleep”). A symptom is a measurable experience or behavior (sleeping 4 hours/night, early-morning awakening, fatigue).
assessment
interviewing
measurement
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28
QUESTION
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Why is risk screening considered routine rather than optional?
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28
ANSWER
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Because avoiding risk questions increases danger; direct, calm screening identifies self-harm/suicide/violence/abuse or severe impairment early and supports appropriate safety planning and documentation.
risk
safety
assessment
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