Thursday, April 08, 2004

Here are the answers to this weeks questions: 1.a 2.a.3.d.4.b.5.d.

The Finn and Tonsager article displayed some interesting but not completely surprising results related to giving feedback to clients after an assessment is completed. The results of this study suggest that processing the results of an assessment with the client can potentially reduce current symptomatology. To me, reviewing feedback to testing has always been an important part of the testing process. The second article distributed to us that was written by Pope seemed to address the best way to complete this part of the assessment. It reviewed some very important ethical considerations involved for clinicians engaging in this task. I appreciated this article as it offered me some valuable information to facilitate this type of feedback session. I have had the opportunity to engage in a few feedback sessions on my last practicum and also at our clinic. I felt the article will offer me some additional information to strengthen my own skills for future feedback sessions. Also, I found the section "classification of tasks and roles" very interesting and one that many practicing psychologists should increase their awareness of...as I can imagine this may be an area that get out of control on occassion.

Thursday, April 01, 2004

Here are my answers to this weeks article: d,a,c,b,d.

This weeks article on "Prediction and Diagnosis" explored various issues related to prediction and diagnosis of individuals and groups when different approaches were utilized. One area this article discussed included the validity of clinical predictions when an interview is incorporated into the process. Essentially, they presented an argument that interviews do not increase accuracy when used to make predictions about certain behaviors. This is an interesting finding, especially since clinical intakes relies on gathering a great deal of it's client's factual information (psych history, developmental and familial history, medications, health related facts and so on) to determine a client's current diagnosis and therapeutic needs. We also are trained to use specific measures as we try to determine a diagnosis to best describe the current psychopathology of the patient. This article basically hypothesizes that this process is useless and not a very good tool to use to better understand the individual client. I do feel that increased training, credentialing, and experience will increase a clinician or psychologist's success in making some type of prediction. I do not feel that using one's " gut" feeling or relying on intuition is a suitable method for prediction and diagnosis. An actuarial approach to better understand the likelihood that someone will behave in a particular way can be useful. However, I do not feel that this is an "end all" approach, and also one that can be used as a guide only to understand behavior in general. Again, I feel it is more important to learn history, background information and evaluate/observe behaivor in session to make the most accurate prediction/diagnosis.

Thursday, March 25, 2004

Here are the answers to the Pope, Tabachnick and Keith-Spiegel (1987) article: a,b,b,c,d, c,c,d,d,b,b,b.

Pope, Tabachnick and Keith-Speigel (1987) conducted research exploring specific behaviors psychologists engage in with thier clients or related to the therapeutic relationship. It also reviewed the psychologist's beliefs about the specific behaviors and asked those completing the survey to identify or evaluate the ethics involved in participating in each situation. The content of the questions asked was comprehensive as it reviewed items such as beliefs about hospitalizing a patient involuntarily or accepting a gift less than $5 from a client. It also asked psychologists to rate the occurrance of behaviors such as disrobing in front of clients, talking about clients (with names) at dinnerparties or with friends. It was shocking to see the bizarre behaviors endorsed by psychologists that are currently practicing in the clinical field. Many endorsed engaging in some unusual behaivors as least on rare occassions that are ethical violations. How does this help our profession when licensed psychologists are engaging in unethical practice or exploiting thier clients in some way? This article was quite an eye opener for me. I was both surprised and disgusted as I read down the long list of unethical, unusual and unprofessional actions that seem to happen in many practices. I would like to see an updated survey completed in this same area and compare any changes that may have occurred over the past 15 years.

Thursday, March 11, 2004

Answers for Questions to Moon et al.'s article on frequent WAIS-R errors: b,d,a,a,b.

This article challenged test administrators ability to comply with necessary conformity to standardization in the administration of the WAIS-R. The subjects researched to test this phenomenon were doctoral level students. One third had completed the required coursework learning the fundamentals of administering the WAIS-R. The remaining 2/3's of the doctoral students had not yet completed this course, but were currently enrolled in the class. Needless to say, there were significant results showing that standardization requirements were not maintained. The amount of error in conformity to specific administration requirements seems especially high. This aspect of the article causes some concern to me because this test and any standardized test is meant to be administered and scored in a specific manner for a number of reasons. It is not fair to the client who is participating in this testing to not receive the test in any way other than that suggested by the manufacturer of the testing material. Many times reports are transferred to other professionals for referral purposes. How can we trust the report if we believe that not all psychologists are completing the entire testing in the standardized manner that was required? Another thought in response to the subject sample that was used for this study, having some doctoral students who have completed a WAIS course and some students currently enrolled in a WAIS course does not seem to constitute a valid representation of psychology professionals to judge the population of those who conform to standardized procedures and those who do not. Also, is it fair to say that a doctoral student enrolled in a WAIS course should already know all of the requirements for the administration and scoring of a WAIS without much practice on other students or practice subjects? In my opinion, this does not seem to be a valid representation to suggest the results of this study may represent a larger sample of experienced psychologists who test regularly. However, I'm sure the problem exists on some level and I believe it is something that should be evaluated more closely to better understand the true percentage of errors for those adminstrating and scoring standardized tests.

Tuesday, March 09, 2004

March 7, 2004

Sexual Attraction to Clients Article: Answers: d,b,d,a,a,b,a,b,a,c.

The Pope, Keith-Spiegel, and Tabachnick (1986) article mentioned several important issues related to therapist-client attraction. It also highlighted some surprising statistics related to sexual intimacy between therapists and their clients. The fact that one article that was sited offered results suggesting this actually happens in 5-10 percent of therapeutic relationships is extremely shocking. Another article that was sited by Pope et al. suggests that 90 percent of the clients who have previously been involved with their therapist have displayed detrimental effects in some way following the affair (approx. 90 percent!). It seems ironic that these individuals, who are initially seeking help from a therapist, are vulnerable and are taken advantage of by this professional. Additionally, as a result of this affair are facing more problems, trauma, or exaccerbated symptoms.

This article discusses in depth the question of attraction between therapists and their clients. I felt that conceptualizing this phenomenon through the psychoanalytic perspective was appropriate and made a great deal of sense. I believe that this is a natural occurrence for any two people involved in a relationship that are exploring intimate details of one’s life to a great extent. Therapists are no exception. The difference is that we need to be aware and conscientious of this happening and to be responsible when we realize that this is taking place. I’m not sure that we’ve been trained extensively on specific ways to manage this event, as the article suggests, but that is also a great reason to consult with peers or supervisors. This was a good article to read and one that I would recommend to other students.

Thursday, February 12, 2004

February 12, 2004

Answers to questions in Monaghan (1993) article: D, A, B, C, A, B, B, B.

This article discussed many important aspects related to risk assessment, retrieving past records, documentation, consultation, risk management, and more. I read the article during a break while at practicum. I have a later peer supervision meeting in which I am planning to reproduce copies of this articles for other professionals at my practicum site, as I feel there is a great deal of valuable information that should be passed on to others actively working with difficult or potentially violent patients. Although everyone seems to be aware of the Tarasoff law or "duty to protect", there are many aspects related to this law that may sometimes be lost or forgotten to those in the field. This article is a strong reminder of factors that are necessary when practicing therapy.

The article discusses the concept of "serious threat" according to national standards and states the importance of knowing the states standards for understanding specifically what counts as a "serious threat" or a "reasonably identifiable victim". I am wondering what is Pennsylvanias stance on these terms/concepts and would like to clarify the specifics on PA's statutes or laws related to 'duty to protect' and 'duty to warn'.

Retrieving past psychological documentation or records when seeing a new patient can provide a great deal of information to enhance the effectiveness or efficiency of a new treatment provider. However, how many of us actually take the time to attempt to retrieve this type of documentation from past therapists or hospitals? The impact of this information will not only benefit the therapist, as it will provide a significant amount of additional information sometimes missed during an intake. It will also benefit the client by offering him or her more effective therapeutic treatment. Additionally, as seen in the Monaghan article, it will benefit others if there is a potential for violence. This is seen by offering clinicians information about past violent actions towards others and will be an additonal source to guide treatment.

Thursday, February 05, 2004

questions and answers
Here are my answers for the Bearhs & Guntheil articles quiz: 1. b 2. c. 3. a. 4. a.

My answers for the Bergin article are as follows: 1. c. 2. b. 3. b. 4. d. 5. a. 6. c.

Bergin's article on values and religious issues in the context of psychotherapy had an impact on me after I completed the reading. I have always attempted to keep my own values and religious beliefs in check and not use them in a way to influence my treatment. Additionally, I personally feel that even though an individual in therapy may define values and beliefs different from my own, that I can still be effective as a therapist and remain non-judgemental. I feel it is extremely important that my own values, personal goals, and spiritual beliefs are clear in my own mind and so that I can consciously refrain from using them to influence a client that I may be working with. This also seems to be something that has been reinforces through my academic training. It seems that this may not be the case, however, for all professionals in the mental health field, as I have witnessed some individuals discuss strong reactions to their clients' religious decisions or value system rather than working with the client where they are at the moment. This issue is something that should be addressed within various programs training social workers and mental health professionals.

This page is powered by Blogger. Isn't yours?