Tema 6 Diagnóstico

TEMA 6: ANÁLISIS DESCRIPTIVO I

• Proceso de Evaluación Psicológica Clínica: Focuses on descriptive analysis, functional analysis, and diagnosis within a clinical psychological assessment. (Muñoz, Ausín, & Panadero, 2019)

ANÁLISIS DESCRIPTIVO

• Exploración Inicial: Identifying initial problems and their sequences.
• Análisis del Desarrollo y Narración: Evaluating developmental patterns and narratives.
• Variables de la Persona: Analyzing the individual's characteristics.
• Variables del Contexto: Evaluating the environment's influence.

ANÁLISIS FUNCIONAL

• Hipótesis Iniciales: Formulating initial hypotheses.
• Hipótesis de Trabajo: Developing working hypotheses.
• Análisis Funcional de cada Problema: Investigating the etiology, course, and maintenance of each problem.

DIAGNÓSTICO

• Impresión Diagnóstica: Initial diagnostic impressions.
• Hipótesis Diagnósticas: Potential diagnostic hypotheses.
• Diagnóstico (Criterios): Classifying the issue based on specific criteria.
• Datos Epidemiologicos: Collecting data on the course, comorbidity, etc.
• Modelos Psicopatológicos: Applying relevant models.

FORMULACIÓN

• (Theory of the case: explanation and prediction(with and without treatment):)
• Etiología: Causes and origins
• Curso: Evolution and progress of the condition.
• Mantenimiento: Factors that sustain the problem.
• Pronóstico: Predicted future outcomes (with or without treatment).
• Contraste de Hipótesis de Mantenimiento: Testing the hypotheses on maintenance factors.

INFORMES Y DEVOLUCIÓN DE INFORMACIÓN

• Información y Devolución: Providing information and feedback.

8. DISEÑO DEL TRATAMIENTO

• Objetivos, Técnicas y Momentos de la Intervención: Outlining treatment goals, methods, and timing.
• Programas Estandarizados: Treatment plans following evidence-based approaches.
• Plan Personalizado: Tailor made, personalized treatment.
• Tratamientos Estandarizados: Guidelines like NICE, APA, and other standardized treatment approaches.

9. EVALUACIÓN DEL CAMBIO

• Evaluación Durante el Tratamiento: Assessing progress during treatment.

10. EVALUACIÓN DE SEGUIMIENTO Y EFECTIVIDAD

• Evaluación de Seguimiento: Assessment to track the course beyond treatment.
• Efectividad: Evaluating the positive impacts of the intervention.

1. IDENTIFICACIÓN DE PROBLEMAS

• Problema: Issue with transactions between the individual and the environment creating feelings of discomfort, hindering daily activities or impacting health.

• Criterios de Problema: Must be neither all-encompassing nor just a diagnosis nor too minor to affect the overall behaviour; rather, it must be in a suitable middle ground, meaning a manageable size that allows segmentation while being conceptually and practically relevant.

• Transacciones Individuo-Ambiente: Transactions between a person's behaviour and surroundings.

• Excepciones: Problems that don't necessarily cause distress to the individual but to others or problems that are seen as abnormal by the individual, despite not being so in the eyes of an outsider. (e.g., exhibitionism or some forms of abuse).

• Problemas etiquetados como patológicos (por modelos psicopatológicos): Issues recognised as problematic according to behavioural models (ex: hallucinations).

• Evaluación de una lista de Problemas:

  • Assists in structuring assessment processes (EPC).
  • Details the types and extent of the person's issues.
  • Creates information to make use of possible hypothesis.
  • Helps the patient to understand the situation.

CONSIDERACIONES (LISTA DE PROBLEMAS)

• Recoger exhaustivamente: Collecting all identified problems meticulously.
• Uso de Listas: Writing all problems allows the observer to view all at once.
• Dos listas: One list is shared and one remains confidential for the professional.
• Consenso: Agreement on the list with the patient.
• Posibles omisiones: Potential issues that might have been overlooked. Consideration to revisit the list later.

PATRONES DE CONDUCTA

• Esquema Descriptivo de ansiedad y evitación social: Illustrated as a flow diagram, outlining the sequence of interaction, perception of threat, maladaptive behaviours contributing to anxiety and social avoidance.

TIPOS DE SECUENCIAS Y MODELOS

• Lineales: E-R or E-C-R (Antecedente-Conducta-Consecuencia).
• Jerárquicas: (Simple/Compleja) Antecedente-Consecuencia.

GUÍA DE ENTREVISTA CLÍNICA GENERAL

• Interacción Inicial: Observing client's characteristics (punctuality, personal presentation, behaviour, cooperation). Further elaboration with questions on time & space perception if necessary.
• Delimitación de Problemas: Identifying and clarifying initial problems and issues; asking about concerns in various life domains. Considering a priority for problems.
• Análisis de Secuencias Actuales: Starting with the most pressing problem to pinpoint sequence details, including frequency, duration, and intensity. Describing the situation like a movie to understand the problematic behaviour as precise as possible.
• Identificación de cada componente de la secuencia: Identifying the beginning and end of a sequence. Recognizing associated actions and reactions. Pinpointing all elements (internal and external) of the sequence.
• Cambios de la Actividad: Identifying situations that bring a pause or change in the sequence to identify possible triggers and/or ending points, to use to clarify the process.

HISTORIAS CLÍNICAS

• Fecha de primera aparición del problema: Timepoint when the issue first emerged.
• Incidentes clave: Highlighted major events and periods influencing the problem's evolution before the current session.
• Importancia del problema: Extent to which the problem impacts their life.