CHYS 2P35 Assessment Lecture Notes PDF

CHYS 2P35 -- Assessment Lecture 3 notes [Clinical Interview] Varies in structure Structured Interview: consists of a standardized series of questioned with predetermined wording and order - Systematic approach that is less prone to variations - E.g. in my research...Anxiety and Related Disor...

CHYS 2P35 -- Assessment Lecture 3 notes [Clinical Interview] Varies in structure Structured Interview: consists of a standardized series of questioned with predetermined wording and order - Systematic approach that is less prone to variations - E.g. in my research...Anxiety and Related Disorders Interview Schedule for DSM-5 A structured clinical interview developed to assess *DSM-5* symptoms: A structured clinical interview developed to assess *DSM-5* symptoms **Definition of Clinical Interview** A series of questions that clinicians administer in face-to-face interactions (or via telehealth) with the client. It is the most universally used assessment procedure for parents and children. Unstructured Interview: involves a series of open ended questions - Information sought through interviews - Reasons for being in treatment - Syptoms - Health status - Family background - Life history \*Similar to treatment, assessment procedures should follow certain guidelines to allow for **evidence-based assessment**. THINGS TO THINK ABOUT... - Multiple problems present before a referral is made - Often a thorough assessment is needed and a treatment plan is devised - Described as good detective work - Revisiting the Biopsychosocial model - Treatment Plans are based on the assessment and assessment tends to be ongoing - What is this? What does it mean? CASE OF ALEXA - Alexa is 10 years old. She described a number of anxiety-related symptoms. These symptoms often interfered with her friendships, participating in sports, and meeting new people. - The psychologist administered the Anxiety and Related Disorder Interview Schedule for DSM-5. Alexa was above the cut-off criteria for [social anxiety disorder]. The psychologist wanted Alexa to do some observation of her own behavior through thought records. - The [assessment results were directly related to the prescribed intervention (Cognitive Behavior Therapy). The psychologist continued to assess her symptoms to see if there was a reduction while progressing through treatment. ] - In this case the psychologist is trying to determine weather social anxiety is present **Where to begin...** - Use of evidence-based assessment and clinical judgment to examine a child's socio-emotional and cognitive functioning. Social, environmental factors, and cultural factors need to be considered. - Assists in analyzing the presenting issues - Its going to progress and change overtime... you will have to go back and tweak it accordingly KEY POINT: *\*\*\* Assessments are only meaningful if they result in practical and effective interventions* Q. How do you make assessment and treatment meaningful? - Easily understood - 'listening' to the parent and child -- what is feasible - Is there rapport and buy-in? - This is an ONGOING THEME throughout [CASE OF SAVANNAH] - 14 years old, Grade 9 - Reason for Referral: Depression - Recent symptoms were described as occurring when her mother was hospitalized with pneumonia - School Refusal, Frequent Stomach Pains - Wanted to be with her mother on a very frequent basis - Was quiet, appeared sad, was socially isolated - Sleep issues and loss of appetite - Feelings of hopelessness and social isolation - Experienced a drop in grades **Where does professional Begin?** Q. Is there a need for diagnosis of a psychological disorder or multiple disorders? - This decision usually begins with clinical assessment - Problem-solving analysis looks at things like **etiology, treatment options, and possible outcomes.** - Etiology refers to the root causes of childhood disorders. Why are certain variables present? Where did they originate? \**based on empirical evidence and clinical judgment* **Taking a look at etiology and using the assessment to Generate Treatment Options...** - Possible causes - Family history - Traumatic event - How did Savannah view what happened to her mom? - History of symptoms (e.g., stomach aches, school avoidance) - Was there a medical cause or could this be related to anxiety? - Assessment would then be used to GUIDE treatment - In this sense the modality treatment that would make sense for savannah would be individual therapy... **Semi Structured interview questions** Depressed mood/irritability - Do you feel sad? - Do you get moody? Loss of Interest - Have you lost interest in doing things, like your hobbies? - Is there anything you look forward to doing? **Assessment** Clinical Description: details out the [unique] behaviors, thoughts and feelings the make up the features of the client's psychological issues. It looks at dimensions such as intensity, frequency and severity of the challenges at hand. Acknowledging Child Voice FIRST - FIRST , what are the youth concerns? - SECOND, what are the parents concerns? \*\*\* issues of consent and capacity [Multimodal Assessment ] **Tying things together** - Clinical interview - Behavioral Observation - Important to 'operationalize' the behaviour - How do you gather information about the target behaviour? - Observing in a variety of settings such as school, home, at the clinic, etc... - Look at dimensions that are part of the clinical description... e.g. intensity, duration - With the clinical interview and observation, you have indirect and direct information to analyze [Cognitive Assessments and Tests of Adaptive functioning ] Q. What is adaptive Functioning? - Functional skills that an individual preforms in everyday life - Some examples **Adaptive functioning** Examples: - Communication - Social Skills - Motor Skills - Self-Care Skills - Skills that contribute to Independence (looking at age and developmental level) \*\*We asses this with standardized tests like the Vineland-3 [Characteristics of Psychological Assessment ] Psychological assessment**:** is a procedure in which a clinician provides a formal evaluation of an individual's cognitive, personality, and psychosocial functioning - A broad range of measurement techniques, all of which involve having people provide scorable information about their psychological functioning **Intelligence Training** Uses include: - Overall cognitive evaluation - Diagnosis of learning disabilities - Determination of giftedness - Prediction of intellectual disability - Prediction of future academic achievement - Diagnosis of neurological and psychiatric disorders **Assessments for Behaviour Challenges** **Further look at Behavioral Assessment** Unlike psychological tests, behavioral assessments record actions rather than responses to rating scales - also involves looking at triggers/setting events and consequences. A form of measurement based on objective recording of the individual's behavior - Include descriptions of the events that precede or follow the target behavior (looking at the behavior as well as antecedents and consequences). - BUT...What is behavioral interviewing? - It involves asking questions about the behavior itself and how often it occurs. It CLINICAL CASE of JESSE - Self-injury (tapping hand to head) - Antecedent = presentation of a task; Behavior = tapping hand to head; Consequence = Task is taken away. - What could be done in this situation involving communicating needs and wants? **Behavioral Assessments** Target Behaviours: behaviours of concern that the client and clinician wish to change Q. So what is included in behavioral assessments? - Behavioral interviewing - Behavioral observation - Self monitoring BEHAVIORAL OBSESRVATION - Being able to watch and observe the behaviours of clients in their natural environment - This allows for the avoidance of your actions interfering with the experiment SELF MONOTORING - Individualizing the experiment to the particular client - They take the experiment home and the parent observes - Implies the reward system post - It's a rap around treatment Q. What could this then lead to? - Things to think about - Discussion about prognosis - Making predictions about the future under specific conditions - Planning Treatment, application of treatment and evaluation - E.g. Degression and the case of savannah **Mental Status Examination -- now OR** Definition: A method of objectively assessing a client's behavior and functioning in a number of spheres, with particular attention to the symptoms associated with psychological disturbance \*\* used to assess a clients current state of Mind **Mini Mental State Examination (MMSE)** - Structured (screening) tool that clinicians use as a brief screening device to assess for neurocognitive issues Q.What do we mean by neurocognitive difficulty? E.g., frequent forgetfulness - The clinician administers a set of short memory tasks and compares the client's scores to established norms - If the client scores below a certain cutoff, the clinician then continues to more thorough testing to determine the nature and extent of potential neurocognitive impairments