Index

ABC model 112

accountability 2, 24, 47, 134, 149, 158, 189

assessing clients 27, 28

additional assessment and testing 56–9

client focused research approach 59

COMPASS tracking system 58

monitoring, empirical evidence 58

phases to therapy, Lutz et al. 58

pre-treatment scores, client 59

assessment process 27

current diagnostic practices 29

diagnostic manuals 27

initial interview, annotated proforma 40

mental disorder 28

attrition rates 137

behavioural case formulation, functional analysis 61–7

aim 62

antecedents, categories 62

mediators 62

moderators 62

case example 66–7

causal variables 62

clinical experimentation 66

components 62, 64

antecedents 62

behavior 63

consequences 63

consequences, categories 63–4

negative reinforcer 64

positive reinforcer 63

punisher 63

response cost 64

definition 62

functional analysis, components 63

hypothesis-driven approach 61

limitation 67

target behavior, focus 62

behavioural function identification, 65

assessment methods 65

analog 65

indirect 65

naturalistic 65

behaviour therapy, psychotherapy 95–109

case formulation, assessment and treatment linkage 60, 91

client information, importance 60

definition, Eells 60

process 61

reasons for behaviour, variables 65

automatic reinforcement 65

negative reinforcement 65

positive reinforcement 65

steps 61

case management 157–80

confidentiality, maintenance 160–6

confidentiality negotiation, working with minors 162–3

confidentiality to patients 161–2

disclosure scope, control 163–4

information disclosure guidelines 162–3

patient information, securing 164–6

emergency procedures 173–4

core principles 173

evaluation and treatment phase, tasks 178–80

termination/transfer report 179

good record maintenance 157–60

characteristics, good clinical record 159–60

clinical activity documentation, purpose 157–9

intake and treatment planning phase, tasks 166–74

case information, presentation and documentation 167–9

ethical issues 167

informed consent 166

referral issues, clarification 167

risk assessment and management 169–74

progress notes, writing 176–7

tasks 157

treatment implementation phase, tasks 174–8

progress toward goal attainment, documentation 174

termination planning, initiation 175–8

case presentation components, importance 168

Clark, cognitive model of panic attack 77

client data, conceptualization/documentation/management 158

clients, relating with 11, 15–20

body language 17

closed/open questions 16, 18–19

degree of influence, clinician 19

eye-contact, importance 16–17

introduction of problems, client 16

preliminary introduction, therapist 15

therapist responses, potentially useful 19

therapy, goal of 19

troubleshooting, common client issues 23–6

agitated clients 24

anxious clients 24

interview refocusing 25

personal information enquiry, by client 25

session, collaborative nature of 25

support and sympathy, expression 24

talkative clients 24

therapist, attitude 23

voice tone 17–18

clinical psychology practice, stake holders 6–10, 147, 183

effectiveness research 7

efficacy studies 6

health care industrialization 9

managed (health) care organizations, evolution 9

presenting evidence 8–9

research activity types 6

society, interests of 7

stakeholders, three classes 6

subjective units of discomfort (SUD) 8

cognitive behavioural case formulation 67–80

case example 69–80

formulation and treatment, link 79

perpetuating cognitions and consequences 73–5

potential problems 80

precipitating variables 71–3

predisposing factors 75–6

prescribed interventions 79–80

problems, presentation of 69–71

provisional conceptualization 76–9

case formulation model 69

case formulation worksheet 70

completed worksheet 80, 81

clinical practice model, inclusion 82

personality inventory 78

NEO-PI-R 78

SCL-90-R 78

Persons model 67

core beliefs 67

hypothesis, working 68

origins 68

precipitants and activating situations 68

problem list 67

strengths 69

treatment plan 68

treatment, predicted obstacles 68–9

weaknesses 69

cognitive therapy, psychotherapy 111–17

Acceptance and Commitment Therapy (ACT) 117

cognitive (behavior) therapy, Beck 112

bias, types 112–13

automatic thoughts 113

cognitive restructuring 111

downward technique, Burns 113–14

rationale 114–17

rational emotive therapy (RET), Ellis 111–12

procedural steps 112

unconscious thoughts, role 114

confidentiality 15, 24, 157, 244

contigency management 96–104

behavioural maintenance 103–4

conditioned excitors 104

conditioned inhibitors 104

occasion setters 104

contingency contracting 101

desired behaviors, increasing 97

negative reinforcement 97

positive reinforcement/reward 97

pyramid chart 97

social reinforcement 97

differential reinforcement types 100

habit reversal 101

treatment components 101

new behaviour introduction, strategies 102–3

chaining, types 103

shaping and reward successive approximations 102–3

performance variables 101–2

reinforcement schedules 102

response 102

subject 101–2

problem behaviours, decreasing 98–100

clinical practice, phenomena 99

contingent punishment 98

over correction 100

positive practice 100

response cost and extinction 99

satiation 99

time-out reinforcement 98–9

reinforcer, definitions 96–7

reinforcers, types 97

cost-containment 4

diagnostic and statistical manual of mental disorders (DSM) 29–33

Axis I, clinical disorders 30–1

Axis II, personality disorders and mental retardation 31

Axis III, general medical conditions 31

Axis IV, psychosocial and environmental problems 97

Axis V, global assessment of functioning (GAF) 32–3

DSM-IV 29–33

diagnostic interview 34–9

generalized anxiety disorder (GAD), client with 35–6

client, complete picture of 38

clinician, choice of direction 37

‘concentration’, meaning of 36

coping resources identification 39

diagnostic aspect 38

DSM-IV criteria 36–7

problem history 37

proforma, for assistance 39

series of stages, Prochaska et al. 39

diagnostic interview, different client groups 39–48

Beck depression inventory (BDI) 42

behaviour and symptom identification index (BASIS-32) 42

Center for epidemiological studies – depression scale 42

general health questionnaire (GHQ) 42

Hamilton anxiety scale (HAS) and the Hamilton rating scale for depression (HAM-D) 42

interviewing children 39

interviewing elderly groups 41

psychological symptoms, screening for 41–3

SCL-90-R & BSI 41

diagnosis limitations and future directions 54–6

identifiable psychometric assessments 55

observable symptoms, focus on 55

prevention and early intervention, focus on 55

specific criteria introduction 55

treatment outcome, limited predictors 55

unlisted problems, clinical disorders 55

diagnostic systems 29–34

cultural sensitivity 34

dialectical behavior therapy (DBT), psychotherapy 109–11

dilemmas 110

drawback 111

merits 111

documentation tasks 157

dual relationship 197, 228, 232

empathy 12, 60, 105, 207

empirical foundations, therapeutic relationship 11–14

process variables, categories 14

review on therapy-specific behavior, Orlinsky et al. 13

studies, Miller et al. 12–3

therapeutic process variables and outcome, relationship size 13, 21

empirically supported treatments (ESTs) 11, 12

delivery 120–32

exposure to feared stimuli, example 120–5

essential targets for change, Barlow 121

exposure treatment, aim 122

self-efficacy theory 121

new treatments 133

rationale for exposure, example 123–5

relaxation, example 125–32

exposure 94

Eysenck, criticisms 1–2

functional analysis 61

group treatment 134

assessment and pre-group orientation 137–41

best participation, guidelines 139

clarity format and program duration 139

faith and optimism 140

frustrations and disappointments, anticipation 140

group formulation 138

individual case formulation 137

patient enlistment 139

preparatory tasks 139-41

setting ground rules 140

typical practice adaptations 141

group, patient selection for 137

group, start activities 141–2

first session, importance 141–2

rationale of program, review 142

interpersonal interaction, therapeutic tool 134

progress and outcomes, monitoring and evaluation 142–6

easy-to-follow feedback 144

group progress data, routine examination 144

individual case formulation and treatment, integration 136, 144

program evaluation 146

successful outcomes, accurate documentations 146

systematic accounting, group progress 145

smoking cessation treatment 136

biological markers, carbon monoxide 136

change trajectories 143

example 138–9, 142-4

patient characteristics, general information 138

Tobacco Dependence Treatment Handbook 135

treatment progress, pattern of 144, 145

treatment program selection 135–7

treatment strategies, practice guidelines for 135

health care providers, psychologists as 240

effective interventions, providing 246–9

presenting problems, focus on 246

limited data, decisiveness 248

effective short-term techniques 248

motivational interviewing techniques 248

ethical issues, attending 251

good team players, psychologists as 249

accepting referrals 249

clear and frequent communication 249

sensitive and hierarchical team structures 249

flexibility and availability 249

health care resources, psychologist competition 241–4

evidence-based treatments 241

cost-effective care delivery 241

fee-for-service model 241

billing scoring system 242

cost-effectiveness 242

cost-offset 242

illness, leading causes 240

initial evaluation phases, Rowan and Runyan 247–8

integrated care, value addition 244–6

selective serotonin reuptake inhibitors (SSRIs) 244

problem-focussed initial encounter 244

solution-focused treatment planning 245

good enough treatment, guiding principles for 245

integrated care settings, skillsets 246–51

medical things, familiarity with 249–50

physical conditions and medications, knowledge on 249

medical reimbursement codes, familiarity with 250

medicos, adopt with 250

out comes, accountability 250

psychological services, necessary/discretionary health care 241

stepped care models, Davidson’s definition 245

stepped-up approach, treatment of hypertension 245

stepped care approach, pain management 246

homework 199

humanity of clients, cross-cultural and ethical aspects 217

assessing ethical dilemmas, 227

clinical psychology practice, factors affecting 217–19

health intervention 217

Schou and Wight, studies on dental heath campaign 218

confidentiality 227–8

legal rules and ethical standards 228

culture sensitive practice, clinical psychology 219–22

caveats 219

individualism 220

dual relationships 228-9

Canadian Psychological Association 229

sexual relationships 229

ethical decision-making, guidelines 225–7

British Psychological Society, 226

Canadian code of ethics for psychologists 225

Canadian Psychological Society 226

Kluckhohm and Stodtbeck, culture-sensitive practice parameters 220–2

activity, preferred mode 221

behavioural changes 222

human character 220

people and natural world, relationship 220

people relationships 221

relational orientation 220

self-evaluation 221

time orientation 221

structured problem solving, steps 222–4

ethical decision-making 224–9

interpersonal psychotherapy (IPT)

basics 117–20

developmental stages 118

interpersonal deficits 119–20

interpersonal role disputes 118–19

role transitions 119

case example 80–90

depression, deal with 82–6

interpersonal problems, assessment 86–8

therapeutic contract, negotiation 89–90

case formulation 80–92

CBT, contrast with 90–2

interpersonal communication 86

loss and growth 86

phases 81

international classification of diseases (ICD) 29

depressive episode, varieties 33

disorders, categories 33

ICD-10 33–4

management tasks 157

mental disorders 28, 85, 237

mental status examination (MSE) 48–54

Cognitive Capacity Screening Examination (CCSE) 54

cognitive state 50–4

attention and concentration 51

delusions 52

derealization/depersonalization 53

hallucinations 52

insight and judgement 53

intelligence and abstraction 54

memory 51

orientation 50

perception 52

speech and language 53

thought disturbances 51

thought, form and content 51

emotional state 50

mood and affect 50

High Sensitivity Cognitive Screen (HSCS) 54

Mental Status Questionnaire (MSQ) 54

mini mental state exam 54

physical state 49–50

appearance 49

attitude 49

behaviour 49

motor activity 49

Short Portable Mental Status Questionnaire (SPMSQ) 54

Treatment Protocol Project 48, 54

monitoring 7, 56, 101, 137, 158, 182

motivation 68, 101, 136, 206

motivational interviewing 144, 207, 248

patient information, securing 164–6

guidelines, risk avoidance 164-5

problem solving 219

programme evaluation 147, 148

change, advocating and promoting 155–6

empirically based outcome evaluation 156

key findings communication, opportunities 155

recommendations, non-use and translation 155

recommended changes, adoption 156

strategies, promotion 155

team formation 156

conclusions 147

evaluation data 147

evaluation findings, data collection and analysis 152–3

evaluation findings, translation 153–5

good recommendations, qualities 153, 154

written recommendations 154

evaluation plan, development 151–2

considerations, issues 151

cost estimation, plan 152

data collection and management strategies, selection 151–2

dissemination strategies, outcomes of the evaluation 152

information, recipients and users 151

personnel and material resources 151

five basic steps 149–56

negotiation and communication skills 147, 148

right questions, asking 149–51

clarificative evaluation 149

impact evaluation 150

interactive evaluation 150

monitoring evaluation 150

outcome monitoring data 150

proactive evaluation 149

skill training, modes 148

punishment 64, 97

questions 16, 36, 96, 148

reinforcement 65, 96

relaxation 97, 101

Rescorla-Wagner model 99

resistance 199

rural and remote settings, working in 230

fishbowl, professional boundaries maintenance 231–5

multidisciplinary care, natural support networks and 236–9

clinical activities 238

community education 237

community referral systems 238

generalist role 238

partnership development 237

multiple relationship management, strategies 233

addressing client needs 234

consultation seeking 235

educating client 234

monitoring comfort level 234

obtaining informed consent 234

out-of-therapy discussion 233

overlapping relationship, termination 235

overlapping relationships documentation, case notes 233

procedure development 234

role compartmentalization, 233

role-boundary conflicts, monitoring 235

slippery slope phenomenon 235

time limits 234

worst case scenario, imagination 234

professional isolation, coping strategies 235–9

rural mental health services, drawbacks 230–1

fishbowl situation 231

help-seeking situation 231

rural practice, scientist practitioner approach 232

rural practitioners, public image 231

telehealth 236

definition 236

science-informed model of clinical psychology practice, approach 1, 4–5, 147, 152, 182

client–therapist relationship 4

clinical practice, public accountability 5

outputs 10

professional organizations, promotion by 9

treatment data/client decisions linking, case formulation 4

treatment selection 94

scientist–practitioner model, approach 2–3, 243

Lightner Witmer 2

screening 41

self-management, contingency management 104–9

behavioral contracting, use 105–7

modeling 107–9

applications 108

imitation 107

observational learning 107

role-plays 109

role-reversal 109

types 108

motivational interviewing strategy 105

role, reasons 104

structured and semi-structured diagnostic interviews, adults 43–6

anxiety disorders interview schedule for DSM-IV (ADIS-IV) 44

composite international diagnostic schedule (CIDI) 44

diagnostic interview schedule (DIS) 44

instruments available 43-6

mini-international neuropsychiatric interview (MIDI) 45

primary care evaluation of mental disorders (PRIME-MD) 45

schedule for affective disorders and schizophrenia (SADS) 45

SADS lifetime anxiety for DSM-IV 45

schedule for clinical assessment in neuropsychiatry (SCAN) 46

structured clinical interview for DSM-IV axis-I disorders (SCID) 46

SCID-CV, SCID-I 46

symptom-driven diagnostic system for primary care (SDDS-PC) 45

structured and semi-structured diagnostic interviews, children 46–7

child and adolescent psychiatric assessment (CAPA) 46

child assessment schedule (CAS) 47

children’s interview for psychiatric syndromes (ChIPS) 47

diagnostic interview schedule for children (DISC) 46

interview schedule for children and adolescents (ISCA) 47

schedule for affective disorders and schizophrenia for school-age children (K-SADS) 47

structured and semi-structured diagnostic interviews, older adults 47

Cambridge mental disorders of the elderly examination (CAMDEX) 47

comprehensive assessment and referral evaluation (CARE) 47

Geriatric mental state schedule (GSM) 47

suicide risk level determination 169–70

categories 172–3

decision framework, Joiner et al. 169–71

management strategies 170, 172–3

supervision 181

agenda setting 188–9

audio- and video tapes, learning from 189–91

impression management, guarding against 191

stage setting 190

tape segments selection 190

challenge to advance 194

competency-based approach, types 184–6

cognitive-behavioral supervision 184

development approaches 185

Gestalt supervision 184

process-based approaches 185–6

formative and summative evaluation 194–5

goals 181–4

quality assurance 183

supervision data presentation 184

group supervision 193

impression management checklist 191

learning supervisory skills 195–8

prescriptive strategies 197–8

reflective strategies 196–7

supportive strategies 196

reflective supervisee, 186–8

client, follow-up session 188

client, subsequent session 188

preparatory events, prior to supervision 187

solutions generated, during supervision 187

subsequent supervision 187–8

trigger event 186

trigger event, reactions to 186

supervisory activities and outcomes, accounting for 191–3

supervision record form 192

supervisory practice, pros and cons 181

tension identification chart 128

termination planning 177, 206

therapeutic alliance, building 14–23

client communication, strategies 20–1

empathic understanding 22

encouraging 20–1

paraphrasing, keyskills 21

summary creation 21

components 14–15

therapy session conduct, conclusions 15

treating clients 93

psychotherapy literature 93

limitations 94

types 93

psychotherapy, types 95

treatment manuals 11, 135

treatment non-compliance, managing 199

client–therapist interactions, examples 199, 208, 209, 211, 212

homework non-compliance, managing 214–16

motivation enhancement, resistance management 206–14

avoiding argumentation 210–1

developing discrepancies 209–10

empathic communication 207–9

general principles, motivational interviewing 207

Miller and Rollnick, contributions 207

resistance, rolling with 211–2

self-efficacy, supporting 212–14

therapeutic resistance 212

resistance and non-compliance, model of 199–201

resistance management, at different phases 202–6

“search and destroy” approach 206

assessment phase 202–3

examples 204–5

implementation phase 203–5

termination phase 205–6

therapeutic resistance 201–2

transtheoretical approach 202

Wachtel, definition 201