Listening skills are used to give the client an opportunity and encouragement to tell their story. Non-selective listening skills refer to skills that exert little influence and are intended to encourage and stimulate the client. The are several non-selective listening skills:Non-verbal behaviourThis includes the following skills:Facial expressionThis should be tailored to the individual (e.g. occasional smiling; frowning)Eye contactThe clinician should look at, or in the direction of the client most of the times but should not stare or avoid eye contact.Body languageThis communicates the tenseness of the situation.Encouraging gesturesThis includes nodding and using supportive hand gestures.Verbal following silencesThis includes the following skills:Verbal followingThis includes ensuring that one’s comments line up as closely as possible with what the client says and does not introduce new topics (e.g. minimal encouragement). It gives the client the opportunity to explore and elaborate on their own line of thought.Use of silencesThis gives the client the opportunity to consider what they have just said.Selective skills refer to skills that are used to select a certain aspect of the client’s story which is deemed important. This can be done by going into the content, feeling of giving extra attention to a certain subject. There are several selective listening skills:Open questionsThis gives the client a lot of freedom in their answers.Closed questionsThis does not give the client a lot of freedom and often stem from the clinician’s frame of reference. It has three disadvantages:It restricts the client in their range of possible responses.The questions are often suggestive.It may steer the conversation to a question-answer format.Why-questionsThis is a form of open question that can give the idea of the need to justify oneself.ParaphrasingThis refers to briefly reproducing in one’s own words the gist of...
Clinical Skills: Developmental Psychology – Lecture 1 (UNIVERSITY OF AMSTERDAM)
There are several characteristics of early adolescence (i.e. 10 – 14):
There are several characteristics of middle adolescence (i.e. 14 – 16):
There are several characteristics of late adolescence: (i.e. 16 – 22)
Resistance of treatment often stems from the fear that the meaning of behaviour (e.g. undesirable behaviour) will not be recognized. The clinician needs to name what one observes (1), switch off judgement (2), ask how one can help (3) and state that the opinion of the client matters (4).
Observation uses a person as an instrument and can serve as a diagnostic technique when observation is used with the aim of drawing conclusions. There are several benefits of observation:
There are also several problems with observation:
There are several types of observation:
Treatment effects are determined by:
A scientist-practitioner works as a clinician and uses conversation skills (1), psychodiagnostics (2) and treatment (3) based on science.
The regulatory cycle focuses on decision making and change. It is purposeful and directional and includes problem-solving. There are several steps:
The regulatory cycle aims to achieve goals to solve a problem while the empirical cycle aims to test whether a hypothesis is correct. Each step in the regulatory cycle involves going through the whole
.....read more Clinical Skills: Developmental Psychology – Lecture 2 (UNIVERSITY OF AMSTERDAM) Almost one in eight young people are in youth services (e.g. mental health services). Abnormal development refers to development not being normal and often includes excessive parts of behaviour or behaviour that is not shown enough. Cognitive distortions are common. There are several definitions:
Classification is important as it gives directions to what is normal and what is abnormal. It contains a meaningful grouping of symptoms and syndromes. It is important to have knowledge of what is normal to determine when there is a problem and when there is a disorder. There are two levels of classification:
There are two main functions of classification systems:
There are several advantages of using a classification system such as the DSM-V:
There are also several disadvantages of using the DSM-V:
There are several theoretical models on which a classification system can be based:
.....read more Clinical assessment of child and adolescent personality and behaviour by Frick, Barry, & Kamphaus (fourth edition) – Chapter 2 summaryA psychological test refers to a systematic procedure for comparing the behaviour of two or more people. Standardization refers to collecting a sample for the purpose of norm-referencing and it refers to the administration of a measure according to a consistent set of rules. A standardized administration is necessary to produce reliable and valid measurement.
A diagnostic schedule (e.g. rating scale) refers to a specialized psychometric method that provides a structured procedure for collecting and categorizing behavioural data that corresponds to diagnostic categories or systems. It is used to diagnose a syndrome. The goal of an instrument determines whether it is a diagnostic schedule (e.g. diagnose or not). Rating scales allow for the rapid and accurate identification of domains of behaviour that may require diagnosis or intervention.
There are several definitions used when testing children:
Standard scores allow for comparisons across tests because they have equal units along the scale. Gender norm-referencing could erase the gender effects in groups and subsequently reduce gender biases in diagnosing. However, the DSM-5 often does not have a different threshold
.....read more Clinical assessment of child and adolescent personality and behaviour by Frick, Barry, & Kamphaus (fourth edition) – Chapter 3 summaryUsing a developmental approach has several implications for the assessment process:
There are several practical implications for assessment:
Clinical assessment of child and adolescent personality and behaviour by Frick, Barry, & Kamphaus (fourth edition) – Chapter 4 summaryInformed consent should be provided before any clinical service to a child or adolescent. The informed consent must be obtained from at least one of the parents if the child is below the age of consent. Without exception, it should be the first thing that is done in clinical assessment. There are several basic elements of informed consent:
Children under the age of consent do not have the right to refuse participation. However, the clinician needs to seek the individual’s agreement (1), consider preferences and best interests (2) and provide an appropriate explanation (3) to people who cannot give informed consent. The child has the right to have the policies and procedures explained to them in a language that is appropriate to their developmental level.
Clinicians should only administer tests for which one is competent. They should carefully follow the standardized procedures for administration and scoring specified by the test developer. Administration procedures that introduce construct-irrelevant variance (e.g. distractions) should be avoided.
Only interpretations that have been supported by research should be made from test scores (i.e. evidence-based clinical practice). The results should be explained to the individual being tested in developmentally appropriate language.
Clinicians need to protect the integrity of testing materials. If it is not protected, users who are not qualified to interpret the results may use it or future test-takers will get acquainted with the materials, making them invalid for testing.
Fairness refers to responsiveness to individual characteristics and testing contexts to ensure that test scores will yield valid interpretations for intended uses (e.g. make adjustments to the test for people who are visually impaired). Test bias (i.e. measurement bias) refers to the validity of interpretations not being equally valid across groups. Differential item functioning (DIF) occurs when equally able test takers differ in their probabilities of answering a test item correctly as a function of group membership. This is evidence of test bias.
There are several guidelines for working with a multicultural population:
Clinical assessment of child and adolescent personality and behaviour by Frick, Barry, & Kamphaus (fourth edition) – Chapter 5 summaryNon-specifics refer to contextual factors within which the techniques of psychotherapy take place (e.g. therapeutic alliance). During the assessment procedure, the reason for referral should be taken into account. The interpretations that one anticipates making at the end of the evaluation should guide the selection of tests for the assessment battery (e.g. hypotheses about the referral question and the problem behaviour). When the referrer is unsure about what can be done to help the child or unsure about the nature of the problems, the goal of assessment is to diagnose the source of the problems and make treatment recommendations based on this diagnosis.
It is always important to determine whether an evaluation is in the child’s best interest as a request is not sufficient reason to conduct the evaluation. A second opinion can be valuable although it needs to be taken into account whether it is will not only reinforce the parent’s disagreement with the outcomes or form unrealistic expectations about what the result of evaluation can be.
There are four primary sources of error variance that can affect the reliability of assessment:
Aggregation refers to obtaining information from multiple sources and across multiple settings and can be used to control error variance and to increase reliability. Aggregation and reliability increase as the length of a test increases. However, the additional tests that are added should be reliable, as it otherwise decreases the reliability of the test battery.
The clinician needs to take several things into account when designing an assessment battery:
Rapport refers to the interactions between the clinician and the client that promote confidence and cooperation in the assessment process (e.g. warm relationship). An attitude of acceptance (1), understanding (2) and respect for the integrity of the client (3) are essential for building rapport. The self-esteem and the consequences of testing for parents need to be taken into account (e.g. feel like a failure when a child has a disability). It is also important to take the time that teachers have into account and not monopolize it. The rapport with the teacher can be enhanced by calling the teacher and personally thanking them for their effort.
Building rapport with youth is often characterized by having multiple participants, such as parents and teachers (1), lack of motivation of the child (2) and a limited timeframe (3). This
.....read more Clinical assessment of child and adolescent personality and behaviour by Frick, Barry, & Kamphaus (fourth edition) – Chapter 13 summaryHistory taking is essential in child psychological assessment for several reasons:
It consists of several aspects:
It is important to take the goodness of fit between the child’s characteristics and the context into account in which one is expected to function. The content of history taking often includes complaints/symptoms (1), developmental history (2), family history (3), social functioning (4), academic functioning (5), family relations (6), interests and strengths (7) and views of the problem (8).
Genograms refer to a family tree that allows the clinician to document the family structure (1), the relationships among family members (2), critical events (3) and any particular variables of interest (4). It presents information graphically in a manner that is quickly interpreted.
There are several behaviours that should be observed by the clinician during history taking:
Clinical assessment of child and adolescent personality and behaviour by Frick, Barry, & Kamphaus (fourth edition) – Chapter 15 summaryAssessment should include many areas of functioning (1), use multiple techniques (2) and use multiple sources (3). The integration of this information is often difficult due to the low rate of agreement between informants but this may reflect real situational variability in children’s behaviour. Informant disagreement is influenced by the type of behaviour being assessed and the measurement technique used across informants (i.e. assessment strategy).
The level of analysis should be taken into account when assessing a lack of agreement between informants as individual behaviours show less consistency across informants than broader dimensions of behaviours (e.g. diagnosis). To understand the different behavioural manifestations, it is important to understand the demands of different contexts.
Complex schemes refer to systems in which one source of information is weighed more heavily than others. Simple schemes (i.e. either/or approach) refer to systems in which information from all sources is weighed equally. Complex schemes are often based on clinical judgement rather than empirical evidence, meaning that simple schemes may be superior. However, this is only when informants are asked to provide information that they are expected to know. There may be a differential validity of various informants across behavioural domains.
The quality of information provided by different informants is influenced by the age of the child. The importance of parents and teachers as informants may decrease with age and the importance of children’s self-report may increase. Nonetheless, the reliability of parent report is still acceptable in adolescence. Marital conflict (1), parental adjustment (2), maternal alcoholism (3), marital difficulties (4), ethnicity (5), different motivation (6) and testing conditions (7) may influence the report of various informants and should be considered when interpreting discrepant information.
There are several common cognitive strategies that can lead to errors in the problem-solving process:
The use of these heuristics can be minimalized by using a systematic problem-solving approach. The problem orientation refers to the clinician’s overall theoretical orientation for viewing problem behaviour and defines the proper content and methods of assessment. An orientation of planned critical multiplism (i.e. clinical outcomes are brought about by multiple interacting factors) is a useful problem orientation to avoid the heuristics.
There are several steps for integrating information:
Clinical assessment of child and adolescent personality and behaviour by Frick, Barry, & Kamphaus (fourth edition) – Chapter 16 summaryIt is essential to consider the different people who will read a report to avoid improper interpretation of the results when writing a report. The clinician should aim to make reports accessible and useful to all involved people. The report refers to the means by which a client’s history and difficulties are described, results are obtained and interpreted, and suggestions for future approaches to the difficulties are discussed.
A psychometric property refers to a portion of the report that presents only test scores and is usually given at the beginning of a report. This is often not of use for parents.
There are several pitfalls of report writing:
There are several good practices for report writing:
Psychological communication: Theories, roles and skills for counsellors by van der Molen, Lang, Trower, & Look (second edition) – Chapter 5 summaryA goal refers to what the client or clinician would like to achieve (e.g. reduction of problems). There are two types of goals:
The choice of outcome goals is primarily the client’s responsibility and goals may change and need to be adapted throughout sessions. The clinician needs to adopt a role and this role may change. There are four roles:
Overgeneralization (e.g. “all Scottish people suck”) may occur when the client shows too little differentiation and too quick integration. All new information is immediately slotted into an existing mental framework. The client may also show too much differentiation and too little integration, meaning that there are too many nuances and information is not arranged into a clearly defined whole. The communicative detective role should be used if this is the case. However, this role should not be used if the confidant role deems sufficient.
The helping model (i.e. Egon’s model) refers to a framework that contains a set of guidelines for carrying out counselling. The model allows the clinician to organize the course of counselling with the client. There is cumulative building of goals and tasks and the stages apply to each problem as it emerges. It consists of three stages:
Psychological communication: Theories, roles and skills for counsellors by van der Molen, Lang, Trower, & Look (second edition) – Chapter 6 summaryListening skills are used to give the client an opportunity and encouragement to tell their story. Non-selective listening skills refer to skills that exert little influence and are intended to encourage and stimulate the client. The are several non-selective listening skills:
Selective skills refer to skills that are used to select a certain aspect of the client’s story which is deemed important. This can be done by going into the content, feeling of giving extra attention to a certain subject. There are several selective listening skills:
Psychological communication: Theories, roles and skills for counsellors by van der Molen, Lang, Trower, & Look (second edition) – Chapter 7 summaryPsychological interpretation refers to redefining or restructuring the situation through the presentation of an alternate description of behaviour. The goal is to obtain new insights. Ubiquitous interpretation refers to interpreting from a certain frame of reference or viewpoint. Interpretation consists of a continuum between what is close to the client’s frame of reference and things that lie outside of the frame of reference of the client. It is important to not phrase interpretations right away:
An interpretation should be presented in a tentative tone and in language familiar to the client. However, a scholarly way of talking could be useful as long as it is in an understandable tone and helps the client understand their behaviour and problems. There are several skills (i.e. operationalizations) of interpretation;
Psychological communication: Theories, roles and skills for counsellors by van der Molen, Lang, Trower, & Look (second edition) – Chapter 2 summaryThe diagnosis-prescription model (i.e. client is object of research) refers to an intake model where the client answers questions asked by the clinician with little room for own input and additional thoughts. The clinician has the full control over the conversation. There is a diagnosis afterwards and this is used to prescribe a ‘solution’. The clinician takes the role of the expert and views the client in an overly goal-oriented and reductive manner. This model can occur when the client expresses the need for concrete advice and support.
The cooperation model (i.e. client is partner in counselling) refers to an intake model where the clinician works together with the client to find a solution to the problem. The clinician believes that the client should be encouraged to be self-reliant in searching for solutions for their problems and the clinician should actively and attentively help the client to think through one’s problems. The clinician should constantly aim to take the client’s perspective. To ensure that the client does not keep relying on others, it is important to discuss why it is important to make own choices and share in problem-solving endeavours.
Psychological communication: Theories, roles and skills for counsellors by van der Molen, Lang, Trower, & Look (second edition) – Chapter 5 summaryA goal refers to what the client or clinician would like to achieve (e.g. reduction of problems). There are two types of goals:
The choice of outcome goals is primarily the client’s responsibility and goals may change and need to be adapted throughout sessions. The clinician needs to adopt a role and this role may change. There are four roles:
Overgeneralization (e.g. “all Scottish people suck”) may occur when the client shows too little differentiation and too quick integration. All new information is immediately slotted into an existing mental framework. The client may also show too much differentiation and too little integration, meaning that there are too many nuances and information is not arranged into a clearly defined whole. The communicative detective role should be used if this is the case. However, this role should not be used if the confidant role deems sufficient.
The helping model (i.e. Egon’s model) refers to a framework that contains a set of guidelines for carrying out counselling. The model allows the clinician to organize the course of counselling with the client. There is cumulative building of goals and tasks and the stages apply to each problem as it emerges. It consists of three stages:
Psychological communication: Theories, roles and skills for counsellors by van der Molen, Lang, Trower, & Look (second edition) – Chapter 6 summaryListening skills are used to give the client an opportunity and encouragement to tell their story. Non-selective listening skills refer to skills that exert little influence and are intended to encourage and stimulate the client. The are several non-selective listening skills:
Selective skills refer to skills that are used to select a certain aspect of the client’s story which is deemed important. This can be done by going into the content, feeling of giving extra attention to a certain subject. There are several selective listening skills:
Psychological communication: Theories, roles and skills for counsellors by van der Molen, Lang, Trower, & Look (second edition) – Chapter 7 summaryPsychological interpretation refers to redefining or restructuring the situation through the presentation of an alternate description of behaviour. The goal is to obtain new insights. Ubiquitous interpretation refers to interpreting from a certain frame of reference or viewpoint. Interpretation consists of a continuum between what is close to the client’s frame of reference and things that lie outside of the frame of reference of the client. It is important to not phrase interpretations right away:
An interpretation should be presented in a tentative tone and in language familiar to the client. However, a scholarly way of talking could be useful as long as it is in an understandable tone and helps the client understand their behaviour and problems. There are several skills (i.e. operationalizations) of interpretation;
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