Workgroup notes with Psychodiagnostics at the Leiden University

Workgroup 1

- During this first workgroup, we introduced ourselves to one another and worked on a role-play assignment (assignment 1 on BlackBoard).

- We learned that as a therapist doing an intake interview takes a lot of patience. Key characterstics that you must possess is being able to put on a mask and don't show your own personal opinion to the client. You need to seem professional and non-judgmental. Don't try to convince your client that for example; treatment for their child would be a good idea; let your clients come up with a solution themselves. We as therapist only guide them in their way to this. Let the client guide the content of the therapy session.

- During a therapy session, it is of crucial importance that you engage in active listening. You do this by reacting to what your client is saying every now and then, for example by paraphrasing the remarks he or she made. Make comments like 'so if I understand correctly...'. It is okay if the client than corrects you.

- You need to be empathetic as well. Engage in comments like 'that must have been very hard for you' to show your empathy and create a safe environment for your client. Your client must feel that it is safe for him or her to say anything to you.

- Important as well is to ensure confidentiality of what your client says to you as a therapist. You can outline this by ensuring that 'everything you discuss with the client stays within that room'. The client has to give consent to this.

Workgroup 2

- In this workgroup, we focused on the strategy phase of the psychodiagnostic cycle. 

- In this phase, we cluster behaviors, thoughts and feelings of the client. Then we draw a diagnosis and formulate hypotheses and research question. After all these things are completed, we move on to the testing phase.

- Positive factors can compensate for the severity of the negative factors that are present in the patient's life. Positive factors are "favourable factors that protect the client from risk factors that are currently present".

- In the process of coming up with hypotheses, it is important to also generate alternative hypothesis. Hypotheses are only mentioned in the appendix of the clinician's report.

- Explanatory hypotheses are formulated in terms of explaining behavior. Identifying hypotheses are formulated in terms of identifying a disorder in the client.

- Clinicians may only ask questions that are relevant for giving the right advice to the patient.

- During this workgroup, we practiced with giving a subtest of an intelligence test to a testee. In this process, it was important to closely follow the instructions.

Workgroup 3

- In this workgroup, we first discussed some general feedback on TurnitIn assignment 1: First of all, we should keep in mind that intake information should be a running story and not listed as bulletpoints in the report. Clusters of behaviors should however be listed as bulletpoints.

- For an intake report, we cannot formulate research questions and hypotheses that seek a diagnosis in the case. We are not in the stage of diagnosing yet.

- We should not report raw test scores in the results part of the report, but only list them in a table in the appendix.

- We should not provide a diagnosis based on a single test.

- Then we practiced with a neuropsychological test; the Wisconsin Card Sorting Test. We practiced with the role of the experimenter. The general lesson was that we should really read the instructions very thoroughly prior to the actual test.

- For TurnitIn assignment 2 we received some general tips:

- We should take notice of what information should be in the report and what information should be reported in the appendices of the report. For example; we should not mention raw test scores in the report, but only in the appendices.

- Another tip is that we should not focus excessively on the WISC results when writing our report; since we have not administered this test ourselves.

Workgroup 4

- From now on, the workgroups will focus on assessment of adults.

- In clinical practice, we work a lot with homework. We discussed our homework assignment of daily registration of our happiness. Clients sometimes don't do their homework. As a clinician, you may ask the question; What makes it so hard for you? Were my instructions too vague? Are you too busy?

- In this workgroup, we looked at the case of Lucy. She is experiencing low mood and depressive symptoms. We watched a clip of her first clinical session. We should keep in the back of our mind that normally, patients are not able to talk so elaborately about their emotions, cognitions, et cetera, like Lucy does. Often, clinicians have to uncover these things during therapy sessions.

- We practiced with the MINI questionnaire, which is a quick test that only requires yes and no answers to statements. The questionnaire assesses complaints relating to mood, affect and behaviors.

- Then, we practiced with the CES-D, which is a self-report questionnaire of statements relating to depression. 

- We formulated a research question and hyptohesis for the case of Lucy: Is Lucy suffering from Major Depressive Disorder (MDD)? The hypothesis is that she is suffering from MDD; and the alternative hypothesis is that she isn't. Our testing criteria are the MINI and CES-D. The results of the MINI indicate that Lucy meets the criteria for MDD. The results of the CES-D indicate that Lucy's score is significantly above the cut-off score of 16. The conclusion is that we have an indication that Lucy is suffering from Major Depressive Disorder.

Workgroup 5

- During this workgroup, we reviewed TurnitIn assignment 3, a non-graded assignment. The general point of criticism was that we should focus more on mentioning what specific subscales we used from the tests and what the connections of these subscales are with the research question central in the report.

- We practiced with two cases and studied their results on the MMPI, the Sentence Completion Test, and especially the Thematic Apperception Test: The Thematic Apperception Test consists of several pictures, from which the client must answer the question what the situation is in that picture, what has led up to this situation, and what will happen next. For their result on the Thematic Apperception Test (TAT), we asked three central questions: 1. What emotions of the client are evident from this material? 2. What themes central for the client become evident from this material? 3. What do we notice about each client's thinking style?

- One case was about a woman aged 45 who suffered from a lot of anxiety. She sets very high expectations of herself, and themes such as hope and dispair, autonomy, suicide, and negative self-worth were central to her. In the TAT, she made up coherent stories and formulated complete sentences.

- The second case was about a man aged 21 who suffered from ADHD. During the TAT, he experienced a lot of confusion and he found it hard to detect and relate to emotions. The theme of aggression appeared pretty central to him. The client had an unstructured thinking style that was all over the place. He seemed disorganized and uable to concentrate on a task.

- For the second part of the workgroup, we focused on the document that describes the Code of Ethics of the NIP; which is the Dutch institution for psychologists. A psychologists is ought to abide by the rules as describes in this codebook. We watched several videos of different moments in a therapy session in order ot observe any errors that were made by the psychologist according to this Code of Ethics.

Workgroup 6

- During this workgroup, we held presentations about the DSM-V criteria of a psychological disorder of our own choice. We reported not only the criteria, but also a common self-report questionnaire that is used to test for that particular disorder.

- We reported about a ecological momentary assessment strategy that we had to come up with ourselves. Ecological momentary assessment is the repeated sampling of behavior of someone in a natural environment. We formulated these EMAs in self-report questions; e.g. "how often per week do you...".

- Finally, we also reported about biological markers of our disorder of choice. These could be DNA or hormone abnormalities, brain abnormalities, but also any other symptoms that the body displays in case of the disorder.