Clinical Psychology

Spring 2015Kyle Stephenson

Overview – Day 7•Behavioral Assessment

▫Theory▫Controlled observation/performance▫Self-monitoring

•The clinical report▫Content & samples

Concepts in behavioral assessment•Sign

▫Inference about performance or response▫Symbolic of other characteristics

•Sample▫Identify characteristics of interest▫Assume these traits carry over to non-test

situation

Concepts in behavioral assessment•Functional analysis

▫B.F. Skinner Precise analysis of stimuli that precede

behavior and consequences that follow Learned behaviors Influence of consequence Precise description

Antecedent conditions Consequent events Can use this knowledge to understand motive

and alter behavior

Concepts in behavioral assessment•SORC method: a model for

conceptualizing clinical problems from a behavioral perspective▫Stimulus to behavior▫Organismic variables▫Response or problem▫Consequence

Overview – Day 7•Behavioral Assessment

▫Theory▫Controlled observation/performance▫Self-monitoring

•The clinical report▫Content & samples

Observational Method #1•Controlled observation

▫Clinical or natural settings▫Environment is “designed”▫Trigger specific behaviors so they can be

observed▫Situational testing

Example: Interaction Behavior Code

Observational Method #2•Controlled performance technique

▫Contrived situations that allow for control & standardization

▫Behavioral avoidance assessment Series of tasks requiring increasingly

threatening interactions Fear arousal assessed in addition to behavior

▫Influence of researcher can be an issue (internal vs. external validity)

Exercise Symptoms Anxiety (1-10) Similarity (1-10)

Run in place Heart rate increase

2 2

Spinning Dizzy 9 9*Overbreathing Short of breath 8 9*Straw-breathing

Some shortness of breath

5 2

Stare @ self/spot

Unreal 10 10*

Lift head quickly

Nothing much 1 0

Tense body Tingling, hot flash

7 5

Other

Interoceptive assessment

Overview – Day 7•Behavioral Assessment

▫Theory▫Controlled observation/performance▫Self-monitoring

•The clinical report▫Content & samples

Observational Method #3•Self monitoring

▫Records of emotion, thought, behavior▫Frequency, duration, intensity▫Shows stimulus & triggers▫Dysfunctional Thought Record: a

compilation of the patient’s automatic thoughts

▫Can be inaccuracies in self-reports

Panic Attack Record

Date: ______________________ Time began: ___________ Time ended: ___________

Triggers: ________________________________________________________________

____Expected ____Unexpected

Maximum fear: 0---------1---------2---------3---------4---------5---------6---------7---------8 None Mild Moderate Strong Extreme

Check all symptoms present to at least a mild degree:___ Pounding heart ___ Sweating ___ Hot/cold flush___ Tight/pain in chest ___ Choking ___ Fear of dying___ Shortness of breath ___ Nausea/Diarrhea ___ Fear going crazy___ Dizzy ___ Unreality ___ Fear of losing control___Trembling ___ Numbing/tingling ___ Other:_____________

Physiological Component

Behavioral Component

Cognitive Component

The physical symptoms I experienced were….

Heart beat fastMy hands shookGot sweaty

The way I acted or things I did that were observable to others were…(Also indicate whether you escaped from situation or avoided it)

The laser pointer was shaking in my handMy voice was shakyI didn’t come back on Tue for rest of training

The thoughts I had were….

I am blowing this training

My colleagues are bored stiff

They can tell how nervous I am

Other Behavior Assessment Techniques•Role-playing

▫A technique in which patients are directed to respond the way they would typically respond if they were in a given situation

•Inventories and checklists▫Self-report techniques▫Identify behaviors, emotional responses,

and perceptions of environment

Overview – Day 7•Behavioral Assessment

▫Theory▫Controlled observation/performance▫Self-monitoring

•The clinical report▫Content & samples

The Clinical Report•Referral source: address the referral

question!•Aids to communication

▫Language▫Individualize reports▫Level of detail

Cite items and observations

Sample Psychological Report

Sample reports•Therapy intake report

•Court-ordered report

•Neuropsychological report

Take-Home• Behavioral assessment is typically the most time-

intensive method, but often provides the best information regarding real-world problems of clients

• There are many types of clinical reports, but all share the goal of answering the referral question, providing appropriate context, and giving recommendations