Chapter_04_Summary_Outline - Chapter 4 Overview/Summary...

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Chapter 4 Overview/Summary Understanding and appropriately treating psychological disorders depends, in large part on the adequacy of clinical assessment. The assessment process typically involves interviews, observations, and psychological tests that are then integrated to develop a summary of the client’s symptoms and problems. Assessment results are frequently used to establish a baseline of client behavior from which subsequent behavior can be judged and in the process of clinical diagnosis; that is, classifying a disorder according to a clearly defined system such as the DSM-IV TR or the ICD-10. Even after this initial assessment and diagnosis, continued assessment is critical to determine the course and effectiveness of treatment procedures. There are several basic elements of clinical assessment. Identification of the presenting problem or the major symptoms and behavior is most likely the first step in the assessment process. Providing a diagnosis may assist in treatment planning and may be required for insurance purposes. Clinically, assessment will most likely involve collecting information about the client’s behavioral history, intellectual functioning, personality characteristics, and environmental pressures and resources. The precise nature of the information collected will of course depend on the nature of the presenting problem. Because a wide range of factors may contribute to maladaptive behavior, assessment may also include medical evaluation. A general medical examination may be followed by a more comprehensive neurological examination that could involve neuropsychological testing or, in some circumstances, neurological tests–such as an EEG or a CAT, PET, or MRI scan–to aid in determining the site and extent of organic brain disorder. The precise nature of tests administered during this assessment process may be influenced by the theoretical orientation of the clinician. For example, a more biologically oriented clinician may be more apt to focus on assessment procedures aimed at determining underlying organic malfunctioning while a more cognitively oriented clinician may focus on dysfunctional thoughts. In order for any assessment procedure to be effective, however, the client must feel comfortable with the clinician. The clinician should explain the purpose of the assessment process and must help the client understand the limits of confidentiality. Psychosocial assessment methods focus on providing a realistic picture of how the client interacts with his or her social environment. Data is gathered allowing the clinician to form hypotheses that are confirmed, modified, or discarded as the clinician proceeds. The most widely used and most flexible psychosocial assessment methods are the clinical interview and behavior observation. These methods provide a wealth of clinical information and can vary from highly structured and reliable procedures to more unstructured and less reliable procedures. Psychological tests represent a more indirect method of assessing psychological
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Chapter_04_Summary_Outline - Chapter 4 Overview/Summary...

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