what are the eras of psychological practice?
<1920: prescientific era
1920-1940: demonstration era
1940-1990: early scientific era
>1990: evidence-based practice movement
what is the 3 legged stool of EBP?
incorporates:
1) current best practice
2) clinical expertise
3) patient characteristics, cultures, and preferences
when making decisions about how to care for patients
needs all aspects, otherwise stool would ‘fall over’
what does the ‘current best evidence’ leg of EBP refer to?
evidence drawn from the best available research (empirically supported)
changes as new findings emerge and new approaches are developed (ensures practices are not based on out of date research)
what does the ‘clinical expertise’ leg of EBP refer to?
high quality training and commitment to staying up to date with the latest research and guidelines
can use the 5As (Ask, Acquire, Appraise, Apply, Assess)
what does the ‘patient preferences’ leg of EBP refer to?
considering the patient as an individual with unique goals, culture, willingness to participate and preferences
does the research apply to the patient (WEIRD sampling)?
why does clinical experience sometimes have limitations?
- little evidence that experience increases expertise
- may experience over-confidence
- may experience therapist-drift rather than staying up to date
why is EBP important?
- to ensure what we do (still) works
- first of all, do no harm
- detect potentially harmful therapies
- optimal allocation of resources
what kinds of psychological assessment are most common?
- diagnostic questionnaires
- psychological tests
- structured, semi structures, or clinical interviews (most common)
- behavioural observation
what does a diagnosis do?
- guides treatment planning
- enable clients access to certain funding / support
- help clients understand and explain their experience
what is diagnosis formulation?
what is the most common method?
develop an understanding of why (this person, this problem, now?)
helps guide treatment
most common method 4ps (predisposing, precipitating, perpetuating, protective)
(bio, enviro, psycho measures)
