PSY 244 CLINICAL PSYCHOLOGY-I

1. PSY 244CLINICAL PSYCHOLOGY-I BAHAR BAŞTUĞ Assist. Prof. Dr.

2. Consultative, Teaching and Administrative Roles

3. Lecture Preview • Consultation • Teaching • Administration

4. In addition to research, assessment, and psychotherapy, consultation, teaching, and administration are three common professional services offered by clinical psychologists. These activities are not necessarily separate or distinct.

5. Psychologists may both teach and consult in addition to conducting psychotherapy, psychological testing or research. Therefore, an overlap may exist among these activities.

6. Consultation Clinical psychologists study, research, and treat awide range of problems and people who aredistressed by problematic feelings, thoughts,and behaviors. Psychologists are experts about theories and principles of humanbehavior. This expertise can be used to helpmany individuals, families, groups, and institutions.

7. Consultation Clinical psychologists are asked to consult with others to assist in solving problems in diverse settings.

8. Consultation Psychologists provide cons to others. They regularly receive cons from others. Consultation may be provided to othermental health professionals; to organizations,groups, and individuals; and to the generalpublic.

9. Consultation the application of knowledge and theories of human behavior to specific questions and problems in various community settings such as hospitals, clinics, schools, businesses, and government agencies. Cons involvesoffering professional advice to others concerningproblems that exist in their setting.

10. Consultation Cons usually involves the participation of a consultantwith specialized knowledge and skill and a consulteeor client who benefits from the expertise of the consultant. Unlike one-to-one psychotherapy, a consultant has the opportunity to assist large groups of people and entire organizations through his or her work with a consultee.

11. «Two (or more) heads are betterthan one» Clayton and Bongar (1994) reported thatcons activities improve quality of care, client satisfaction, and treatment outcome.

12. Consultation roles for clinical psychologists Consultants may take many different roles based on a continuum between being directive and being nondirective. Directive consultant is viewed as offering expert and technical consultation. They helpconsulteessolve problems through theirknowledge about issues.

13. Nondirective consultants use their skills and expertise to facilitate the consultee’s skills. Directive cons generally is task-oriented, whereas the nondirective approach is process-oriented. The directive approach focuses more on results, while the nondirective approach focuses on process or growth.

14. Dougherty defined the following six common cons roles: • expert, • trainer/educator, • advocate, • collaborator, • fact finder, and • process specialist.

15. The expert consultant is the most common one. The expert consultant is a technological advisor. He/she has the specialized skills, knowledge, or experience that the consultee needs to help solve a problem. An expert consultant may have special skills in conducting intelligence testing for children applying to a school system’s gifted and talented program. The school hires the consultant to help them understand what the test scores mean.

16. The trainer/educator consultant has specialized information that is useful to the client and can be acquired through education. A consultant may be asked to train employees of a company to manage stress better through the use of relaxation techniques. A consultant who has knowledge about domestic violence may train police officers to recognize the signs and symptoms of domestic violence.

17. The advocate consultant seeks to convince a consultee to do something that the consultant believes. A consultantmay advocatefor the rights of severely disabled patientswho have difficulty advocating for themselves.

18. The collaborator consultant is an equal partner working with a consultee to achieve a common goal. If a researcher is interested in learning more about the effect of physical exercise in the treatment of depr and knows a great deal about exercise but little about depr, the researcher may decide to work with a collaborating consultant who is an expert on depr. An individual psychotherapist and a group psychotherapist treating the same patient might collaborate.

19. The fact finder consultation role involves seeking information and relaying the results to consultees who lack the expertise, time, energy, or psychological sensitivities to do the task themselves. A psychologistmay be interested in buying a new computerfor his laboratory. He may hire a factfinding consultant who has knowledgeabout the use of computers. Or a company concerned aboutpoor morale might hire an outside fact-findingconsultant to investigate the causes of theproblem.

20. The role of the process-specialist consultant is to help the consultee better understand the process of events that might cause problems. A clinic manager dissatisfied with running the staff meetings might hire a process-specialist consultant to observe the meetings and suggest ways to improve communication and staff participation.

21. Types of Consultation In mental health settings, there are several typesof cons conducted byclinical psychologists: • (1) informal peer groupcons, • (2) client-centered case cons, • (3) program-centered administrativecons, • (4) consultee-centered casecons, and • (5) consultee-centered administrativecons.

22. Types of Consultation informal peer group cons is the most used. It involves asking coworkers to consult on a challenging case informally during lunch or time breaks. A psychologistmay struggle with the treatment ofa difficult patient. The psychologist may believe that processhas stopped and wonders how he or shemight best alter the treatment plan to best assistthe patient. The psychologist might askeda colleague to discuss the case to develop insight into bettertreatment strategies.

23. Types of Consultation client-centered case cons involves cons with a fellow professional such as another psychologist who is responsible for the treatment of a particular patient. Bothconsulteeand consultant have some responsibilityfor the care of the patient.

24. Types of Consultation program-centered administrative cons focuses on a program or system rather than on an individual case. The cons involve an important aspect ofthe functioning of a clinic, practice or researchprogram. Apsychologist might seek consultationabout the curriculum, structure, and advertisingstrategy of group psychotherapy programsfor patients. The consultation might concernhow best to conduct intake interviewsand assign patients to therapists in a large mental health clinic.

25. Types of Consultation consultee-centered case cons focuses on challenges experienced by the consultee rather than on problems concerning a client. Inexperience,lack of information, and mistakesmade by the consultee are often the topic ofdiscussion. A graduate student may seek consultation from an experienced supervisor about discomfort and anxiety experienced when conducting psychotherapy with patients who are older than the student.

26. Types of Consultation consultee-centered administrative cons involves working on administrative and personnel issues within an agency. An outpatient clinicboard of directors may wish to consult with apsychologist about problems in the leadershipperformance of their executive director.

27. Organizational Consultation Clinical psychologists provide consultation to nonmental health agencies and organizations such as businesses, nonprofit agencies, and government organizations dealing with the interpersonal and organizational problems and conflicts. Organizational consultation uses systems theory.

28. For systems theory, all aspects of a system interact and react to changes and behavior in each element of the system. Eachelement or subsystem within the large organizationalstructure is dependent on other elementsor subsystems,changes that occur at one level will usually influence changes at other levels. Consultants to organizations must use systems theory to diagnose organizational problems and provide interventions.

30. Executive Coaching It has become popular in business and industry. Clinical psychologists, social workers, marriage and family therapists,human resources specialists have developedservices as an executivecoach. They focus on ways to help executives become better leaders and managers as well as develop strategies to improve interpersonal relationships, productivity, and efficiency in companies. Executivecoaches may consult with business leadersabout stress management andgoal setting.

32. Stages of Consultation The stages that have been used forthetherapy process apply tocons: • understanding the question, • assessment, • intervention, • termination, and • follow up.

33. Stages of Consultation (1) Understanding the Question: In order to understand the nature of the referral question,the consultant must evaluate the situation and the goals of the cons. Theconsultant must determine if his or her training, experience, and expertise is enough to provide a cons.

34. Stages of Consultation The initial question changes during the course of the cons. Sometimes before agreeing to be hired, a consultant must determine whether the organization is ready for the experience. An organization initiates contact with a consultant, but it may be resistant to change, to feedback, or to the results of the cons.

35. Stages of Consultation (2)Assessment: This phase includes interviews and psychological testing and/or review of records or other data. The consultant should enter the organizationalsystem. The consultant mustassess the customs, beliefs, rules, and generalclimate of the organization. He/She must attemptto develop a trusting relationship with theconsulteesbefore offering any advice.

36. Stages of Consultation Interviewing is the most common methodof a consassessment. The consultant may choose to use either structured and standardized interviews or unstructured, and nonstandardized interviews. Surveys, questionnaires and direct observation are methods of assessment in cons. A consultant may observe an organization, sit in onmeetings, and/or watch people while working andinteracting.

37. Once an assessment is complete, the consultant develops a diagnosis and outlines goals for intervention. The goals should be specific,realistic, measurable, and based on collaborationbetween consultant and consultees.

38. Stages of Consultation (3) Intervention: The consultant can develop an intervention strategy. The consultant provides the advice or suggestions for change. In this stage, applying occurs. Applying the intervention is the responsibility of the consultee, with guidance from the consultant. Once an intervention is applied, an evaluation is conducted to determine whether the intervention has been useful.

39. Stages of Consultation (4) Termination: After the goals of the cons have been met, or not, the termination phase occurs. Researchers recommend conducting a terminate interview to discuss the consultation process, share feedback, plan for follow-up at termination.

40. Stages of Consultation (5) Follow-Up: Interventions and advicemay or may not be used.The advice may be what the consultee doesn’t wanted to hear, the intervention plans maynot be realistic, or they may be too difficult to apply. Follow-up maximizes the consultee’s benefit from the consultation.

41. To Whom Do Clinical Psychologists Offer Consultation? Clinical psychologists provide advice and cons to their peers. They may have a high degree of expertise in a certain area less familiar to other people. Psychologists may consult with a colleague about a patient they treat in psychotherapy when they are unsure how best to handle a particular therapeutic situation. Discussing a case with an objective and unbiased colleague is very useful.

42. Psychologists may seek cons when conducting psychological evaluations or testing. Some of the data from an evaluation may be difficult to interpret or may conflict with data from other sources. The psychologist conductingthe evaluation may seek a secondopinion by asking a colleague to cons onthe case and review the testing materials.

43. Psychologists conducting research consult with colleagues. A psychologist may seek the cons of another to assist in interpreting research data, designing appropriate experiments, and determining equipment to use.

44. Consultation with Nonmental Health Professionals Many psychologists consult with teachers and administrators, physicians and nurses, attorneys and judges, clergy, the military, and people working in business and industry. Psychologists consult with medical personnel concerning patient care. Many medical patients need assistancein coping with anxor deprassociatedwith their illness.

45. Many hospitals have a consultation-liaison (C&L) service so that psychological consultation can be made available to every medical department at all times. Patients recovering from a heart attack, obtaining dialysis for kidney failure, or receiving radiation/chemotherapy for cancer are fearful and depressed.Consultation with a psychologist may assist these patients in coping more effectively with their treatment, diagnosis, feelings, and posthospital adjustment.

46. Psychologists consult withteachers and schoolpersonnel in every kind of schools. Many psychologists consult with attorneysand judges on various casessuch as child custody and criminal cases. They may be asked to consult on the selection and training of new police and fire recruits.

47. What are needed to be an effective consultant? Excellentgroup andproblem-solving skills, the ability towork with organizations, andprofessional and ethicalbehavior areimportant. Skills necessary for effective consultationare empathy, genuineness, socialskills, ease in working with othersand effective listening.

48. Teaching Teaching activities are a part of the professional duties of many psychologists. Clinical psychologists teach in awide variety of settings and to a wide varietyof audiences.Teaching may involveformal college classroom instruction, individualsupervision of a psychologist-in-training,or lecturing on stress-management techniquesto firms or schools.

49. Teaching may be incorporated into psychotherapy and psychological testing activities. For instance, a psychologist may teach a patient how to use relaxation techniques to cope with stress or teach a couple how to communicate better. Psychoeducational approaches involve teaching patients to cope with a wide range of medical and psychiatric problems.

50. Teaching in Academic Settings Many clinical psychologists teach in psychology departments in colleges and universities. They teach courses: Introduction to Psychology, Abnormal Psychology, Clinical Psychology, Psychological Testing, Statistics, and Research Methods. Academic psychologists may teach undergraduates, graduates, and postgraduates.