Psychological Diagnoscs and Quality Management (MSc Alexandra Faessler)

Psychological Diagnos.cs Quality Management

M. Sc. Alexandra Faessler

University Psychiatric Clincs Basel Ambulatory (CBT)

Why do we do diagnos.cs?

+pro -‐contra

à Evidence based prac.ce in psychology à Empirically supported treatments

Sam

Procedure

Start of therapy End of therapy

Pre assessment: -‐Case history ques.onnarie -‐Screening SKID II -‐BSCL -‐BDI-‐II -‐BAI -‐PSQI -‐CTQ

Post assessment: -‐BSCL -‐BDI-‐II -‐BAI -‐PSQI

Quality assessment GAS = Goal aRainment

scale

+ Protocol aTer each session

+ Specific ques.onnaires


Procedure


Pre assessment: -‐Case history ques.onnarie -‐DIPS -‐Screening SKID II -‐BSCL -‐BDI-‐II -‐BAI -‐PSQI -‐CTQ



scale




Case history ques.onnaire

Procedure





scale




Diagnos.cs

Diagnosis: Screenings

•  DIPS= Diagnos.c Interview for mental disorders Margraf, Schneider & Suppiger, 2005

– Social Phobia (ICD-‐10 F40.1) – Dysthymia (ICD-‐10 F34.1) – Not passed Exams (ICD-‐10 Z55.2)

•  SKID II (Structured clinical interview for DSM-‐IV) – No findings Fydrich et al., 1997

Procedure





scale




BSCL = Brief Symptom Checklist

Franke, G. H. (2015). BSCL-‐53®-‐S. Brief Symptom-‐Checklist–Standard–German Manual.

20 25 30 35 40 45 50 55 60 65 70 75 80

Auswertungsprofil BSCL Eintri9 T-‐Wert

Depression

Procedure





scale




BDI II Becks Depression Inventory

Result BDI II -‐ Depression

Procedure





scale




More ques.onnaires… •  BAI = Becks Anxiety Inventory (Beck et al., 1988)

•  PSQI = The PiNsburgh Sleep Quality Index (PSQI) (Riemann & Backhaus, 1996)

•  CTQ = Childhood Trauma QuesRonnaire (Wingenfeld & Spitzer 2010)

•  Specific ques.onnaires

–  SIAS = Social interacRon anxiety quesRonnaire –  SPS = Social phobia quesRonnaire

(Kupper & Denolet 2012) ...

Specific ques.onnaires

Pre-‐ assessment results: Outcome

Procedure





scale




Protocol aTer each session

•  Including: –  Important events – What happened in the therapy session – Homework – Thoughts for next session

Procedure





scale




Quality assessment •  Self-‐report ques.onnaire •  Therapy session 15, 30, 45,… last •  Measured on a

1 (very unsa.sfied) to 6 (very sa.sfied) scale Sa.sfac.on with… -  Registra.on -  Care of therapist -  Competencies of the therapist -  Free choice in therapy -  Result of the therapy at the current moment

Quality assessment Quality –  Diagnos.cs and procedure –  Background and treatment possibili.es

–  Therapy process –  Steps helped me to get beRer

– Most important issues were topic

–  Daily life

Quality assessment Open ques.ons: – Posi.ve… – What you could do beRer…

– Most important…

What do we do with it?

•  Discuss with supervisor

•  Collect data (Acess) for quality management

Goalsekng

Folie 29

Single and small steps

Subgoal

Subgoal

Subgoal

Subgoal

Therapy goal

Start EVALUATION

SMART goals

S = Specific ac.ons

M = Meaningful

A = ARainable R = Resources T = Time

Kiresuk, T. J., Smith, A., & Cardillo, J. E. (2014). Goal aRainment scaling: Applica.ons, theory, and measurement. Psychology Press.

Measuring Goals Goal aRainmant scale (GAS)

•  Pa.ent and therapist decide together about the goal

•  Define SMART goals •  Define how the goal might get beRer or worse

•  Define .me to reach the goal


GAS

Points Percentage Wording

+2 90–100 %

most favorable outcome

+1 75–89 % greater than expected outcome

0 50–74 % expected outcome

-‐1 25–49 % less than expected outcome

-‐2 Under 25 % most unfavorable outcome


How about this goals?

«I don’t want to feel fear any more» «I want to loose 2 kg in the next 3 months» «I just want to be happy» «I want to know, who I am» «In 6 months, I want to fly to Basel to visit Alexandra» «In 1 month I would like just to wash my hands 6 .mes a day»


Other methods: Metaphors

Kanfer et al. (1996) pp. 442-‐446)

Procedure





scale




Post-‐ assessment results

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Health & Medicine

Psychological Diagnoscs and Quality Management (MSc Alexandra Faessler)