心理评估的巧用

心理测验是心理咨询师用于评估来访者心理状况的工具，它的某些变式可以直接用于咨询中，发挥辅助治疗甚至是直接治疗的作用。     

沙盘游戏应用于临床心理评估的研究进展

目的 探讨沙盘游戏应用于临床心理评估的研究现状.方法 从沙盘游戏产生的背景和过程、沙盘游戏应用于心理评估的可能性、沙盘游戏在临床心理评估领域的研究进展等几个方面对国内外心理学有关文献进行综述,提出了研究的不足,并展望了沙盘游戏的研究趋势.结果 沙盘游戏的临床心理评估功能主要用于:区别健常人与非健常人;心理疾病的诊断;心理障碍的疗效判断指标;发展为投射测量工具.结论 沙盘游戏治疗所具有的临床心理评估功能,值得进一步研究.     

临床心理评估的过去、现在与未来

临床心理评估是临床心理学的一个重要内容 ,在 2 0世纪刚刚过去 ,新世纪的曙光来临之际 ,对临床心理评估过去的发展情况的现状进行一个简略的回顾 ,有助于我们更加清楚地认识和把握这个领域未来的发展趋势。194 6年 ,《美国临床心理学杂志》(ＪｏｕｒｎａｌｏｆＣｌｉｎ ｉｃａｌＰｓｙｃｈｏｌｏｇｙ)发表了Ｈｕｎｔ的一篇论文“诊断性测验在临床心理学中的未来”[1] ,此文针对当时有些反对使用心理测验的临床心理学家过分强调“主观判断”和临床心理评估中存在的过分依赖“测验分数”这两种现象进行了讨论 ,并对临床心理测验与量表的编制…     

癫及癫性精神障碍患者的精神症状分析

目的:探讨癫及癫合并精神障碍的诊断治疗,并对其精神症状分析,进一步提高诊断的准确性并降低治疗风险。方法:对123例癫病人随访跟踪,采用病人自身对照方法,对其进行心理评估;对癫性精神障碍患者进行双重治疗,观察其症状变化。结果:症状和药物引起的癫性精神障碍病人自杀意念明显增高,使治疗风险加大。结论:仔细观察癫及癫性精神障碍病人的治疗效果和精神状况,合理用药,及早给予心理干预使临床治疗的风险降低。     

癫(癎)及癫(癎)性精神障碍患者的精神症状分析

目的:探讨癫(癎)及癫(癎)合并精神障碍的诊断治疗,并对其精神症状分析,进一步提高诊断的准确性并降低治疗风险.方法:对123例癫(癎)病人随访跟踪,采用病人自身对照方法,对其进行心理评估;对癫(癎)性精神障碍患者进行双重治疗,观察其症状变化.结果:症状和药物引起的癫(癎)性精神障碍病人自杀意念明显增高,使治疗风险加大.结论:仔细观察癫(癎)及癫(癎)性精神障碍病人的治疗效果和精神状况,合理用药,及早给予心理干预使临床治疗的风险降低.     

胜任力为基础的阶梯式评估与反馈体系在北京协和医院内科住院医师规范化培训中的应用

目的尝试建立跟踪式的、形成性的、以住院医师的胜任力为基础的评价与反馈体系,以便于对其反馈和提高。方法参考国际上住院医师规范化培训的经验,结合我国内科住院医师规范化培训的情况及要求,设计了全新的阶梯式培养评估与反馈体系,并在6名2016级内科临床博士后范围内尝试应用。结果评估后不仅可以反映临床博士后的整体水平,亦可以更个体化的反映不足以便于反馈。结论该阶梯式评估与反馈体系运用至临床实践中进行监测性、形成性、阶段性的评估具有较强的可行性和重要价值。     

癫痫治疗效果的复杂度评估分析

目的:针对当前临床对癫痫患者的治疗效果还缺少一种快速、客观的评估方法,本文提出了一种使用复杂度算法快速评估癫痫患者治疗效果的分析方法。方法:通过对同一癫痫患者脑电信号治疗前后的多次采样,使用复杂度算法分析癫痫患者在尺度为120,步长为10,噪声容限为0.15时的脑电波信号,通过对比癫痫患者治疗前、后的脑电信号复杂度,从而达到评估癫痫患者治疗效果的目的。结果:癫痫患者在经过一段时间治疗后的脑电信号复杂度明显大于癫痫患者治疗前的脑电信号复杂度,并且在治疗过程中我们可以明显的看到癫痫患者脑电波的复杂度变化。结论:通过临床实践验证,复杂度算法在分析癫痫患者脑电波信号方面具有较好的一致性,可以通过分析患者的脑电信号复杂度快速的给医生一个直观的评估参考标准,且只需较短的的数据就可以达到分析目的,可能成为评估癫痫患者治疗效果的一个有效手段。     

恶性肿瘤患者情绪障碍评估与治疗研究进展

恶性肿瘤是严重威胁人类生命健康的常见疾病,可造成患者生理和心理的严重创伤。研究表明,大部分恶性肿瘤患者可发生情绪障碍,其中以抑郁与焦虑最常见,因而极大的降低了患者的生活质量,严重影响着恶性肿瘤患者的治疗和康复。因此,识别和治疗恶性肿瘤患者的情绪障碍已经成为临床医护人员的迫切任务。选择合适的筛选工具对恶性肿瘤患者进行情绪障碍评估,并根据评估结果结合相应的临床表现选择恰当有效的治疗方式,能够延长恶性肿瘤患者的生存时间及提高患者带瘤生存的生活质量。为了我国临床医师对恶性肿瘤患者情绪障碍的评估工具及相关治疗方式有更好的了解,故作以下综述。     

犯罪性评估

目的通过对有关犯罪性研究的回顾与评价，提出了对犯罪性进行评估的新构想，方法釆用文献研究法。结果国内对犯罪性抨估的研究存在一些不足，本文从人格特征（包含社会评价维度的人格特征）出发，提出从自我控制、社会人际关系，价值观、责任心四个堆度对犯罪性进行评估，结论需要加强对犯罪性抨估的本土化研究。     

团体心理干预对老年冠心病患者焦虑情绪的影响

目的:探讨心理评估及团体心理干预在缓解老年冠心病患者焦虑情绪中的应用效果。方法:将心内科2016年2—6月收治的90例老年冠心病患者分为观察组和对照组各45例,两组治疗方法均衡,对照组采用常规心理干预,观察组心理评估后实施团体心理干预,均干预12周。比较两组患者的焦虑、抑郁情绪及社会支持度。结果:观察组干预12周后的焦虑、抑郁评分低于对照组,差异有统计学意义(t=-6.389,-9.453;P0.05)。观察组干预12周后主观支持、客观支持、支持利用度评分高于对照组,差异有统计学意义(t=5.161,7.733,11.530;P0.05)。结论:心理评估及团体心理干预能够显著缓解老年冠心病患者焦虑、抑郁情绪,提高患者的社会支持度。     

Psychological assessment in clinical practice in Britain

One hundred and fifty‐eight clinical psychologists practising in Britain completed a questionnaire concerning their use of and views about psychological assessment. The respondents reported spending on average slightly more than 50% of their working day on face‐to‐face clinical work and 13% of their time with clients on individual assessment. The results were compared to those of a similar survey conducted in the United States. Compared to their American counterparts, British clinical psychologists used formal psychometric and projective tests infrequently. Clinical interviews were the most frequently mentioned form of assessment in both countries. Notwithstanding their infrequent use of formal assessment procedures, the majority of the British clinical psychologists stated that trainees should learn about some psychological tests, primarily in order to facilitate the therapeutic process. The comparison of North American and British practice illuminates factors influencing assessment choices, and poses questions about the validity and reliability of current assessment practices. Copyright © 2002 John Wiley & Sons, Ltd.     

Therapeutic alliance—not therapist competence or group cohesion—contributes to reduction of psychological distress in group‐based mindfulness‐based cognitive therapy for cancer patients

Mindfulness‐based cognitive therapy (MBCT) is an innovative evidence‐based intervention in mental and somatic health care. Gaining knowledge of therapeutic factors associated with treatment outcome can improve MBCT. This study focused on predictors of treatment outcome of MBCT for cancer patients and examined whether group cohesion, therapeutic alliance, and therapist competence predicted reduction of psychological distress after MBCT for cancer patients. Moreover, it was examined whether therapist competence facilitated therapeutic alliance or group cohesion. Multilevel analyses were conducted on a subsample of patients collected in a larger randomized controlled trial on individual internet‐based versus group‐based MBCT versus treatment as usual in distressed cancer patients. The current analyses included the 84 patients who completed group‐based MBCT out of 120 patients who were randomized to group‐based MBCT. Group cohesion and therapist competence did not predict reduction in psychological distress, whereas therapeutic alliance did. In addition, therapist competence did not predict therapeutic alliance but was associated with reduced group cohesion. Our findings revealed that therapeutic alliance significantly contributed to reduction of psychological distress in MBCT for cancer patients. Elaborating the clinical implications of the predictive significance of therapeutic alliance might be of added value to enhance the potential effect of MBCT.     

Psychological Assessment and Psychotherapy in Long-Term Care

The continued growth of the older adult population, combined with the inclusion of psychologists in Medicare, is leading to psychological services increasingly being delivered in long-term care settings. This article reviews some basic concepts in psychological assessment and psychotherapy with older adults in long-term care settings. A guide is provided for the assessment of dementia, delirium, and depression. The use of validated empirical instruments, the collection of multiple sources of historical data, and the incorporation of assessment results in treatment planning are emphasized. Psychotherapy with persons having a dementia, and psychotherapy with persons having a personality disorder are the focus of the treatment section of this article. We argue that these have been neglected areas of practice, and yet treatment can produce significant benefits to these patients.     

In Pursuit of Empirically Supported Assessment for Use in Medical Settings

Psychological assessment in the medical setting presents many opportunities and challenges. On the question of what constitutes empirically supported assessment practice, there are few clear answers and perhaps fewer exemplars. The goal of this article was not to review the current status of empirically supported assessment in medical settings, but rather to highlight some areas of measurement innovation that may move this field toward its promise of a more stable evidence base supporting the use of patient‐reported outcome measures for clinical research, patient education, and clinical care. In addition, assessment in the medical setting provides one very unique opportunity that many psychologists are not honed in on: the use of psychological assessment to assess quality health care. This is an emerging reality that poses significant methodological puzzles and opens doors for those committed to psychological assessment.     

Current status and future directions of psychological assessment: introduction

This article introduces the major themes and context for the special series on the current status and future directions of psychological assessment. The internal and external challenges to assessment are outlined along with a listing of professional publications responding to these challenges. Each of the articles in the Special Series is introduced and includes topics on the current status of assessment, survival strategies, financial efficacy, and treatment planning.     

Almost Clinically Significant ( p < .10 ): Current Measures May Only Approach Clinical Significance

The review by Sheldrick et al. evaluates treatments for children and adolescents with conduct disorder and whether they produce clinically significant changes. The present commentary focuses on the difficulties in interpreting current measures of clinical significance, the reliance on symptom reduction as the sole or primary criterion, and the need to match the criteria and measures of clinical significance to the clinical problems, treatment goals, and lives of the clients. Recommendations are made to establish measures of clinically significant change, and include conceptual elaboration of the construct, empirical research on the criteria (i.e., what it is that reflects real or important therapeutic changes in everyday life), validation of current measures of clinical significance, and development of a typology of clinical problems that might point to which indices of clinical significance are most pertinent. Clinically significant change can be measured in many ways, but it is still not entirely clear what any of the ways means in the lives of clients.     

分离性身份识别障碍的心理病理机制和临床评估

文章主要介绍了分离性身份识别障碍(DID)形成的四种心理学解释,以及用于DID临床评估的三类测评工具。当前关于DID心理病理机制的研究带有较为明显的心理动力学色彩,多理论整合的系统性研究和深度的个案研究有待更多的开展。早期创伤记忆的遗忘机制研究是深入研究DID心理病理机制的一个重要方向。