What diversity factors, cultural considerations, or other demographic variables pertaining to this client would you take into account in rendering diagnoses, choosing assessment measures, forming case conceptualizations, and designing the treatment plan?
I am sure that there is more but I am trying to get a head start on this 🙂
Recommendations for the Comprehensive Examination
My first recommendation is to get started now on the test. You can actually start writing your answers today.
Review the PowerPoint presentation and look at the questions as well as the grading rubric. Also, there is a reading list and you should start assembling your resources.
Although you do not know the vignette and it changes with each administration of the test, you can still start to formulate and write your answers. The questions are linked to the five learning objectives for the MA in Forensic Psychology program (subheadings below).
Psychological Theory and Practice
For example, the first question asks how you would conduct a clinical assessment.
A. What assessment would you conduct to enhance your understanding of the client(s) problems and how would they direct your diagnostic formation? In addition, what formal assessment procedures (either conducted by you or by someone you would refer to) would enhance your understanding of the problems and direct your treatment planning? Why?
With only a few minor things, most initial clinical assessments follow a uniform pattern. You will want to include the use of collateral sources, a clinical interview (structured, semi-structured or unstructured), a MSE and select psychological assessments. You will need to address substance use issues as well as suicidal ideation. Along with these issues mentioned, you may want to consider additional assessments (neurological, intellectual, vocational, etc.) based on the specifics of the vignette. But, you can start on this question now.
• Identify collateral sources
• Discuss type of interview
• Discuss use of MSE, substance use and suicidal ideation assessment
• Discuss and provide rationale for psychological testing
• Discuss any relevant referrals and the referral question
• Attend to any cultural issues related to assessment
The second question asks for a DSM-5 diagnosis along with a discussion of differential diagnosis.
B. Provide your diagnostic impressions (based on the DSM-5) for this individual. In narrative form, please describe how the individual meets the diagnostic criteria for the disorder(s) chosen in addition to the differential diagnostic thought process that you used to reach your hypotheses. Be sure to include any additional (missing) information that is needed to either rule out or confirm your differential diagnoses.
Naturally, this diagnosis depends on the vignette. You can prepare for this by having a copy of the DSM-5 readily available. I do not know how someone could adequately answer this question without the DSM-5. Be sure to use the DSM-5 and not the DSM-IV.
Legal Theory and Application
The third question addresses offender and victim theories as well as personality theories that may be used to explain the behavior presented in the vignette.
A. Using information from the provided vignette, describe the background, current presentation, and behavior of the client from a perspective which takes into consideration theories of offender and/or victim psychology and personality/psychopathology theories to support your position.
Again, although you do not yet know the vignette, you can still lay the groundwork for offender and/or victim theories as well as a theory on personality.
For example, you could discuss the basic tenets of social learning theory regarding the various ways behaviors can be learned. Once you have the vignette, you can apply specifics to the vignette. You should also explore offender and/or victim theories and start to write down the basic tenets of the theory. Example would be differential association theory, strain theory, etc.
The next question asks you to define the three psycholegal standards of competency to stand trial, risk assessment and criminal responsibility.
B. Describe the psycholegal standards and/or definitions for each of the following: competence to stand trial, risk of dangerousness, and insanity.
Identify and describe one or more landmark case(s) for each standard (at least three cases total). Describe the elements or issues that a mental health professional usually focuses on when assessing a person’s adjudicative competence, risk and insanity, and any additional items that might be especially important to focus on in the provided vignette.
You can elaborate on each of these and cite relevant case law. You should discuss the standards of each, competency to stand trial, risk assessment and criminal responsibility, and cite case law for each of the three psycholegal standards. You can have this accomplished before the exam is released. Once the exam is released and you have the vignette, you can add to your discussion as to how the three standards apply to specific examples from the vignette.
• Provide definitions and case law for each of the three standards
• Competency to stand trial
• Risk of dangerousness assessment
• Provide subheadings
• Show how the cases cited related to the legal standard
• Identify what elements a forensic mental health professional assesses for each standard
Research and Evaluation
The next question asks you to identify assessment instruments for the three psycholegal issues.
A. Describe tests or assessment procedures that you would employ in the vignette to address these forensic issues (competence to stand trial, risk of dangerousness, and insanity) and what your anticipated conclusions would be based upon that information provided in the vignette.
You can do this question now and review the literature and reading list for appropriate assessment tools and then provide detail on the assessment instruments and how the assessments are conducted. You have a number of resources available that you can use to identify assessment tolls to assess competency to stand trial, risk or dangerousness and criminal responsibility.
Once again, when you have the vignette, you can go back and apply details of the case to your response.
• Use subheadings in this section for the three legal standards
• Identify what assessment instruments are used to assess each of the three legal standards and provide a rationale for the assessment tools selected
• Identify any cultural concerns relevant to assessment
• Provide a realistic expectation of the expert opinion for the case vignette for each of the three standards
The next question asks for a treatment plan.
B. Develop one empirically supported therapeutic treatment plan for the client in the vignette. Please make sure you summarize the empirical evidence with appropriate citations to support your treatment choice(s) in working with your client. Be sure to discuss the effectiveness and limitations in working with this particular client, including this client’s background, using the above treatment plans.
You can start this answer now. You will need to discuss in detail a treatment approach. The treatment approach should correspond to the theoretical orientation that you selected for the question above (theory to describe the behavior). Many students select Cognitive Behavior Therapy (CBT) as there is a wealth of empirical evidence for the effectiveness of this approach. You should be able to describe in detail what CBT is, the underlying assumptions of the treatment approach and therapeutic change as well as specific techniques used in the therapy. Once you have the vignette and know the diagnosis, you will need to find research to support the use of this approach with that diagnosis.
• Identify the name of the theory – this should relate back to the theoretical case conceptualization
• Discuss the types of interventions recommended by the approach
• Discuss your rationale for the interventions
• Identify short- and long-term goals.
• Discuss the ways in which effectiveness will be assessed
• Discuss the anticipated effectiveness and limitations of the approach for this particular client
• Summarize the empirical support for the approach with appropriate citations (not just your own opinion)
The next question addresses diversity issues.
A. What diversity factors, cultural considerations, or other demographic variables pertaining to this client would you take into account in rendering diagnoses, choosing assessment measures, forming case conceptualizations, and designing the treatment plan? Be sure to discuss cultural/diversity factors that could apply even if they are not explicitly mentioned in the vignette.
You want to consider diversity broadly and include ethnicity and race, as well as gender, age, marital status, religious affiliation, sexual orientation, etc. You can start to assemble resources on diversity issues and assessment and treatment with regard to forensic settings.
The next question does not require a direct response but rather is an assessment of your writing and correct use of APA format. You really need to use the APA Publication Manual for correct APA format for the references. Also, you should use a grammar checker and spell checker for all your work.
B. Your writing, use of citations, ability to form a logical argument, and proper APA Style, including the use of paraphrasing, will be evaluated as a measure of your interpersonal effectiveness. No response is required for “B”.
• Be sure to use APA format for your exam. All sources should be properly cited.
• You are strongly encouraged to use APA format for headings and subheadings.
• Your headings and subheadings should correspond to each of the exam questions. This helps the scorers to easily find each of your answers.
Leadership, Consultation, and Ethics
The next question addresses professional roles.
A. Describe how you would work within a professional treatment team to consult, triage, and treat this case. Include a description of the various members of the professional team with whom you would be likely to interact. Additionally, explain the roles and responsibilities of each member of the treatment team.
You can start on this answer already. Consider what professionals work together as part of a treatment team. You could identify and define the different health care professionals as well as how they will interact.
• In other words, what roles would individual team members assume, and how would they interact?
• Discuss how they specifically would work together as a team. For instance, they might have weekly meetings, phone conferences, or some combination.
• Whereas much of your exam focuses on the role of the forensic professional, this question calls for your perspective as a treatment provider.
Finally, the last question addresses the ethical practice of forensic psychology.
B. What are the ethical and legal dilemmas this vignette introduced? What would be your immediate steps and why? Please be specific and make sure that you describe your process of ethical decision making and the solutions/consequences to which this process might lead. Your discussion should be informed by the American Psychological Association’s Ethics Code as well as the Specialty Guidelines for Forensic Psychologists.
You can start on this question as well. You can gather together the APA Ethical Principles and Code of Conduct as well as the Specialty Guidelines for Forensic Psychology. You can discuss these two documents and review the basic principles in the APA code. Once you have the exam, you can apply aspects of the vignette to the ethical issues.