Table 3.
Operationally defined natural decision-making theory terms and constructs measured for clinical psychology.
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Natural Decision-Making Process E= Experts, N= Novice |
Form of Assessment in this MH Study Number of questions (summated per verbal protocol and averaged across vignettes) Qualitative description of questions |
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Type of Reasoning: E=Forward reasoning (demonstrated by asking few relevant questions) N=Backward reasoning (demonstrated by asking many irrelevant and relevant questions) | |
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Organization of Information & Deriving Hypotheses (Diagnoses) E=Highly organized & accurate (generate minimal hypotheses-diagnoses with accuracy) N=Poorly organized & less accurate (generate many hypotheses-multiple diagnoses with inaccuracy) |
Number of diagnoses (summated all unique diagnoses stated and averaged across vignettes) % DBD Dx (DBD, ODD, CD, DBD NOS) % each diagnostic classification (Mood D/Os, Anxiety D/Os, ADHD, LD & Other-Attachment D/O, Substance D/Os) (%s summated for each vignette) |
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Attention to Information and Level of Abstraction: E=High abstraction (attend to relevant information and high level of abstraction-attend to child factors such as symptoms) N=Low abstraction (attend to all information, focusing on detail and low level of abstraction- attend to child, parent and family factors such as context) |
Total Number of factors attended to of any type (across all vignettes) Mean Number of Child factors attended to (averaged across vignettes)* Mean Number of Parent factors attended to (averaged across vignettes)† Mean Number of Family factors attended to (averaged across vignettes)† |
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Finding a solution: E=Timely solution, Effective solution (clearly stating use of an effective treatment, providing details with rationale) N=Extended time in generating solution or no solution, Ineffective solution (stating use of ineffective treatment or vague statement of treatment, providing limited to no details or rationale) |
% time discussing treatment (# of treatment lines divided by total lines of protocol and averaged across vignettes) Score of treatment extensiveness (assigned rating between 1–5 and averaged across vignettes)‡ |
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Incorporating Actuarial Information: E= Incorporate actuarial information with individual’s characteristics and demonstrate flexibility in applying it (use of EBT and standardized assessments) N= Unsure how to incorporate actuarial information with an individual’s characteristic and challenged by applying it flexibly (no use of EBT or standardized assessments) |
Mean % of treatment plans including EBT (across all vignettes per clinician: PCIT, PMT, PSST, MST, IY. CBT)§ Number of Standardized Assessments indicated |
Notes: DBD= disruptive behavior disorder, ODD= Oppositional Defiant Disorder, CD= Conduct Disorder, NOS= Not Otherwise Specified, ADHD= Attention Deficit Hyperactivity Disorder, LD= Learning Disorder, Dx = Diagnosis, D/O = Disorder;
A total of 6 child factors were reported for this study from clinician responses and included: 1) relationships with peers, 2) disruptive behaviors at home, 3) disruptive behaviors at school, 4) psychological or school testing/assessment, 5) academic performance, and 6) social skills,
A coding scheme developed in a previous study (Baker-Ericzén, Jenkins, et al., 2010) was used to code the occurrence of a set of 7 parent and 18 family factors,
treatment plan scored 1 had limited detail (i.e. broad description of treatment plan with short explanation), a plan scored 5 had details and explanations (i.e. the treatment was labeled, explained, and described in detail with defined steps or strategies). EBT= evidence-based treatment, PCIT= Parent Child Interaction Therapy, PMT= Parent Management Training, PSST= Problem Solving Skills Training, MST= Multisystemic Therapy, IY= Incredible Years Parent Training, CBT= Cognitive-Behavior Therapy
EBT determined from published lists according to EST definition (Eyberg, et al., 2008; Ollendick & King, 2004; Warren, et al., 2010).