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Developing Clinical Judgment in the Neophyte Counselor

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Michael Haderlie. Developing Clinical Judgment in the Neophyte Counselor. Defining clinical judgment. The judgments, inferences, and practices of clinicians A process of critical thinking in order to integrate data and make a decision Idiographic Unstructured Multidimensional Subjective.

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Presentation Transcript
defining clinical judgment
Defining clinical judgment
  • The judgments, inferences, and practices of clinicians
  • A process of critical thinking in order to integrate data and make a decision
    • Idiographic
    • Unstructured
    • Multidimensional
    • Subjective
related terms
Related terms
  • Decision making
  • Clinical prediction
process of clinical decision making
Process of clinical decision making
  • Define the problem/task
  • Collect data
  • Integrate the data
  • Make decision/judgment
  • Evaluate outcome of decision
  • Continue to re-evaluate as necessary
controversies in judgment research
Controversies in judgment research
  • Clinical vs. actuarial (statistical) prediction
    • Which is more accurate?
  • The role of experience
    • Does clinical judgment improve with experience?
expert versus novice differences in decision making
Expert versus novice differences in decision-making
  • Time spent understanding problem
  • Knowledge base (size and structure)
  • Automatic processing and efficiency
  • Long- and short-term memory
  • Depth of patterns identified
  • Number of ideas generated
  • Self-monitoring
barriers to developing clinical judgment in counseling
Barriers to developing clinical judgment in counseling
  • Complexity of tasks
    • “ill-defined” problems
  • Lack of feedback about judgments
  • Cognitive biases
cognitive biases
Cognitive biases
  • Anchoring-and-adjustment heuristic
    • Information that comes first is focused on
    • Later information is ignored or downplayed
  • Confirmatory bias
    • Tendency to seek and overweigh evidence that is consistent with one’s beliefs
    • Confirmatory hypothesis testing
cognitive biases11
Cognitive biases
  • Hindsight bias
    • Knowledge of an outcome leads us to believe that the outcome was easily predictable
  • Availability heuristic
    • Making judgments based on how easily information comes to mind
    • “Fad” diagnoses
  • Ignoring base rates
developing clinical judgment
Developing clinical judgment
  • Recognize limitations of clinical judgment
  • Increase knowledge base
  • Develop clear definition of the judgment to be made
  • Specific training relevant to the judgment task
developing clinical judgment13
Developing clinical judgment
  • Incorporate reliable standardized data (combine statistical and clinical approaches)
  • Focus on decision-making process, rather than outcome
  • Identify rationale for decisions
developing clinical judgment14
Developing clinical judgment
  • “Debiasing” strategies
    • be aware of cognitive biases
    • seek disconfirmatory evidence
  • Consider base rates
  • Seek immediate feedback regarding decisions