Psychology NOW Archives - 더트리그룹

Remote Administration of the Comprehensive Psychological/Psycho-educational Evaluation

The International Psychological Services center of the Tree Group has been providing treatment services online; however, the comprehensive psychological/psycho-educational evaluation has been provided offline only as various assessment tools are needed to carry out the evaluation. Nevertheless, in times when travel is restricted and social distancing is necessary, the Tree Group has become more aware of those who need comprehensive psychological/psycho-educational evaluation from abroad. Therefore, the Tree Group has decided to provide remote administration of the comprehensive psychological/psycho-educational evaluation by following the protocols updated by Pearson regarding Tele-practice of psychological and educational evaluations.

Where will the comprehensive psychological/psycho-educational evaluation take place?

The clinic has been providing years of online services to those in both Korea and abroad using diverse online platforms. Recently, due to the global pandemic, theTreeGroup has created and actively utilized a virtual office on Teams to provide better services online. The comprehensive psychological/psycho-educational evaluation will also be held on Teams to those who might find it difficult to visit our clinic in person.

How is the comprehensive psychological/psycho-educational evaluation arranged?

The clinic receives all referrals and contacts from international schools and parents. The school can make the initial contact; however, we then encourage the parents to call us for further information. During the first few contacts, an intake interview along with a comprehensive psychological/psycho-educational evaluation can be arranged to create a good diagnostic picture of the child or/and to make an effective treatment plan. The results of the intake interview and the comprehensive psychological/psycho-educational evaluation can also be shared with the school under the parent’s consent.

What is involved in the comprehensive psychological/psycho-educational evaluation?

The clinic uses various scientifically proven assessments to understand a child’s cognitive and academic abilities as well as the child’s behavioural and psychological issues. Below are several of the assessments included in the evaluation.

The content of the assessment varies slightly depending on the age of the child. The clinic also uses the Korean version of the Wechsler Intelligence Scale for Children – Fifth Edition to those who are bilingual. The inclusion of both the English and Korean versions of the assessment is to have a better understanding of the child’s language development and state.

How is the remote administration of the comprehensive psychological/psycho-educational evaluation different to that provided in person?

The parents will be more actively involved in the evaluation as there are subtests within the WISC-V that requires timing and handling of response booklets. Prior to the evaluation, the parents will be provided with guidance on how to support their child during the evaluation. The WISC-V Block Design subtest which is used to measure a child’s visual-spatial coordination abilities will be excluded from the evaluation as a professional is needed to guide the child in using the evaluation tool. The performance results from the Visual Puzzles subtest will be substituted in calculating the scores. More information regarding the tele-practice of WISC-V can be found in the link below provided by Pearson.

https://www.pearsonassessments.com/professional-assessments/digital-solutions/telepractice/telepractice-and-the-wisc-v.html#

For further information or/and arrangement of the comprehensive psychological/psycho-educational evaluation please contact us at (+82)2-557-8823 or send us an email to ips@treegroup.onmicrosoft.com.

Sleep hygiene and psychopathology

By 양미린 Yang Mirin, MA.

The interaction between chronic sleep deprivation and psychopathology has been widely researched. Chronic sleep deprivation is related to obesity, heart disease, type 2 diabetes and dysfunction of the immune system. Additionally, sleeping hours could be a significant predictor of increased risk of death, as well as psychological disorders, such as depression and suicide.

According to the Diagnostic and Statistical Manaual of Mental Disorders 5th edition (DSM-V), sleep-wake disorders encompass ten disorder groups, which involve: insomnia disorder, hypersomnolence disorder, narcolepsy, breathing-related sleep disorders, circadian rhythm sleep disorders, non-REM (NREM) sleep arousal disorders, nightmare disorder, REM sleep behavior disorder, restless legs syndrome, and substance- or medication-induced sleep disorder.

An individual experiences insomnia due to (1) stress, (2) lack of social support and, (3) abnormal everyday life routines.

Furthermore, according to Dr. Susan Rubman, COVID19 could influence the perception of the bedroom: instead of perceiving it as a place where you can rest, it is now commonly seen as a place where you work remotely. Similarly, a range of behavior developed during COVID19, such as staying indoors, large amounts of exposure to electronic devices, irregular eating patterns, increased consumption of alcohol. Such behavior affects individuals’ circadian rhythm and increases their risk of sleeping problems.

Sleep-wake disorders can be treated by cognitive behavioral therapy (CBT), during which individuals learn to identify and replace thoughts and behaviors that cause sleeping problems.

To maintain sleep hygiene, you are recommended to have:

– A dark, quiet, cool environment

– Blinds to make the room darker

– White noise

– No work-related tools or electronics : the light from electronics can cause unwanted sleep wakening, developing the cognitive and behavioral relationship between a bedroom and wakening

Sleep problems should be considered as one behavior, rather than a biological function. Sleep disorders are frequently comorbid with bipolar disorders, depression and/or anxiety disorders. Thus, treatment of sleep disorders may alleviate the progression of psychiatric disorders.

Sleep disorders exacerbate our psychological and physiological health. Through CBT, we should identify and be aware of thoughts and behaviors that cause sleep problems.

We hope you practice healthy sleep hygiene and take a step towards having a safe everyday life through “With Corona”.

Reference:

Diagnostic and Statistical Manual 5th Edition, American Psychological Association (APA)

* We appreciate our clients for their honest and sincere testimonials.

Adolescents’ porn literacy and sexual self-determination capability

By 양미린 Mirin Yang, MSc

Nowadays, adolescents can easily access pornography only through a few clicks on the Internet. The effect of pornography on the development of children and adolescents has been widely researched with a range of controversial results. Yet, there is no doubt that pornography constructs a false portrayal of sexuality.

Experts in the fields of psychology, public health and sex education express concerns that current children and adolescents are susceptible to sexual assaults, due to early development of their sexual perception, precocious puberty, advanced technology and the frequent exposure to media. Having restrictions on the use of media contents and technology may not provide the long-term effect. Thus, the experts came up with a new approach of improving individuals’ porn literacy.

Porn literacy aims to teach adolescents to have a critical view of pornography contents and to develop an appropriate perception of sexuality. Additionally, porn literacy allows adolescents to have responsibilities in relationships and demonstrates sexual self-determination capability.

In the US, most public schools provide sex education, despite a slight difference in each curriculum. In general, such curriculum involves teaching the history of pornography, legality, gender norms, double standard, healthy relationships, and contraception. However, there is no program that aims to train porn literacy.

There are continuous news reports regarding sexual assaults and abuse. There are strong feelings of anger and distress from the public. The society should consider the best long-term solutions, such as developing appropriate laws. Just because sex is an uncomfortable topic to discuss at home or at school, we may be taking away adolescents’ opportunities to develop sexual self-determination capability. Instead of avoiding the conversation and calling it “protection” from pornography, we should see what the most important next step is in providing the best care for the young adults’ community.

References

APA Monitor on Psychology

이정민, 이수정, 염현이(2020). 아동청소년의 성적 자기결정권에 관한 연령추정 연구. 이화젠더법학, 12(2), 95-133.

My life after learning DBT has become hopeful

woman at the beach with her hands together

""Loving my life and my survival instinct led me to be here every week for 1 year."

DBT Client

I was doubtful whether DBT can help me make a change in my life. My symptoms aren’t 100% gone but I learned and experienced the skills to overcome my difficulties.

If my past 30 years were a hassle, my life after learning DBT has become hopeful. My life goal is to be confident in making my own path and DBT has helped me in achieving this goal. It has not been easy visiting the clinic every week for the past year. However, what motivated me was the love I had for myself and my instinct for survival.

I believed that I had to be physically and mentally healthy to nurture my child, and I am more than pleased now that I am enjoying the small things in life with my precious child.

* We appreciate our clients for their honest and sincere testimonials.

Burnout syndrome

By 양미린 Yang Mirin, MA.

Nowadays, the term “burnout syndrome” is being used to describe individuals’ daily stress, anxiety, and exhaustion. Although burnout is synonymous to extreme tiredness and depression, the World Health Organisation (WHO) considers the term as an occupational phenomenon, rather than a medical disorder. There are three symptoms of such phenomenon:

(1) feelings of energy depletion due to chronic work stress

(2) negative or cynical attitudes towards your job

(3) developing negative self-ego with reduced work efficiency.

These symptoms develop when the work-related stress has not been dealt with. Individuals may overcome the stress on their own, or with the support of the colleagues at the organizational level. For instance, companies have been encouraged to offer a four-day week, flexible commuting system, extended holiday, removing overtime hours and employee support programmes.

Dr. Christina Maslach suggests that being aware of the difference between coping and preventing burnout syndrome is critical. Individuals may cope with work stress by taking breaks or going on a holiday. However, the fundamental environment of the workplace and job conditions remains the same and continues developing the organisational-level stress. Research suggests that six characteristics of the relationship between the organisation and the individual below may increase the risk of having burnout syndrome.

– Workload and resource: large amount of work with limited time, information, technological resources.

– Control/discretion over work: lack of control over work

– Social and intrinsic rewards/recognition: lack of rewards and recognition within the society for completing the tasks (other than salary)

– Community: bullying between colleagues, lack of support within the team

– Fairness: being treated unfairly (e.g. the case of glass ceiling, racism, lying)

– Values and meaning of the work: having self-doubts and no pride about the job.

A lot of individuals with burnout syndrome wonder “what am I doing wrong?”, “how do I resolve the issue?” and try to find the solution from themselves. Although one may find problems and solutions at the individual level, do not let them affect your confidence and self-esteem. Instead, find a spare moment to look around and notice the supportive atmosphere around you.

Reference:

American Psychological Association (APA) Monitor

Exposure Response Prevention Therapy

By 이승하 Seungha Lee, MSc

What Is Exposure Response Prevention (ERP) Therapy?

Clients with Obsessive Compulsive Disorder (OCD) are encouraged to let intrusive thoughts occur without having to neutralize their anxieties with compulsions in Exposure Response Prevention (ERP) therapy. The therapy is a part of Cognitive Behavioral Therapy (CBT) and has been widely used as one of the most effective treatments for OCD. In this breakthrough series, we would like to share with you a story of a young adult who had serious checking behaviors and how she overcame her fears with ERP therapy.

What Is Exposure Response Prevention (ERP) Therapy?

Exposure Response Prevention

Emma made a list of her intrusive thoughts that are highly anxiety-provoking. The intrusive thoughts below are a few that she listed from the least to the most anxious.

– Did I lock the house door? What if a burglar breaks in and takes my family’s possession? What if the burglar harms my family?

– What was the bump that I just felt while driving? What if it was a living creature?

– Did I unplug all the appliances that are not in use? What if I didn’t and our house sets on fire? What if the situation gets worse and I harm my neighbors as well?

These intrusive thoughts made Emma repeatedly drive the same route to check that she did not drive over a living creature and repeatedly check that her house is locked and all appliances are unplugged so that she is 100% sure that her worst fears are not likely to happen. Her symptoms grew over time and she had many occasions when she was late for her classes or appointments.

Emma was asked to reduce her number of checking until she felt minimal level of anxieties even when she did not check at all. She left her house after locking the door and without checking that the door was firmly locked. She did not drive the same route when she think she felt a small bump while driving. She checked whether the appliances were unplugged before leaving the house and did not go back to re-check.

The Exposure Response Prevention stage of the therapy made her realize that the vicious cycle of the intrusive thoughts, anxieties, and compulsive behaviors would only stop if she does not respond to her intrusive thoughts with compulsive behaviors. Emma also learned that her intrusive thoughts may not go away entirely, but that she can live with the intrusive thoughts without reacting to it!

Cognitive Behavior Therapy for Phobias/Anxiety

By 이승하 Seungha Lee, MSc

What Is Cognitive Behavioral Therapy?

Cognitive behavior therapy assumes that our thoughts, feelings, and behaviors are interconnected and involves efforts to change thinking and behavioral patterns to relieve symptoms of psychological problems. The therapy is evidence-based meaning that the therapy has been scientifically proven to produce change in many people who suffer from anxiety disorders, depression, and other severe mental illness.

How Does the Treatment Look Like?

Below is a brief example of how the treatment would look like for David who is 10 years old and has a fear of dogs. (The following example can be specified to phobias and social anxiety.)

STEP 1) Psycho-education: there are several topics that the child can learn and discuss to better understand the reason behind our emotions.

– What are emotions and what good are they?

: David learns the adaptive functions of our emotions as well as how our emotions can become maladaptive.

– How do we identify our emotions? How do we express our emotions both inside and outside?

: David may use the Feelings Vocabulary Chart, Feelings Thermometer, and other fun ways to identify his emotions.

– What is the cognitive triangle?

: David learns that our thoughts, feelings, and behaviors are interconnected. Below is an example with David’s case.

Event: David sees a dog on the street.

Thought: He thinks that the dog will run towards him, bite his ankle and that he will have to go to the emergency room.

Feeling: He feels scared and horrified.

Behavior: He crosses the street and runs away from the dog.

Consequence: David feels relieved.

*Remember that this is only a SHORT-TERM relief!

Every part of the chain can be an intervention point for later in the treatment. Below is an example with David’s case.

Thought: The child becomes a detective and detect any thinking errors that we all make and learn to check the facts.

Feeling: The child can use breathing relaxation skills and other emotion regulation skills to reduce feelings of fear.

Behavior: The child can practice exposure therapy to experience the reduction of anxiety even when he/she is with dogs.

STEP 2) Cognitive Restructuring

– What is the anxiety cycle?

: David learns that avoiding a fearful situation/thing can decrease anxiety temporarily, but it would only increase fear in the long run and that the anxiety cycle continues to prevent him from feeling less fear.

– WHY? This is because David does not have the opportunity to learn that dogs are okay to be around with and believes that he has not been bitten because he stayed away from dogs.

: Thus, David then learns that not running away from dogs is the ONLY way he can overcome his fear of dogs. (Can you think of a way how David can overcome his fear of dogs without learning that they are okay to be around with? Probably NO!)

– Detect thinking errors that we all make.

: The following are several examples of our thinking errors: catastrophizing, feelings as facts, mind reading, blaming yourself, jumping to conclusions etc.

: David imagining that the dog will bite his ankle and that he will have to go to the emergency room may be an example of catastrophizing.

STEP 3) Exposure

– Plan for exposure therapy!

: David makes a list of fearful situations with the therapist from the least fearful to the most fearful. Below is an example of David’s anxiety hierarchy.

Looking at pictures of puppies -> Looking at pictures of dogs -> Looking at pictures of large dogs -> Watching videos of a dog -> Watching videos of dogs -> Standing two meters away from a real dog -> Standing one meter away from a real dog

Standing right next to a real dog -> Touching the dog gently -> Hugging and playing with the dog

– The remaining part of the treatment is exposure therapy. It is important that David gets to experience and feel no or mild levels of anxiety at the completion of each stage!

Remote Administration of the Comprehensive Psychological/Psycho-educational Evaluation

By 이승하 Seungha Lee, MSc

Where will the comprehensive psychological/psycho-educational evaluation take place?

How is the comprehensive psychological/psycho-educational evaluation arranged?

What is involved in the comprehensive psychological/psycho-educational evaluation?

The clinic uses various scientifically proven assessments to understand a child’s cognitive and academic abilities as well as the child’s behavioral and psychological issues. Below are several of the assessments included in the evaluation.

How is the remote administration of the comprehensive psychological/psycho-educational evaluation different to that provided in person?

Telepractice and the WISC–V

For further information or/and arrangement of the comprehensive psychological/psycho-educational evaluation please contact us at (+82)2-557-8823 or send us an email to info@thetreeg.com

Guidelines for Analyzing WAIS-IV/WISC-V

By 양미린 Mirin Yang, MA

Wechsler Adult Intelligence Scale-IV (WAIS-IV) and Wechsler Intelligence Scale for Children-V (WISC-V) are intelligence tests that measure an adult’s and a child’s intellectual ability and five cognitive domains that impact performance. These tests have taken a crucial role in psychological testing as they can help provide concise analyses on one’s psychological state along with other psychological tests. Therefore, it is imperative to keep in mind the necessary cautions and guidelines as well as the steps to interpret the test results.

The following errors include some of the most common errors when administering these intelligence tests and thus need awareness of the test administrator: Failing to record examinee responses, circle scores, or record times; Questioning the examinee inappropriately; Incorrectly converting raw scores to standard score; Incorrectly calculating raw scores for subtest totals.

When interpreting the test results, these five levels of procedure should be taken into consideration.

Level I. Interpret the Full Scale IQ
Level II. Interpret index scores and CHC groupings
- Interpret personal strengths and weaknesses
  - Index scores: Verbal Comprehension, Perceptual Reasoning (Visual Spatial & Fluid Reasoning on WISC-V), Working Memory, Processing Speed
  - CHC/other custer groupings: Fluid Reasoning, Verbal Fluid Reasoning, Nonverbal Fluid Reasoning, Quantitative Reasoning, Lexical Knowledge, General Information, Visual Processing, Cognitive Proficiency, Visual Motor Speed, Problem Solving without Visual Motor Speed, Long Term Memory, Auditory Working Memory/Short Term Memory (all core and supplemental subtests must be given to calculate CHC groupings)
Level III. Interpret subtest variability
Level IV. Qualitative/ process analysis
Level V. Analyze intrasubtest variability

Finally, WAIS-IV/WISC-V test results should not be the sole source to analyze one’s psychological state. Rather, they should be used with other psychological tests, observations, and self-reports in order to create a more accurate interpretation.

Stimulus Discrimination Training

By 양미린 Mirin Yang, MA

What is Stimulus Discrimination Training?

Stimulus Discrimination Training is the process of reinforcing a behavior only when a specific antecedent stimulus is present. Here, the stimulus is one that precedes the occurrence of the behavior.

Two steps are involved in this training:

1. The behavior is reinforced when the discriminative stimulus is present. The discriminative stimulus is the antecedent stimulus that is present when the behavior is reinforced.

2. It is important to note that when any other antecedent stimuli except the antecedent stimulus are present, the behavior is not reinforced.

At the Tree Group, we implement this strategy to teach our clients how to engage in certain behaviors in the presence of a stimulus.