Researchers have addressed many clinician and client attributes in relation to the accuracy of judgments made by mental health professionals. One such moderator addressed clinicians’ judgment accuracy in relation to experience. Contrary to what many clinicians expect, a number of studies have failed to demonstrate a positive correlation between judgment accuracy and experience (e.g., Berman & Berman, 1984; Ruscio & Stern, 2005; Schinka & Sines, 1974). In Spengler et al. (2009), the relationship between judgment accuracy and experience was assessed via a largescale meta-analysis that examined studies of clinical judgment and experience from 1970 to 1996. The result was a small but reliable, homogeneous effect demonstrating a positive correlation between judgment accuracy and experience. The Spengler et al. meta-analysis found relatively few significant moderator effects influencing the experience-accuracy effect, namely the type of judgment made by clinicians, the criterion validity of accuracy measures used, and publication source. In the present study, results from clinical judgment and experience studies from 1997 to 2010 were combined in a meta-analysis. An update and extension allowed for cross-validation of the Spengler et al. meta-analysis with more recent research as well as an exploration of additional moderator variables, such as profession type and inclusion of non-mental health participants. The overall effect was .16, with a 95 percent confidence interval that was above zero (CI = .05 to .26). This overall effect indicated experience significantly impacted judgment accuracy, consistent with expectations. The overall effect was shown to be heterogeneous, indicating the Q statistic was sufficiently large to reject the null hypothesis regarding homogeneity of the effect size distribution. Exploratory analyses revealed the presence of two significant moderator variables, namely judgment type and publication source. Limitations included lack of variability of judgment type and difficulty with or complete inability to assess other potential moderators of interest, such as feedback and utilization of test protocols for the stimulus measure. Other limitations included utilization of a less exhaustive search strategy, in which some relevant studies may have been missed. Despite limitations, the results of the present metaanalysis largely replicated those of the Spengler et al. meta-analysis. / Department of Counseling Psychology and Guidance Services

Clinical judgment faith bias is a hypothesized tendency for clinicians to make more pathological judgments for clients with socially nonnormative faith than for otherwise identical clients with socially normative faith. To test for clinical judgment faith bias, Dillman’s (2007) Tailored Design method for mail and internet surveys was employed. A random sample of 141 psychologists in clinical practice completed a series of questionnaires measuring clinician religiousness and spirituality, view of faith helpfulness, multicultural awareness and knowledge, and diagnostic and prognostic judgments of a clinical vignette describing a client with Generalized Anxiety Disorder and two manipulated attributes: magnitude of faith (low, moderate, or high) and type of faith (religious or spiritual). Five multivariate multiple regression analyses were conducted, with a series of follow-up multivariate tests. The results of the analyses were not significant. The magnitude of faith in the vignette did not influence the diagnostic or prognostic judgments of clinicians, clinicians did not make significantly different judgments for religious cases than for spiritual cases, and faith magnitude did not interact with faith type. Furthermore, clinician attributes did not appear to affect clinical judgments in any way. Implications are discussed for theory, research and clinical practice. / Department of Counseling Psychology and Guidance Services

Borderline Personality Disorder (BPD) is a major health problem and is associated with considerable psychosocial distress and impairment, resulting in a high degree of morbidity and a significant impact on the mental health system. Patients with BPD are difficult to treat clinically, the main issue being engaging the patient and then maintaining the relationship. Patients with BPD constitute 10-20% of psychiatric inpatients, utilise a large amount of mental health resources and have a 10% successful suicide rate. Therefore, it is essential that attention is given to improving effectiveness of treatment approaches for patients with BPD, including engagement. The purpose of the study was to explore and describe the lived world of patients with BPD in order to develop supporting guidelines to improve non-compliance of patients with BPD. The objective of the study was to develop guidelines to improve compliance, which is expected to minimise self-harm risks and improve the quality of the patients’ lives. A qualitative, phenomenological methodology was chosen because it is particularly well suited to study human experiences of health (LoBiondo-Wood & Haber, 2011:141). It is a design that emphasizes discovery through interpreting meaning as opposed to quantification and prediction. Understanding and interpretation of data was thus the hallmark of the research design. This phenomenological study examined human experiences through the descriptions provided by the people involved, i.e. lived experiences. Data collection was done using recorded interviews guided by a semi-structured interview schedule. Memos collected during interviews supplemented the data. Data analysis was hallmarked by constant comparison, contextualisation and description of emerging themes. The main findings, described in three main themes, were the importance of the relationship with the clinician, the overwhelming feelings experienced by the patients and the sense of futility in treatment. These were all linked to the lack of hope the patient felt regarding their clinician, ever being able to manage their continuously oscillating emotions and the purpose of treatment. The findings led to the construction of guidelines to foster initial and continued engagement in treatment with patients with BPD. The guidelines covered issues of clinical practice and management input. / Health Studies / D. Litt. et Phil. (Health Studies)

Borderline Personality Disorder (BPD) is a major health problem and is associated with considerable psychosocial distress and impairment, resulting in a high degree of morbidity and a significant impact on the mental health system. Patients with BPD are difficult to treat clinically, the main issue being engaging the patient and then maintaining the relationship. Patients with BPD constitute 10-20% of psychiatric inpatients, utilise a large amount of mental health resources and have a 10% successful suicide rate. Therefore, it is essential that attention is given to improving effectiveness of treatment approaches for patients with BPD, including engagement. The purpose of the study was to explore and describe the lived world of patients with BPD in order to develop supporting guidelines to improve non-compliance of patients with BPD. The objective of the study was to develop guidelines to improve compliance, which is expected to minimise self-harm risks and improve the quality of the patients’ lives. A qualitative, phenomenological methodology was chosen because it is particularly well suited to study human experiences of health (LoBiondo-Wood & Haber, 2011:141). It is a design that emphasizes discovery through interpreting meaning as opposed to quantification and prediction. Understanding and interpretation of data was thus the hallmark of the research design. This phenomenological study examined human experiences through the descriptions provided by the people involved, i.e. lived experiences. Data collection was done using recorded interviews guided by a semi-structured interview schedule. Memos collected during interviews supplemented the data. Data analysis was hallmarked by constant comparison, contextualisation and description of emerging themes. The main findings, described in three main themes, were the importance of the relationship with the clinician, the overwhelming feelings experienced by the patients and the sense of futility in treatment. These were all linked to the lack of hope the patient felt regarding their clinician, ever being able to manage their continuously oscillating emotions and the purpose of treatment. The findings led to the construction of guidelines to foster initial and continued engagement in treatment with patients with BPD. The guidelines covered issues of clinical practice and management input. / Health Studies / D. Litt. et Phil. (Health Studies)