臨床心理学英語：必須語彙とフレーズ

"presenting complaint"

The primary problem or concern that brings a client to clinical attention, stated in the client's own words during the initial assessment

"The presenting complaint was persistent low mood and inability to concentrate, which had been present for approximately six months."

"psychosocial history"

A comprehensive account of a client's developmental, social, occupational, and relational background gathered to contextualise current difficulties

"The psychosocial history revealed a pattern of early attachment difficulties following the death of the client's primary caregiver at age four."

"standardised assessment"

A validated, norm-referenced psychological measure administered and scored according to fixed procedures to allow comparison with population norms

"The standardised assessment included the PHQ-9 for depression and the GAD-7 for anxiety, both of which fell in the moderate severity range."

"mental state examination"

A structured observation and description of a client's appearance, behaviour, speech, mood, thought, perception, cognition, and insight at the time of assessment

"The mental state examination revealed congruent affect, coherent thought content, and no evidence of perceptual disturbance."

"differential diagnosis"

A list of possible diagnostic formulations considered to explain a client's presentation, ranked by likelihood and differentiated through further assessment

"The differential diagnosis included major depressive disorder, persistent depressive disorder, and adjustment disorder with depressed mood."

"baseline functioning"

A description of the client's level of psychological and social functioning prior to the onset of the current difficulties, used as a reference for treatment goals

"Baseline functioning was described as good prior to the traumatic event, with the client working full-time and maintaining active social relationships."

"collateral information"

Clinical information gathered from a third party, such as a relative or referring professional, to supplement the client's self-report

"Collateral information from the client's partner confirmed the reported pattern of sleep disturbance and social withdrawal."

"functional impairment"

The degree to which psychological symptoms interfere with a client's ability to carry out daily activities, work, relationships, or self-care

"Functional impairment was significant, with the client unable to return to work and avoiding all social contact for the past three months."

"predisposing factors"

Background vulnerabilities — biological, psychological, or social — that increase a person's susceptibility to developing a particular psychological difficulty

"Predisposing factors included a family history of anxiety disorders and early childhood experiences of unpredictable parenting."

"precipitating factors"

Specific events or stressors that triggered or initiated the onset of the client's current psychological difficulties

"The precipitating factor was a sudden redundancy which undermined the client's core beliefs about competence and self-worth."

"perpetuating factors"

Cognitive, behavioural, or interpersonal processes that maintain and reinforce the client's difficulties over time

"Perpetuating factors included avoidance of anxiety-provoking situations and repetitive negative thinking about the future."

"protective factors"

Personal strengths, social supports, or contextual resources that reduce distress and promote resilience and recovery

"Protective factors identified in the formulation included strong family support, good problem-solving skills, and meaningful employment."

"maintaining cycle"

A diagrammatic representation of the reciprocal relationships between thoughts, emotions, physical sensations, and behaviours that sustain psychological difficulties

"The maintaining cycle showed how catastrophic thoughts triggered panic symptoms, which in turn increased the client's fear of losing control."

"cognitive model"

A theoretical framework explaining how distorted or unhelpful patterns of thinking contribute to emotional distress and maladaptive behaviour

"The cognitive model for social anxiety proposed that the client's self-focused attention and negative post-event processing maintained fear of social evaluation."

"cross-sectional formulation"

A snapshot formulation that links current thoughts, feelings, physical sensations, and behaviours to explain the client's difficulties at a specific point in time

"The cross-sectional formulation was shared with the client using a "hot cross bun" diagram to illustrate the connections between each domain."

"longitudinal formulation"

A developmental formulation that traces the origins and evolution of a client's difficulties from early life experiences to the present day

"The longitudinal formulation connected the client's early experiences of emotional neglect to current difficulties with self-compassion and interpersonal trust."

"major depressive episode"

A clinical syndrome characterised by depressed mood or anhedonia lasting at least two weeks, accompanied by cognitive and neurovegetative symptoms causing significant impairment

"The client met criteria for a major depressive episode with prominent anhedonia, psychomotor retardation, and persistent hopelessness."

"generalised anxiety disorder"

A condition characterised by excessive, difficult-to-control worry about multiple domains of life, accompanied by physical symptoms of tension and arousal

"Generalised anxiety disorder was diagnosed following six months of pervasive worry about health, finances, and relationships that the client found impossible to switch off."

"post-traumatic stress disorder"

A condition arising after exposure to traumatic events, marked by intrusive re-experiencing, avoidance, negative alterations in cognition and mood, and hyperarousal

"Post-traumatic stress disorder was diagnosed following a road traffic accident, with the client reporting vivid flashbacks, nightmares, and hypervigilance when driving."

"borderline personality disorder"

A pervasive pattern of instability in interpersonal relationships, self-image, and affect, combined with marked impulsivity, often associated with intense fear of abandonment

"The formulation drew on a biosocial model to understand the client's borderline personality disorder within the context of early emotional invalidation."

"obsessive-compulsive disorder"

A condition characterised by intrusive, unwanted thoughts (obsessions) and repetitive behaviours or mental acts (compulsions) performed to neutralise distress

"Obsessive-compulsive disorder was maintained by the client's belief that performing checking rituals prevented harm, which was explored using an inference-based model."

"specific phobia"

An intense, persistent fear of a specific object or situation that is out of proportion to the actual danger and leads to avoidance or significant distress

"The specific phobia of vomiting had led to severe dietary restriction and social avoidance, and was addressed through graduated exposure."

"adjustment disorder"

An emotional or behavioural response to an identifiable stressor that is disproportionate in severity and causes marked distress or functional impairment

"An adjustment disorder with mixed anxiety and depressed mood was identified following the client's unexpected relationship breakdown."

"somatic symptom disorder"

A condition in which physical symptoms are associated with disproportionate thoughts, feelings, and behaviours related to health, causing significant distress regardless of any established medical diagnosis

"Somatic symptom disorder was formulated in terms of heightened body vigilance and catastrophic interpretation of benign physical sensations."

"cognitive behavioural therapy"

A structured, time-limited therapy that targets the reciprocal relationships between unhelpful thoughts, emotions, and behaviours to reduce distress and build adaptive coping

"Cognitive behavioural therapy was delivered over sixteen sessions, focusing on identifying and challenging the client's core belief that she was fundamentally unlovable."

"behavioural activation"

A component of CBT for depression that systematically increases engagement in rewarding and meaningful activities to counteract avoidance and low mood

"Behavioural activation was introduced in sessions three and four, with the client scheduling three valued activities per week to build momentum and positive affect."

"exposure and response prevention"

A behavioural intervention for OCD in which the client deliberately confronts feared stimuli while refraining from performing compulsive rituals, allowing anxiety to habituate

"Exposure and response prevention began with touching door handles without handwashing, progressing gradually up the hierarchy over eight sessions."

"dialectical behaviour therapy"

A comprehensive, skills-based therapy combining cognitive-behavioural techniques with mindfulness and acceptance strategies, originally developed for borderline personality disorder

"Dialectical behaviour therapy was recommended given the client's pattern of self-harm, intense interpersonal conflict, and chronic emotional dysregulation."

"acceptance and commitment therapy"

A third-wave CBT approach that promotes psychological flexibility by fostering acceptance of difficult internal experiences and commitment to values-based action

"Acceptance and commitment therapy used defusion exercises to help the client relate differently to self-critical thoughts, reducing their behavioural impact."

"schema therapy"

An integrative therapy targeting deep-rooted maladaptive schemas formed in early life, using cognitive, behavioural, and experiential techniques to promote schema healing

"Schema therapy addressed the client's defectiveness schema, which originated in experiences of chronic criticism and ridicule during childhood."

"eye movement desensitisation and reprocessing"

A trauma-focused therapy in which bilateral stimulation — most commonly eye movements — is used while the client processes traumatic memories to reduce their emotional intensity

"Eye movement desensitisation and reprocessing was used to target the three most distressing traumatic memories identified during the assessment phase."

"motivational interviewing"

A collaborative, client-centred communication style that explores and resolves ambivalence about behaviour change, enhancing intrinsic motivation

"Motivational interviewing was used in the initial sessions to explore the client's ambivalence about reducing alcohol use before more structured interventions were introduced."

"suicidal ideation"

Thoughts of ending one's own life, assessed along dimensions of frequency, intensity, duration, and the presence of intent or plan

"The client disclosed passive suicidal ideation — a wish to be dead — but denied active intent, plan, or access to means."

"risk formulation"

A structured clinical narrative that integrates static, dynamic, and protective risk factors to explain and contextualise a client's level of risk

"The risk formulation identified hopelessness, social isolation, and recent loss as the primary dynamic factors elevating current risk."

"safety plan"

A collaboratively developed written plan specifying warning signs, coping strategies, social supports, and professional contacts to be used during a mental health crisis

"A safety plan was developed with the client, including three trusted contacts and a crisis helpline number to be used before acting on any suicidal thoughts."

"duty of care"

The professional and ethical obligation of a psychologist to act in the best interests of a client and take reasonable steps to prevent foreseeable harm

"The duty of care required the clinician to inform the client's general practitioner of the elevated suicide risk identified during the assessment."

"capacity to consent"

The client's ability to understand, retain, and weigh information relevant to a decision and communicate a choice, assessed as decision-specific and time-specific

"Capacity to consent to the treatment plan was assessed and confirmed, with the client demonstrating a clear understanding of the proposed intervention and its alternatives."

"mandatory reporting"

A legal obligation to disclose information to the appropriate authorities when a clinician has reasonable grounds to suspect abuse, neglect, or serious harm

"Mandatory reporting was triggered when the client disclosed that her young child had witnessed repeated episodes of severe domestic violence."

"self-harm"

Deliberate injury to one's own body as a way of coping with overwhelming emotional distress, distinguished from suicidal behaviour by the absence of intent to die

"The client disclosed a history of self-harm by cutting, which had resumed during periods of intense interpersonal conflict over the past year."

"risk stratification"

The process of categorising a client's overall level of risk as low, medium, or high to inform the intensity and urgency of clinical intervention

"Following risk stratification the client was placed in the high-risk category, triggering weekly contact and a referral to the crisis resolution home treatment team."

"clinical supervision"

A structured professional relationship in which an experienced practitioner supports a less experienced clinician to reflect on and develop their clinical practice

"Clinical supervision provided a reflective space to explore the counter-transference evoked by the client's hostility in sessions."

"formulation-driven intervention"

An approach in which treatment decisions and therapeutic techniques are chosen based on the individualised psychological formulation rather than diagnosis alone

"A formulation-driven intervention was designed that specifically targeted the shame-based maintaining processes identified in the conceptualisation."

"stepped care model"

A framework for organising mental health services in which clients begin with the least intensive evidence-based treatment and step up to more intensive care if needed

"Under the stepped care model the client was first offered guided self-help for mild depression before being stepped up to individual CBT."

"psychoeducation"

Structured information provided to clients and their families about the nature of a psychological condition, its maintaining factors, and the rationale for treatment

"Psychoeducation about the fight-or-flight response was provided in session one to normalise the client's physical anxiety symptoms."

"multidisciplinary team"

A collaborative group of professionals from different health and social care disciplines who jointly assess, plan, and deliver care to a client

"The multidisciplinary team included a consultant psychiatrist, clinical psychologist, community psychiatric nurse, social worker, and occupational therapist."

"therapeutic alliance"

The quality of the collaborative bond and agreement on goals and tasks between a therapist and client, one of the strongest predictors of therapy outcome

"Building a strong therapeutic alliance was prioritised in the early sessions, particularly given the client's history of attachment difficulties and previous experiences of being let down by professionals."

"outcome measures"

Validated questionnaires administered at regular intervals during therapy to track changes in symptoms, functioning, or well-being and inform treatment decisions

"Outcome measures were completed at the start of each session and reviewed fortnightly to assess progress and agree any modifications to the treatment plan."

"reflective practice"

The ongoing process of critically examining one's clinical work, emotional responses, and theoretical assumptions in order to develop as a practitioner

"Reflective practice was facilitated through weekly supervision, personal therapy, and the use of a clinical reflective journal during training."