INTRODUCTION TO CLINICAL PSYCHOLOGY, THIRD CANADIAN EDITION by John Hunsley and Catherine M. Lee Chapter 5

Overview Questions Introduction to psychological assessment Psychological testing Evidence-based assessment Ethical considerations Group exercise on referrals for psychological assessment For next class

Core Competencies in Assessment From Krishnamurthy et al. (2004) Knowledge of: psychometric theory the scientific, theoretical, empirical, and contextual bases of psychological assessment Knowledge, skills, and techniques to assess cognitive, affective, behavioural, and personality dimensions of human experience

Core Competencies in Assessment Ability to: assess intervention outcomes evaluate critically the multiple roles, contexts, and relationships in which clients and psychologists function and the reciprocal impact of these on the assessment activity establish, maintain, and understand the collaborative professional relationship involved in the assessment activity

Core Competencies in Assessment Understanding of the relation between assessment and intervention, assessment as an intervention, and intervention planning Technical assessment skills: problem/goal identification and case conceptualization understanding and selection of appropriate assessment methods effective use of the assessment methods systematic data gathering integration and analysis of information understandable, useful, and responsive communication of findings development of recommendations

Psychological assessment: Purposes Stand-alone Integrated Screening Diagnosis Prognosis Treatment recommendations Diagnosis & case formulation Prognosis Treatment planning Treatment monitoring Treatment evaluation In referrals exercise at the end of the class students are asked to work in groups to generate possible purposes of assessment for a child, adolescent, adult or older adult referred for psychological assessment.

Accuracy and Errors in Clinical Prediction True Positives False Positives True Negatives False Negatives

Psychological Testing Assessment versus testing Psychometric considerations Testing practices in clinical psychology

What is a psychological test? An evaluative device or procedure in which a sample of an examinee’s behavior in a specified domain is obtained and subsequently evaluated and scored using a standardized process Standards for Educational and Psychological Testing (APA, 1999)

Qualities of a psychological test Standardization Reliability Validity Norms

Some differences between Testing Assessment Yields scores on a measure What is this person’s IQ? Requires standard administration and scoring Can be conducted by a trained technician Addresses a specific question Does he have a learning disability and if so how can we help him deal with it Usually has multiple sources of data including standardized testing, but also interview Requires integration, and interpretation

Testing practices in clinical psychology Children Adults Intelligence Symptom checklists Personality Usually multi-informant Symptom checklists Personality Cognitive functioning Usually single informant

Evidence-based psychological assessment Integrating data Gathering data using adequate tools Generating hypotheses Noticing

Ethical considerations in assessment Informed consent What will assessment involve Who will get a copy of report Awareness of limits of confidentiality Responsible caring—selecting tools that are suitable to address the question Interpreting data in an even-handed way

Referrals: Children and Adolescents Aden is 7 years old. He is having difficulty concentrating in school. He is having a hard time learning to read. His teacher thinks he should see a psychologist. Kayla is 14. Her parents separated a year ago and she alternates between living with her mother and step-father and with her father. In recent months she has been cranky and unwilling to do her homework. She seems to get upset at the slightest provocation. Her father would like her to be seen by a psychologist.

Referrals: Adults Since he received a potentially lethal electric shock at work, Boris (age 48) has had difficulty managing his temper. He is moody and unpredictable. He seems to be having some memory problems. His family physician thinks he should see a psychologist Clara (age 84) has lived on her own since she was widowed two years ago. She seems to be withdrawing from activities. She had a minor car accident recently when she turned left across the path of an oncoming vehicle. Her son is encouraging her to see a psychologist.

Referrals for psychological assessment In groups of 5-6 review the information on referral for psychological assessment Identify areas of psychological research that could be relevant in assessing this person Generate ideas about: The question that a psychological assessment could address Hypotheses that a psychologist might explore The types of assessment strategies that might be useful The ethical issues that would need to be considered

Developing a plan for an assessment Determining the 1 or 2 questions (purpose) Diagnosis; treatment; eligibility for services; life decision (education, job, parenting plan) Generating multiple hypotheses that need to be examined to address the question Gathering data to test the hypotheses using a biopsychosocial approach Keeping ethical issues in mind Consent Confidentiality (to be covered in next chapters)

For next class….

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