Chapter 14 Using Tests in Clinical and Counseling Settings
Assessment vs. Testing Tests are focused and specific. Clinical “assessment” includes a broad info-gathering and interpretation.
The Role of Managed Care Demand for greater accountability. Demand for short-term therapy. Clients are expected to learn coping skills quickly. Reluctance to pay for extensive and expensive testing. Greater use of the psychiatric model of giving drugs. Emphasis on cost saving and efficiency.
3 Models of How Testing Is Used by Clinicians and Counselors Info-gathering model Therapeutic model Differential treatment model
Information-gathering Model Provides standardized comprisons with others. Makes predictions about real world setting. Provides baseline measure for evaluating success of treatment.
The Therapeutic Model Assessment leads to dialog that facilitates behavioral change; i.e., self-discovery and insights.
The Differential Treatment Model Testing provides data for evaluating treatments.
Tests Used for Diagnosis and Intervention Diagnosis: indentifying the client’s problem or disorder. Also called screening. Can be informal. May involve a DSM-IV category and label.DSM-IVlabel Diagnosis leads to the design of an intervention or treatment plan. This process varies with the professional making the judgment (i.e., unreliably).
The Clinical Interview Structured: predetermined set of questions. May be scored. Leads to diagnosis. Nondirective clinical interview: few predetermined questions, most are ad hoc…flexible, but can lead to hypothesis confirmation bias (i.e., seeking info to confirm a predetermined hunch).
Semistructured: some predetermined questions, some open-ended, plus follow- up questions.
Dangers of the Nondirective Interview Hypothesis confirmation bias: seeking info to confirm a predetermined hunch; e.g., false memory syndrome.false memory syndrome Self-fulfilling prophecy: Interviewer’s expectations influence the client’s actual responses.
Structured Personality Tests Objective, self-report measures of psychopathological behavior; e.g., MMPI-2 (Sample report)MMPI-2Sample report
Objective, self-report measures of normal personality 16 Personality Factor Inventory (16PF)16 Personality Factor Inventory California Personality Inventory (CPI)California Personality Inventory Strong Interest Inventory
Projective Techniques Storytelling 1.Rorschach Inkblot Technique (Criticism)Rorschach Inkblot TechniqueCriticism
Projective Techniques Storytelling (cont’d) 2. Thematic Apperception Test (TAT)
Projective Drawing 1. House-Tree-Person (HTP) 2. Draw-A-Person Technique
Sentence Completion Test
Neuropsychological Tests Electroencephalogram (EEG) Event-related potential (ERP) Imaging techniques; e.g., PET, MRI
Developmental Applications: Psychopathological Applications Anxiety: specific brain structures (e.g., temporal lobe) and neurotransmitters. Depression can affect test performance. Schizophrenia has been linked to brain dysfunction.
Specialized Tests for Clinical Disorders Single-construct tests such as the Beck Depression Inventory or Beck Anxiety Inventory. State vs. trait testing such as Spielberger’sState-Trait Anger Expression Inventory (STAXI) and State-Trait Anxiety Inventory (STAI)
Beware of Bogus Personality Tests
The Barnum Effect: accepting general character descriptions as being specifically applicable to ourselves. Provides an illusion of uniqueness.The Barnum Effect (video example)
Graphology
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