Assessment of Adolescents Chapter 3

Assessment Assumptions about assessment to guide social workers when determining what type of assessment protocol to implement with adolescents (and their families) (Jordan and Franklin, 1995) – (1) assessment is empirically based – (2) assessment must be made from a systems perspective – (3) measurement is essential – (4) ethical practitioners evaluate their clinical work – (5) well-qualified practitioners are knowledgeable about numerous assessment methods in developing assessment Assessment is the first active phase of treatment

Themes in Clinical Assessment Common themes in adolescent clinical assessment: – 1. There is no gold standard to validate assessment. – 2. Multiple measures need to be used to capture diverse facets of the clinical problem. – 3. Multiple disorders or symptoms from different disorders ought to be measured because of high rates of comorbidity. – 4. Multiple informants are needed to obtain information from different perspectives and from different contexts. – 5. Adaptive functioning, impairment, or more generally how individuals are doing in their everyday lives are important to assess and are separate from symptoms and disorders. – 6. Influences (or moderators) of performance need to be considered for interpreting the measures, including sex, age or developmental level, culture, and ethnicity, among others.

Methods of Assessment with Adolescents Interviews Self-observation Observation by others Family sculpting Individualized rating scales Rapid assessment instruments Standardized assessment tools

Dealing with “I don’t know” 1. Allow silence (about 20 to 30 seconds). 2. Rephrase the question. 3. Ask a relationship question (adolescents sometimes feel put on the spot by having to answer questions about themselves but can take the perspective of others to view their behavior). 4. Say, "I know you don't know, so just make it up," which bypasses teens' resistance or fear that they don't know or don't have the right answer. Or, using pre-suppositional language, say, "Suppose you did know..." 5. Speak hypothetically about others: "What would [pro-social peers that teens respect] say they do to keep out of trouble [get passing grades or get along with their parents]?" (p. 136) – Corcoran & Springer (2005) Asking evocative questions may help adolescent clients increase their readiness for change. Eg. “What is there about _____ that you or other people might see as a reason for concern?” Ask questions about the advantages of change – What would you like your life to be like 5 years from now – If you could make this change immediately, by magic, how might things be better for you

Reliability and Validity Reliability A measurement instrument is reliable to the extent that it consistently yields similar results over repeated and independent administrators. Reliability is represented through coefficients from.0 to 1.0 Guidelines for acceptability of reliability coefficients for use with individual clients to aid in clinical decision making: <.70=unacceptable.70 to.79=undesirable.80 to.84=minimally acceptable.85 to.89=respectable.90 to.95=very good <.95=excellent Validity Validity represents how accurately an instrument measures what it is supposed to measure. Types of validity – Content validity – Criterion-related validity – Construct validity The social worker must make decisions about a measure’s validity in relationship to its intended use. The worker must determine if the measure is valid for a specific client in a specific setting at a specific time. A measure may be valid for one client but not for another.