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

Chapter 5

INTRODUCTION TO CLINICAL

PSYCHOLOGY, THIRD CANADIAN EDITION

by John Hunsley and Catherine M. Lee

• Questions

• Introduction to psychological assessment

• Psychological testing

• Evidence-based assessment

• Ethical considerations

• Group exercise on referrals for psychological assessment

• For next class

Overview

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

Core Competencies in Assessment

• Diagnosis & case formulation

• Prognosis

• Treatment planning

• Treatment monitoring

• Treatment evaluation

Integrated

• Screening

• Diagnosis

• Prognosis

• Treatment recommendations

Stand-alone

Psychological assessment: Purposes

• True Negatives

• False Negatives

• True Positives

• False Positives

Accuracy and Errors in Clinical Prediction

• Assessment versus testing

• Psychometric considerations

• Testing practices in clinical psychology

Psychological Testing

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 processStandards for Educational and Psychological Testing (APA, 1999)

What is a psychological test?

Standardization Reliability

ValidityNorms

Qualities of a psychological test

• 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

Assessment

• Yields scores on a measure– What is this person’s IQ?

• Requires standard administration and scoring

• Can be conducted by a trained technician

Testing

Some differences between

• Symptom checklists

• Personality

• Cognitive functioning

• Usually single informant

Adults

• Intelligence

• Symptom checklists

• Personality

• Usually multi-informant

Children

Testing practices in clinical psychology

Integrating data

NoticingEvidence-based psychological 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

Ethical considerations in assessment

• 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: Children and Adolescents

• 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: Adults

• 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

Referrals for psychological assessment

• 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)

Developing a plan for an assessment

For next class….

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