Transcript Chapter 14 Using Tests in Clinical and Counseling Settings

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.
• 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 followup questions.
Dangers of the Nondirective
Interview
• Hypothesis confirmation bias: seeking
info to confirm a predetermined hunch;
e.g., 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)
• Objective, self-report measures of normal
personality
• 16 Personality Factor Inventory (16PF)
• California Personality Inventory (CPI)
• Strong Interest Inventory
Projective Techniques
Storytelling
1. Rorschach Inkblot Technique (Criticism)
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.
• (video example)
• Graphology
end