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

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