Lecture 2- Jan 18 2013
Assessment, Diagnosis, Treatment, typically comes in that chronological order, however assessment it
is an ongoing process.
Assuming the diagnosis is incorrect, assessment doesn’t stop with a diagnosis.
If treatment is unsuccessful
3 Types of Assessment Method:
When you see a client that comes and sees you complaining about a psychological disorder there are 3
ways to carry out an assessment
1. Interview (Verbal interaction),most common form of assessment
a. Not as common in children,observation is more common in children
2. Observation ( Looking at behaviour)
3. Testing (Exclusive domain to psychologist), psychologist have come up with standardized and
statistical test against the norm, the average behaviour. In order to purchase this test, you need
a certificate, a PHD or are a psychologist,
The Process of assessment:
First Part: The Referral-Reference from some other mental health professional who has
indicated that an individual requires a formal assessment quick review. Someone that has the credential
who indicates that there may be a psychopathology and require a formal assessment.
The referral comes from a general practitioner, can come from nurse, social worker,
psychologist, psychiatric nurse (nurse practitioner, have additional training in pharmacal therapy),
Physician Assistant (PA). They have the ability to refer others to a psychological assessment. The
assessment provides accesser with main problems. Basic information is collected at the referral. Things
required; basic identifier: name, age, gender, mental status, primary symptoms and onset. Just need
information in referral to know who to refer to.
Ex. Don’t sleep, don’t eat, don’t take pleasure in the things you do for weeks. Needs to refer you
to someone who specializes in depression. Someone who can observe and assess information. Someone
adept to defining and determining whether someone has depression, disthymia (persisting or on going
type of depression, mood regularly low) or bipolar disorder. Which one is it?
Formal assessment: Discussed through the assessment of the psychologist.
2 Warnings / and things to keep in mind in a psychologist when doing formal assessment, because it
may affect what data they collect:
1. You the psychologist are observing behaviour in one point in time in one location .
a. The client is coming to in a relatively artificial surround at one point in time. Ivy Quach
Lecture 2- Jan 18 2013
b. What’s the client’s initial reaction going to be like.
c. Emotional disposition of client going to be more anxious. The person’s behaviour isn’t
going to be something you normally see
d. Initial job is to try to reduce anxiety. People are trying to gather as much info as possible
and client won’t give as much info.
e. Need to develop relationship with client, psychologist that are rushed and speed things
up collect information that is not accurate.
f. Need to develop relationship with client, to build “rapport”, without rapport you may
collect skewed data because they’re guarded, anxious, etc...
2. Observer Bias: made by psychologist/psychiatrist
a. The referral should not lead you to bias and lean towards what they have. Because
symptoms are co-morbid.
The simplest form of assessment- Observation, the amount of info you can gather from behaviour, how
a person presents themselves,
4 Categories in Behavioural Observation:
1. General Appearance & Attire, how they look what, what their wearing, are there obvious
extremes, physical abnormalities.
a. Ex. The person has a number of bruises, cuts, scars on arms, neck (extreme in appear)
i. Could suspect self harm, abuse, impulsive behaviour, physiological disorder,
clumsy (Epilepsy, Seizures)
b. Does what they’re wearing fit their age and social economic status, take note on their
grooming, indication of... psychosis?
c. Ex. Extremely skinny teenager may be indicator of eating disorder
2. Emotional Gestures & Facial Expression, picking up on settle gestures, learning through
experience “pick up”, universal signs and cross culture. Basic emotion that are expressed
universally (anger, happy, surprise, sad, fear, disgust) they expressions are seen cross
culturally and pre-programmed.
a. Picking up on cues that allow you ask questions, and determine whether it’s
appropriate to do so.
3. Gross (large movements) and fine motor acts: small and large movement must be carefully
observed. Associated with neuro, pharmo, psycho and physi-cological variables associated
with the symptoms exhibited.
a. Ex. Abnormally overact, fidget, movement is constant, and consider more than usual.
Sitting still but shaking, Hypothesis: Anxiety, ADD, Catatonia (extreme movement
disorder) typical symptom of a psychotic disorder, substance abuse disorder, or some
sort of chemical imbalance, OCD Ivy Quach
Lecture 2- Jan 18 2013
4. Verbalization (Context of Verbalization), Syntax, and Structure: Not interested in what
they’re saying, but how it’s coming out and verbalized. Is it appropriate for level or schooling
and age? What they say can provide a level of intellect.
a. Neo-alogism (New-word-makeup): making up new words, may be indication of
psychosis, sometimes of neurological disorder.
b. Client that makes up facts-Confabulation (indication of neurological disorder), also to
see ability to remember information on what they say to you
c. Hyponation; remember things that most people would not remember (OCD)
Interviews: A more formal observation
Questions are posed and verbal responses are expected. Question you ask are based on
information you obtain from the referral. Typically the questions are asked in 3 areas (identifying data).
More detail question of clients background (Birthplace, family, occupation, residence, schooling, study,
1. Who you are...
a. You can have a psychological pathology and still be functional. Typically a person
needs to see someone when they are dysfunctional. If psychopathology doesn’t
interfere with function, typically won’t see a psychologist.
b. Helps with prognosis (course and outcome of pathology, likely to happen/symptom)
c. Dysfunction environment needs to be fixed first
2. Identifying Data and Primary complaints
a. Ex. Referral, assessment and treatment can be done by the same person
b. What had happened, what people have told you, everything about it
3. Data on family history: Background of people around you and people related to you.
Mounting body of evidences have a genetic component. Interaction in a dysfunctional
environment, need to be presented. Brothers, sister, parents, grandparents, aunts and
uncles. Physical and Psychological. Purpose of developing rapport, and want optimal data
2 Types of Interview:
1. Structure Interviews: High Reliability, Low Rapport,
a. Structured, a set of questions that you are required to ask. Questions are usually
exhaustive so you don’t miss any information (very useful).
b. Affects rapport, sure that you asking questions necessary but not really building
rapport. So eventually learn to ask questions that build rapport
2. Unstructured Interviews: Low Reliability, High Rapport
b. Good for rapport, as it’s having a conversation with client.
c. Take notes on what you listen to, filtering and tossing out information. Ivy Quach
Lecture 2- Jan 18 2013
During the interview you monitor the truthfulness and honesty. When a client claims they have a
pathology when they don’t (malingering)
Testing behavioural condition with testing. Testing what you’re behaviourally good (Post World
War II). Norms are developed and how most people score on the behavioural spectrum. Had a degree of
precision and objectivity.
Likert Scale, interest in anxiety (from 1-10). The most common form measurement. The only
measurement that we have, only self-report,