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4. Psychological Assessment.pdf

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York University
PSYC 3230
James Alcock

4. Psychological Assessment Monday, January 28, 2013 9:00 AM Scientist-PractitionerModel • Clinical psychologists need to be more than just someone who goes around giving therapy ○ Have to be informed about research • Clinical psychology is about 100 years old • Grounded in psychological research • 1949, Boulder Conference on Graduate Education in Psychology ○ Developed a model of training ○ Clinical psychologist to be trained BOTH as scientists and practitioners • Clinical psychologists should use their training as scientist researchers to guide their practice ○ Apply critical thinking ○ Employ empirically-supported techniques ○ Evaluate client progress ○ Empirical research Clinicalvs.statisticalprediction • Statistical (actuarial) method-- classify the individual in terms of similar cases (nomothetic) -- as in testing • Clinical method-- attempting to understand the individual apart from other cases (idiographic) ○ Advocates argue that psychological causation is always personal and never actuarial • Gordon Allport in the 1940s ○ We should discard all predictions based on class membership ○ E.g., if 80% of all delinquents from broken homes are recidivists, it does not follow that a single delinquent from a broken home has an 80% probability of becoming a recidivist ○ Probability is based on frequencies obtained across repeated trials. However, a particular delinquent represents only a single trial ○ If we know all the variables that are related to recidivism then we would be able to predict the delinquent's outcome with certainty • Paul Meehl (1954) argued against this view: ○ We can use statistical predictors, based on categories; why not use them if they give 70 or 80% accuracy ○ Meehl reviewed empirical comparisons of statistical (actuarial) and clinical predictions of outcomes:  Success in training programs  Recidivism  Recovery from psychosis • Yet, there often seems to be something disturbing about using a statistical approach ○ E.g., likelihood that an offender will re-offend ○ E.g., likelihood that an individual will become violent  [Violence cannot be predicted, and we should not pretend that we can predict it. As a clinician, you can only talk about risk] ○ E.g., for admission to graduate school Methodsof assessment • Interviews • Objective tests (doesn't involve the judgment of the clinician in terms of deciding what the answers mean, i.e., MMPI) mean, i.e., MMPI) • Projective tests (no evidence they're useful) • Physiological measures (e.g., galvanic skin response, finger temperature-- indication of autonomic arousal) Clinicalinterview • Can be structured, semi-structured, or unstructured • What do we want to find out? ○ Apparent problem ○ Life history (not the same as psychoanalysts, doesn’t assume that every problem you have is linked to something earlier in childhood) ○ Stresses ○ Mental status examination • Mental status examination is a semi-structured part of a clinical interview ○ Clinician observes and asks questions  Appearance [Signs of personal neglect-- If male, are they unshaven? If female, is her make-up running or is she not wearing any make-up?]  Behavior  Sensorium (five senses working properly?)  Orientation (how we
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