PSY 3303 Lecture Notes - Lecture 9: Temporal Lobe Epilepsy, Raymond Cattell, Percentile Rank
Chapter 5
Hunsley, J., & Lee, C. (2014). Clinical Psychology: An Evidence-Based Approach. (3rd Ed.). United States:
Wiley.
ssessment: Overview
INTRODUCTION
Classification requires the collection of data in a process known as assessment
PSYCHOLOGICAL ASSESSMENT
Psychological assessment is an iterative decision-making process in which data are systematically
collected on the person (or persons); the person's history; and the person's physical, social, and
cultural environments
Leads to a refinement of the understanding of the problem and to an alteration in c assessment
activities
Psychological assessment involves the gathering and Integration of multiple types of data from
multiple sources and perspectives
The psychologist generates hypotheses about the client and, therefore, may alter or refine the
initial assessment questions
Evidence for and against these hypotheses
Clinical psychologists should be competent in conducting assessments
Competence in assessment requires both conceptual knowledge and practical assessment skills
o Staying up to date
The Purposes of Psychological Assessment
o Assessment-Focused Services versus Intervention-Focused Services
These assessment-focused services are conducted primarily to provide information
that can be used to address a person's current or anticipated psychosocial deficits
The psychologist must be cognizant of these referral factors
Thorough knowledge of the legal context
Intervention-focused assessment services: assessments conducted in the context of
intervention services
Most common
Not a stand-alone service, but is conducted as a first step in providing an
effective intervention
Pre-treatment assessment findings are used to determine appropriate
psychological interventions
Categorized assessment activities as roughly falling into one of two domains:
Stand-alone assessment in which the main intent is to present conclusions and
recommendations about the person's functioning; and assessment in which the
main intent is to intervene to improve the person's functioning with the
assessment data being used in support of this service
o Screening
Screening: a procedure to identify individuals who may have problems of a clinical
magnitude or who may be at risk for developing such problems
Called on to assist in the development or implementation of screening measures
Psychological services are then offered to those who have been identified as having
problems
People may also actively seek out a screening assessment. In the United States, there
are national screening days
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o Diagnosis/Case Formulation
Assessment data are used to formulate a clinical diagnosis:
Information on symptoms is compared with diagnostic criteria to determine whether
the symptom profile matches criteria for DSM diagnose
Diagnosis can provide an initial framework for a treatment plan
In the past, diagnosis or psychodiagnosis referred to the process in which the
psychologist used interview and testing data to render a comprehensive
representation of the patient's psychological makeup
The term case formulation is now more commonly used to describe the use of
assessment data to develop a comprehensive and clinically relevant conceptualization
of a patient's psychological functioning
Provides information on the patient's situation, current problems, and a set of
hypotheses linking psychosocial factors with the patient's clinical condition
o Prognosis/Prediction
Psychological assessment always implies some form of prediction about the patient's
future
Prognosis: predictions made about the future course of a patient's psychological
functioning, based on the use of assessment data combination with relevant empirical
literature
Deal with future outcomes at the group level
Challenges for clinicians is to predict possible outcomes
Must weigh a number of variables such as time and cost, the consequences of
inaccurate decisions, and the base rate of the predicted d outcome
Time spent on assessment may mean less time is available to provide an
intervention
Someone must cover these costs
Prediction errors are inevitable
Predict carefully because someone is paying and time should be spent
best
All of these types of errors are influenced by the base rate of a bas problem or
diagnosis: that is, the frequency with which the problem/ diagnosis occurs in the
population
The less frequently a problem occurs, the more likely a prediction error will
occur
The consequences of error must be seriously considered
At the prediction that an event will occur was accurate [true positive] or that the
prediction of a non-event was accurate (e.g., that no diagnosis was warranted or that
a specific event such as a suicide attempt would not occur—true negative
Two types of incorrect predictions
A false positive occurs when the psychologist predicts that an event will occur
but, in fact, it does not occur
A false negative occurs when an event occurs that was not predicted by the
psychologist
In referring to accuracy in clinical predictions , psychologists employ two additional
concepts: sensitivity and specificity
Sensitivity refers to the number of times an event is predicted, across cases,
compared with the total number of times that the event actually occurs
Proportion of true positives identified by the assessment
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Specificity deals with the prediction of non-events
It refers to the number of times a non-event is predicted across cases
compared with the total number of times that no event occurred;
alternatively, it can be considered as the relative proportion of true
negatives
o Treatment Planning
Treatment planning is the process by which information about the clients context
(including sociodemographic and psychological characteristics, diagnoses, and life
circumstances) is used in combination with the scientific literature on psychotherapy
to develop a proposed course of action that addresses the client's needs and
circumstances
Facilitates communication among professionals working with the client, provides a
clear statement about the nature of the planned services to agencies that may need
to authorize and/or I pay for the services, and provides a document that can be
reviewed as part of an agency's quality assurance activities to ensure that appropriate
services are being provided
The first step in developing a treatment plan is to determine whether there are
treatment options with established effectiveness for the types of problems the client
presents
A useful treatment plan must cover three general areas: problem identification,
treatment goals, and treatment strategies and tactics
Finally, a description of treatment strategies provides information on the general
approach to addressing the clinical problems, whereas a description of treatment
tactics provides details of specific tasks, procedures, or techniques that will be used in
treatment
o Treatment Monitoring
Once a clear treatment plan is in place, the psychologist closely monitors the impact
of treatment
Enables the psychologist to change the treatment plan based upon the patient's
response to treatment
Treatment monitoring refers to explicitly tracking progress through the use of specific
' questions or psychological measures
Can substantially affect treatment outcome
Client deterioration was reduced and the positive effects of psychotherapy were
enhanced
o Treatment Evaluation
No significant correlations were found between the professionals' perceptions of
client improvement and data from self-report measures completed by both parents
and children
Treatment outcome data can also be used to document the typical range of outcomes
clients experience and the nature and duration of treatment required to obtain
successful outcomes
Data gathered for treatment outcome purposes can yield information relevant to an
entire psychological practice or service
PSYCHOLOGICAL TESTING
The Standards for Educational and Psychological Testing set out principles that psychologists must
follow in developing and using tests and assessment procedures
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Document Summary
Introduction (cid:120) classification requires the collection of data in a process known as assessment. Psychological assessment (cid:120) psychological assessment is an iterative decision-making process in which data are systematically collected on the person (or persons); the person"s history; and the person"s physical, social, and cultural environments. In the united states, there are national screening days: diagnosis/case formulation (cid:120) assessment data are used to formulate a clinical diagnosis: (cid:120) Information on symptoms is compared with diagnostic criteria to determine whether the symptom profile matches criteria for dsm diagnose (cid:120) diagnosis can provide an initial framework for a treatment plan (cid:120) In referring to accuracy in clinical predictions , psychologists employ two additional concepts: sensitivity and specificity (cid:131) Sensitivity refers to the number of times an event is predicted, across cases, compared with the total number of times that the event actually occurs (cid:120) proportion of true positives identified by the assessment (cid:131) Specificity deals with the prediction of non-events (cid:120)
