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Chapter 3

Chapter 3 (5th edition)

Course Code
Connie Boudens

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Chapter 3 Clinical Assessment
Most predominant theoretical orientation was cognitive (31%), followed by eclectic-integrative (22%) and
then psychodynamic (18%) and behavioural (15%)
Therapeutic assessment.- An approach to as assessment that regards the assessment process as the beginning
of therapeutic tic intervention; that is, structuring assessment so that it may provide new insights, a. a sense of
relief, a more mindful approach to cope with life challenges, simply the sense that someone is taking an interest
and cares.
Generally, reliability refers to consistency of measurement
Interrater reliability: the degree to which two independent observers or judges agree
Test-retest reliability: measures the extent to which people being observed twice or taking the same test twice
(maybe even several weeks or months apart), score in generally the same way
oOnly makes sense when the theory assumes that people will not change appreciably between testing on
the variable being measured (ex. IQ)
Alternate-form reliability: using two forms of tests rather than giving the same test twice, perhaps when there is
concern that people will remember their answers from the first test and aim merely to be consistent
Internal consistency reliability: assesses whether the items are related to one another (like on an anxiety
questionnaire all the questions are related to anxiety)
In each of these types of reliability, a correlation (measure of how closely 2 variables are related) is calculated b/w
raters or sets of itemsThe higher correlation, the better the reliability
Generally, is related to whether a measure fulfills its intended purpose
Related to validity; unreliable measure will not have good validity
Content validity: whether a measure adequately samples the domain of interest
oOnly modest if events that actually occur are not represented.
Criterion validity: evaluated by determining whether a measure is associated in an expected way with some
other measure (the criterion)
oAka. Concurrent validity
oThat is actually shows that say depressed people show depressed scores and not depressed people don’t
oPredictive validity: evaluating the ability of the measure to predict some other variable that is measured
in the future (IQ on future school experience)
Construct validity: relevant when we want to interpret a test as measure of some characteristic or construct that
is not simply defined (like anxiousness or distorted cognition)
oEvaluated by looking at a wide variety of data from multiple scores
oIs an important part of the process of theory testing
Case validity is unique because the focus here is on validity of the interpretations and decisions made with
respect to a particular person.
oRecommended the need for another type of validity because information about mul tiple constructs as
they apply to an individual “is not fully captured by the principles of construct validity
Would be demonstrated when the person is accurately assessed in their life context in a way that takes into
account interactions between the person and situations as well as interactions of the person’s schemas (e.g., the
combination ofa need to be perfect in a person who also tends to be a procrastinator).
Requires considering the person in typical situations versus maximal situations (i.e., the difference between how a
person usually is versus what they are capable of in atypical or extreme situations).
Designed to determine cognitive, emotional, personality, and behavioural factors in psychopathological
The interviewer uses language as the principle mean to finding out about another

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Different from a normal interview: the interviewers attention on how the respondent answers or does not answer
the question (attentive to any emotion as well)
The paradigm w/in which an interviewer operates influences the type of information sought, how it is obtained,
and how it is interpreted
They will inquire about the persons childhood history (psychoanalytical), current environmental conditions
The interviewer must obtain the trust of that person
Therapists empathize with their clients in order to get information out
Clinicians have a vague outline, but they all use different strategies of interviewing
Each clinician develops ways of asking questions with which he or she is comfortable and that seem to draw out
information that will maximum benefit the client
Unstructured interview, so they must rely on intuition and general experience
Reliability for initial clinical interview is probably low (two interviewers may reach different conclusions about a
client) , also validity is hard to confirm
One in which the questions are set out in a prescribed fashion for the interviewer
oStructured Clinical Interview Diagnosis (SCID) for Axis 1 of DSM-IV
Branching interview (client response to one question determines the next question asked)
Rated on a 3 point scale of severity
Improvement of diagnostic reliability
Also developed for diagnosing personality disorders and more specific disorders (anxiety disorders)
Hunsley and Mash, evidence-based assessment a way of paralleling developments in evidence-based treatments.
Evidence-based assessment selects assessment measures based on extensive criteria including the reliability of the
measures and reading level required
Amanda Jensen-Doss endorsed this call for evidence-based assessment.
oMost clinicians in actual practice are lot engaged in recommended forms of clinical assessment
Problems undermining clinical assessment in actual settings were identified including: (1) the continuing
proliferation and predominance of the unstructured clinical interview; (2) the low reliability af and validity of
unstructured clinical interviews; [3) suggestions that very low numbers of clinicians adhere to best practice
assessment guidelines; and (4) the relatively rare use of assessment in formal treatment monitoring by clinicians
Psychological tests: standardized procedures designed to measure a person’s performance on a particular task or
to assess his or her personality
It yields important information in their own right, such as personality characteristics or situational determinants of
a person’s problems
The same test is administered to many people at different times
Standardization: statistical norms for the test can thereby be established as soon as sufficient data have been
Test norms are standards that are used to interpret an individual’s score because the score by itself for an
individual is meaningless without a comparison context.
oUsually expressed in terms of the mean scores obtained by specific groups (e.g., the mean score for
Canadians versus the mean score for Americans) and the distribution or variability of scores within a
population (usually expressed as the standard deviation).
3 types of psychological tests: self-report personality inventories, projective personality tests, and tests of
Person is asked to complete a self-report questionnaire indicating whether statements assessing habitual
tendencies apply to him or her

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Minnesota Multiphasic Personality Inventory (MMPI): an inexpensive means of detecting psychopathology
and detect a number of psychological problems (multiphasic)
oBest known and most frequently used and researched
Widely used to screen large groups of ppl for whom clinical interviews are not feasible
MMPI – 2 has several designs to improve validity and acceptability
It has a difference in including minority groups. needless topics and sexist wording were removed
Reference to sexual adjustment, bowel and bladder functions, and excessive religiosity were
oThere is a validity scale that is designed to detect deliberately faked responses
Lie scale: a series of statements set a trap for the person who is trying to look too good (their
scores would be viewed with more scepticism)
Butcher provided an overview of the controversial changes as part of his claim that “The MMPI-2 community of
researchers is sharply divided according to these changes’
Release of a shortened version (338 items, 40% shorter) that did away with the classic clinical scales and instead
introduced the MMPI-2 Restructured Clinical (RC) scales
oDimensions were derived from theoretical conceptualizations and confirmed via statistical analyses
Nine RC scales are demoralization, somatic complaints, low positive emotions, dysfunctional negative emotions,
cynicism, and ideas of persecution, anti-social behaviours, aberrant experiences, and hypomanic activation.
MMPI-2 Lees-Haley Fake Bad Scale, created to primarily identify people in personal litigation lawsuits who
claim to have been injured but who are actually malingering and faking bad (i.e., accentuating deficits that don’t
really exist, such as the child who pretends to have a stomach ache to jet out of going to school)
Psychological assessment device in which a set of standard stimuli-inkblots or drawings ambiguous enough to
allow variation in response is presented to the individual (unstructured material, and the unconscious process will
reveal their true attitudes, motivations and modes of behaviour = projective hypothesis)
oRorschach Inkblot test: best known for its projective techniques (they are shown 10 inkblots at a time
and asked to tell what figures or objects he or she sees in each of them) – there is black, white, greys, red
splotches, and 3 pastel colors
oThematic Apperception Test (TAT): another well known projective test. They are shown a series of
black and white pictures and asked to tell the story
oProjective tests are to reduce the defence mechanisms of repression and get to the basic cause of distress
oThe content of the person’s responses is viewed as symbolic of internal dynamics (E.g. a man who sees
buttocks in one of the inkblots might be judged to have homosexual interests)
oOther uses of the inkblot test concentrate on the form of the person’s responses. The person’s responses
are viewed as a sample of how he or she perceptually and cognitively organizes real life situations.
oThe Roberts Apperception Test for Children illustrates how the use of projective tests has evolved to
provide more standardized, objectively scored assessment tools. This test is similar to the TAT, but the
Roberts test provides objective criteria for scoring, along w/ normative data to determine whether the
child’s pattern of responses is abnormal
oCultural processes are central to responses on the Rorschach but haven’t received adequate empirical
Originally Binet constructed a mental test to help a school board predict which children are in need for help
Aka. IQ test
Intelligence test: a standardized means of assessing a person’s current mental ability
Wechsler Adult Intelligence Scale (WAIS) and for children (WISC)
Standford-Binet test. They are all based on the assumption that a detailed sample of individuals current
intellectual functioning can predict how well he or she will perform in school
They are also used:
In conjunction with achievement tests to diagnose learning disabilities and identify strength and
weakness areas
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