Psychology 3301F/G Chapter Notes - Chapter 5: Evidence Based Assessment, Psychological Evaluation, Clinical Formulation

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Chapter 5: Assessment
Intro
Classification requires the collection of data in a process known as assessment
Many cases, assessments are highly subjective and are potentially bias and unfair
Psychological assessment strategies and tolls are used increasingly for a number of educational and
employment purposes
Psychological Assessment
Iterative decision making process in which data are systematically collected on the person; their history;
and persons, physical, social and cultural environments
Assessment involves gathering and integration of multiple types of data from multiple sources and
perspectives
o At a iiu, ioles ifo poided  the liet ad ifo ased o the pshologist’s
observation
All psychological assessments are undertaken to address specific goals, such as
o A) evaluating childs cognitive abilities
o B) identifying characteristics and behaviours associated with social rejection etc
Guided by assessment goals, the psychologist clearly and precisely formulate the questions to be addressed
during assessment
o These questions inform the selection of the most appropriate assessment methods and
instruments
Psychological assessments must be conducted in a manner that is informed by an awareness of human
diversity and is sensitive to client characteristics, including but not limited to age, gender, ethnicity, culture,
sexual orientation and religious beliefs
All clinical psychologists must be competent in conducting assessments
Purposes of Psych Assessment
First important distinction is between situations in which psych assessment is the primary clinical service
provided and situations in which the psych assessment is just one element
Assessment focused services vs. intervention focused services
Some psych assessments are stand-alone services (e.g. child custody evaluations)
o In these cases answer basic questions about the persons current functioning or suitability for
services and to provide recommendations for remediation of problems whereby a psychologist or
by another health care or education specialist
Assessment-foused seies: seies oduted piail to poide ifo o a peso’s pshosoial
functioning
Given importance of such decisions, psychologists must use evidence based assessment tools and must
follow all ethical standards in providing these services
Psychological assessments are most commonly conducting in the context of intervention services
In these intervention-focused assessment services, the psych assessment is not a stand-alone service, but
is conducted as a first step in providing an effective intervention
o All intervention should involve some assessment
pre treatment assessment findings are used to determine appropriate psychological interventions
stand-alone assessment in which the main intent is to present conclusions and recommendations about the
peso’s futioig; ad assesset i hih the ai itet is to iteee to ipoe the peso’s
functioning, with the assessment data being used in support of this service
Screening
= procedure to identify individuals who may have problems of a clinical magnitude or who may be at risk
for developing such problems
purpose for a disorder, condition, or characteristic is to identify as accurately as possible, individuals who
may have problems of a clinical magnitude or who may be at risk for developing such problems
Diagnosis/Case Formation
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information on symptoms is compared with diagnostic criteria to determine whether the symptom profile
matches criteria for DSM diagnoses
knowing a diagnosis helps with communication and search the scientific literature for information on
associated features such as etiology and prognosis
diagnostic info can also provide key info on the types of treatment options that have been found to be
effective in clinical trials
diagnosis can provide an initial framework for a treatment plan that can be modified to fully address the
liet’s oes ad life iustaes
historically diagnosis was used to describe the entire process of conducting a psych assessment and
formulating a picture
in the past, diagnosis or psychodiagnosis referred to the process in which the psychologist used interview
ad testig data to ede a opehesie epesetatio of the patiet’s psh akeup
case formulation = description of patient that provides info on their life situation current problems and a
set of hpotheses likig pshosoial fatos ith patiet’s liial oditio
Prognosis/Prediction
psh assesset alas iplies soe fo of peditio aout the patiet’s futue
prognosis = peditios ade aout the futue ouse of a patiet’s psh futioig, ased o use of
assessment data in combination with relevant empirical literature
liiia’s task is to use this poailisti ifo i a ae that takes ito aout the uique circumstances
of the patient being assessed
clinician must strike a balance between the desire to obtain more info and need to be conscious of the real
constraints that influence the scope of the assessment
misdiagnosis has the potential not only to result in ineffective treatment, but also to add to the burden
experienced by the individual
errors can also occur in which a person is diagnosed when, in fact, no diagnosis is warranted
all of these types of errors are influenced by the base rate of a problem or diagnosis: the frequency with
which the problem/diagnosis occurs in the population
true positive = prediction that an event will occur was accurate
true negative = prediction of non event was accurate
sensitivity = proportion of true positives identified by the assessment
specificity = proportion of true negatives identified by the assessment
o prediction of non-events
decision about which assessment procedures to select should be informed by a thorough consideration of
the poedue’s sesitiit ad speifiit ad the psh ad fiaial osts steig fo iauate
clinical predictions
Treatment planning
Is the poess  hih ifoatio aout the liet’s otet is used i oiatio ith the scientific
literature on psychotherapy to develop a proposed course of action that addresses the clients needs and
circumstances
Treatment planning provides a clear focus for treatment and gives client realistic expectations about
process and outcome
Treatment plan is a valuable tool that facilitates communication among professionals working with the
client, provides clear statement about the nature of the planned services to agencies that may need to
authorize services, etc
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
Clear statement of the problems to be addressed; provides starting point for understanding the proposed
treatment and determining its success
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