Psychology 3301F/G Chapter Notes - Chapter 5: Evidence Based Assessment, Psychological Evaluation, Clinical Formulation
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11 Apr 2018
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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 iiu, ioles ifo poided the liet ad ifo ased o the pshologist’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-foused seies: seies oduted piail to poide ifo o a peso’s pshosoial
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
peso’s futioig; ad assesset i hih the ai itet is to iteee to ipoe the peso’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
liet’s oes ad life iustaes
• 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
ad testig data to ede a opehesie epesetatio of the patiet’s psh akeup
• case formulation = description of patient that provides info on their life situation current problems and a
set of hpotheses likig pshosoial fatos ith patiet’s liial oditio
Prognosis/Prediction
• psh assesset alas iplies soe fo of peditio aout the patiet’s futue
• prognosis = peditios ade aout the futue ouse of a patiet’s psh futioig, ased o use of
assessment data in combination with relevant empirical literature
• liiia’s task is to use this poailisti ifo i a ae that takes ito aout the uique 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 poedue’s sesitiit ad speifiit ad the psh ad fiaial osts steig fo iauate
clinical predictions
Treatment planning
• Is the poess hih ifoatio aout the liet’s otet is used i oiatio 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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