THE CONCEPT OF ASSESSMENT IN CLINICAL PSYCHOLOGY
Psychological assessment is often described as the processes involved in the systematic gathering of information about a person in relation to his or her environment in order to make an informed based decision that is in the best interest of the individual.
In clinical psychology practice, some questions are pertinent in understanding clients’ current issues, ways of coping in the past, evaluation of the pre-existing coping, what started the problem(s), are there other resources to solve these problems which are not currently employed? What are the likely predictions about the behaviour in the future?
The clinical psychologist is uniquely equipped to examine these issues systematically through procedures that had been carefully developed and evaluated in the field of psychology.
First, a psychologist formulates an initial question or set of questions. These questions are typically developed in response to a referral or request for help made by either an individual or by others on behalf of an individual. (e.g., concerned family members, parent, and physician). Which is often called the clinical interview.
Clinical interview: This is a discussion in which the psychologist asks specific, open-ended questions in order to assess a client’s thoughts, behaviours and feelings. It is often referred to as a conversation with a purpose. The essence of the clinical interview is to get a good grasp on how the patient sees his or her situation and to try to get a clear picture of what the patient’s thoughts, feelings and behaviours are when he/she is not in our (the psychologists) office.
Clinical interviews can be done in many ways. The structure, formality, medical discussion and time all depend on the specific situation and what we (the psychologist) are trying to understand about the patient.
While clinical interview is important it does not tell us tell us everything that is needed to know about the individual and objectively analyse what is seen in the client.
The implication of these complex relationships for psychological assessment is clear—a psychologist may assess the client and his or her problem at a number of different levels. The primary aspects of the person that are possible targets for assessment are biological processes, cognitions, emotions and behaviour.
Assessment Tools: There are many areas of assessment, and tools to assess them, however, some of the major ones we focus on in diamondmoor are highlighted here:
Ability and achievement
– Kaufman Brief Intelligence Test, second edition (KBIT-2)
– Wechsler Preschool and Primary Scale of Intelligence (WPPSI-III)
– Wechsler Intelligence Scale for Children (WISC-IV)
– Wechsler Non-verbal Scale of Ability (WNV)
Speech and Language
– Assessment of Language and Literacy (ALL)
– Vineland Adaptive Behaviour scales second edition (Vineland-II)
Personality/ health /wellbeing
– Millon Index of personality styles revised (MIPS revised)
– MMPI-2 (Minnesota Multiphasic Personality Inventory-2)
– Beck inventories
– Positive and Negative syndrome scale (PANSS)
– Thematic Apperception Test (TAT)
AND lots more
DETERMINING THE GOALS OF ASSESMENT
The second step in the process of clinical assessment is the formulation of the psychologist’s goal in a particular case. Once again, psychologists are confronted with a number of choices as they carry out the assessment process. Goals may include diagnostic classification, determination of the severity of a problem, risk screening for future problems and evaluation of the effects of treatment, and prediction about the likelihood of certain types of future behaviour
SELECTING STANDARDS FOR MAKING DECISIONS
Knowing what to measure is only part of the process of assessment. A psychologist must also know what to do with the information once it is collected. Making decisions about the information is essential, decisions and judgments require points of reference for comparison.
Standards are used to determine if a problem exists, how severe a problem is, and whether the individual has evidenced improvement over a specified period of time. Comparisons can be made to standards that involve other people (normative standards) or to the self at other points in time (self-referent standards)
Psychological assessment reflects the meeting point of two important functions of psychological interest. In the nature of people in general (the normative, or nomothetic tradition) and concerns about a specific person (the individual, idiographic tradition). When working with an individual, a psychologist is drawing on the idiographic traditions. This process involves the discovery of what is unique about this person given his or her history, current personality structure, and present environment conditions.
In arriving at an impression of this individual, however, the psychologist is frequently required to make Judgments about this person in comparison to most other people. In doing so, the psychologist draws on the nomothetic tradition of laws and rules that apply to the behaviour of people in general.
The information obtained in the psychological assessment process is valuable only to the extent that it can be used in making important decisions about the person or persons who are the focus of assessment. The goals of assessment–diagnosis, screening, prediction, and evaluation of intervention—determine the types of decisions that are made. The decisions that are made on the basis of psychological assessments can have profound effects on people’s lives. The process of making decisions is complex and the stakes are high. Therefore, it is important to understand the factors that influence the decisions and judgments made by clinical psychologists and ways to optimize the quality of these decisions
ETHICAL ISSUES IN ASSESSMENT
Psychologists are guided by a general set of rules or a code of conduct that includes rules for ethical conduct in the psychological assessment process. These guidelines have been developed to protect the best interests of the clients that are served by professional psychologists. Foremost among these guidelines are concerns for protecting clients from abuse by actions of psychologists, ensuring the confidentiality of information that is obtained, protecting clients’ rights to privacy, ensuring the use of procedures that have well-established reliability and validity, and using the results of psychological assessment data in the best interests of clients.
Psychologists often obtain information about clients that reflects the most personal and intimate aspects of their lives. This information is shared with a psychologist in the strictest of confidence and with the expectation that no one has a right to access that information without the full informed consent of the client. Therefore, clients have the right to be aware of and to understand any and all information that has been obtained as part of the assessment process, to know where and how that information is stored, and to regulate who has access to that information
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