Chapter 3: Basic Features of Clinical Assessment Flashcards
Clinical Assessment
A process of gathering information to solve a problem; To be effective, assessment activities should should be organized in a sequence of systematic, logically related steps driven by a goal
Clinical Assessment Process
Receive and clarify the referral question Plan data collection procedures Collect assessment data Process data and form conclusion Communicate assessment results
Referral Source
Person or agency requesting the psychological assessment
Referral Question
Question or issue to be addressed in the assessment; important because it shapes the clinician’s choice of assessment instruments, interpretation of results, and communication of results
Context of the Referral
Helps clarify the purpose of assessment;
Sources of Assessment Data
Interviews Behavioral Obserations Psychological Tests Case History Data Therapist Physician or Treatment Team Client School Parent Court Employer, goverment agency, or other third party
Therapist
Would this person be a good candidate for group psychotherapy?
How effective have I been in treating with anxiety disorders?
Physician or Treatment Team
What is the correct psychological diagnosis for this client?
What cognitive and emotional limitations does this person have following her accident, and what strengths does she have to draw on during rehabilitation?
Client
What, if anything, should we do to salvage this marriage?
School
What is an appropriate educational placement for this child?
How should we intervene to help this student better manage violent tendencies and problems in relationships with peers and teachers?
Parent
Is my child suffering from depression and in need of counseling?
How can we help my child chope with the loss of his mother?
My child becomes very emotional and refuses to go to school: What can I do?
Court
Does this person pose an imminent threat of danger to himself or others?
Which custody arrangement is in the best interest of this child?
Is this client mentally able to understand the criminal charges against him and to assist an attorney in mounting a legal defense?
Employer, Government Agency, or other Third Party
Is this person suffering from a mental illness that would qualify him to receive disability payments?
What form of treatment would best help this person to resume productive employment, and for which types of employment would the person be best suited?
Factors which Affect the Selection Process
Quality of the assessment instrument or procedure
Characteristics of clients when deciding on assessments
Selecting instruments that are appropriate for each client in terms of reading level, length, and the like
Explanation of procedures and purposes of the assessment, using language that clients can understand
Value of Multiple Assessment Sources
Allows the therapist to cross-validate information about a wide variety of topics
Used to separate those who cannot engage in certain behaviors from those who do not engage in them
Useful in evaluating the effects of treatment
Processing Data and Forming Conclusions
Must be transformed from raw form into interpretations and conclusions that address a referral question
Processing task formidable because it reqires a mental leap from known data to what is assumed to be true on the basis of those data
Integration from various sources must be integrated
Assessment Report
Organized presentation of results; must be clearly written and clearly related to the goal that prompted the assessment in the first place
Psychodiagnosis
Proper treatment often depend on knowing what, exactly, is wrong with a client
Research into the causes of psyychological disorders requires reliable and valid identification of disordersa nd accurate differentiation of one disorder from another
Classification allows clinicians to efficiently communicate with one another about disorders in a professional shorthand
Treatment Planning
Identifying ideal connections between diagnoses and psychotherapy methods; What treatment by whom is the most effective for this individual with that specific problem, and under which set of circumstances
Goal of Clinical Assessment
Make predictions about human behavior; Includes prognosis, future performance, or dangerousness
Prognosis
Descriptions of how the symptoms of disorder might change with or without treatment
Predictions about the outcome of treatment: refer more generally to predictions about changes in symptoms without treatment and with certain circumstances
Information about: Client’s level of social support and subjective distress; Factors relating to the client, setting, or fit between client and therapist
Future Performance
Descriptions of how someone will perform in a given job or situation
Dangerousness
Descriptions of the likelihood of someone behaving violently toward the self or others
Prognosis for Predicting Future Performance
Helps in selecting people who are most likely to perform well in certain jobs
Prognosis to Predict Dangerousness
Called forensic evaluations; can be evaluated in terms of the pattern of four possible outcomes
True Positive
When the clinician predicts dangerousness and the person behaves as predicted
False Negative
When the clinican predicts no dangerousness and the person acts dangerously
True Negative
When the clinician predicts there is no danger and the person does not behave dangerously
