Chapter 5 Flashcards
Competencies in Psychological Assessment Expected at the Point of Licensure (ASPPB) 1
Apply knowledge of individual and cultural characteristics in assessment and diagnosis to limit bias
Competencies in Psychological Assessment Expected at the Point of Licensure (ASPPB) 2
Demonstrate effective interviewing (ask more detailed questions)
Competencies in Psychological Assessment Expected at the Point of Licensure (ASPPB) 3
Select instruments based on available normed data and/or criterion-referenced standards, and address any limitations in that selection (normal criteria reference data)
Competencies in Psychological Assessment Expected at the Point of Licensure (ASPPB) 4
Administer and score instruments following current guidelines and psychometric research
Competencies in Psychological Assessment Expected at the Point of Licensure (ASPPB) 5
Interpret and synthesize results from multiple sources following current guidelines and psychometric research (integrate data from many sources, ie. parents, spouse, etc.)
Competencies in Psychological Assessment Expected at the Point of Licensure (ASPPB) 6
Formulate diagnoses, recommendations and/or professional opinions using relevant criteria and considering all assessment data
Competencies in Psychological Assessment Expected at the Point of Licensure (ASPPB) 7
Communicate assessment results in an integrative manner (clear reports/feedback - put in understandable terms)
Competencies in Psychological Assessment Expected at the Point of Licensure (ASPPB) 8
Evaluate effectiveness of psychological services (best fit treatment; consult with other specialists)
Psychological Assessment Stand Alone Purposes
- Finding potential issues for further evaluation
- Screening (need more evaluation)
- Diagnosis (presence of psychological disorder)
- Prognosis (predicts course and outcome of condition)
- Treatment recommendations (guides appropriate intervention, like systematic desensitization for OCD)
Psychological Assessment for Integrated Purposes
- Diagnosis and case formulation (many questions to link together)
- Prognosis (normalizing behaviours)
- Treatment planning
- Treatment monitoring (how is it working based on questionnaire and asking; helps track progress)
- Treatment evaluation (reflecting)
True Positives
Make a prediction for an outcome that occurs (identify condition and they have it)
True Negatives
Make prediction that no event will occur or does not make prediction and no event does occur (do not identify condition and does not have condition)
False Positives
Make a prediction for an event that does not occur (identify condition and they do not have it)
False Negatives
Fail to predict event that occurs (do not identify condition but has condition)
How to prevent accuracy and errors in clinical prediction
DSM helps
Evidence-based psychological assessment
- Structured layered approach (validity/reliability considered and starts with observation)
1. Noticing (all issues happening, addressing patterns, behaviours, concerns)
2. Generating Hypotheses (are there concentration issues, developmental, trauma, etc.? What focus is needed to address problems best?)
3. Gathering data using adequate tools (how to find out certain key info, selecting/administering standard test, abilities)
4. Integrating Data (Taking all of this info from various sources and using data gathered to put it all together and using EBP to do this ethically and make appropriate conclusion, more info and less bias, synthesizing info from multiple sources, ie. parents, teachers, data, etc.)
Psychological Testing
- Measure cognitive, emotional, behavioural
- Assessment versus testing (whole picture for everything that you are gathering info on)
- Psychometric considerations (need valid, appropriate, and standardized tests for specific ppns)
- Testing practices in clinical psychology (cognitive functioning, personality, behavioural, diagnoses, treatment planning, etc.)
What is a psychological test?
- An evaluative device or procedure in which a sample (responses and observations) of an examinee’s behaviour in a specified domain is obtained and subsequently evaluated and scored using a standardized process
- Tests are objective measures from which we can create subjective meaning
- Behavioural sampling and observation before first encounter is very important
- Standardized evaluation derives meaning from these tests results
Qualities of a psychological test
- Standardization (can be very specific/very strict on rules so that everyone being tested has the exact same experience; consistent administration, scoring based on a protocol)
- Reliability (consistent with results over time and across populations
- Validity
- Norms (comparative to representative sample (what is normal vs abnormal based on age range, education, sex, etc.) and is helpful in real life events and problems, like determining whether someone suffers brain damage)
Reliability
Consistency and stability of tests over time and over radar
Internal Consistency
- A form of reliability
- The extent to which all aspects of a test contribute in a similar way to the overall score (if measuring anxiety, does it relate consistently to all aspects of anxiety and does it just measure anxiety, not stress or depression)
Test-Retest Reliability
- A form of reliability
- The extent to which similar results would be obtained if the person was retested at some point after the initial test (a lot of tests are verbal)
Inter-rater/scorer reliability
- A form of reliability
- The extent to which similar results would be obtained if the test was conducted by another evaluator (same conclusion)
Testing
- Provides data
- Yields numerical scores on a measure, labelled high or low (what is this person’s IQ?)
- Requires standard administration and scoring
- Can be conducted by a trained technician
Assessment
- Provides meaning
- Addresses a specific question (does he have a learning disability and how can we help him deal with it)
- Usually has multiple sources of data including standardized testing, but also interview (observations)
- Requires integration, and interpretation (psychometrist can do this, comprehensive process going past just diagnosis)
Testing Practices in Clinical Psychology for Children
- Intelligence/cognitive functioning (ie. WISC)
- Symptom checklists (ie. BASC)
- Personality (ie. PAI-A; more at teen ages, evaluates emotional/social functioning)
- Usually multi-informant (ie. self, parent, teacher; as we cannot take children’s words as is, need additional accounts but these may be very different, so take this data at face value and make judgement accordingly)
Testing Practices in Clinical Psychology for Adults
- Symptom checklists (ie. BDI, BAI; for mental health outcome)
- Personality (ie. MMPI, PAI)
- Cognitive functioning (ie. WAIS)
- Usually a single informant is sufficient (ie., self, spouse, etc.)
Most common tests taught in psych programs
- Wechsler Adult Intelligence Test, 4e (WAIS)
- Wechsler Intelligence Scale for Children, 4e (WISC)
- Minnesota Multiphasic Personality Inventory-2 (MMPI)
- Beck Depression Inventory-II (BDI)
- Woodcock Johnson III Tests of Achievement (WJ; for academics)
- Wechsler Memory Scales, 4e (WMS; more for adults)
- Personality Assessment Inventory (PAI)
- Wechsler Individual Achievement Test, 3e (WAIT; moreso for children academics)
Ethical Considerations in Assessment
- Informed consent (what will assessment involve, who will get a copy of the report, involves explaining process and purpose of assessment, assent or other legal guardian’s consent, etc.)
- Awareness of confidentiality limits (in case of risk of harm or other legal mandates requiring consent to be broken)
- Responsible caring - selecting tools that are suitable to address the question (gathering validity of measurable tools that measure a domain by integrating them)
- Interpreting data in an even-handed way (objective, like clinical interview, testing child/adult, debrief, assent for kids, some blurry lines depending where you are, maybe provide a specific therapist/resource for specific types of behaviours, not supposed to do assessment and therapy on the same client)
CPA Ethical Principles in Assessment
- Respect for the Dignity of Persons and Peoples (Ensures fairness, informed consent, and cultural sensitivity; protects confidentiality and anonymity in assessment)
- Responsible Caring (Uses evidence-based tools appropriate for the client’s needs; if assessing for GAD, use tools best representative to client’s identity and assessment purpose, specific tools for what and whom you are telling)
- Integrity in Relationships (promotes honesty and objectivity in reporting results; avoiding conflicts not interests, collaborating with everyone to understand what’s best for the client)
- Responsibility to Society (Contributes to knowledge that benefits individuals and communities; come together with parents and share knowledge that can benefit child, provide recommendations tailored/meaningful to client; use assessments to advocate for clients’ needs in broader systems)
CPA Ethical Principles’ Impact on Assessment
- Ensuring Fair and Culturally Responsive Assessment (selection of appropriate tests for diverse ppns, avoiding threats and biases, appropriate for client’s purpose)
- Informed consent and confidentiality (know purpose of treatment, know risks and limits to confidentiality, empowers indivs and families with knowledge, talk to professionals for consultation report)
- Accuracy and Professional Competence (tools are updated consistently, psychs to be up to date with tools to ensure they are updated and valid, clear objective reports)
- Beneficence and Advocacy (Avoiding jargon heavy reports, explaining in more concrete/application based ways, promoting equal access to support and accommodations)
Developing a Plan for Assessment
- Determining the 1 or 2 questions purpose
- Generating multiple hypotheses that need to be examined to address the question
- Gathering data to test the hypotheses using a biopsychosocial approach
- Keeping ethical issues in mind
Developing a Plan for Assessment - Purpose
Where they they want more support, whether that is diagnosis (clarification), treatment (clarification), eligibility for services (AISH), life decisions for education, job, parenting plan, etc.
Developing a Plan for Assessment - Multiple Hypotheses
Multiple explanations and (well structured) assessments, life decisions and how they may be potentially affected, results for a clear treatment, etc.
Developing a Plan for Assessment - Biopsychosocial support for data collection
Anything biological, psychological or social (including cultural background) that may or are influencing the client, as they are not isolated beings alone in their own world, they are affected by what surrounds them; it also helps to direct assessment and get holistic picture of client
Developing a Plan for Assessment - Ethicality
Consent and Confidentiality (informed consent and why does confidentiality get potentially broken)
Biological Impacts on Assessment
- Medical history (chronic illnesses, conditions, issues, problems at birth, etc.)
- Genetic influences (family history)
- Neurological factors (brain injury)
- Physical health (motor, sleep, nutrition)
- Medication (already or to be prescribed medication, interactions)
Psychological Impacts on Assessment
- Cognitive functioning
- Emotional and behavioural patterns (mood, coping)
- Mental Health history (things that may or may not have worked)
- Developmental milestones
- Personality and temperament
Social Impacts on Assessment
- Family context (SES, stability, family dynamics and if that and behaviour in family is abnormal or normal)
- Cultural and environmental influences (identity, beliefs, involvements)
- Educational Environment
- Social Relationships (friends, relationships, social skills)
- Life events (any traumas, losses, stressors)
How does one collect all this information in an interview-based assessment?
Consider any normalities or abnormalities in these topics: Medical history, genetic influences, neurological factors, physical health, medication, mental health history, developmental milestones, personality and temperament, family context, cultural and environmental influences, social relationships, life events, education environments
How does one collect all this information in a testing-based assessment?
- Cognitive functioning
- Emotional and behavioural patterns
- Academic functioning
