Class 5 Flashcards
Things to learn in the assessment interview
Presenting problem
Questions to be answered
History
Observation
Collateral sources of information
What are you looking for when administering a testing battery
Looking for patterns of scores that inform answers
Considering the patterns of elevation and low scores within the test
Comparing multiple tests to discern bigger patterns
Integrating history, collateral information, interactions
Personality Assessment battery
Self-report (MMPI, PAI, NEO)
Performance-based test (Rorschach, Wartegg Drawing Completion, Adult Attachment Projective, Thurston Cradock Test of Shame)
Early Memories
Other measures to explore/confirm
Cognitive Codes capture what
“Designed to capture disruptive or illogical thought processes that are indicative of a thought disturbance”
Two types of cognitive codes
Language and reasoning based (Oddities in describing or justifying a response):
- DV1, DV2
- DR1, DR2
- PEC
Perceptually-based (Oddities in combining visual images and response features):
- INC1, INC2
- FAB1, FAB2
- CON
Levels in Cognitive codes
Levels 1 and 2
1 = mild to modest cognitive slippage or deviation; Benign, often playful, parenthetical, or misinformed
2 = moderate to severe/bizarre cognitive slippage or deviation (stands out because manifestly inappropriate or bizarre)
> the two levels reflect the varying degree of bizarreness in the response (extent to which reality is disregarded)
DV
Deviant Verbalization
Mistaken or inappropriate word or phrase
DV1: verbalization is relatively clear and not bizarre (e.g he is all clowned up)
DV2: incomprehensible or very difficult to understand word misuse that interferes with communication. (e.g. “the outside lookers, the onlookers of the outside”)
If in doubt, go with Level 1 (Level 2 should be obvious)
What if a client corrects a DV
If recognized and taken back, lessen the severity appropriately.
If immediately recognized and corrected, don’t score a DV
May change a DV2 to a DV1
(E.G., Deer with antenna’s—no antlers > don not code DV1 or INCOM1)
How do you consider age and education with DVs
Do not consider age, education, etc. (these are considered in norms and interpretation)
Trivial redundancies (eg. Two twins) –> is that a DV
Trivial redundancies that are nearly conventional do NOT get a DV1
E.g., two twins, big giant, little tiny
Other exceptions for DVs
Colloquial suffixes like “ish” or “y” NOT DV1 (E.g., ”greenish” “lemony”)
Colloquial comical terms Not DV1 (E.g., “fancy-shamancy” “blew the bejeus out of it”)
DV and Bilingual
switching languages in itself is not reason to code DV
Obviously, DVs related to bilingualism should not be interpreted as related to thought disorder
DR
Deviant Response
Loose associations, task distortions, rambling circumstantial responses that drift off task.
Illogical or irrelevant replies to the question: What might this be?”
Don’t over code for benign or humorous asides, or understandable but unusual wording
DR1 (It could be oysters, but I guess they are out of season)
DR2 (It’s a little baby coming out of a mother, but she didn’t really have a little baby even though she is a mother)
DR and if the client beleives the response is real
Excessive emotional reaction as if the response is real or poses a threat
Whether Level 1 or 2 depends on the extent to which the client believes the response is real.
“A dark monster about to attack me”
“Oh my! This is a bug of some kind with blood. How did that happen? I don’t like the red though. It looks like blood”
“That’s the bf flying that I saw before (DR2–losing the “as if” and treating a response as if it is real)
When to not code DR
NO DR FOR
A. Brief asides (I must be hungry)
B. Brief parenthetical, humorous, flippant, self-descriptive, or insecure comments (you might think this is stupid)
C. Simple descriptions of personal attitudes or preferences
….BUT only if the client returns to the task
