Module1;Introduction to Psychological Assessment Flashcards
explain the importance of psychological assessment to modern psychological practice
Valid and reliable psychological assessments are fundamental to modern psychological practice. Such assessments are aimed to have reliable outcomes /predictions for various appropriate populations but are still tools which require expert knowledge to administer and interpret.
describe ethical guidelines that relate to assessment and the culturally appropriate assessment process
psychologists must be competent in administering and interpreting any test they use and assessments must be conducted with a clear view to benefitting the client and ‘doing no harm’. Clients need to give informed consent and consideration must be made regarding confidentiality and who will be made aware of the assessment findings. It is also important to be aware of the impact of labels and the potential for stigma.
It is also important to fully address cultural considerations to be able to select the most appropriate assessment approach
explain how context can influence the requirements and implications of psychological assessment
Context encompasses who/why has the patient been referred. What is the perceived problem or question to be answered and what could be the anticipated consequences of how that question is answered.
The form of assessment may vary widely with different reasons for psychological assessment and what the aim is.
outline how cultural context can influence psychological assessment.
Cultural context may influence psychological assessment by;
a) language difficulties
b)gestures/eye contact etc being different for different cultures
c)norms of behaviour being different
d)cultural assessments of an individual’s issues being different
e)support networks being different
These can all contribute to the culturally unaware making judgement errors which can affect assessment and tx.
What is a Psychological Assessment? Why are they used? What is the Referral context?
A psychological assessment is a formal process that uses validated and reliable measures of psychological or cognitive functioning. May be conducted via questionarires, interviews,specific skill tests, behavioural observations etc. Can be used to define personalities,skills,limitations, dsm 5 diagnoses. May be used in employment gauging, counselling, diagnosis, coping etc. Must always be aware that they have been developed within a culture and have natural biases.
The Referral Context, is WHY the psychological assessment has been requested. It sets the criteria for what type of assessment is required and how the results are to be interpreted.
For a PSYCHIATRIC referral, the psychological assessment helps to define issues and appropriate tx’s. It is important that if multiple professionals such as psychiatrist/psychologist/gp etc are involved in a patient’s care, that similarity of language and approach are used to prevent conflicting advice/approach.
In a GENERAL MEDICAL referral, a psychological assessment is used to find psychosocial issues which may be contributing to prolongation of medical issues.
In a LEGAL setting, psychological assessment can help determine decisions pertaining to guilt or innocence (eg not guilty by virtue of insanity plea), child custody, appropriateness of sentence, best remand facility for offender,etc.
In an EDUCATIONAL setting, a psychological assessment may help determine appropriateness of career, whether there are disabilities and if so how aid would best be provided, or useful study aids/techniques etc.
In Psychological practice, an assessment is done to determine not only what the client issues are, but whether there can be commonality of approach between practitioner and client. The way forward will be determined by both parties’ preferences.
What ethical guidelines are there to conducting a Psychological assessment? What are culturally-appropriate assessment processes?
There are ethical guideline put out by the APS, the Royal Australian New Zealand College of Psychiatrists, and the Aboriginal Indigenous Psychology Association, to name some.
Guidelines include being patient, allowing relationships between oneself and the community to develop, being respectful, examining one’s own biases and being prepared to engage with community facilitators if necessary.One should also consider whether one is the best candidate or if other help or translator services are required.
DSM-v also encourages the clinician to assess a patient from a perspective which is aware of cultural differences/requirements.
For Aboriginal/Torres Strait Islanders it is necessary to understand the concept of country, beware of the devastation of the stolen generation, be mindful of the health gap between typical Australians and the Indigenous, seek community support/help, offer traditional healers/services with qualified personnel, work alongside and with the help of Aboriginal Mental Health Workers. Ensure adequate follow up.
CULTURALLY APPROPRIATE ASSESSMENT;
Stage 1: Proactive steps
Proactive steps before the assessment require that practitioners receive and
maintain formal training in culturally appropriate assessment.
Stage 2: Assessment outset
The outset of assessment requires that practitioners undertake a comprehensive interview with their client before deciding on the assessment processes and use of any formal testing (if that seems appropriate). They recommend an exploration of cultural history, contact with other cultural groups, acculturation status and stress, some assessment of language and language skills. This may include using an interpreter and/or the translation of the material. A crucial element of this stage is to explain fully and document the limitations of any testing protocol that may be used.
Stage 3: Assessment process
The assessment process requires that practitioners recognise and document the impact of language and non-verbal communication. Proactive training should alert the assessor to the potential impact of culturally relevant international variables.
Stage 4: Results reporting
The interpretation and reporting of results requires that practitioners incorporate cultural explanations and avoid labelling in the final stage when interpreting the results.
Outline professional responsibilities related to psychological assessments.
Use tests which are appropriate and explained fully to the client. Store tests and personal information appropriately.
APS position statement on psychological testing
Psychological testing must only be conducted by psychologists trained in the area and familiar with the intricacies of such testing, or by those trained and directly under the psychologist’s supervision. Tests must be conducted only when with an understanding of the subject’s gender/culture/cognitive ability it is expected the test to yield useful information. The privacy and storage of such tests are the psychologist’s responsibility.
BDI (Becker Depression Inventory)
a 21-item, self-report rating inventory that measures characteristic attitudes and symptoms of depression (Beck, et al., 1961). The BDI has been developed in different forms,including a 13 point short form and a newer BDI-2 form. Requires 5-6th grade reading level.High internal consistency (consistency for the BDI ranges from .73 to .92).Queries states of min for past 2 weeks.
DASS (Depression, Anxiety, Stress Scales)
Typically a 42-point self report questionnaire (the 21 point version is also valid)to determine possible level of depression, anxiety or stress. The test is readily available to the general public. Considers the participant’s state for the preceding week.
K10 (Kessler Psychological Distress Scale)
Asks 10 short questions regarding how participant has been feeling over the past 4 weeks.Designed as a screening test for adults.
WAIS (Wechsler Adult Intelligent Scale)
WAIS consists of several subtests that provide scores for different cognitive domains. These subtests assess an individual’s ability to process information and their speed of processing. The test takes into account age and provides norms for comparison with individuals of the same age range. Also used to help diagnose cognitive deficiencies.
Rorschach
Inkblot test “tell me what you see” used to assess subject’s emotional state. Arguable how valid is (?)
Projective technique.
Psychometric properties
Psychometric properties refer to the validity and reliability of the measurement tool.
Projective technique
Projective techniques allow respondents to project their subjective or true opinions and beliefs onto other people or even objects. The respondent’s real feelings are then inferred from what s/he says about others. Projective techniques are normally used during individual or small group interviews.
