Unit 6: Assessment, Testing, And The Diagnostic Process Flashcards
A multifaceted process that involves a variety of functions, such as testing and evaluation, that counsellors go through in an effort to determine and individuals characteristics, aptitudes, achievements, and personal qualities. Can be viewed as an integrative process that combines a variety of information into a meaningful pattern reflecting relevant aspects of an individual
Assessment
What are some of the important steps that a counsellor seeks to accomplish in the initial assessment process?
- Familiarizing yourself with the clients world and characteristic functioning
- Learning about past events and developmental issues that have been significant
- Studying family history and the current living situation
- Assessing the clients strengths and weaknesses with regard to intellectual, academic, emotional, interpersonal, moral, and behavioural functioning
- Checking out risk factors related to substance abuse, suicide, or harm to others
- Identifying presenting problems
- Formulating a diagnostic impression
- Developing a treatment plan to reach mutually agreed-upon therapeutic goals
Assessment is a multifaceted process. Discuss how assessment must be an integrative process and why.
Assessment can be viewed as an integrative process that combines a variety of information into a meaningful pattern reflecting relevant aspects of an individual. It never depends on a single measure, nor does it emphasize one dimension at the expense of another. For an assessment profile to be meaningful and useful, it must provide a means for understanding the individual from as broad and integrative a perspective as possible
What are some of the practical concerns that need to be considered in this process of assessment?
We want the most accurate information as possible, but There is limited time and resources, we need a shortcut method. A shortcut method might be a standardized test
A measure of past academic performance
Standardized test score
Tests that have been designed to ensure uniformity of administration and scoring and for which norms are generally available
Standardized measures
These do not ensure uniformity of measurement and tend to be subjective, and take a more general and diverse approach to gathering information
Non-standardized measures
What were some of the historical events that brought assessment to the forefront and how have these events affected how assessment is conducted today?
The history of assessment is interwoven with a parallel evolution of the testing movement. For instance, in the 20th century James Cattell was one of the first experimental psychologists and coined the term mental test to describe his attempts to measure the intellectual ability of students building on the work of sir Francis Galton and his development of rating scales, questionnaires, and statistical methods. Researchers in Europe such as Kraeplin and Binet we’re also assessing the mentally ill, and Binet’s scales measured children’s mental abilities.
The development of group intelligence testing during World War I gave real impetus to psychological and educational testing as we know it today. The US Army Alpha and Beta were the first group intelligence tests used to screen out those who might be unfit to serve. The armies experience with group intelligence and personality testing provided the basis for a significant expansion of the assessment process in the 1920s 1940s where many other tests were developed to measure a wide range of characteristics, including intelligence, attitude, ability, attitude, personality, and interests.
The second major acceleration in the development and use of testing occurred in the ears around World War II for many of the same reasons mentioned earlier-to find more efficient ways to screen personnel and thereby make use of their talents in optimal ways
Refers to the consistency or accuracy of a test score
Reliability
Refers to the extent to which tests actually measure what they purport
Validity
A standardized test of intelligence that consists of several factors: abstract thinking, problem-solving, capacity to acquire knowledge, adjustment to new situations, and sustaining of abilities in order to achieve desired goals.
Most of these tests also include a set of tasks that require a client to demonstrate memory, pattern recognition, decision-making, verbal and analytic skills, general knowledge, and the ability to manipulate the environment
Tests of ability
Two of the most popular intelligence tests are the Stanford-Binet and the Wechsler scales which both attempt to measure IQ as a general underlying composite of intelligence
These standardized test are concerned primarily with prediction of a person’s performance in the future
Aptitude tests
Example: the scholastic aptitude test or SAT, the American college test or a CT, the law school admission test or LSAT
A standardized test, often called proficiency tests, used to measure learning, acquired capabilities, or develop skills
Achievement tests
Widely used and can be adapted to almost any type of task from measuring course content to administering the road test for a drivers license. Results can be used as diagnostic tools, as demonstrators of accountability, and, because past performance is the best measure of future performance, as predictors
Tests designed to measure an individual’s day-to-day behaviour or performance that are interested not in what a person can do but in what a person does.
Typical performance tests
What are two common categories of typical performance testing?
Personality inventories and interest inventories
Test designed to gather information on an individual’s preferences, attitudes, personality patterns, or problems. Results are expressed by comparison with a specific reference group
Personality inventories
Example: the personal orientation inventory or POI, the Minnesota multiphasic personality inventory MMPI – II, or the Beck Depression inventory-II BDI-II
These tests attempt to develop a profile of an individual’s career interest areas through a series of questions about preferences, jobs, hobbies, and other activities. The pattern of responses is then compared to the responses of persons successfully engaged in a variety of occupational areas
Interest inventories
A limitation of these inventories is that, because interest does not reflect ability, it is possible for a person to dislike a career area in which he or she has earned a high score
What are the steps a counsellor might follow in selecting a test to use with a client?
- Determine the goals of your client
- Choose instruments to reach client goals
- Access information about possible instruments
- Examine validity, reliability, cross-cultural fairness, and practicality of the possible instruments
- Choose an instrument wisely: after you’ve narrowed down your selection to a few choices, consider such issues as convenience, cost, ease of administration, ease of interpretation, and your own comfort level
How are measures of reliability and validity determined?
The publisher may have data on a specific test or you can do a journal search to find articles that have assessed whether an instrument is in compliance with standards
These non-standardized measures are commonly used to gather information that is often unavailable through other means. Can be classified in a number of different ways, according to type (systematic, controlled, or informal), The setting in which they take place (natural or contrived), or methods used (interview, direct observation)
Observational assessment
The interview is the most commonly used observational technique in counselling. Observational methods, however, lack the normative data available from well-defined populations, a characteristic of standardized assessment tools, and are therefore more susceptible to biases. Also been criticized because subjects can change their behaviour if they know they are being observed, and relatively limited range of situations available for observation may not produce adequate sample of behaviour
Discuss some of the issues that influence the methodology that counsellors must follow in the assessment process
The setting where they work, the availability of instruments, “turf battles” over which professional license entitles one to administer tests, and counsellors theoretical orientation
Briefly describe the five diagnostic models used in the helping professions
Depending on their professional identity, training, and treatment philosophy, counsellors or therapist may rely on a medical, developmental, phenomenological, behavioral, or systemic model. Each of these diagnostic systems is based on different structures, assumptions, and research data and have distinct advantages and disadvantages.
Compare the medical model with the developmental model
The developmental model has been used traditionally and educational settings and is part of our identity as counselors. As opposed to a medical model, a developmentally based diagnosis describes clients symptoms and behaviours in terms of their adaptive functions and focusses primarily on levels and stages of present functioning.
The diagnostic and statistical manual of mental disorders and the international classification of diseases, are diagnostic systems developed primarily by psychiatrists employing a medical model of conceptualizing mental illness.
This diagnostic model’s primary structure is the discrete categories of psychopathology which gets its information from data based on quantitative research.
Medical model
Advantages: organization of etiology, symptom clusters, and prognosis
Disadvantages: categories not as discreet and reliable as desired; individual reduced to label
Treatment implications: application of treatment to diminish symptoms and cure underlying illness
This diagnostic models primary structure is on predictable stages of normal development and gets its information from case studies, qualitative, and quantitative research
Developmental model
Advantages: ease of prediction, emphasis on healthy functioning
Disadvantages: stages overlap and are difficult to assess, system is not universal
Treatment implications: identification of current level of functioning so as to stimulate growth to the next stage
This diagnostic model primary structure is complex descriptions of the person with minimal use of labels and gets its information from qualitative research and personal experience
Phenomenological model
Advantages: focusses on capturing essences
Disadvantages: model is subjective, subject to biases and distortion
Treatment implications: use of self as instrument to establish relationship and understand clients world
This diagnostic models primary structure is the specific description and identification of behaviours and reinforcers and get information from direct observation and quantitative measurement
Behavioural model
Advantages: ability to be very specific and descriptive
Disadvantages: misses complexity of human experience
Treatment implications: establishment of specific goals to increase or decrease target behaviours
This diagnostic model primary structure is contextual descriptors and gets its information from direct observation and family history
Systemic model
Advantages: ability to see bigger picture of presenting issues
Disadvantages: negates autonomy and individuality
Treatment implications: works within family dynamics and structures
Another alternative assessment and diagnostic strategy where a client specific behaviours are described in meaningful, illustrative, individualized language, not only to help the counsellor to understand exactly which concerns are to be addressed but also to aid the clients understanding of how, when, where, and with whom the self-defeating
patterns are exhibited
Behavioural diagnosis
Describe some of the ethical concerns of diagnosis
Less than perfect reliability, diagnoses are often in consistently applied and err in the direction of pathology rather than health.
Counsellors expectations, theoretical orientation, and observational skills, as well as the clients inconsistent behavior, attitudes towards treatment, similarity to the counsellor in basic values, and socioeconomic background affect the accuracy and validity of a psychiatric diagnosis
The DSM has failed to account for the role of culture.
Traditional diagnostic systems can be easily abused in that the encourage practitioners to look at people as labels.
Diagnoses can be dehumanizing in that they pigeonhole human beings into slots that can be difficult to escape. Is important to use the least stigmatizing label possible
Explain why counsellors usually use the developmental model and why psychiatrists or clinical psychologists usually use the medical model in their respective practises
Diagnoses are often inconsistently applied and err in the direction of pathology rather than health, which counsellors find to be particularly restricting, because much of their orientation views client symptomology from a developmental rather than a psychopathological perspective; that is, rather than trying exclusively to find out what is wrong with clients, the attempt to focus on clients internal strengths, capacity for self-healing, and resources for resolving normal life crises.
Explain the difference between good listening and assessment in a counselling interview.
The counsellor does both, they are active listeners and reflect on what is going on which communicates that they understand the clients experience, yet they are also guiding the conversation in order to assess the specific nature of the symptoms and determine whether they are chronic or situational
