Chapter 5 Assessment: Overview INTRODUCTION TO CLINICAL PSYCHOLOGY 2E HUNSLEY & LEE PREPARED BY DR. CATHY CHOVAZ, KING’S COLLEGE, UWO.

Chapter 5Assessment: Overview

INTRODUCTION TO CLINICAL PSYCHOLOGY 2EHUNSLEY & LEE

PREPARED BY DR. CATHY CHOVAZ, KING’S COLLEGE, UWO

Psychological Assessment Competencies in Psychological Assessment Assessment Focused Intervention Focused Additional Assessment Types Psychological Testing

Assessment – Topics

An iterative process Systematic Information about the person’s physical,

social, and cultural environments Refining the question at hand before

responding to a question or a goal of the assessment

Psychological Assessment

Generating and refining hypotheses Importance of being informed about human

diversity Age Gender Sexual orientation Culture Religious beliefs

Psychological Assessment

Knowledge of: psychometric theory the scientific, theoretical, empirical, and

contextual bases of assessment

Knowledge, skills, and techniques to assess: cognitive affective behavioral personality

Competencies inPsychological Assessment

Ability to: assess intervention outcomes evaluate multiple roles that clients and psychologists

function

Understanding of the relation between assessment and intervention and intervention planning

Technical assessment skills, including problem/goal identification and case conceptualization

Competencies inPsychological Assessment

Assessment-focused services: Information provided that addresses a person’s current or anticipated psychosocial deficits

For example, child custody evaluations

Assessment Focused

Intervention-focused services: The first step in gathering information about appropriate treatment

For example, intake evaluation at a clinic

Intervention Focused

Screening: A tool often developed to identify a disorder, condition or characteristic, depending on the site For example, a measure that identifies mental

health problems in adolescents

Diagnosis/Case Formulation: The development of an understanding of the basis/etiology of the problem that informs treatment For example, early stages of therapy

Additional Assessment Types

Prognosis/Prediction: An assessment used to see whether a problem will worsen without treatment Whether one needs therapy for a given problem

Prediction errors – unfortunately common in clinical psychology

Base rate – frequency of a problem in the general population

Additional Assessment Types

Prognosis/Prediction (cont):Sensitivity – the number of times an event is predicted compared to the actual number of eventsSpecificity – the number of times a non-event is predicted compared to the actual number of non-events

Prediction True Event True Non-EventEvent True Positives (A) False Positives (B)Non-Event False Negatives (C) True Negatives (D)Sensitivity: A / (A + C)Specificity: D / (D + B)

Additional Assessment Types

A Psychologist who conducts assessments to determine who is at risk for future suicide attempts

Sensitivity – provides information on how well the assessment procedures are able to detect future suicide attemptsSpecificity – provides information on how well the assessment procedures were able to identify individuals who would not attempt suicideIdeal - ↑specificity and ↑sensitivity

Example

1. PlanningGreat deal of assessment is designed to inform

treatment-related decisions

Useful treatment plan:1. Problem Identification2. Treatment Goals3. Treatment Strategies

Treatment

2. Monitoring Psychologist must closely monitor the impact

of Tx Enables treatment plans to change to better

meet the patient’s needs (i.e., shortened, lengthened, intensified)

How is it monitored? Interviews Brief psychological tests Specific tests designed for goals

Treatment (cont.)

1. Evaluation Outcome data is typically collected to

document the extent to which psychological treatment has been effective in achieving stated goals

May also be used to evaluate an entire service or individual clinicians

Also yields much more data on the effects on clients, strengths and weaknesses of the strategy, etc.

Treatment (cont.)

Psychological testing:

A sample of a person’s behavior scored in a standardized process Not the same as psychological assessment (which is

often more multi-faceted and may not use tests per se)

Psychological Testing

Standardization: Consistency across clinicians in the procedure

used to administer and score a test

Reliability: A measure of the consistency of the test

Internal consistency: whether all aspects of the test contribute meaningfully

Test-retest reliability: whether similar results would be obtained at 2 time points

Inter-rater reliability: whether similar results would be found by several raters

Psychological Testing: Important Concepts

Validity: Whether a test measures what it is supposed to

measure

Content validity: whether the test measures all aspects of the construct

Concurrent and predictive validity: whether the test data are consistent with other related constructs

Discriminant validity: whether the test is not measuring unrelated constructs

Incremental validity: whether the measure adds to other sources of data

Psychological Testing: Important Concepts

Norms: Using a large sample to determine cut off

scores on a test Representative sample: importance of using a

sample that matches the population Percentile rank: percentage of those in the

normative group that fell below a given test score

Evidence-based assessment: using theory and research to guide the process of assessment

Psychological Testing: Important Concepts

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