Psychological assessment
Lecture 1 What is psychological assessment 2
Classification systems 2
Communication and professionalism as a therapist 2
General clinical communication skills 3
Assessment instruments 3
Lecture 2 The diagnostic process 4
Referral 4
Complaints analysis 4
Lecture 3 Phases of diagnosis 6
Classification phase 6
Explanation phase 7
Prediction phase 7
Indication phase 7
Lecture 4 The helper 8
The professional helper 8
Theories to guide professional helping processes 9
The helper at work, goals and roles 9
The helper at work, a helping model 10
Lecture 7 IQ 12
Historic theories and measurement of intelligence 12
Cattell hierarchical model (CHC) 12
Testing cognitive abilities (developmental perspective) 12
WISC V 13
WISC V scoring and comparing to a norm 13
The scores: the primary profile analysis 14
The global ability index (GAI) 14
Lecture 8 Guest lecture intake 16
Categorical DSM discourse 16
Interaction client and intaker / impact on process 16
Providing clinical advice and treatment plan: indication phase 16
Treatment 17
The report 18
Lecture 9 Guest lecture forensic assessment 19
Questions to psychologists 19
Clinical examination and observation: FIRST COMA 20
Psychological examination 20
Forensic evaluation 20
Lecture 10 Overview 21
Treatment planning - shared decision making 21
Reporting 21
Whole process 22
,Lecture 1 What is psychological assessment
A shared decision making process in which a clinician defines diagnostic questions,
formulates and tests hypotheses about the client’s functioning and integrates the information
collected from methods, resulting in an understanding of the problem and indications for
treatments.
Goals is 2 areas of competence:
1. Psychological practice: the practising scientist.
- Systematic, substantiated diagnostic judgements and decisionmaking
2. Communication and professionalism in entering into a helping relationship
- Counseling and treatment relationships in the diagnostic context
A scientifically sound procedure for collecting information should follow these steps:
1. Observation: collecting of information
2. Induction: inference to formulate hypotheses based on a theory
3. Deduction: derive testable predictions
4. Testing hypothesis and predictions
5. Evaluation of the process and its outcome
Classification systems
Classification is whether or not something is present.
- Categorical: ALL THESE ASSUMPTIONS ARE FALSE
- Presence/absence: should be predictive of symptoms course and
development
- Cut-off based on number of symptoms distinguishing healthy from
pathological
- Assumed homogenous and mutually exclusive categories
- Dimensional: truth for psychopathology, no clear-cut difference between normal and
abnormal and overlap across dimensions.
Normal vs abnormal
No consensus in defining normal and abnormal, risk of stigma and over-pathologizing.
Suffering and limitation in social and occupational activities and statistical deviation from
norm (but what if justified by context). We are all vulnerable to mental disorders, the goal is
to help people prevent and go through periods of extreme difficulty, but no difference
between ‘healthy clinician’ and ‘sick patient’.
Communication and professionalism as a therapist
Based on the client-centered approach of Carl Rogers: personal approach, self-actualization,
unconditional acceptance. 3 conditions for growth
1. Unconditional positive appreciation (acceptance)
- Show commitment towards client (be on time, trust, respect)
- Make effort to understand client (empathy, active listening)
- NOT unconditionally approve, DO take client’s point of view seriously
- Express warmth and proximity and reflect on thoughts, feelings, behaviour of
counsellor or client or the relationship (like ‘you seem nervous’ or ‘i’m glad
you can share that with me’.)
- Notice transference and countertransference and describe what is going on in
the situation.
2. Genuineness
- Helper is themselves, not playing a role, reduces emotional distance to client.
- Important: spontaneity, consistence of behaviour of helper (distrust by client
when detecting incongruence), acknowledging negative/positive feelings,
express naturally.
, -
Openness and self-disclosure, parallel to feelings of client (i also feel not only
positive feelings towards my children…).
3. Empathy
- Ability to understand someone from his or her experience and showing that
you understand.
Critique on Roger’s theory
1. Too optimistic: behaviorists only believe in self-actualization in response to
reinforcement.
2. Too vague: lack of directivity, process of self-actualization is unclear
A cognitive theory of experiencing (Wexler)
Experiencing as an active process: self-actualization can be impeded by external
influences (eg quality of relationships). Rogers says self-actualization is a passive process,
Wexler says people give meaning to events (events have no meaning). Experiencing is an
active process.
The role of feelings:
- Rogers: feelings play essential part, stored within a person and emerge when one is
open to them.
- Wexler: emotions are linked to cognitive processes, feelings as a result of information
processing.
- Degree of significance determines feelings (not always) + role of sudden changes
- New information can cause people to re-examine previous beliefs
General clinical communication skills
1. Non selective listening skills
- Non-verbal following
- Verbal following, silences
2. Selective listening skills
- Asking questions (importance of tone)
- Paraphrasing of content (selective reinforcement)
- Reflection of feeling
- Concreteness
3. Regulating skills
- Opening the conversation and making initial contact
- Linking back to goals
- Clarify the situation
- Thinking out loud
- Ending the interview: clarify in advance the time, use summary, gauge clients’
experience of the session, potential difficulties are client is in the middle of a
story or new hot topic brought up.
4. Skills in nuancing
- Interpreting
- Confront
- Positive relabelling
- Giving information
Regulating skills - closing: ending the interview
Clarify in advance the time and announce when close to conclusion. Summarize, consider
conducting meta-conversation. Potential difficulty is being in the middle of a problematic
story or new hot topic is brought up: acknowledge briefly and come back to it next time.
Assessment instruments
1. Observation (most commonly used):
Lecture 1 What is psychological assessment 2
Classification systems 2
Communication and professionalism as a therapist 2
General clinical communication skills 3
Assessment instruments 3
Lecture 2 The diagnostic process 4
Referral 4
Complaints analysis 4
Lecture 3 Phases of diagnosis 6
Classification phase 6
Explanation phase 7
Prediction phase 7
Indication phase 7
Lecture 4 The helper 8
The professional helper 8
Theories to guide professional helping processes 9
The helper at work, goals and roles 9
The helper at work, a helping model 10
Lecture 7 IQ 12
Historic theories and measurement of intelligence 12
Cattell hierarchical model (CHC) 12
Testing cognitive abilities (developmental perspective) 12
WISC V 13
WISC V scoring and comparing to a norm 13
The scores: the primary profile analysis 14
The global ability index (GAI) 14
Lecture 8 Guest lecture intake 16
Categorical DSM discourse 16
Interaction client and intaker / impact on process 16
Providing clinical advice and treatment plan: indication phase 16
Treatment 17
The report 18
Lecture 9 Guest lecture forensic assessment 19
Questions to psychologists 19
Clinical examination and observation: FIRST COMA 20
Psychological examination 20
Forensic evaluation 20
Lecture 10 Overview 21
Treatment planning - shared decision making 21
Reporting 21
Whole process 22
,Lecture 1 What is psychological assessment
A shared decision making process in which a clinician defines diagnostic questions,
formulates and tests hypotheses about the client’s functioning and integrates the information
collected from methods, resulting in an understanding of the problem and indications for
treatments.
Goals is 2 areas of competence:
1. Psychological practice: the practising scientist.
- Systematic, substantiated diagnostic judgements and decisionmaking
2. Communication and professionalism in entering into a helping relationship
- Counseling and treatment relationships in the diagnostic context
A scientifically sound procedure for collecting information should follow these steps:
1. Observation: collecting of information
2. Induction: inference to formulate hypotheses based on a theory
3. Deduction: derive testable predictions
4. Testing hypothesis and predictions
5. Evaluation of the process and its outcome
Classification systems
Classification is whether or not something is present.
- Categorical: ALL THESE ASSUMPTIONS ARE FALSE
- Presence/absence: should be predictive of symptoms course and
development
- Cut-off based on number of symptoms distinguishing healthy from
pathological
- Assumed homogenous and mutually exclusive categories
- Dimensional: truth for psychopathology, no clear-cut difference between normal and
abnormal and overlap across dimensions.
Normal vs abnormal
No consensus in defining normal and abnormal, risk of stigma and over-pathologizing.
Suffering and limitation in social and occupational activities and statistical deviation from
norm (but what if justified by context). We are all vulnerable to mental disorders, the goal is
to help people prevent and go through periods of extreme difficulty, but no difference
between ‘healthy clinician’ and ‘sick patient’.
Communication and professionalism as a therapist
Based on the client-centered approach of Carl Rogers: personal approach, self-actualization,
unconditional acceptance. 3 conditions for growth
1. Unconditional positive appreciation (acceptance)
- Show commitment towards client (be on time, trust, respect)
- Make effort to understand client (empathy, active listening)
- NOT unconditionally approve, DO take client’s point of view seriously
- Express warmth and proximity and reflect on thoughts, feelings, behaviour of
counsellor or client or the relationship (like ‘you seem nervous’ or ‘i’m glad
you can share that with me’.)
- Notice transference and countertransference and describe what is going on in
the situation.
2. Genuineness
- Helper is themselves, not playing a role, reduces emotional distance to client.
- Important: spontaneity, consistence of behaviour of helper (distrust by client
when detecting incongruence), acknowledging negative/positive feelings,
express naturally.
, -
Openness and self-disclosure, parallel to feelings of client (i also feel not only
positive feelings towards my children…).
3. Empathy
- Ability to understand someone from his or her experience and showing that
you understand.
Critique on Roger’s theory
1. Too optimistic: behaviorists only believe in self-actualization in response to
reinforcement.
2. Too vague: lack of directivity, process of self-actualization is unclear
A cognitive theory of experiencing (Wexler)
Experiencing as an active process: self-actualization can be impeded by external
influences (eg quality of relationships). Rogers says self-actualization is a passive process,
Wexler says people give meaning to events (events have no meaning). Experiencing is an
active process.
The role of feelings:
- Rogers: feelings play essential part, stored within a person and emerge when one is
open to them.
- Wexler: emotions are linked to cognitive processes, feelings as a result of information
processing.
- Degree of significance determines feelings (not always) + role of sudden changes
- New information can cause people to re-examine previous beliefs
General clinical communication skills
1. Non selective listening skills
- Non-verbal following
- Verbal following, silences
2. Selective listening skills
- Asking questions (importance of tone)
- Paraphrasing of content (selective reinforcement)
- Reflection of feeling
- Concreteness
3. Regulating skills
- Opening the conversation and making initial contact
- Linking back to goals
- Clarify the situation
- Thinking out loud
- Ending the interview: clarify in advance the time, use summary, gauge clients’
experience of the session, potential difficulties are client is in the middle of a
story or new hot topic brought up.
4. Skills in nuancing
- Interpreting
- Confront
- Positive relabelling
- Giving information
Regulating skills - closing: ending the interview
Clarify in advance the time and announce when close to conclusion. Summarize, consider
conducting meta-conversation. Potential difficulty is being in the middle of a problematic
story or new hot topic is brought up: acknowledge briefly and come back to it next time.
Assessment instruments
1. Observation (most commonly used):
