ch05 (done).ppt

CHAPTER 5 – ASSESSMENT OVERVIEW COPYRIGHT © 2014 JOHN WILEY & SONS, INC. ALL RIGHTS RESERVED. ASSESSMENT IN CLINICAL PSYCHOLOGY Definition and Purpose  Clinical assessment involves an evaluation of an individual’s strengths and weaknesses, a conceptualization of the problem at hand (as well...

CHAPTER 5 – ASSESSMENT OVERVIEW COPYRIGHT © 2014 JOHN WILEY & SONS, INC. ALL RIGHTS RESERVED. ASSESSMENT IN CLINICAL PSYCHOLOGY Definition and Purpose  Clinical assessment involves an evaluation of an individual’s strengths and weaknesses, a conceptualization of the problem at hand (as well as possible etiological factors), and some prescription for alleviating the problem  All of these lead us to a better understanding of the client  alleviating :hafifletici ASSESSMENT IN CLINICAL PSYCHOLOGY Definition and Purpose  Ongoing Process  Our ability to successfully treat psychological problems is directly related to our ability to define the problems  PSYCHOLOGICAL (CLINICAL) ASSESSMENT An iterative decition making process Systematic data collection Information about the person’s physical, social, and cultural environments Innitial understanding of the problem to be assesed, preliminary information is gathered Refining the question at hand before responding to a question or a goal of the assessment İterative: tekrarlayıcı refine: arıtmak,inceltmek, düzeltmek; preliminary::ön hazırlık, ilk COPYRIGHT © 2014 JOHN WILEY & SONS, INC. ALL RIGHTS RESERVED. ASSESSMENT IN CLINICAL PSYCHOLOGY The Referral  Referral by whom?  Parent, friend, teacher, psychiatrist, judge  Referral question(s)  What aspect of a patient’s behavior needs attention and clarification?  Example: Why is Jale disobedient? ASSESSMENT IN CLINICAL PSYCHOLOGY What influences how the clinician addresses the referral question?  Clinician’s theoretical orientation  Psychodynamic, behavioral, etc.  Choice of assessment instruments  Theoretical orientation impacts which assessment tools the clinician will use PSYCHOLOGICAL ASSESSMENT Generating and refining hypotheses Importance of being informed about human diversity  Age  Gender  Sexual orientation  Culture  Religious beliefs  etc COPYRIGHT © 2014 JOHN WILEY & SONS, INC. ALL RIGHTS RESERVED. PSYCHOLOGICAL ASSESSMENT Psychological assesment involves the gathering and integration of multiple types of data from multiple sources and perspectives. Guided by assesment tools, the psychologist clearly and precisely formulates the questions to be addressed the assessment. Throughout the process of data collection, the psychologist generate hypotheses about the client and, may alter or refine the initial assessment questions in order to examine these hypotheses. COPYRIGHT © 2014 JOHN WILEY & SONS, INC. ALL RIGHTS RESERVED. PSYCHOLOGICAL ASSESSMENT Before generating a final set of conclusions designed to answer the questions that initially let to initiating, the psychological assessment, the psychologist consults with the client (and possibly others) about the accuracy of these conclusions. COPYRIGHT © 2014 JOHN WILEY & SONS, INC. ALL RIGHTS RESERVED. COMPETENCIES IN PSYCHOLOGICAL ASSESSMENT All clinical psychologists should be competent in conducting assesment Knowledge of:  psychometric theory  the scientific, theoretical, empirical, and contextual bases of assessment Knowledge, skills, and techniques to assess: cognitive, affective, behavioral, and personality COPYRIGHT © 2014 JOHN WILEY & SONS, INC. ALL RIGHTS RESERVED. COPYRIGHT © 2014 JOHN WILEY & SONS, INC. ALL RIGHTS RESERVED. COMPETENCIES IN PSYCHOLOGICAL 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 COPYRIGHT © 2014 JOHN WILEY & SONS, INC. ALL RIGHTS RESERVED. COPYRIGHT © 2014 JOHN WILEY & SONS, INC. ALL RIGHTS RESERVED. PURPOSES OF PSYCHOLOGICAL ASSESMENT Between situations in which psychological assesment is the primary clinical service provided ? Situations in which psychological assesment is just one element of the clinical service? COPYRIGHT © 2014 JOHN WILEY & SONS, INC. ALL RIGHTS RESERVED. ASSESSMENT FOCUSED VS. INTERVENTION FOCUSED Assessment-focused services: Information provided that addresses a person’s current or anticipated psychosocial deficits  E.g., child custody evaluations, to determine the best parenting arrangements for children whose parents are separeting or divorcing; neuropsychological assesment to evaluate the extent of cognitive and memory impairment following a severe concussion. Intervention-focused services: The first step in gathering information about appropriate treatment. All intervention should involve some assesment.  E.g., Intake evaluation at a clinic COPYRIGHT © 2014 JOHN WILEY & SONS, INC. ALL RIGHTS RESERVED. ASSESSMENT FOCUSED VS. INTERVENTION FOCUSED Predetermined assesment findings are used to determine appropriate psychological interventions. These data also provide a useful point of comparison for interpriting subsequent assesment findings obtained during or after treatment. It is also important that psychologists have thorough knowledge of the legal context in which their assesments will be used. COPYRIGHT © 2014 JOHN WILEY & SONS, INC. ALL RIGHTS RESERVED. ADDITIONAL ASSESSMENT TYPES Screening: A tool often developed to identify a disorder, condition or characteristic, depending on the site E.g., A measure that identifies mental health problems in adolescents.  Screening is useful in identifying those at risk, it is important that screening tools are not as same as tools used in diagnosis. E.g., If you score high on depression screening instrument, it does not mean that you would necessarily meet diagnostic criteria for depression. COPYRIGHT © 2014 JOHN WILEY & SONS, INC. ALL RIGHTS RESERVED. ADDITIONAL ASSESSMENT TYPES Diagnosis/Case Formulation: The development of an understanding of the basis/etiology of the problem that informs treatment  Knowing the diagnosis for a person helps clinicians communicate with other health professionals and search the scientific literature for information on associated features such as etiology and prognoses. COPYRIGHT © 2014 JOHN WILEY & SONS, INC. ALL RIGHTS RESERVED. ADDITIONAL ASSESSMENT TYPES Diagnosis can provide an initial framework for treatment plan that can be modified to fully adress the client’s concerns and life circumstances. The term diagnosis is used to describe the entire process of conducting a psychological assesment and formulating a clinical picture of the client. The term case formulation is now more commonly used to describe the use of assesment data to develop a coprehensive and clinacally relevant conceptualization of a patient’s psychological functioning. COPYRIGHT © 2014 JOHN WILEY & SONS, INC. ALL RIGHTS RESERVED. ADDITIONAL ASSESSMENT TYPES Prognosis/Prediction: An assessment used to see whether a problem will worsen without treatment. The clinician’s task is to use a probabilistic information in a manner that takes into account the unique circumstances of the patient being assessed. E.g., Whether one needs therapy for a given problem  Accuracy of prediction is a problem. Prediction errors are inevitable. COPYRIGHT © 2014 JOHN WILEY & SONS, INC. ALL RIGHTS RESERVED. ADDITIONAL ASSESSMENT TYPES  Prediction errors – unfortunately common in clinical psychology This type error is influenced by base rate of a problem or diagnosis.  Base rate – frequency of a problem in the general population COPYRIGHT © 2014 JOHN WILEY & SONS, INC. ALL RIGHTS RESERVED. PSYCHOLOGICAL TESTING 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) COPYRIGHT © 2014 JOHN WILEY & SONS, INC. ALL RIGHTS RESERVED.  COPYRIGHT © 2014 JOHN WILEY & SONS, INC. ALL RIGHTS RESERVED. PSYCHOLOGICAL TESTING: IMPORTANT CONCEPTS Standardization: Consistency across clinicians in the procedure used to administer and score a test  COPYRIGHT © 2014 JOHN WILEY & SONS, INC. ALL RIGHTS RESERVED. PSYCHOLOGICAL TESTING: IMPORTANT CONCEPTS 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 COPYRIGHT © 2014 JOHN WILEY & SONS, INC. ALL RIGHTS PSYCHOLOGICAL TESTING: IMPORTANT CONCEPTS  Discriminant validity: whether the test is not measuring unrelated constructs  Incremental validity: whether the measure adds to other sources of data COPYRIGHT © 2014 JOHN WILEY & SONS, INC. ALL RIGHTS 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 COPYRIGHT © 2014 JOHN WILEY & SONS, INC. ALL RIGHTS PSYCHOLOGICAL TESTING: IMPORTANT CONCEPTS Online testing: not the same as a psychological assessment  Research using standard tools: appears to be similar to traditional in person assessment Growing research work on internet assessment prior to individual meetings COPYRIGHT © 2014 JOHN WILEY & SONS, INC. ALL RIGHTS RESERVED.