Allyn & Bacon copyright 2000 1

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Clinical Assessment- procedure in which a clinician uses psychological tests, observation, and interviews to develop a summary of the client’s symptoms and problems in order to understand their nature and extent.
Assessment paves the way for diagnosis
Relationship between Assessment & Diagnosis
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Dynamic process that precedes and continues throughout treatment. (see Dynamic
Formulation; text book)
Why is Diagnosis Necessary?
• Insurance Claims
• Help in planning and managing treatment.
• Guide staffing and facility patterns

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Four General Areas in Assessment
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I. Assess the Presenting Problem
II. Social History
III. Personality Factors
IV. Social Context
Factors Influencing Assessment
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The influence of professional orientation
Trust and rapport between the clinicianclient

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The General Physical Examination
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Check systems of the body to rule out behavioral symptoms that closely mimic those of mental disorders (e.g. breathing, hormones).
The Neurological Examination
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EEG- graphic record of the brains electrical activity
(assesses brain waves: look for dysrhythmia)
Anatomical Brain Scans
• CAT Scan (relies on the use of x-ray)
• MRI (better due to ability to differentiate tissues)
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PET Scans- provides a metabolic portrait
Functional MRI- measures changes in local oxygenation

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The Neuropsychological Examination
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Testing devices are used to measure a persons performance on cognitive, perceptual, and motor tasks as a clue to the extent and location of brain damage.
Standardized Tests or Test Battery
• Example (Halstead-Reitan Battery -6 hours)
• Funding is problematic
• Time consuming.

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Assessment Interviews
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Structured (most reliable) and Unstructured
Interviews
Computerized Interviewing
Clinical observation of behavior
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Self-Monitoring
Rating scales
Kinds of Clinical Observations
• Natural Setting
• Role Playing
• Create a Transaction in Vivo

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Intelligence Tests
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Vocabulary (verbal)
Digit span (performance)
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Projective Personality Tests
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The Rorschach
The Thematic Apperception Test (TAT)
Sentence Completion Test
All Projective Tests are Somewhat Subjective and Time Consuming

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Objective personality tests
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The MMPI
The clinical scales of the MMPI
Criticisms of the MMPI
The MMPI-2

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Ethical issues in assessment
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Potential cultural bias of instrument or clinician
Theoretical orientation of the clinician
Under-emphasis on the external situation
Insufficient validation
Inaccurate data or premature evaluation

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Incorporating psychological test data into therapy – an unfulfilled relationship

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Most clinicians do not routinely use assessment techniques
Research supports use of assessment techniques in proper diagnosis and treatment
When test results are shared appropriately with a client positive outcomes in treatment are noted
Test feedback alone can produce therapeutic results that were comparable to or better than therapy without test feedback