Chapter 5
Assessment: Overview
I N T R O D U C T I O N TO C L I N I C A L P S Y C H O L O G Y 2 E
HUNSLEY & LEE
P R E P A R E D B Y D R . C AT H Y C H O V A Z , K I N G ’ S C O L L E G E , U W O
Assessment – Topics
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Psychological Assessment
Competencies in Psychological Assessment
Assessment Focused
Intervention Focused
Additional Assessment Types
Psychological Testing
Psychological Assessment
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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
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Generating and refining hypotheses
Importance of being informed about human diversity
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Age
Gender
Sexual orientation
Culture
Religious beliefs
Competencies in
Psychological Assessment
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Knowledge of:
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psychometric theory
the scientific, theoretical, empirical, and contextual bases of
assessment
Knowledge, skills, and techniques to assess:
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cognitive
affective
behavioral
personality
Competencies in
Psychological Assessment
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Ability to:
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assess intervention outcomes
evaluate multiple roles that clients and psychologists function
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Understanding of the relation between assessment
and intervention and intervention planning
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Technical assessment skills, including problem/goal
identification and case conceptualization
Assessment Focused
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Assessment-focused services:
Information provided that addresses a person’s current or
anticipated psychosocial deficits
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For example, child custody evaluations
Intervention Focused
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Intervention-focused services:
The first step in gathering information about appropriate
treatment
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For example, intake evaluation at a clinic
Additional Assessment Types
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Screening: A tool often developed to identify a disorder,
condition or characteristic, depending on the site
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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
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For example, early stages of therapy
Additional Assessment Types
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Prognosis/Prediction: An assessment used to see
whether a problem will worsen without treatment
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Whether one needs therapy for a given problem
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Prediction errors – unfortunately common in clinical
psychology
Base rate – frequency of a problem in the general population
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Additional Assessment Types
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Prognosis/Prediction (cont):
Sensitivity
– the number of times an event is predicted compared
to the actual number of events
Specificity – the number of times a non-event is predicted
compared to the actual number of non-events
Prediction
Event
Non-Event
True Event
True Non-Event
True Positives (A)
False Positives (B)
False Negatives (C) True Negatives (D)
Sensitivity: A / (A + C)
Specificity: D / (D + B)
Example
A Psychologist who conducts assessments to
determine who is at risk for future suicide attempts
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Sensitivity – provides information on how well the
assessment procedures are able to detect future suicide
attempts
Specificity – provides information on how well the
assessment procedures were able to identify individuals
who would not attempt suicide
Ideal - ↑specificity and ↑sensitivity
Treatment
1. Planning
Great deal of assessment is designed to inform
treatment-related decisions
Useful treatment plan:
1. Problem Identification
2. Treatment Goals
3. Treatment Strategies
Treatment (cont.)
2. Monitoring
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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?
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Interviews
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Brief psychological tests
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Specific tests designed for goals
Treatment (cont.)
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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.
Psychological Testing
Psychological testing:
A sample of a person’s behavior scored in a standardized
process
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Not the same as psychological assessment (which is often more
multi-faceted and may not use tests per se)
Psychological Testing:
Important Concepts
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Standardization:
Consistency across clinicians in the procedure used to
administer and score a test
Reliability:
A measure of the consistency of the test
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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
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Validity:
Whether a test measures what it is supposed to measure
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Content validity: whether the test measures all aspects of the
construct
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Concurrent and predictive validity: whether the test data
are consistent with other related constructs
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Discriminant validity: whether the test is not measuring
unrelated constructs
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Incremental validity: whether the measure adds to other
sources of data
Psychological Testing:
Important Concepts
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Norms:
Using a large sample to determine cut off scores on a test
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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
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