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 Psychological Assessment Competencies in Psychological Assessment Assessment Focused Intervention Focused Additional Assessment Types Psychological Testing Psychological Assessment 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 Competencies in 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 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 Assessment Focused Assessment-focused services: Information provided that addresses a person’s current or anticipated psychosocial deficits For example, child custody evaluations Intervention Focused Intervention-focused services: The first step in gathering information about appropriate treatment For example, intake evaluation at a clinic Additional Assessment Types 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 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 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 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. 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) Psychological Testing: Important Concepts 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 Copyright Copyright © 2010 John Wiley & Sons Canada, Ltd. All rights reserved. Reproduction or translation of this work beyond that permitted by Access Copyright (The Canadian Copyright Licensing Agency) is unlawful. Requests for further information should be addressed to the Permissions Department, John Wiley & Sons Canada, Ltd. The purchaser may make back-up copies for his or her own use only and not for distribution or resale. The author and the publisher assume no responsibility for errors, omissions, or damages caused by the use of these programs or from the use of the information contained herein.