Clinical Psychology - Assessment

Assessment

An important area of expertise for many clinical psychologists is assessment, and there are indications that as many as 91% of psychologists utilize this core clinical practice. Such evaluations are usually conducted in order to gain insight into, and form hypotheses about, psychological or behavioral problems. As such, the results of these assessments are often used to clarify a person's diagnosis and assist in planning treatments or arranging for services. Methods used to gather information include formal tests, clinical interviews, reviews of past records, and behavioral observations.

There exist literally hundreds of various assessment tools, although only a few have been shown to have both high validity (i.e., test actually measures what it claims to measure) and reliability (i.e., consistency). These measures generally fall within one of several categories, including the following:

• Intelligence & achievement tests – These tests are designed to measure certain aspects of cognitive functioning (often referred to as IQ) in comparison to a group of people with similar characteristics (such as age or education). These tests, including the WISC-IV and WAIS-IV, attempt to measure traits such as general knowledge, verbal comprehension, working memory, attention/concentration, logical reasoning, and visual/spatial perception. Several of these tests have been shown to accurately predict scholastic achievement and occupational performance, and help to identify a person's cognitive strengths and weaknesses.
• Personality tests – These tests aim to describe patterns of behavior, thoughts, and feelings, and generally fall within two categories: objective and projective. Objective measures, such as the MMPI-2 or the MCMI-III, are based on forced-choice responses—such as yes/no, true/false, or a rating scale—and generate scores that can be compared to a normative group. Projective tests, such as the Rorschach inkblot test, use open-ended responses, often based on ambiguous stimuli, to reveal non-conscious psychological dynamics such as motivations and perceptions of the self and the world.
• Neuropsychological tests - Tests in this category are often used to evaluate a person's cognitive functioning and its relationship to a person's behavior or psychological functioning. They are used in a variety of settings, for purposes such as clarifying a diagnosis (especially in distinguishing between psychiatric and neurological symptoms), better understanding the impact of a person's neurological condition on their behavior, treatment planning (especially in rehabilitation settings), and for legal questions, such as determining if a person is faking their symptoms (also referred to as malingering) or if they are capable to stand trial.
• Clinical interviews – Clinical psychologists are also trained to gather data by observing behavior and collecting detailed histories. The clinical interview is a vital part of assessment, even when using other formalized measures, as it provides a context in which to understand test results. Psychologists can employ a structured format (such as the SCID or the MMSE), a semi-structured format (such as a sequence of questions) or an unstructured format to gather information about a person's symptoms and past and present functioning. Such assessments often include evaluations of general appearance and behavior, mood and affect, perception, comprehension, orientation, memory, thought process, and/or communication.