Slide 1Determining the Client’s NeedsCharacteristics of Assessment ToolsCharacteristics of Assessment ToolsTypes of AssessmentsClinical InterviewsStructured vs. UnstructuredClinical InterviewsWhat are the limitations of clinical interviews?Clinical ObservationsClinical ObservationsClinical TestsResponse InventoriesResponse InventoriesPsychophysiological TestsPsychophysiological TestsNeurological TestsNeuropsychological TestsMerits of neurological and neuropsychological testsIntelligence TestsPersonality InventoriesPersonality InventoriesSlide 23Personality InventoriesMerits & limitations of personality inventoriesProjective TestsRorschach TestThematic Apperception TestOther Projective TestsMerits & limitations of projective testsDiagnosisDSM-5DSM-5Slide 34Is the New DSM-5 System Effective?Danger in a label?TreatmentEffectiveness of TreatmentIs therapy generally effective?Are particular therapies generally effective?Particular therapies for particular problems?Where are We Now?Clinical Assessment, Diagnosis, and TreatmentChapter 42/3/15-2/5/15Determining the Client’s NeedsAssessment: the collection of relevant information to better understand the client’s current circumstancesNeed to gather idiographic informationSpecific needs and information of the individualHow and why does the client behave abnormally?How can the client be helped?Characteristics of Assessment ToolsStandardizationSet up common steps that are followed for each administrationReliabilityHow consistent is the measure?It should always yield the same results in the same situationTwo main types: 1. Test-retest reliability2. Interrater reliabilityCharacteristics of Assessment ToolsValidityIs it accurate?Does it measure what it’s supposed to measure?Three main types:1. Face validity2. Predictive validity3. Concurrent validityTypes of AssessmentsThree broad categoriesClinical interviewsObservationsTestsClinical InterviewsFace-to-face interview between therapist and clientCollect detailed information about:Demographic informationPersonal history and relationshipsCurrent problems and symptomsClient’s goals for treatmentObtain behavioral observations:Facial expressions and eye contactPostureEmotionsMotor coordinationStructured vs. UnstructuredStructured interviewQuestions are prepared and clinician follows exactly what is writtenIncludes a standard set of questionsSemi-structured interviewGeneral questions are provided but the clinician is able to deviate from these questions Unstructured interview Clinician asks open-ended questions “Tell me about yourself”Clinical InterviewsMay also include a mental status exam– assessment of client’s: AwarenessOrientation to time and placeAttention spanMemoryJudgment and insightThought content and processesMoodAppearanceWhat are the limitations of clinical interviews?Interviews may lack validityInterviews may lack reliabilityInterviewers may be biasedClinical ObservationsNaturalistic and Analog observationsTake place in homes, schools, or clinicsWhen naturalistic is not possible, may use videoDisadvantagesNot always reliable and/or validCan’t necessarily record everythingObserver drift: decline in accuracy over timeObserver biasClient reactivityMay lack cross-situational validityClinical ObservationsSelf-monitoringRecord frequency of one’s behaviors, feelings, or cognitions over timeAdvantagesUseful for assessing infrequent and overly frequent behaviorsAllows measurement of private thoughtsDisadvantagesNot always validMay inadvertently change behavior as a resultClinical TestsDevices for gathering information about specific aspects of a person’s psychological functioningSix most common types of tests:1. Response inventories2. Psychophysiological3. Neurological & Neuropsychological4. Intelligence5. Personality inventories6. Projective measuresResponse InventoriesFocus on one specific area of functioningAffective InventoriesMeasure severity of anxiety, depression, and angerExample: Beck Depression InventorySocial Skills InventoriesInquires about how individual would react in a variety of social situationsCognitive InventoriesInvestigates individual’s thinking style and assumptionsResponse InventoriesMerits and Limitations:Strong face validityBut…Often not standardizedLittle reliability testingLittle validity testingPsychophysiological TestsMeasures physiological responses to determine potential psychological problemsTests measure changes in:Heart rateMuscle activity (electromyography)Skin conductance (galvanic skin response)Example: Polygraph (Lie Detector Test)Electrodes are placed in various regions of the body to detect changes in various physiological functionsPsychophysiological TestsMerits and LimitationsDo not rely on self-report or observationRequire expensive equipmentMay lack reliability and/or validityNeurological TestsDirectly assess brain structure and activityNeuroimagingComputerized Axial Tomography (CAT or CT)X-rays the brain’s structure from different anglesPositron Emission Tomography (PET)Motion picture of chemical activity Functional Magnetic Resonance Imaging (fMRI)Allows us to see the picture of functioning brainIndications of neuron activity at sites throughout the brainShows changes of blood flow and volume in different brain areasNeuropsychological TestsMeasure cognitive, perceptual, and motor performancesOften used to assess brain damageExample:Bender Visual-Motor Gestalt TestShow clients pictures of basic geometrical designsHave them replicate the designsLater, have them re-draw the designs from memory• Learning & Memory • Attention • Visual/spatial• Executive functions • Language • Processing speedMerits of neurological and neuropsychological testsCan be very accurateBest when used as part of a battery of tests, each targeting a specific skill areaEssential for the diagnosis and treatment of brain damage or neurodegenerative conditionsFor example: traumatic brain injury, Alzheimer’s disease, strokeIntelligence TestsSeries of tasks requiring use of verbal and nonverbal skillsIntelligence Quotient (IQ)Used to be found by dividing mental age by chronological ageNow more