The requirement to learn the skills of personality assessment is often viewed by students as a fears

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• The requirement to learn the skills of
  personality assessment is often viewed by
  students as a fearsome burden or insurmountable
  task for which the purpose is not always clear.
• --John Exner

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Building Collaborative Assessment Skills A
Practicum Clinics Intake Procedure

• Jessie Goicoechea, Ph.D., Clinic Director
• Katy Sampson, M.A.
• G. Keilan Rickard, M.A.
• Duquesne University
• April 13, 2007

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Overview

• Review of competencies literature
• Challenges to meeting competencies
• a) Program challenges
• b) Student challenges
• c) Personal observations

4
Overview

• Clinical utility and emerging popularity of
  collaborative assessment
• Our Clinics intake procedure
• Procedure
• Case examples
• Video demonstration

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Competencies

• 2002 APPIC Competencies Conference
• Psychological assessment among the 8 core
  competencies

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Competencies

• Krishnamurthy et al. (2004) identify core
  competencies of psych assessment
• 1. Background in the basics of psychometric
  theory
• 2. Knowledge of the scientific, theoretical,
  empirical, and contextual
• bases of assessment
• 3. Knowledge, skill, and techniques to assess the
  cognitive, affective, behavioral, and personality
  dimensions of human experience
• 4. Ability to assess outcomes of treatment
• 5. Ability to evaluate critically the multiple
  roles, contexts, and relationships within which
  clients and psychologists function
• 6. Ability to establish, maintain, and understand
  the collaborative professional relationship
• 7. Understanding of the relationship between
  assessment and intervention, assessment as
  intervention, and intervention planning
• 8. Technical assessment skills

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Competencies

• Technical Assessment Skills
• Problem and/or goal identification
• Understanding and selection of appropriate
  assessment methods
• Effective application of assessment procedures
  with clients and the various systems in which
  they function
• Systematic data gathering
• Integration of information, inference, and
  analysis
• Communication of findings and development of
  recommendations to address problems and goals
• Provision of feedback that is understandable,
  useful, and responsive to the client (be it an
  individual, group, organization, or referral
  source)

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Competencies

• Krishnamurthy et al. (2004)
• 1. Background in the basics of psychometric
  theory
• 2. Knowledge of the scientific, theoretical,
  empirical, and contextual bases of assessment
• 3. Knowledge, skill, and techniques to assess the
  cognitive, affective, behavioral, and personality
  dimensions of human experience
• 4. Ability to assess outcomes of treatment
• 5. Ability to evaluate critically the multiple
  roles, contexts, and relationships within which
  clients and psychologists function
• 6. Ability to establish, maintain, and understand
  the collaborative professional relationship
• 7. Understanding of the relationship between
  assessment and intervention, assessment as
  intervention, and intervention planning
• 8. Technical assessment skills

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Competencies

• C. Hatcher Lassiter (2007) outline practicum
  competencies in psych assessment
• 1. Ability to select and implement multiple means
  of evaluation in ways that are responsive to and
  respectful of diverse individuals, couples,
  families, and groups
• 2. Ability to utilize systematic approaches to
  gathering data to inform clinical decision making
• 3. Knowledge of issues related to integration of
  different data sources
• 4. Ability to integrate assessment data from
  different sources for diagnostic purposes
• 5. Ability to formulate and apply diagnoses to
  understand the strengths and limitations of
  current diagnostic approaches
• 6. Capacity for effective use of supervision to
  implement and enhance skills

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Challenges

• Program Challenges
• In graduate psych programs, there has been less
  emphasis on assessment than on treatment, hence
  less training and coursework in assessment this
  despite the fact that internship sites highly
  value assessment experience and expect
  proficiency (Krishnamurthy et al., 2004).
• Many have noted a decrease in the preparation and
  training of doctoral students to provide
  assessment services, particularly in projective
  techniques (Belter Piotrowski, 2001 Aiken et
  al., 1990 Duran, Blanchard, Mindell,1988).

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Challenges

• Intern directors have voiced dissatisfied with
  interns level of experience in test-based
  assessment skills (Goldberg, 1998 Lopez et al.,
  1996 Malouf, Hass, Farah, 1983).
• Only 25 of graduate students had adequate
  report-writing experience with the 13 most
  frequently used tests (Stedman, Hatch,
  Schoenfeld, 2001).
• Assessment courses may be routinely taught, but
  relatively little has been written about
  assessment instruction (Handler Hilsenroth,
  1995) and there has been little investigation of
  how training is actually conducted (Childs
  Eyde, 2002).

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Challenges

• Student Challenges
• Handler Hilsenroth (1995) investigated graduate
  students experiences of their Rorschach
  training. They found
• 1. Without a theoretical understanding of the
  test and of personality, administration and
  scoring can seem arbitrary and capricious.
• 2. Students struggled to transform data into
  relevant clinical interpretations, and to
  effectively integrate and communicate findings.
• 3. Even after a second course in Rorschach,
  almost 25 of students were dissatisfied with
  their training in the use of the Rorschach for
  report writing.

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Challenges

• Common concerns and fears among graduate students
  facing assessment (according to Fowler, 1998)
• 1. The wish and fear of the expert voice
• 2. Balancing morbid vs. Pollyanish
  interpretations
• 3. Using oneself as an instrument of
  assessment
• 4. Integration and communication of results

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Challenges

• Counterproductive assessor styles (according to
  Fischer, 1994)
• 1. Being sociable
• 2. Being collusive or avoidant
• 3. Being a technician
• 4. Being a rescuer
• 5. Being an opponent

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Challenges

• C. Personal Observations
• Students have felt a tension between standardized
  administration and a warmer therapeutic stance.
  They struggle to integrate nonspecific
  therapeutic skills (e.g., offering an empathic,
  non-judgmental presence) with what can initially
  feel like a very different set of skills for
  testing and assessment. 
• Assessment calls for a certain kind of authority,
  one that may seem at odds with a not-knowing
  approach.
• Translating scores from objective tests into
  jargon free and non-technical language is a
  challenge, but is recommended (Brenner, 2003
  Fischer, 1994 APA, 1992).

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Challenges

• Feeling concerned that fumbling around with
  stopwatches, pencils, clipboards, and other
  testing materials will betray the students
  inexperience. And theres a corollary concern
  that if the client detects the students
  inexperience, the client will disregard the
  student as merely a charlatan.
• Fear of testing vulnerable clients

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Collaborative Approaches

• involve the client in interpreting test data.
• have empirical support for their clinical
  utility.
• can help trainers and students work through the
  above challenges in order to better develop
  skills and maybe even exceed expected levels of
  competency.

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Guiding Principles

• The client and the clinician work together to
  form a deeper understanding of the clients
  situation.
• Clinicians engage the client as
  co-assessor/co-evaluator.
• There are interactive feedback sessions, unlike
  the traditional approach of unidirectional
  sharing of results.
• There is joint discussion of test findings along
  the way.
• Primary data are life events, not just test
  scores.
• There is dialogue about how the testing (scores
  and comportment toward the tests) elucidates life
  challenges the test situation evokes
  structurally similar life events.

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Guiding Principles

• The meaning of a given score is arrived at in
  dialogue together, understood as fully
  contextualized and individualized.
• The clinician and client explore the clients
  life in process.
• It goes beyond normative data to address a
  particular persons situation as she experiences
  it and contributes to it.
• It is interventional in the course of the
  assessment, clients can see, there in the tests,
  movement into problematic terrain, and can pivot
  into an alternative route.
• The clinician allows her understanding of the
  test findings to be refined by the client.
• See Riddle, Byers, Grimesey, 2002 Fischer, 1994

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Collaborative Assessment

• Empirical support
• With suicidal clients (Jobes et al., 2005)
• With clients at university counseling centers
  (Finn Tonsager, 1992 Newman Greenway, 1997)
• To improve therapeutic alliance (Hilsenroth,
  Peters, Ackerman, 2004)
• Other studies Finn Martin, 1997 Hanson,
  Clairborn, Kerr, 1997

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Collaborative Assessment

• Further uses/recommendations
• For securing commitment to treatment from
  individuals with BPD (Ben-Porath, 2004)
• To help transition foster adolescents into
  emancipation (Mangione, Borden, Abrams, 2006)
• With American Indian and Alaskan native clients
  (Allen, 2002)
• With couples (Snyder, Heyman, Haynes, 2005)
• With sexual minorities (Lasser Gottlieb, 2004)
• With individuals suffering from eating disorders
  (Michel, 2002)

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Practicum Intake Procedure

• First session
• Clinical interview
• Psychosocial history
• Talk with the client about what to expect next
  highlighting working together

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Practicum Intake Procedure

• Second session
• Refining/clarifying presenting concerns
• Gathering more life-world data elicit concrete
  examples
• What does the client want to learn from the
  tests?
• Move into the first task tests are selected for
  fit with presenting concern, in consultation with
  the supervisor and Clinic Director, and in
  concert with course sequence
• Explore comportment toward the task and testing
  situation reflect on test-taking attitude a
  process approach
• At least two tests are administered
• Collaborative discussion continues into the third
  session
• Results in an integrated report for each client,
  complete with thematic findings across
  instruments, therapeutic implications, and
  collaboratively developed suggestions. Reports
  are sometimes shared with the client.

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Conclusion

• Our procedure is consistent with recommendations
  that beyond classroom learning, training should
  include course-linked labs and practica in a way
  that is integrated with training in intervention
  and treatment planning (Krishnamurthy et al.,
  2004 Childs Eyde, 2002 Stedman et al., 2002).
• Upcoming survey research on our clients
  experience of this assessment phase of the intake.

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References

• Aiken, L.S., West, S.G., Sechrest, L., Reno,
  R.R. (1990). Graduate training in statistics,
  methodology, and measurement in psychology. 
  American Psychologist, 45, 721-734.
• Allen, J. (2002). Assessment training for
  practice in American Indian and Alaska native
• settings. Journal of Personality Assessment,
  79(2), 216-225.
• American Psychological Association. (1992).
  Ethical principles of psychologists and code of
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• The Association of Directors of Psychology
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• Competencies workgroup, the Council of Chairs of
  Training Councils (CCTC)
• practicum competencies workgroup, Hatcher, R.L.
  Lassiter, K.D. (2006,
• October, 24). The practicum competencies
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References

• Duran, V., Blanchard, E., Mindell, J. (1988).
  Training in projective tests Survey of
• clinical training directors and internship
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