Career Counseling, Assessment, and Diagnosis

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Career Counseling, Assessment, and Diagnosis

• Psy 340 Section 3

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Section 3 Goals

• Understand major career counseling theories,
  philosophy, tools, and place in psychology
• Gain an overview of assessment theory, types,
  uses, key personality and intellectual
  assessments
• Role of diagnosis, DSM, uses and criticisms

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Career Counseling Theories

• Frank Parsons (1909)
• Knowledge of self, world of work (wow) and match
  the two
• Evolution of P-E fit models
• John Holland (1985) Hollands Hexagon
• Social Cognitive Career Theory (SCCT)

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Hollands Theory

• People and careers can be described in terms of 6
  dimensions
• RIASEC
• Realistic
• Investigative
• Artistic
• Social
• Enterprising
• Conventional

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Hollands Theory (cont)

• Holland Code
• 3 letter combination (people and work)
• Person-Environment congruence
• Congruence
• Match between person and environment
• predictive of satisfaction, not stability and
  achievement
• Major theory
• Tests
• Generated lots of research

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Social Cognitive Career Theory (SCCT)

• Lent, Brown, Hackett, 1994
• Relationship with Bandura Social Learning
  Theory
• Role of
• Person Factors
• Environment Factors
• Interests to Goals to Actions

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SCCT Model
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SCCT Summary

• Who you are and where you are influences learning
  experiences
• Person and environment factors
• Shapes interests and expectations
• Interests dont always result in actions
• Interests may shape goals and one may or may not
  act on goals
• Barriers may impact interests translated to goals

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Career Counseling Same as Personal-Emotional
(PE) counseling?

• Roots and emphasis in counseling psychology
• Venn Diagram
• Personal
• Career choices in relation to personal life
• Are they really that different? Isolated?
• Use different theory and assessments

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Assessment in Career

• Strong Interest Inventory (SII)
• Uses Hollands theory
• Self-Directed Search (SDS)
• Card sorts qualitative assessment
• Occupations
• Values
• Majors
• Myers-Briggs Type Indicator (MBTI)

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Career Resources

• Occupation Outlook Handbook
• O-Net
• Career Counseling
• University Counseling Center
• Pre-Major Advisement (PM students only)
• Career Services

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Career Counseling Summary

• Career counseling is central to counseling
  psychologys development and current focus
• Similar to PE counseling, with additional
  theories
• Hollands Person-environment congruence
• SCCT
• Person and environmental factors
• Importance of self-efficacy and expectations

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Assessment Overview

• Everyday assessment vs. psychological assessment
• Psychological assessment requirements
• Systematic
• Objective
• Accurate
• Scientific method to understand others
• Explain and predict behavior

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So what is assessment??

• Gathering information!!
• Behavior
• Functioning
• Personality
• Typically thought of a psychological tests
• Quantitative data
• Empirically tested
• Tests have norms to allow for comparison

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Types of assessment

• Assessment may cover
• Personality
• Interests
• Intelligence
• Behaviors
• Modes of assessments
• Tests
• procedure or instrument used gather information
• Interview
• Very common
• Quantitative and Qualitative assessment

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Quantitative vs. Qualitative Assessment?

• Quantitative
• Usually using tests or standardized measures
• Norms and standards for comparison
• Specific and structured

• Qualitative
• Holistic/ integrated
• No norms, standards
• Assessment during the counseling process
• Flexible

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Building Blocks of Testing

• Standardization
• Set procedure and testing environment to insure
  similar test administrations
• Norms
• scores generated from large standardized group
• How most people do on test
• Allow for comparison
• Reliability and validity
• Is the test scientifically reliable?

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Reliability of Tests

• Reliability
• Consistency of a measurement device
• Are the same results obtained each use?
• Types of reliability
• Test-retest Does the test give the same results
  at different times?
• Internal consistency Do different parts of the
  test give the same results?
• Interrater reliability Do different people using
  the measure come up with similar answers?

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Validity of Tests

• Validity
• Does the test measure what is supposed to?
• Appropriateness of test interpretation
• Types of validity
• Face validity does it look like it is measuring
  what it is supposed to measure?
• Predictive validity how well do tests score
  predict behavior that the test should predict?
• Concurrent validity correlation of score with
  scores on established test
• Construct validity the degree to which the
  measure reflects the structure of the
  hypothesized construct

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Expanded View of Assessment

• Spengler et al. (1995) assessment is everywhere
• Continual assessment, beyond testing
• All assessment is subjective, value judgments
• Goldman (1990,1991)
• Benefits of qualitative assessment
• Types
• Qualitative assessment as a piece of the puzzle
• Combination, not replacement

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Qualitative Assessment

• How does it stand up to??
• assessment requirements of
• Systematic
• Objective
• Accurate
• Is it reliable? Valid?
• What role does qualitative assessment play?

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Steps of Assessment

• Referral question
• Deciding what is being assessed
• What is the best means of assessment?
• Determine goals of assessment
• Collecting data
• Tests, interviews,varied sources
• Always reference referral question

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Steps of Assessment (cont.)

• Interpretation
• Make decisions and judgments using data
• Diagnosis
• To facilitate treatment and communication among
  the treating professionals
• Psychological report
• Communicate the results

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Diagnosis and the DSM

• Emil Kraepelin developed 1st classification
  system
• ID and labeled symptom sets
• Specific cause, course, outcome
• Diagnosis
• After assessment
• Identify disorder that fits symptom profile
• Role in the medical model
• Problem identification
• Discover cause of problem
• Treat problem scientifically

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DSM and Multi-axial Assessment

• Diagnostic and Statistical Manual of Mental
  Disorders (DSM)
• Evolved through revisions
• Politics of inclusion
• Current DSM-IV-R
• First DSM in 1952
• Diagnosis on 5 axis to capture the complexity of
  psychological disorders

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Multiaxial Assessment in DSM

• Axis I Clinical syndromes
• Typical labels (e.g. bi-polar)
• Can be temporary
• Axis II Personality Disorders
• Long-standing, enduring characteristics
• Axis III Physical Conditions/Disorders
• Injuries, chronic illnesses
• Axis IV Severity of Psychological Stressors
• Axis V Global Assessment of Functioning (GAF)

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DSM Uses and Criticisms

• USES
• Communication
• Research
• Unified fields
• Facilitate treatment

• CRITICISMS
• Sexist
• Culturally biased
• Defining categories more political than
  scientific
• Problems with labeling, stigmas

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DSM Discussion

• Is diagnosis necessary?
• Is the DSM necessary?
• What purpose does the DSM serve?
• Pros and cons of labeling
• What are some other options other than the DSM
  that could meet similar needs but be an
  improvement?

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Personality and Behavioral Assessment Overview

• Interview
• Intake, Mental Status,Case history
• Projective personality tests
• Rorschach, TAT, etc.
• Objective personality tests
• MMPI, NEO-PI, MBTI
• Behavioral assessment

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Therapeutic Interview

• Dual purpose
• Gather info and help client
• Intake interview
• Determine nature of problem and fit w/ agency
• Initial information used for case assignment
• Varying timing and format (structure)
• General information gathered
• Basic info, problem onset, current functioning,
  coping, attempted solutions, etc.

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Therapeutic Interview (cont)

• Mental Status Exam
• Formal assessment of mental functioning
• Often performed in ER
• Covers several areas of functioning
• (e.g., appearance, speech/thought, mood, memory,
  attention, etc) see pg 102
• Case history
• Gathers info on personal and family history and
  social situation
• Covers broad areas
• (e.g., current situation, family history, health,
  education, marriage/ current family,etc.) see
  pg.103

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Projective Personality Tests

• Rorschach Inkblot Test
• 10 inkblots, tell what is, ID specific aspect
• Thematic Apperception Test (TAT)
• 31 cards with vague pictures to illicit themes
• Make up story about the picture
• Kinetic Family Drawing (KFD)
• Draw members of family doing something
• Rotter Sentence Completion
• Oral or written form
• I hate. Mothers are .
• Reliability, validity, clinical usefulness debate

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Objective Personality Tests

• Objective vs. subjective
• Similar to qualitative vs. quantitative
• Scale construction methods
• Empirical (external)
• Administer items and see what items differ
  between what groups
• Inductive
• Administer items and analyze mathematically how
  items hang together
• Deductive
• Theory/definition before create test
• Items created to fit theory

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MMPI and MMPI-II

• Developed with the Empirical approach
• 1930s-40s to diagnose psychopathology
• Items that designate between groups make the
  scales
• Several hundred statements about life, opinions,
  likes/ dislikes, etc.
• Forced choice T/F
• I am happy most of the time
• Revised in 1989 as MMPI-II

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MMPI-II Clinical Scales

• Hypochondriasis
• Preoccupation with body
• Depression
• Hysteria
• Psychopathic deviate
• Antisocial behavior
• Masculine-Feminine

• Paranoia
• Psychasthenia
• Obsessions/compulsions
• Schizophrenia
• Mania
• Social introversion

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MMPI-II (cont)

• Validity scales
• ? number of omitted items
• L tendency to lie, self in favorable light
• F unusual items, fake bad
• K defensiveness, corrective factor
• Graph of scores
• Highest codes
• Give profile of person
• Use of cookbooks

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NEO-Personality Inventory (NEO-PI)

• Based on Costa McCraes five factor personality
  theory
• Measurement of normal personality
• Five Factors (OCEAN)
• Neuroticism
• Extraversion
• Openness to experience
• Agreeableness
• Conscientiousness
• 240 statements, 4-point Likert scale indicating
  extent of agreement

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Myers-Briggs Type Indicator(MBTI)

• Developed with the deductive approached
• Based on Jungs 4 dimensions of personality
• Extraversion-Introversion
• Sensing-Intuition
• Thinking-Feeling
• Judging-Perceiving
• Code/ Profile for people, 16 codes

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Behavioral Assessment

• From behaviorism and behavior therapy
• Look at observable rather than underling
  personality
• Techniques
• Behavioral assessment interviews
• Observation (naturalistic, analogue, participant)
• Self-Monitoring
• Behavioral questionnaires
• Biofeedback

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Issues in Assessment

• IQ testing
• Computer generated scoring
• Validity, reliability?
• Professional responsibility
• Training requirements
• Test administration
• Ethics
• Releasing and maintenance of results
• Use of testing (e.g. MMPI for hiring?)

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Intellectual Assessment

• Problem of defining intelligence
• Fluid intelligence
• Non-verbal, relatively culture free mental skills
• E.g., the capacity to adapt to new situations
• Crystallized intelligence
• Skills and knowledge acquired through repeated
  exposure and practice
• Verbal vs. Performance intelligence

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Intelligence Scales

• Stanford-Binet Intelligence Scale
• Developed to predict which children would do well
  in school
• Skills areas and standards for each
• Verbal reasoning
• Quantitative reasoning
• Abstract/Visual reasoning
• Short-term memory
• Age norms
• Raw scores transformed into IQ
• IQ of 100 is average, 16 standard deviation

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Intellectual Assessment

• Weschler Tests
• Weschler Intelligence Scale for Children
  (WISC-III, 1991)
• Weschler Adult Intelligence Scale (WAIS-R, 1981)
• All tests divided into two aspects
• Verbal (e.g., vocabulary comprehension)
• Performance (e.g., puzzles copying designs)
• Full scale IQ verbal IQ performance IQ
• Mean of 100, standard deviation of 15
• Used to assess learning disabilities and
  neuropsychological disorders

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Neuropsychological Assessment

• Neuropsychology studies relationship b/w brain
  and behavior
• Neuropsychological assessment
• Set of procedures to detect presence, extent, and
  type of brain damage/ impairment
• Evaluate behaviors that are linked to specific
  brain functioning
• Brain damage is increasing in society
• Research on the brain and behavior has increased
  due to technology
• X-rays, EEGs, CAT scans, PET scans

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Revisiting Assessment Steps

• Referral question
• Collecting data
• Diagnosis
• Psychological report
• Communicate the results

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Psychological Report

• Written summary of impressions and assessment
  results to guide client conceptualization and
  treatment
• Always consider
• Referral question
• What is the purpose
• Who is the audience
• What is the necessary information
• What (if any) information could harm the client
  currently or in the future

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Psychological Report (cont.)

• Aspects included
• Referral question
• Presenting problem/ Background information
• Assessment results
• Behavioral assessment
• Testing results and observations
• Diagnosis
• Integrated summary and suggested treatment

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Review of the Goals

• Career counseling theories, philosophy, tools,
  and place in psychology
• Overview of assessment
• Theory
• Types (Qual. And Quant.)
• Uses and instruments (Personality, Interests,
  Intelligence, Behavioral, etc.)
• Testing basics
• Communicating findings
• Role of diagnosis and DSM
• uses and criticisms