ASSESSMENT IN

CLINICAL PSYCHOLOGY
UNIT 1
6
UNIT 1
[Link] testing approaches and test choice rationale
[Link] assessment
[Link] observation
[Link] taking, mental status examination (MSE) and mini
use (MMSE)
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PSYCHOLOGICAL TESTING APPROACHES AND TEST CHOICE
Definition: RATIONALE
• Psychological tests are standard measure devised to assess behaviour objectively
and used by psychologist to help people make decision about their lives and
understand more about themselves.
• A psychological assessment evaluates thinking, learning, behavior and emotions.
• The assessment may include interviews, observation, testing and consultation
with other professionals involved in psychological tests.
• Psychological assessment is a process that involves the integration of information
from multiple sources, such as, tests of normal and abnormal personality, tests of
ability or intelligence, tests of interests or attitudes, as well as information from
personal interviews
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[Link] TESTING
APPROACHES AND TEST CHOICE
RATIONALE
Psychological Testing approach
• Interview
• Observation
• Self-report
• Projective techniques.
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PSYCHOLOGICAL TESTING
APPROACHES AND TEST CHOICE
Principles of testing: RATIONALE
• Standardization
• Reliability
• Validity
• Objectivity
• Norms
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PSYCHOLOGICAL TESTING
APPROACHES AND TEST CHOICE
Rationale: Why are you using
RATIONALEthe test? The reason?
- Diagnosis
- Research
-Idenrifying problems
- Predicting
- Assesment of strengths l/skills
- Self assessment
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2. BEHAVIORAL ASSESSMENT
• Behavioral assessment distinguishes itself by being a set of specific
techniques as well as a way of thinking about

• Behavior disorders and how these disorders can be changed. One of its core
assumptions is that behavior can be most effectively understood by
focusing on preceding events and resulting consequences.

• Clearly observable aspects in the way a person interacts with his or her
environment. A typical behavioral assessment might include specific
measures of behavior (overt and covert), antecedents (internal and
external), conditions surrounding behaviors, and consequences.
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BEHAVIORAL ASSESSMENT
HISTORY AND DEVELOPMENT

• Little Albert and his fear of white furry objects

• The earliest formal use of behavioral assessment occurred in industrial and
organizational settings
• The development and expansion of behavioral medicine has also drawn
extensively on behavioral assessment strategies in the evaluation of
headaches, coronary heart disease, Reynaud’s disease, asthma, chronic
pain, sleep disturbances, and eating disorders
• Behaviorism beginning in 1930's
• Pavlov: Pavlovian or classical conditioning
• B.F. Skinner: Skinner box for rat learning research
• Operant or response-stimulus (RS) conditioning
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BEHAVIORAL ASSESSMENT
ISSUES RELATED TO RELIABILITY AND VALIDITY

• Unique behavior that occurs infrequently (i.e., violation of drugs or firearms

in schools) may be much more difficult to measure and monitor
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BEHAVIORAL ASSESSMENT
ASSETS

• Probably the greatest advantage of behavioral assessment is that its

practitioners have continually paid attention to its relevance toward
treatment.
• Wide range of possible techniques
• Useful when the problem is determined primarily by environmental factors.

Limilations:
• Cognitive assessment is necessarily unobservable and relies on client self-
reports.
• Extensive resources in terms of time, personnel, and equipment.
• Behavioral instruments have not been designed to deal with problems
frequently encountered in clinical practice, such as dissociative disorders,
paranoia, and hypochondriasis.
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BEHAVIORAL ASSESSMENT
STRATEGIES OF BEHAVIORAL ASSESSMENT

[Link] Interviewing:
• Behaviorally oriented interviews generally focus on describing and
understanding the relationships between antecedents, behaviors, and
consequences (ABC).
• Identify relevant target behaviors or select additional behavioral
assessment procedures
• Steps:
• Rapport, Open-ended questions, A wide-based behavioral assessment, An
interview should end by providing the client with a summary of the
information obtained
• Initially, provide the client with an overview of what needs to be
accomplished and why a clear and detailed specification of the problem
behavior is important.
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BEHAVIORAL ASSESSMENT
2. Behavioral Observation:
Narrative Recording

Narrative recording requires that the observer simply make note of behaviors of inter-
est. There is little quantification, and the observations can vary in the degree of infer-
ences made. For example, an observer may stick closely to direct descriptions of
behavior, such as noting that someone frequently laughs and smiles at his or her friends,
or may infer from these behaviors that the client has good peer relations.

Interval Recording
A clinician may choose to record whether selected aspects of behavior occur within
predetermined intervals. As a result, this technique is also referred to as time sampling,
interval sampling, or interval time sampling.
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BEHAVIORAL ASSESSMENT
2. Behavioral Observation:

Event Recording: Event recording depends on the occurrence of the behavior

itself. The observer must wait for the target behavior to occur, and then record relevant
details of the behavior. Examples of behaviors most appropriate for event recording are
aggressive actions, greetings, or use of verbal expressions such as assertion or profanity.

Ratings Recording: - 16PF-item questionnaire that evaluates the functional significance of

behavior related to the dimensions of personality
BEHAVIORAL ASSESSMENT 1
3. Cognitive Behavioral Assessment: ognitive behavioral assessments are questionnaires and in-person
conversations meant to give a therapist an understanding of the thoughts, behaviors, and feelings of a client.

4. Cognitive Self-Report Inventories: The person fills out a survey or questionnaire with or without the help of an
investigator

5. Recording Cognitions:
• Thinking Aloud.
• Private Speech: barely audible speech
• Articulated Thoughts: articulate the thoughts he or she is experi-
• encing during these situations (Simulation)
• Production Methods: naturalistic situation
• Endorsement Method: The client might be presented with either a standardized (e.g., Irrational Beliefs Test,
Cognitive Bias Questionnaire) or an informally developed list of items and then be requested to rate
frequency of occurrence
• Thought Listing: summarize their relevant thoughts.
• Thought Sampling: A sample of a person’s thoughts might be obtained by setting a
• prompt (e.g., a beep on a timer), then having the client describe the thoughts he or
• she was having just before the interruption by the prompt.
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CLINICAL OBSERVATION

• Clinical observation refers to the intentional and systematic

watching, listening, and noting of a client’s behavior,
emotions, speech, and physical appearance during
therapeutic or diagnostic sessions. It is often non-intrusive
and ongoing.

Purpose of Clinical Observation

• To identify symptoms and behaviors that may not be reported
by the client.
• To support diagnostic hypotheses (e.g., depression, anxiety,
psychosis).
• To observe patterns, inconsistencies, or changes over time.
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CLINICAL OBSERVATION

Types of Clinical Observation

[Link] Observation
⚬ Conducted in a natural environment (e.g.,
home, school).
⚬ Minimal interference.
[Link] Observation
⚬ Done in controlled settings with specific
prompts or tasks.
⚬ Often used in assessments (e.g.,
neuropsychological tests).
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HISTORY TAKING
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MENTAL STATUS EXAMINATION
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MINI MSE 1
The mini mental state examination:

Orientation
Year, month, day, date. season
Country, county, town, hospital, ward (clinic)

Registration
Examiner names three objects (for example, apple, pen, and table)
Patient asked to repeat objects, one point for each.

Attention Subtract 7 from 100 then repeat from result, stop after
five subtractions. (Answers: 93, 86, 79, 72, 65) Alternatively if patient errs on subtraction get them to
spell world backwards: D L RO W
Score best performance on either task.

Recall
Ask for the names of the objects learned earlier.

Language Give a three stage command. Score one for each stage (for example, 'Take this piece of paper in your right hand, fold it in
half and place it on the table!' Ask patient to read and obey a written command on a piece of paper stating: 'Close your eyes.' Ask
patient to write a sentence. Score correct if
it has a subject and a verb.

Copying
Ask patient to copy intersecting pentagons.
Score as correct if they overlap and each has five sides.