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How to Deepen Your Clinical Effectiveness: The Use of Psychological Assessments in Mental Health Practice. Brookhaven Hospital Seminar Series March 7, 2012 Timothy D. Doty, Psy.D . ~Licensed Psychologist~ Clinical and Forensi c Psychology. Objectives. - PowerPoint PPT Presentation
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How to Deepen Your Clinical Effectiveness:
The Use of Psychological Assessments in Mental Health
Practice
Brookhaven Hospital Seminar SeriesMarch 7, 2012
Timothy D. Doty, Psy.D.~Licensed Psychologist~
Clinical and Forensic Psychology
ObjectivesDiscussion of most prominent psychological (ψ) assessment tools you are likely to see
How to be an informed clinician around the data included in prominent ψ assessments
What ψ assessments can you utilize in your own clinical practice for the benefit of your clients/patients?
How and when to seek ψ assessments consults to benefit your clients?
informal survey
DefinitionsClinical Assessment– any method by which a mental health professional gathers data about an individual, child, adult, couple, family, group, etc.
Most often takes the form of an unstructured interview
DefinitionsPsychological assessment - when a clinician utilizes a variety of test scores, obtained from multiple test methods, interprets the data informed by the patient’s history, referral information, and observed behaviors, in order to understand more fully the person being evaluated for the purpose of answering referral questions, and to communicate findings to the patient, significant others, and referral sources (Meyer, et al, 2001)Psychological testing – an obtained score on a particular psychological/psychoeducational test from which labels may be applied
E.g., psychometric tools in the education setting
Two Sides of the Discussion
We treat what our clients present to us and honor clients’ self-determination to set their own goals and discuss what they want to (including not going where they don’t want to go)
• If you don’t start with clear psychodiagnostics, your treatment will be less effective. Relying on unstructured or semi-structure interviews alone as an assessment misses important data
Prominent Psychological ψ Assessments
Personality TestsMMPI-2 and MMPI-2-RFMillon Clinical Inventories
Cognitive TestsWechsler TestsWAIS-IV, WISC-IV, WMS-IV, WASI-II, WPPSI-IV
Behavior Rating Scales
Burk’s, Conners’, Achenbach, BASCBeck DepressionSymptom scales (SCL-90-R)
Projective TAT, Rorschach, Projective Drawings, Bender-Gestalt Where might tests originate? Psychiatric hospital, psychologists,
school/educational assessment, forensic evaluations
Screening vs. AssessmentScreening
Briefer, less expensiveFewer questions = Less reliable (how likely are we to obtain the same score time after time)
AssessmentMore extensive, difficult to justify to third-party payersMore reliable, greater accuracy in achieving validity (are we actually measuring constructs we intend to measure)
Tools to ConsiderSymptom Checklist (SCL-90-R)Beck Depression InventoryBeck Suicide InventoryTrauma Symptom Inventory Quality of Life (QOLI)SASSI – Adult Substance Abuse Subtle Screening InventoryPREPARE/ENRICH
Public Domain: Hamilton Rating Scale for Depression Rating scales developed by drug companies
How and When to Refer for ψ Assessment Consult
When therapy is “stuck”When a particular diagnostic question remains elusive (is this person on the autistic-spectrum? Am I encountering a personality d/o? Why won’t my patient make suggested changes?)When having a diagnostic “label” can help encourage/motivate further treatment.Prepare clients. Let them know of potential benefits/risks.
Model for ψ Assessment Consultation
Therapeutic Assessment – Developed by Steve Finn, Austin, TXModel places priority on including referring clinician in multiple stages: defining referral question, incremental feedback, final feedback and recommendations for further treatment considerationsEmphasis on collaborative process between client and assessor. What goals does the client have? What would they like to learn about themselves?
ReferencesCamara, W.J., Nathan, J.S. & Puente, A.E. (2000). Psychological test usage: Implications in professional psychology. Professional Psychology: Research and Practice. (31)2, 141-154. Clair, D. & Prendergrast, D. (1994). Brief Psychotherapy and psychological assessments: Entering a relationship, establishing a focus, and providing feedback. Professional Psychology: Research and Practice. (25)1, 46-49Finn, S.E. (2007). In Our Clients' Shoes: Theory and Techniques of Therapeutic Assessment. Routledge.Finn, S.E. & Tonsager, M.E. (1992). Therapeutic Effects of Providing MMPI-2 test feedback to college students awaiting therapy. Psychological Assessment. (4)3, 278-287.
References, cont’dMeyer, G.J., Finn, S.E., Eyde, L.D., Kay, G.G., Moreland, K.L., Dies, R.R, Eisman, E.J., Kubiszyn, T.W., & Reed, G.M. (2001). Psychological testing and psychological assessment: A review of evidence and issues. American Psychologist. (56) 2, 128-165. Riccio, C.A., & Rodriguez, O.L. (2007). Integration of psychological assessment approaches in school psychology. Psychology in the Schools. (44) 3, 243-255. Watkins, C.E., Campbell, V.L., Nieberding, R. & Hallmark, R. (1995). Contemporary practice of psychological assessment by clinical psychologists. Professional Psychology: Research and Practice. (26) 1, 54-60
ContactTim Doty, Psy.D.
Christian Family Institute6846 S. Canton Ave., Suite 501
Tulsa, OK 74136918.745.0095
[email protected]: @DrTimDoty www.CFItulsa.com