A Review On Ethical Issues and Rules in Psychological Assessment
A Review On Ethical Issues and Rules in Psychological Assessment
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Reyhan Arslan1
Abstract
Psychologists that offer psychological counseling may use psychological tests and some other
measurement techniques in psychological assessment. On the other hand, they may encounter with
many ethical dilemmas while doing these assessments. In this review, firstly the definition, purposes,
and the stages of psychological assessment are explained. After that, ethical rules of psychological
assessment are examined in ways that include both tests and other techniques in the context of ethical
principles in the Ethical Guidelines of American Psychological Association. Besides, these ethical rules
are discussed in the light of findings in the related literature. In the final part, other ethical issues which
are psychologist-counselor relationship in psychological assessment, computer-based assessment,
psychological assessment in rural and low-income areas, and assessment of mentally retarded people are
mentioned and some suggestions that can be considered in doing an ethical assessment are presented.
INTRODUCTION
Psychological assessment involves the evaluation process of individuals’ skills, behaviors and
personal attributes using various psychological methods such as interview, observation and other
assessment tools (Welfel, 2013). It makes a major contribution to the decision-making process for
determining the most appropriate research method to be implemented (Hood and Johnson, 2008).
Additionally, when performed at certain intervals during an ongoing treatment process, psychological
assessment helps to understand whether the implemented treatment is effective (Groth-Marnat, 2009).
Consequently, psychological assessment aims to provide information as to the individual’s cognitive
skills, behaviors and abilities; experienced psychological issues, constraints and the underlying factors;
and the individual’s functionality and therapeutic requirements. In this context, psychological
assessment holds critical importance as it may change the course of an individual’s life through
determining the direction of his/her treatment (Meyer et al., 2001). Psychological assessment does not
only underline an individual’s weaknesses, but also lays emphasis on his/her strengths. In this way,
it helps individuals to use their existing capabilities in a more efficient way through rehabilitating
their weaknesses or selecting a program that helps to enhance their strengths (Koocher and Keith-
Spiegel, 1998). Psychological assessment does not rely merely on test scores; since each individual
feature diverse skills that can be evaluated through various methods. Accordingly, a psychologist is not
the person who merely performs and grades psychological tests (Groth-Marnat, 2009), although such
tests are widely regarded as beneficial tools for the assessment process (Hambleton, Merenda and
Spielberger, 2005). Assessment of the individuals’ mental, emotional, social, linguistic and psycho-
motor development and providing an account of their personalities, behaviors and skills constitute the
intended use of
1 Research Assistant, Istanbul Medipol University, Faculty of Educational Sciences,
[email protected]
psychological tests which are indispensable tools for psychologists in a psychological assessment
process (Koocher and Keith-Spiegel, 1998). Psychological tests can be also useful in diagnosis;
however, diagnosing on the sole basis of test results should be strictly avoided (Szasz, 1970). Certainly,
no psychological assessment method alone could suffice to evaluate a specific attribute, skill or tendency
of an individual and it would not be possible to obtain an accurate result regarding that subject (Groth-
Marnat, 2009). Consequently, psychological assessment methods involve all processes of measurement
and evaluation stages in which various tests, clinical observations and interviews are used to determine
the tendencies of individuals in specific subjects, their skills, personal attributes and psychological
problems. The therapy process is specified with an integrative approach through gathering the
information obtained via interviews with the client and/or his/her family, observations and test results.
As a result of these efforts, the course of treatment is determined by the joint decision of client and the
psychologist (Welfel, 2013).
Maloney and Ward (1976) specified a seven-phase model to define the psychological assessment
process. However, these authors also stated that, these seven phases do not proceed with a strict linear
interaction, and in most of the cases, they even overlap and occur concurrently. The phases of this model
established to define the psychological assessment process are briefly described below.
First phase. The first phase involves gathering information as to the client. Firstly, the factors that
prompt the client to search for treatment/aid are sought. At this point, the psychologist starts to establish
a basis for his/her temporary hypotheses about the client while proceeding with asking questions to
obtain more detailed information. Afterwards, the psychologist performs various psychological tests to
understand the client’s situation. The psychologist, meanwhile, constantly observes and takes note of
the attitudes and behaviors of the client during the interview and the test. In this way, the psychologist
makes use of the non-verbal data obtained with observation, in addition to the objective data such as
verbal statements and test scores. In this phase, the hypotheses about the client are at a preliminary level
and likely to change with addition of new information.
Second phase. In the second phase of psychological assessment, the focus is on diversification and
elaboration of the inferences regarding the client. These inferences serve to a summarizing and
descriptive function. For instance, when the psychologist makes an inference as to the possibility that
the client is suffering from depression, this inference both summarizes the general status of the client
and accounts for his/her retarded motions, focusing issues, undergoing flat effect etc. In the next step,
psychologist attempts to determine whether the client’s situation is chronic, or if it developed against a
situational difficulty encountered by the client. In this period, psychologist draws on information
obtained from test scores or other sources, if available. Consequently, the aim of this phase is to develop
multiple inferences about the client to direct further inquiries.
Third phase. This phase involves acknowledgement or refusal of the inferences made in the second
phase. An inference is completely true in rare situations; the validity of an inference increases as the
psychologist evaluates the consistency and strength of the data that supports a given inference. For
instance, an inference made on the grounds that the client is anxious can be supported with MMPI
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Journal of Family, Counseling, and Education, 3(1), 17-
29
scores or behavioral observations. The abundance of evidences supporting an inference has a direct
effect on the level of confidence in that specific inference.
Fourth phase. In the fourth phase of psychological assessment, the psychologist attempts to reach
more general inferences developed for the client throughout the first three phases. In other words,
in this phase, specific inferences are elaborated to gain insight into the general behavioral patterns of the
client. Briefly, elaboration of the explanations related to the client’s situation, and developing these
explanations are aimed in this phase.
Fifth phase. This phase involves further elaboration of various personal characteristics of the
client. This phase may also involve discussion and definition of general factors such as the client’s
cognitive functions, affection and mood, and the level of interpersonal functionality. Although they look
like similar, as compared the fourth phase, the fifth phase provides a more inclusive and integrative
definition about the client.
Sixth phase. In this phase, the comprehensive definition as to the client is placed in a situational
frame. In a sense, the definitions regarding the client are evaluated in a situational context.
Seventh phase. In this last phase of assessment, specific predictions are made with reference to the
client’s behaviors. This phase is the most critical one in the decision making process and requires the
psychologist to take account of the relationship between personal and situational variables.
Bases for assessment. “Psychologists base their assessments, suggestions, reports and opinions as to
diagnoses upon findings, information and techniques that suffice to prove their results.” (Standard
9.01a, Bases for Assessment [APA, 2010]). According to “Standard 9.01b, Bases for Assessment”:
“Psychologists provide an opinion only after they have supporting evidence of that opinion,
obtained after sufficient research. If conducting such research is not possible, psychologists report
their efforts and outcomes of their efforts. Psychologists examine the possible influence of their
limited knowledge on the reliability and validity of their assessments and confine their findings or
suggestions accordingly” (APA, 2010).
Use of assessments. “Psychologists perform, score, interpret and use assessment techniques,
interviews or tools in accordance with the diagnoses or research” (Standard 9.02a, Use of
Assessments [APA, 2010]). As stated in Standard 9.02b, Use of Assessments principle, psychologists
should use assessment tools, reliability and validity of which are verified on samples that are
equivalent to the subject of their application. In case a test is used without verification of its
validity and reliability, psychologist must explain the strengths and limitations of the results and
their interpretations (APA, 2010). According to Berndt (1984), psychologists should determine as to
whether the sample of the test is similar to the individual being tested, as a means for generalizability of
the results. Rosen, Reaves and Hill (1989) stated that, when choosing among the tests for a client,
psychologists should pay regard to the validity and reliability level of the test and its compliance
with the norms. The use of tests with high validity and reliability reduces biases and judgment
mistakes; and tests enable comparison of individuals with normative groups (Turchik, Karpenko,
Hammers and McNamara, 2007). The most critical issue that
should be regarded is that tests should never be used for inappropriate cases and individuals even
though they have suitable psychometric properties (Standard 8.13, Inappropriate Use of Tests
[Turkish Psychological Association, 2004]). This is mainly ascribed to the fact that, inappropriate use of
a test, outside the scope of its intended use, is very likely to result in invalid or useless inferences, which
is a really undesirable situation (Novick, 1981). Beside its validity and reliability, legal and ethical
compliance of the psychological test should also be questioned (Kaplan and Saccuzzo, 2012). In
standardized tests, test application environments and processes are basically assumed to be identical for
each person (Haney, 1981). If psychologists fail to pay enough attention to applying identical
processes in compliance with the norms, standardized norms lose their applicability and test
results come into question (Groth-Marnat, 2009; Hood and Johnson, 2008). Therefore, in so far as they
can do, psychologists should implement the tests under the conditions in which they are standardized.
Otherwise this should be explicitly stated and reliability of the results should be questioned (Matarazzo,
1990). If the use of an alternative language is outside the scope of the assessment, psychologist
should use assessment methods in accordance with the individual’s preference for language and
his/her capability to use that specific language (Standard 9.02c, Use of Assessment [APA, 2010]).
Accordingly, psychologist should determine the language used by client and client’s proficiency in
that language. Groth-Marnat (2009) suggests that, conducted assessments and used assessment tools
should be – so far as possible - in native language of clients.
2) If the test is implemented as a routine activity of an institution or a training unit (participants may
have volunteered for assessment during a job application, etc.)
Another important issue about taking informed consent is receiving the consent of individuals
with limited or impaired consent capacity. As stated in Standard 9.03b, Informed Consent in
Assessment principle, individuals with questionable capacity, or the ones subject to legal
institutions’ permission for assessment, should be informed as to the objective and procedure of
the assessment with a plain and simple language, prior to receiving their consents (APA, 2010).
The psychological assessment of elder people with impaired cognitive processes also requires
psychologists to inform clients with a plain language and receive their consent accordingly (McGuire,
2009). If psychologist will use a translation service, he/she must also receive the consent of client to use
such service (Standard 9.03c, Informed Consent in Assessment [APA, 2010]).
Release of Test Results. As the optional or obligatory release of test data is regulated by complex legal
and ethical standards, psychologists often encounter ethical contradictions in this subject (Pope and
Vasquez, 2010). Tranel (1994) stated that particularly in legal situations psychologists are often asked
for the raw test scores and this places them in an ethical dilemma between judicial requests and ethical
rules as it is strictly disapproved by ethical rules to submit raw test scores to unqualified
individuals. APA Ethics Code (2010) addresses the definition and release of test results as follows
(Standard 9.04, Release of Test Data):
(a) “Test data, raw and scaled scores involve the responses of clients to test questions or other stimuli, as
well as the notes and records taken by psychologists in relation to the dialogues or behaviors of clients.
Answers of clients to test questions are also covered by the definition of ‘test data’. Psychologists can
submit test data to clients or their assignees only upon the client’s consent. As a means for
protection of the client or third persons from possible harm or prevention of misuse or
misinterpretation of the test, psychologist may avoid releasing test data”.
(b) “In cases where no representative of the client is present, psychologists must release test data
only under legal conditions and if demanded by courts”.
Test construction. Aside from using the existing tests, psychologists can also construct new testing
tools. However some points should be considered while constructing tests. These points are addressed in
American Psychological Association’s Ethics Code (2010) as follows:
Interpreting assessment results. “While interpreting assessment results, psychologists pay regard
to various factors likely to impair the validity of their interpretations or influence their inferences,
individual’s testing skills, and other attributes of the assessed person ( language, cultural
differences, etc.), and the aim of the assessment. If psychologists are of the opinion that their
interpretations are significantly limited, they mention this issue while reporting.” (Standard 9.06,
Interpreting Assessment Results” [APA, 2010]. In this context, while interpreting assessment
results, psychologists should take into account the effect of socio-economic, ethical and
cultural factors (Suzuki and Ponterotto, 2008). While stating their opinions regarding the test
results, psychologists should also be well aware that, the assessed individual’s cultural and
social attributes and language are likely effective on the test results and they should explicitly
state the extent to which the conducted assessment could be influenced depending on these
attributes (Hambleton et al, 2005; Suzuki and Ponterotto, 2008). Psychologists must always pay
particular attention while assessing individuals that are not represented in the norm group of the
standardized test, and they must comply with testing boundaries. If nevertheless psychologists are
obliged to apply the test, they should consider the limitations in interpretation of the test
results and mention these in their report (Hood and Johnson, 2008). In case of an external
factor, which is assumed to have influence on the results of the implemented test (e.g. noisy
environment) or if the individual is under the effect of drug or other substances during
assessment, or if there is a questionable situation as to whether the individual has shared all
attributes regarding the reference group that provides basis for norms, these factors should
also be taken into account during interpretation and explicitly stated in the report (Pope and
Vasquez, 2010).
Assessment by unqualified persons. Application, scoring and interpretation of different tests necessitate
different competency levels (Campbell, Vasquez, Behnke and Kinscherff, 2010). Psychologists are
required to have received proper training to perform and interpret psychological tests, which generally
involves post-graduate education and supervision (Turner, DeMers, Fox and Reed, 2001). Psychologists
are also supposed to equip with specific skills related with psychological assessment. Such skills involve
the evaluation of strengths and shortcomings of a test, selection of suitable tests, having an insight into
the issues about the test’s reliability and validity, and interpretation of diverse results received from
various populations (Fisher, 2016; Turner et al., 2001). In this context, the person performing the test
should be aware of his/her competency boundaries and should not undertake the works that
exceed
his/her capabilities (Barnett and Brad Johnson, 2008; Kaplan and Saccuzzo, 2012). People, especially
the ones using computer-based interpretations, should be trained in this field (Murphy and
Davidshofer, 2005). According to APA Ethics Code (2010), “Psychologists do not give permission
for the use of psychological assessment techniques by unqualified people with exception of
educational works performed under supervision” (Standard 9.07, Assessment by Unqualified
Persons).
Obsolete tests and outdated test results. Psychologists should not base their assessments, decisions or
suggestions about a treatment on obsolete, invalidated and outdated information or test results
(Standard 9.08, Obsolete Tests and Outdated Test Results [APA, 2010]). Psychologists should
implement up-to-date tests and methods in their assessments (Murphy and Davidshofer, 2005).
Psychologists must also avoid making interpretations based on the tests previously performed on
individual as they may have become invalidated. Interpretations should be made on the basis of up-to-
date test data (London and Bray, 1980).
Test scoring and interpretation services. According to APA (2010) Ethics Code (Standard 9.09, Test
Scoring and Interpretation Services) and Turkish Psychological Association (2004) Ethics Code
(Standard 8.9, Test Scoring and Interpretation Services), psychologists must properly define the goals,
norms, validity, reliability and application conditions of their works while providing their colleagues
with assessment or scoring services. It is also stated in both ethics codes that, regardless of whether they
make the scoring or interpretation themselves; or whether they make use of software, psychologists
should undertake the responsibility to ensure the proper use of application, interpretation and
assessment tools.
Explaining assessment results. As long as it does not forbidden by laws or ethical principles or the
client is not negatively affected, psychologist mustn’t withhold the test results from client (Bernet
and Dulcan, 1999). “Psychologists are required to convey the test results to clients subject of
assessment or one of their representatives completely with a clear and plain language” (Standard
9.10, Explaining Assessment Results [APA, 2010]). If presentation of assessment results to the assessed
individual is not deemed proper (corporate consultancy, recruitments, forensic assessment, etc.), client
should be notified of this situation before the assessment process starts (Standard 8.10, Explaining
Assessment Results [Turkish Psychological Association, 2004]).
Maintaining test security. “Test equipment involves test materials, guidelines, various tools, protocols
and test questions. Psychologists are responsible for maintaining the integrity and security of
tests and other assessment techniques in compliance with laws and contractual liabilities and
this Ethics Code herein, also in consideration of copyrights.” (Standard 9.11, Maintaining Test
Security [APA, 2010]). Release of test materials to unqualified/untrained people is a violation
against copyrights (Tranel, 1994). Additionally, when a developed test is to be translated or
adapted or such test is to be utilized, consent of the original test’s developer or publisher must
be received. Partial modifications or reprinting of published tests should be prevented and
copyrights must be respected (Koocher and Keith-Spiegel, 1998; Oles and Davis, 1977).
Assessment in rural and low-income regions. Psychologists in regions with low socioeconomic levels
can be more likely to violate ethical rules. For instance, people living in these areas may be more
concerned about confidentiality (Hargrove, 1986). As for the case of psychological assessment in rural
areas with lower socioeconomic levels, clients may be uninsured; they may not be able to afford
services; hospitals may have limited means and sources, thus being unable to afford assessment tools
(Suzuki and Ponterotto, 2008). Most of the hospitals may still be using obsolete/disused tests.
Geographic isolation, on the other hand, is another cause for concern (Barry, Doherty, Hope, Sixsmith
and Kelleher, 2000). It was stated in a review study of Turchik et al. (2007) that, psychologists working
in such regions encounter more difficulties in consulting with their colleagues about complex
assessments as compared to psychologists working in large cities. Psychologists working in rural areas
can also have trouble in referring their clients to another competent colleague of theirs about a subject
that they feel inadequate, since such professionals are likely to be resident in far places (Turchik et al.,
2007). In another review study, competency related ethical dilemmas about assessments faced by
psychologists living in rural areas, were addressed. One of these dilemmas is that psychologists living in
these areas may from time to time be obligated to conduct the tests that they are not trained for, due to
the insufficient number of qualified professionals. In such situations, psychologists can apply such tests
under the supervision of a qualified colleague of theirs (Werth, Hastings, and Riding-Malon, 2010).
Assessment of children. Children may undergo psychological assessments for several reasons: through
guidance by school counseling, parents’ concern about the changes in child’s condition, or routine
controls (Hood and Johnson, 2008). In general, all ethical rules mentioned in this study also apply to the
assessment of children. In the case of children’s psychological assessment, however, particular attention
should be paid to the issue of receiving informed consent. Adults are deemed authorized to give
informed consent unless they are proved to legally incapacitated. However, children under the age of 18
are not deemed authorized to give an informed consent. Therefore, informed consent should be received
from the child’s parents (Pope and Vasquez, 2010).
Assessment of mentally disabled individuals. Even though patients have limited consent capacity as
a result of their mental disability, psychologists should convey the nature and goal of the
assessment to patients with a simple language and receive their consent accordingly. Patients can
be informed as to the possible consequences of their consent for psychological assessment through
use of simple expressions, open-ended questions and illustrative examples (Bernet and Dulcan,
1999). In some cases, minor modifications on standard application procedures of assessment tools are
recommended as a means for yielding more valid results during the assessment of mentally disabled
individuals. However, implementers of the tests should be previously notified of such modifications
and these modifications
and they should mention them in their reports (Lee, Reynolds and Wilson, 2003). Some of the tests other
than intelligence tests are also sensitive to the attributes of individuals such as their cognitive functions,
linguistic skills, etc. Therefore, psychologists should be notified of the modifications on these tests as
well, and they should carry out the test procedure accordingly (Whitehouse, Tudway, Look and Kroese,
2006). In case interpretation of test findings are called into question due to the mental disability of a
patient, this situation should be regarded as a limitation while conveying the test results and the
situation should be stated accordingly (Adams and Boyd, 2010). Even though few mentally disabled
people apply for a psychological assessment on their own, submission of test results and related
suggestions generally turns out to be helpful, and this may help individuals in developing healthy
coping strategies. While providing mentally disabled individuals with feedback as to their assessment
results, psychologists should consider their cognitive and verbal skills and ensure that feedbacks are
conveyed in a comprehensible form (Adams and Boyd, 2010).
CONCLUSION
With its numerous aspects such as interviews, observations and psychological tests, psychological
assessment provides critical information as to individuals’ cognitive competencies, behaviors,
personality, emotions and thoughts and psychological problems with underlying factors and their
effects on individuals’ daily lives. Although psychological assessment does not merely involve
implementation of psychological tests, the use of psychological tests holds great importance in this
process. Psychological assessment process involves specific phases. Rather than being separated by
strict lines, overlapping of these phases according to the context is crucial in terms of integrity of the
assessment process. The effect of psychologist-client relationship’s nature and feedbacks on assessment
results has been revealed by several studies. In this context, the primary aim in the psychological
assessment process should be providing a well-established relationship with the patient (Finn, 2007).
Numerous studies in the literature provide guidance to the researchers studying in this field regarding
the ethical issues and ethical rules that should be followed. Compliance to ethical rules during
psychological assessments firstly entails the internalization of ethical principles. Psychologists that are
aware of ethical principles and rules can more easily solve ethical dilemmas encountered during the
course of psychological assessment process (Pope and Vasquez, 2010). The following suggestions are
presented with a view to provide psychologists with guidance as to the application of psychological
assessment within the boundary of ethical rules:
1) Psychologists should base their assessments, impressions and suggestions upon sufficient findings,
information and techniques that prove their results.
2) When choosing among a number of tests for clients, psychologists should pay regard to the
validity and reliability level of the test and its compliance with the norms. Psychologists should
implement the tests under the conditions they are standardized.
3) Written or verbal consent should be taken only after it is ensured that the client has a complete
understanding of the nature, aim and technique of the assessment process. However consent should
be received from the parents for assessment of individuals under the age of 18.
4) During interpretation of assessment results, psychologists should take into account the effect of socio-
economic, ethical and cultural factors; and they should explicitly state the extent to which the conducted
assessment could be influenced by these attributes.
5) Implementation, scoring and interpretation of different tests require different competency levels.
Psychologists should be qualified and competent in their field and they should have received proper
training for implementation and interpretation of the test to be performed. Implementers of computed
assisted assessment methods should also be trained regarding the implementation and interpretation of
these methods.
6) ot
7) Psychologists should convey the test results to clients or one of their representatives completely with
a clear and plain language.
9) During psychological assessment of mentally disabled individuals, psychologists can make minor
modifications on standard application procedures of assessment tools to obtain more valid results.
Implementers of the test should be previously notified of this situation and they should mention such
situations in their reports.
10) Psychologists applying the tests should pay particular attention to establishing a good
relationship with the client.
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