• MEASURES/TESTS used in clinical settings should

LECTURE 4: THE CLINICAL provide clinical utility as well.

INTERVIEW – Clinical utility means an assessment
technique improves delivery of services or
client outcome.
THE CLINICAL INTERVIEW
• Clinical psychologists conducting assessments can
• The first major topic on techniques of assessment. employ a wide variety of methods, including
intelligence tests, achievement tests,
• ASSESSMENT is closely and uniquely associated neuropsychological tests, personality tests, and
with the identity of clinical psychology. specialized measures for targeted variables.
• None of the other mental health professionals • Any assessment technique used by a clinical
incorporate assessment into their training and their psychologists should possess the qualities of validity,
work to the extent clinical psychologists do. reliability, and clinical utility.
• Clinical psychologists gather assessment data by – VALIDITY - measures what it claims to
talking to clients, administering tests, and by observing measure
them.
– RELIABILITY - the measure yields
• INTERVIEWS consistent, repeatable results
– are used in overlapping ways for both clinical • An element common to all kinds of psychological
assessment and psychotherapy. assessment is feedback.
– play an important role in the development of a – In other words, clinical psychologists
collaborative relationship between a psychologist and provide their clients with the results of tests or
client. interviews that have been conducted
– are the most common strategy to gather information (American Psychological Association, 2002).
necessary to make a diagnosis and serve many • Overall, the vast majority of clinical psychologists
additional purposes. use interviews, and few assessments are conducted
– Interview data include material that cannot be easily without an interview of some kind.
assessed in psychometric tests and that is important in
generating hypotheses.
THE INTERVIEWER
• The most pivotal element of a clinical interview is
CLINICAL ASSESSMENT the person who conducts it.
INTERVIEWS GENERAL SKILLS
• QUIETING YOURSELF
• Does not simply mean that the interviewer shouldn’t
talk much
• Rather than the interviewer’s speech, what should be
quieted is the interviewer’s internal, self-directed
thinking pattern.
• BEING SELF-AWARE is another important skill
for the clinical interviewer.
– The ability to know how he or she tends to
affect others interpersonally and how others
tend to relate to him or her.
 – Every interviewer has a distinct combination • Use the pitch, tone, volume, and fluctuation in your
of idiosyncratic qualities - looks, voice, voice to let clients know that their words and feelings
mannerisms, etc. - that may evoke certain are deeply appreciated.
responses from clients.
• Pay attention as well the vocal quality of the client
– Skilled interviewers are cognizant of their
VERBAL TRACKING
unique traits have an effect on the interview
process • Effective interviewers are able to repeat key words
and phrases back to their clients to assure the clients
• Good interviewers appreciate the importance of
that they have been accurately heard thus showing that
developing positive working relationships with
you are paying attention to what the client says
clients.
• Not done in a mechanical way (rephrase or
– A good start to the working relationship
summarize)
benefits both parties
• Interviewers skilled at verbal tracking monitor the
– Attentive listening, appropriate empathy,
train of thought implied by clients’ patterns of
genuine respect, and cultural sensitivity play
statements and are thus able to shift topics smoothly
significant roles.
rather than abruptly.
– Positive working relationships are always a
REFERRING TO THE CLIENT BY THE
function of the interviewer’s attitude as well as
PROPER NAME
the interviewer’s actions.
• Using the client’s name correctly is essential
SPECIFIC BEHAVIORS
• Inappropriately using nicknames or shortening names
• It is necessary to master the tools of the trade, namely
are presumptuous mistakes that, for some clients, can
the specific behaviors characteristic of effective
jeopardize the sense of comfort with the interviewer.
interviewers.
• Ask clients how they prefer to be addressed - this can
– Note: Be culturally sensitive when you
be seen as a sign of consideration
execute these behaviors.
OBSERVING CLIENT BEHAVIORS
• A primary task of the interviewer is to listen.
• The previous interview behaviors discussed can be
– Listening may seem like a simple enough
informed by behavioral observations of the client by
task, but it can be broken down into even more
the interviewer.
fundamental building blocks of attending
behaviors. • Psychological reports contain a brief section
describing the behavior of the client during the
EYE CONTACT
process. (e.g., is the client calm or nervous? Listens to
• There is a connection between attentive listening and instructions? Did they ask any questions or
eye contact. clarifications? Do they look well groomed?, etc.)
• When the client notices the interviewer’s continuous, • Provides information on the “how” component
appropriate eye contact, the client feels heard.
• In general, the interviewer should carry out all these
• Scarce, inconsistent eye contact may be viewed by attending behaviors naturally and authentically
some clients as inattentive or insulting (Ivey et al., 2010).
BODY LANGUAGE • Be aware of cultural differences esp. on eye contact,
physical touch, physical distance (“personal space”).
• Culture can shape the connotations of body language
• Guidelines: face the client, appear attentive,
minimize restlessness, and display appropriate facial COMPONENTS OF THE INTERVIEW
expressions.
• Several components are universal to interviews:
VOCAL QUALITIES rapport, technique, and conclusions.
• Pertains not just to words, but how those words
sound to the client’s ears
RAPPORT
• Refers to a positive, comfortable relationship • With indirect questions, the client can expand on
between interviewer and client. anything he/she believes is essential
• Strong rapport - makes clients feel that the • Both directive and nondirective approaches have
interviewer empathizes and has “connected” with shortcomings
them
– DIRECTIVE QUESTIONING – client do
– In turn, clients tend to disclose more not get the chance to express themselves or
information and invest themselves further in what they think is important
the interview process
– NONDIRECTIVE QUESTIONING - fall
STEPS TO ENHANCE THE CLIENT’S short in terms of gathering specific
EXPERIENCE OF RAPPORT: information
• 1. Make an effort to put the client at ease, especially • Aim for balance and versatility
early in the interview session (small talk at the
• At the start of the interview, it may be wise to allow
beginning helps).
clients to speak freely to communicate what they think
• 2. Acknowledge the unique, unusual situation of the is most important. Thus, no direction form the
clinical interview (convey that you recognize their interviewer initially.
position, invite clients to ask questions).
• Later in the session, the interviewer can become
• 3. Enhance rapport by noticing how the client uses more directive, asking the remaining targeted
language and then following the client’s lead (pick up questions and soliciting more limited answers.
on the client’s vocabulary and speak in similar terms).
SPECIFIC INTERVIEWER RESPONSES:
TECHNIQUE
• interviewing technique consists of what the
Technique is what an interviewer does with clients. interviewer chooses to say
DIRECTIVE VERSUS NONDIRECTIVE • Open- and closed ended questions, clarification,
INTERVIEW STYLES confrontation, paraphrasing, reflection of feeling, and
summarizing.
• DIRECTIVE STYLE – used to get exactly the
information they need by asking clients specifically for • When formulating questions, clinicians should
it. consider:
– Directive questions tend to be targeted – What it is they want to elicit
toward specific pieces of information, and
– How that information will advance the
client responses are typically brief.
therapeutic process
– Provides critical data
– What they want to focus on or emphasize
• NONDIRECTIVE STYLE – allows the client to with their questions
determine the course of the interview.
– What tone they want to establish in their
– Without direction from the interviewer, a session
client may choose to spend a lot of time on
The major difference between open and closed
some topics and none on others.
questions “is whether or not the question encourages
• DIRECT QUESTIONING can provide crucial data more client talk.”
that clients may not otherwise choose to discuss:
OPEN- AND CLOSED-ENDED QUESTIONS
• important historical information
• the presence or absence of a particular symptom of a • OPEN-ENDED QUESTIONS - allow the client to
disorder provide elaborate responses and cannot be
• frequency of behaviors answered with a simple yes or no
• duration of a problem
• Designed to elicit narration
• Allow for individualized and spontaneous responses
• INDIRECT QUESTIONING can provide crucial
from clients.
information that interviewers may not otherwise know
to inquire about.
• Open questions encourage clients to talk at greater interviewer is paying attention and
length; promotes exploration comprehending
• Considered more powerful and productive • Not prompted by the interviewer’s need to resolve or
clarify what a client has said.
• Often begin with “how,” “could,” “what,” “why”
• E.g., “How does this affect you?”
REFLECTION OF FEELING
• CLOSED-ENDED QUESTIONS – requires a
specific and limited response • Echoes the client’s emotions
• can be answered with a single word or a few words. • • Reflections of feeling are intended to make clients
Less elaboration and less self-expression by the client; feel that their emotions are recognized, even if their
quick and precise answers comments did not explicitly include labels of their
feelings.
• Closed questions ask for a specific piece of
information. • Unlike paraphrasing, reflecting a client’s feelings
often involves an inference by the interviewer about
• Often begin with “who,” “where,” “are,” “you,” and
the emotions underlying the client’s words.
“do.”
SUMMARIZING
• E.g., “Do you enjoy meeting other people?”
• Usually involves tying together various topics that
CLARIFICATION
may have been discussed, connecting statements that
• Clarification question - purpose is to make sure the may have been made at different points, and
interviewer has an accurate understanding of the identifying themes that have recurred during the
client’s comments. interview.

• Clarification questions not only enhance the • Lets clients know that they have been understood but
interviewer’s ability to “get it,” they also communicate in a more comprehensive, integrative way.
to the client that the interviewer is actively listening
• An accurate summarization conveys to the client that
and processing what the client says.
the interviewer has a good grasp on the “big picture.
CONCLUSIONS
• Typically, clinical interviews involve a conclusion of
some kind made by the interviewer.
• Clarification questions allow the client to correct the
interviewer • In some cases, the conclusion can be essentially
similar to a summarization.
• Note: Sometimes, it’s better to wait than to
immediately demand clarification – do not interrupt • Can be used to provide an initial conceptualization of
clients; may be seen as insensitive. the client’s problem (e.g., specific diagnosis) or give
recommendations.
CONFRONTATION
• Used when there are discrepancies or inconsistencies
in a client’s comments. PRAGMATICS OF THE INTERVIEW
• Can be similar to clarifications, but they focus on NOTE TAKING
apparently contradictory information provided by
clients. • There is little consensus about note taking among
clinical psychologists.
PARAPHRASING
• Advantage: Written notes are certainly more reliable
• Used simply to assure clients that they are being than the interviewer’s memory.
accurately heard.
• Disadvantages: Note taking can be a distraction,
– typically, restate the content of clients’ interviewer may fail to notice important client
comments, using similar language; maintains behaviors, and for the client, who may feel that the
the conversation by assuring the client that the interviewer’s notebook is an obstacle to rapport.
• Aim for a middle ground in note taking – write only • The intake interview determines whether the client
essential highlights. needs treatment; if so, what form of treatment is
needed (inpatient, outpatient, specialized provider,
AUDIO AND VIDEO RECORDINGS
etc.); and whether the current facility can provide that
• Recording a client’s interview requires that the treatment or the client should be referred to a more
interviewer obtain written permission from the client. suitable facility.
• For some clients, recording may hinder openness and
• Make clients comfortable, focus on the person of the
willingness to disclose information.
client, including listening to the client’s story and
• An explanation of the rationale for the recording, as presenting issues.
well as its intended use and a date by which it will be
• Genuine concern and interest - promotes rapport and
erased or destroyed, is typically appreciated by the
a collaborative therapeutic alliance.
client.
• Two most important microskills for rapport building
are basic attending behavior and client-observation
THE INTERVIEW ROOM
skills.
• As a general rule, “when choosing a room [for
interviews], it is useful to strike a balance between
professional formality and casual comfort.”
– Professional but with warmth and comfort
SEATING ARRANGEMENT
– Traditional, psychoanalytic style – client lies
on a couch - rare nowadays
– Client and interviewer sit face-to-face –
Interviewer and client in chairs at an angle
between 90 degrees and 180 degrees
DIAGNOSTIC INTERVIEWS
– A table or desk may be positioned between
the chairs, small side tables may accompany • The purpose of the diagnostic interview is to
each chair, or the chairs may have no furniture diagnose.
between them at all.
• At the end of a well-conducted diagnostic interview,
• Clinical psychologists usually steer clear of overtly the interviewer is able to confidently and accurately
personal items such as family photos, souvenirs, and assign a DSM diagnoses to the client’s problems.
memorabilia.
• It would make sense for the diagnostic interview to
CONFIDENTIALITY include questions that relate to the criteria of DSM
disorders.
• Many people incorrectly assume that any session
with a psychologist is absolutely confidential. STRUCTURED VERSUS UNSTRUCTURED
INTERVIEWS
• To inform their clients about confidentiality, and
correct any misconceptions - interviewers should • STRUCTURED INTERVIEW - a predetermined,
routinely explain policies regarding confidentiality as planned sequence of questions that an interviewer
early as possible. asks a client.
– Structured interviews are constructed for
particular purposes, usually diagnostic
TYPES OF INTERVIEWS
• UNSTRUCTURED INTERVIEW – in contrast,
INTAKE (OR INITIAL) INTERVIEWS involves no predetermined or planned questions.
• Primary purpose: for clinicians to obtain enough • In unstructured interviews, interviewers improvise:
information on client’s history, current situation, They determine their questions on the spot, seeking
presenting problems, and characteristics information that they decide is relevant during the
• Intake interviews typically involve detailed course of the interview.
questioning about the presenting complaint.
 – Such interviews may include
unstructured segments, typically at the
beginning of the interview.

ADVANTAGES OF STRUCTURED MENTAL STATUS EXAM

INTERVIEWS • Employed most often in medical settings
• Its primary purpose is to quickly assess how the
client is functioning at the time of the evaluation.
• Outcome: its yield is usually a brief paragraph that
captures the psychological and cognitive processes of
an individual “right now” - like a psychological
snapshot.
• The format of the mental status exam is not
DISADVANTAGES OF completely standardized.
STRUCTURED INTERVIEWS
• Main categories are typically covered:
– Appearance
– Behavior/psychomotor activity
– Attitude toward interviewer
– Affect and mood
– Speech and thought
– Perceptual disturbances
– Orientation to person, place, and time
• In the early days of clinical psychology, structured – Memory and intelligence
interviews were uncommon, but in recent years they – Reliability, judgment, and insight
have become more accepted and in many settings
preferred. • The mental status exam is not intended as a
meticulous, comprehensive diagnostic tool.
– E.g., Anxiety and Related Disorders
Interview Schedule for DSM-5 • Instead, it is intended for brief, flexible
administration, primarily in hospitals and medical
– Structured Clinical Interview for DSM-5
centers, requiring no manual or other accompanying
Disorders (SCID) – most prominent materials.
structured interview; it is essentially a
comprehensive list of questions that directly CRISIS INTERVIEWS
ask about the specific symptoms of the many
disorders included in the DSM. For the most • a special type of clinical interview and can be
part, each question in the SCID has a one-to- uniquely challenging for the interviewer.
one correspondence with a specific criterion of
a DSM diagnosis. • Purpose that extend beyond mere assessment

• The SCID is modular, which means that • They are designed not only to assess a problem
interviewers can choose only those modules demanding urgent attention (most often, clients
(or sections) of the SCID that are relevant for a actively considering suicide or another act of harm
particular clinical case and omit the other toward self or others) but also to provide immediate
modules. and effective intervention for that problem (direct
and action-oriented).
• In actual practice, quite a few clinical
psychologists blend these approaches to – Crisis counseling is the employment of a
conduct an interview that may be labeled as a variety of direct and action-oriented
partially structured or semistructured approaches to pragmatically help individuals
interview. find resources within themselves and/or
deal externally with crisis.
 • (4) STORYTELLING – focuses attention on the
• Providing an immediate, legitimate alternative to counsellor
suicide can enable the client to endure this period of
very high distress and reach a later point in time when
problems may feel less severe or solutions may be
more viable.

• Sometimes, interviewers in these situations ask

clients to sign or verbally agree to suicide prevention LECTURE 5: ASSESSMENT:
contracts (often called “no-suicide contracts”).
– may have the unintended negative effect – INTELLECTUAL,
legal liability of the psychologist NEUROPSYCHOLOGICAL,
– Alternative: “commitment to treatment” PERSONALITY AND
statements, which essentially involve a BEHAVIORAL TESTING
promise to keep working toward improvement.

CULTURAL COMPONENTS INTELLECTUAL AND

NEUROPSYCHOLOGICAL
Appreciating the Cultural Context ASSESSMENT

• Interviewers should possess sufficient knowledge ● Measuring cognitive performance has been a
about culture - their own as well as their clients’ - to hallmark of clinical psychology since its origin.
understand the meaning of interview material within
the appropriate cultural context. ● Knowing a client’s level of cognitive functioning
(including both strengths and deficits) can help a
• Behaviors, thoughts, or emotions that might be clinical psychologist with diagnosis and treatment of
viewed as abnormal or pathological by some cultural many presenting problems.
standards may in fact be normal according to others.
● Some cases focus on cognitive issues: specific
• Clinical psychologists also make adaptations to learning disorders or giftedness.
cultural expectations or norms when conducting the
interview. ● Throughout the years, psychologists have made
many attempts to define intelligence.
ACKNOWLEDGING CULTURAL
DIFFERENCES ● These include both broad definitions, such as the
ability to learn or to adapt to the environment, and
• It is often wise for the interviewer to acknowledge narrow definitions, such as the ability to engage in
these cultural differences openly abstract thinking (Aiken, 2003).

• In many cases, it is appropriate for the interviewer to INTELLIGENCE TESTING

inquire directly about cultural background to become
more informed about the client’s perspective CLASSIC THEORIES OF INTELLIGENCE

NONHELPFUL INTERVIEW ● Clinical psychologists have never reached a

BEHAVIOR consensus regarding the definition of intelligence.
● Central issue - is intelligence one thing or many
things?
• Four major actions that usually block counselor–
client communication and should be generally avoided:
• CHARLES SPEARMAN – Intelligence is a
singular characteristic
• (1) ADVICE GIVING – disempowering to the
client; exception – crisis counseling
• Spearman labeled this characteristic “g” for general
intelligence and argued that it represented a person’s
• (2) LECTURING (PREACHING) – disguised form
global, overall intellectual ability.
of advice giving
• In measuring different cognitive abilities, Spearman
• (3) EXCESSIVE QUESTIONING – client feels
found that a strong correlation between these abilities,
interogated
suggesting that a single factor underlies them all.
• Spearman acknowledged that more specific factors ● JOHN CARROLL’S (2005) three-stratum theory
(“s”) existed, but he argued that they played a of intelligence, in which intelligence operates at three
relatively minor role in intelligence. Spearman’s focus levels: a single “g” at the top, eight broad factors
on “g” and “s” was known as the two-factor model. immediately beneath “g,” and more than 60 highly
specific abilities beneath these broad factors.
● LOUIS THURSTONE – strongly opposed ○ This model, like most contemporary
Spearman’s singular theory of intelligence. He argued models of intelligence, not only
that intelligence is not one thing; it is many things. acknowledges “g” but also recognizes
● Intelligence should be understood as numerous that more specific abilities exist as
distinct abilities that have little relationship to one well.
another.
● Most contemporary intelligence tests mirror
● Thurstone pioneered multiple factor analysis, this view by producing a single overall score -
which enabled him to identify underlying factors in a one number to represent how intelligent a
large data set. In testing various intellectual abilities, person is - in addition to a number of other
he found several independent factors (not one scores representing more specific abilities.
dominant factor). The Wechsler and Stanford-Binet intelligence
tests are primary among these.
● Eventually, Spearman an Thurstone each
acknowledged the validity of the other’s arguments In the 1980s, two influential information
and came to somewhat of a compromise. processing models of intelligence were
developed.
○ They settled on a hierarchical model of
intelligence in which specific abilities (“s”) ● ROBERT STERNBERG’S (1985)
existed and were important, but they were all triarchic theory
at least somewhat related to one another and to ○ Sternberg argues that there are three
a global, overall, general intelligence (“g”). basic kinds of intelligence -
analytical, creative, and practical -
and that conventional tests measure
only the first kind well. He developed
a test designed to measure all three
(Sternberg Triarchic Abilities Test, or
STAT).

○ A key theme in Sternberg’s theory

is that intelligence should be
understood as something that makes a
person successful in life generally, not
just in academic settings and that
intelligence tests should measure the
factors leading to success.
MORE CONTEMPORARY THEORIES OF
● HOWARD GARDNER - theory of
INTELLIGENCE
multiple intelligences.
● HIERARCHICAL MODELS - hierarchical model
○ Lists eight intelligences or frames
theorists have proposed that there are a small number
of mind: verbal, mathematical, spatial,
of main factors that are comprised of subfactors
bodily–kinesthetic, musical,
intrapersonal, interpersonal, and
● RAYMOND CATTELL proposed two separate
naturalistic.
intelligences:
○ these different types of intelligence
○ FLUID INTELLIGENCE - the ability to
are inadequately assessed by
reason when faced with novel problems
traditional intelligence tests. Gardner
argued that a culturally unbiased
○ CRYSTALLIZED INTELIGENCE - the
assessment requires recognition of the
body of knowledge one has accumulated as a
full range of different types of
result of life experiences; what we have
intelligence.
learned in life, both from formal education and
general life experiences
 ○ According to Gardner’s model, FOURTH EDITION (WPPSI-IV) - designed
instead of asking, “How intelligent are to assess children in the age range from 2
you?” a better question is “How are years 6 months to 7 years 7 months.
you intelligent?”
● The three Wechsler intelligence tests share many
fundamental characteristics:
Assessing Intelligence: The
○ They yield a single full-scale intelligence
Clinical Context score, four or five index scores, and about a
dozen (give or take a few, depending on
● The assessment of intelligence is often an integral optional subtests chosen) specific subtest
component of a psychological assessment. scores (the Wechsler tests employ a
hierarchical model of intelligence).
● Psychologists are careful to differentiate between
intelligence test scores and intelligence per se. ○ They are administered one-on-one and face-
to-face.
○ Commonly used intelligence tests do not
tap the full range of abilities that are ○ Each subtest is brief (about 2–10 mins.) and
included in modern theories of intelligence. consists of items that increase in difficulty -
Tests tend to focus on those abilities related to the subtests are designed such that examinees
academic performance and are not designed to continue until they fail a predetermined
measure social, emotional, and other domains. number of consecutive items (or “max out,” to
state it informally)
● Intelligence tests have only limited content validity
for the broader construct of intelligence (as currently ● The early versions of the WAIS, WISC, and WPPSI
understood), any result on an intelligence test does not provided three main summary scores: Verbal IQ
fully represent a person’s total intelligence. (VIQ), Performance (non-verbal) IQ (PIQ), and
Full Scale IQ (FSIQ; the sum of Verbal and
WESCHLER INTELLIGENCE TESTS Performance scales).

● David Wechsler - developer of the Wechsler ○ Today, the original verbal/performance split
intelligence scales. His name is synonymous with has been replaced by four or five factors,
intelligence testing. each receiving contributions from several
subtests.
● The Wechsler intelligence scales are the most
commonly taught and used individually administered ○ The WAIS has four factors: Verbal
measures of intelligence. Comprehension Index, Perceptual
Reasoning Index, Working Memory Index,
● These scales allows for testing of people across and Processing Speed Index.
almost the entire age range.
● Each Weschler test feature large, carefully collected
● For the past few decades these scales have been sets of normative data. The examinee’s performance
developed in ways that have drawn on contemporary is compared with the performance of a large, same-age
research on intelligence and enhanced the quality of sample of individuals representing a wide-scale
the scales’ psychometric properties and norms. national population.

There are three main Wechsler intelligence scales: ● The full-scale and index scores generated by the
Wechsler tests are “IQ” scores, meaning that they
○ WECHSLER ADULT INTELLIGENCE reflect an intelligence “quotient.”
SCALE - FOURTH EDITION (WAIS-IV) -
designed to assess individuals in the age range ○ The Wechsler intelligence tests share a
of 16 to 90 years general approach to interpretation of scores.
Assessors are instructed to first consider the
○ WECHSLER INTELLIGENCE SCALE full-scale IQ score.
FOR CHILDREN-FIFTH EDITION
(WISC-V) – designed to assess children and ● The Wechsler intelligence tests are all backed by
adolescents in the 6 to 16 age range very impressive psychometric data.
● The Wechsler intelligence tests - and most other
○ WECHSLER PRESCHOOL AND intelligence tests, for that matter - are used for a wide
PRIMARY SCALE OF INTELLIGENCE- range of clinical applications, including
 ○ evaluations that focus on issues of ○ subtests - include extensions at the low and
intellectual disability (intellectual high ends - a greater number of very easy and
developmental disorder) developmental very difficult items - as an effort to more
delays, giftedness, educational and vocational accurately assess people at the extremes.
planning, school placement and qualification,
and other targeted assessment questions. ● Perhaps the most important difference between the
○ they can also be used to provide general SB5 and the Wechsler tests involves their specific
intelligence information in broader contexts. factors and subtests. Whereas the Wechsler tests
feature four or five factors, each of which yields an
● The Wechsler intelligence tests were among the first index score, the SB5 features exactly five. Each of
to become available on a digital platform as an these five factors is measured both verbally and
alternative to the traditional pencil-and-paper format. nonverbally.

NOTABLE STRENGTHS OF THE WESCHLER

TESTS:

• Impressive reliability and validity

• Feature comprehensive and recent normative data
• Cover an extremely wide age range
• Provide full-scale, index, and subtest scores that have
great clinical utility;
• They are very familiar to most clinical psychologists

LIMITATIONS/CRITICISMS: ADDITIONAL TESTS OF INTELLIGENCE:

ADDRESSING CULTURAL FAIRNESS
• Some subtests may be culturally loaded or biased
• The connection between the tests and day-to-day life ● One of the primary criticisms of the Wechsler tests,
(ecological validity) may be limited, the SB5, and other renowned IQ tests has centered on
• Scoring can be complex or subjective on some issues of cultural fairness.
subtests
● These tests have been described as featuring
STANFORD-BINET INTELLIGENCE numerous subtests, especially those relying on verbal
SCALES - FIFTH EDITION skills, that place individuals from minority cultural
groups at a disadvantage - it may unfairly assess the
● The first editions of the Stanford-Binet intelligence intelligence of people of other cultures.
test dominated the field in the early 1900s until the
Wechsler tests began to provide competition. ● A leading example of such a test is the Universal
Nonverbal Intelligence Test-2 (UNIT-2; Bracken &
● Most recent revision: the Stanford-Binet McCallum, 2009, 2015; McCallum & Bracken, 2005,
Intelligence Scales-Fifth Edition (SB5) – similar to 2018) - a completely language-free test of intelligence.
the Wechsler tests in many ways.
● However, UNIT-2 assesses a more limited range of
○ Administered face-to-face and one-on-one abilities than more traditional IQ tests; it is appropriate
only for young clients (no version for preschool
○ Employs a hierarchical model of intelligence children or adults older than 21 has yet been
and therefore yields a singular measure of full- developed); and its psychometric data, although
scale IQ (or “g”), five factor scores, and many encouraging, is limited in quantity.
more specific subtest scores.
● The structure and format of the UNIT-2 remain
● Its psychometric data, including reliability and unfamiliar to many clinical psychologists.
validity, are similarly strong.
MORE FAMILIAR CULTURE FREE TEST IS
● Difference of the SB5 from the Wechsler tests: THE CFIT – CULTURE FREE
○ The SB5 covers the entire life span (ages 2– INTELLIGENCE TEST
85+) as a single test ○ includes normative data
from individuals with specific relevant
diagnoses, including learning problems,
intellectual disability (intellectual
developmental disorder), and ADHD.
 ● Neuropsychological tests can indicate how the
brain is actually functioning.

○ Neuropsychological tests are intended to

measure cognitive function and dysfunction
and, in some cases, to localize impairment to a
particular region of the brain.

Such tests are especially useful for targeted

assessment of problems that might result from a head
injury, prolonged alcohol or drug use, or a
degenerative brain illness.
ACHIEVEMENT TESTING
Neuropsychological tests can also be used to make a
ACHIEVEMENT VERSUS INTELLIGENCE prognosis for improvement, plan rehabilitation,
determine eligibility for accommodations at school or
● Intelligence pertains to cognitive capacity; work, and establish a baseline of neuropsychological
intelligence is what a person can accomplish abilities to be used as a comparison at a later time.
intellectually.
● Today, the field has evolved from a “fixed-battery
● Achievement is what a person has accomplished, phase” in which psychologists typically use the same
especially in the kinds of subjects that people learn in standard set of tests for most clients to a more
school, such as reading, spelling, writing, or math. “flexible-battery phase” in which psychologists
create a more customized battery by picking and
● Achievement tests measure proficiency at certain choosing tests after considering the specific referral
tasks; that is, they measure how much people know or questions and areas of concern.
how well they can perform in specific areas.
● Psychologists who use neuropsychological tests have
● Achievement tests are commonly used when also become more increasingly aware of
assessing for specific learning disorder. neuropsychological assessment anxiety, an
experience in which clients’ performance on these tests
● Prior to DSM-5, the comparison of intelligence and is influenced by the anxiety
achievement was a key factor in determining learning
disabilities. ○ attention, verbal memory, working memory
are especially vulnerable to decrease
○ In DSM-5, “learning disability” is now
called specific learning disorder - the ● Examples of full neuropsychological batteries:
primary comparison is between the person’s Halstead Reitan Neuropsychological Battery (HRB),
achievement (as measured by achievement Neuropsychological Battery (LNNB).
tests and performance at school or work) and
expected levels of achievement for people of ● Brief neuropsychological tests: Bender Visual-
the same age (American Psychiatric Motor Gestalt Test-Second Edition (Bender-Gestalt-
Association, 2013). II), Rey-Osterrieth Complex Figure Test, Repeatable
Battery for the Assessment of Neuropsychological
THE WECHSLER INDIVIDUAL Status (RBANS), and Wechsler Memory Scale-Fourth
ACHIEVEMENT TEST—THIRD EDITION Edition (WMS-IV.
(WIAT-III) is a comprehensive achievement test
for clients aged 4 to 50 years.
PERSONALITY AND
○ measures achievement in four broad areas:
reading, math, written language, and oral BEHAVIORAL ASSESSMENT
language.
MULTIMETHOD ASSESSMENT
NEUROPSYCHOLOGICAL
TESTING ● No measure of personality or behavior is perfect.

● The intent of neuropsychological tests is to measure ○ it is important for clinical psychologists not
cognitive functioning or impairment of the brain and to rely exclusively on any single assessment
its specific components or structures. method
 ○ typically involve a series of direct, brief
● Personality is best assessed by using multiple statements or questions and either true/false or
methods, including tests of different types, interview multiple-choice response options in which
data, observations, or other sources. clients indicate the extent to which the
statement or question applies to them
○ Each method offers a unique perspective on
the client, and often they converge on similar ● In contrast, projective personality tests feature
conclusions. ambiguous stimuli and an open-ended range of client
responses.
● The advantages of multimethod assessment
○ based on the assumption that clients reveal
■ Each method offers a unique perspective, their personalities by the way they make sense
and although some may be more enlightening of vaguely defined objects or situations.
than others, it is the integration of multiple
methods that ultimately proves most
informative. MINNESOTA MULTIPHASIC
PERSONALITY INVENTORY-2 (MMPI-2)
EVIDENCE-BASED ASSESSMENT
● Both the most popular and the most
● Clinical psychologists who practice evidence-based psychometrically sound objective personality test used
assessment select only those methods that have strong by clinical psychologists.
psychometrics, including reliability, validity, and
clinical utility. ○ 567 true or false self-descriptive sentences ○
the items span a wide range of behavior, feelings, and
● Clinical psychologists also select tests that have attitudes
sufficient normative data and are sensitive to issues of
diversity such as age, gender, race, and ethnicity.

● Clinical psychologists typically target their

assessment strategies toward a particular diagnosis or
problem

○ Using the Beck Depression Inventory for

diagnosing depression in adults

● The original MMPI (created by Starke Hathaway

CULTURALLY COMPETENT and J. C. McKinley) was published in 1943.
ASSESSMENT
○ Their objective was to find an objective way
● Essential in personality assessment as every culture to measure psychopathology
has its own perception of “normal” and its own
variations of “abnormal” ○ Hathaway and McKinley created a list of
items that empirically elicit different responses
● A primary danger lies in the possibility of from people in these normal and abnormal
overpathologizing - that is, viewing as abnormal that groups. This was done using a method of test
which is culturally normal. construction called empirical criterion
○ In other words, the clinical psychologist keying.
must appreciate the meaning of a behavior,
thought, or feeling within the context of the ■ Distinct groups answer the test and
client’s culture. If an item elicits different responses
from one group than from another, it’s
OBJECTIVE PERSONALITY TESTS a worthy item and should be included
on the final version of the test.
● Personality tests can be placed in one of two ● In empirical criterion keying - it matters only
categories: objective and projective. whether an item does, in actuality, differentiate two
groups.
● Objective personality tests include unambiguous
test items, offer clients a limited range of responses, ○ According to the empirical criterion keying
and are objectively scored. method, only if the two groups actually
 respond differently to the item should it be ● Another important feature introduced by the MMPI
included on the final version of the test. (and retained in the MMPI-2) was a way to assess
clients’ test-taking attitudes.
○ E.g., “I have visions of things that aren’t real
and that other people can’t see.” ○ self-report instruments are vulnerable to
insincere efforts by the client.
○ Hathaway and McKinley evaluated the items
on distinct groups consisted of people who had ○ Social desirability bias
been diagnosed with particular mental
disorders (e.g., depressed, paranoid, ○ Some clients may intentionally exaggerate
schizophrenic etc.)and a group of “normals.” their symptoms (“fake bad”) to appear more
impaired than they really are; others may
● From a pool of more than 1,000 potential items, only intentionally minimize their symptoms (“fake
550 were retained after the empirical criterion keying good”)
method was complete.
○ Still other clients may respond randomly
● The MMPI has 10 clinical scales (each scale refer to without paying much attention to items at all.
very familiar and common clinical issues.

○ The higher a client scored on a particular

scale, the greater the likelihood that he or she
demonstrated that form of psychopathology.

○ The 10 clinical scales remain the same in the

MMPI-2 to maintain continuity (even if some
terms are antiquated)

● The MMPI and MMPI-2 include a number of items

designed to “catch” these test-taking attitudes. When
responses to these items are grouped together, they
constitute the test’s validity scales.

○ The MMPI and MMPI-2 contain three

specific validity scales: L (Lying, suggesting
“faking good”), K (Defensiveness, also
suggesting “faking good”), and F
(Infrequency, suggesting “faking bad”).

● These validity scales inform the clinical psychologist

about the client’s approach to the test and allow the
psychologist to determine whether the test is valid and
what kinds of adjustments might be appropriate during
the process of interpreting the clinical scales.

● The MMPI-2 came out in 1989

○ Addressed the inadequate normative sample

of the original MMPI

○ Revised statements with outdated or

awkward wording/s.

● MINNESOTA MULTIPHASIC PERSONALITY

INVENTORY-ADOLESCENT (MMPI-A)

○ for clients aged 14 to 18 years; published in

1992
 ○ true/false, pencil-and-paper test consisting of
478 items Criticisms of the MMPI and MMPI-2:

○ Some items target common teen issues such ● too lengthy

as school, family, substance use, and peer
relations. ● requiring reading ability and prolonged attention
beyond the capability of some clients
● Interpretation of the MMPI:
○ After considering the validity scores, clinical ● being susceptible to “faking” by sophisticated clients
psychologists interpret the MMPI-2 or MMPI- who can outwit the validity scales.
A by considering the clinical scale scores most
elevated above normal levels. ● A final criticism of the MMPI tests focuses on their
emphasis on forms of psychopathology as the factors
○ As shorthand, clinical psychologists often that make up personality.
use the elevated scale numbers (“code-types”)
to refer to a client’s profile, as in, “her MMPI- ● The clinical scales of the MMPI tests describe a
A profile is a 3/6” client’s personality by describing the extent to which
the client has various pathologies (depression,
○ Once high clinical scales are identified, schizophrenia, etc.) as opposed to emphasizing other
clinical psychologists turn to the empirical aspects of personality, such as normal traits or
literature describing clients with that pattern of strengths.
elevations (interpretive information)
● Other objective personality tests:
● In addition to the 10 clinical scales, a number of
additional scales - known as supplemental scales and PERSONALITY ASSESSMENT INVENTORY
content scales - have been developed to measure other, (PAI) - 344 items; 18 to 89 years old
often more specific aspects of personality and
pathology MILLON CLINICAL MULTIAXIAL
INVENTORY-IV (MCMI-IV) – emphasizes
● In late 2008, a new, shorter version of the MMPI-2 personality disorders
was released - The MMPI-2 Restructured Form
(MMPI-2-RF) ○ Like MMPI, PAI and MCMI-IV
emphasizes the pathological aspects of
○ contains only 388 of the 567 items on the personality
MMPI-2
NEO PERSONALITY INVENTORY-3 by Paul
○ 10 clinical scales Costa and Robert McCrae

○ assesses “normal” personality characteristics; 240

items

○ Measure the Big Five personality traits

● The MMPI-2, MMPI-2-RF, and MMPI-A are

currently used for a wide variety of purposes in a wide
variety of settings. They are considered
comprehensive tests of personality characteristics
and psychopathology, and they can be helpful in
forming Diagnostic and Statistical Manual of Mental
Disorders (DSM) diagnoses and suggesting placement
(e.g., inpatient vs. outpatient) and treatment.

● An unusual of the MMPI-2 - as therapeutic

assessment (TA) ● NEO-PI-3 also produces 30 “facet” scores (six facets
within each of the five domains) to offer more specific
○ TA involves the use of psychological testing descriptions of components within each trait
- including feedback about the results - as a
brief therapeutic intervention.
● A short form of this test (with 60 items), the NEO
Five Factor Inventory (NEO-FFI), is also available ● For much of the 20th century, there were several
distinct approaches to the administration and scoring
BECK DEPRESSION INVENTORY – II (BDI- of the Rorschach,
II)
○ The Comprehensive System (CS) devised
● An example of more a targeted, noncomprehensive by John Exner (Exner, 1993) is now
objective measure; typically briefer and focus considered the principal scoring system for the
exclusively on one characteristic, such as depression, Rorschach, although a new system, the
anxiety Rorschach Performance Assessment System
(R-PAS).
● a self-report, pencil-and-paper test that assesses
depressive symptoms in adults and adolescents; 21 ● The scoring of a Rorschach response has as much to
items do with the process by which the client made sense of
the blot as the content of the client’s perceptions.

○ In other words, how the client perceives the

PROJECTIVE PERSONALITY TESTS blot is no less important than what the client
sees.
● People will “project” their personalities if presented
with unstructured, ambiguous stimuli and an
● After each response is scored, the scores are
unrestricted opportunity to respond (Tuber & Meehan,
combined into a variety of indices
2015).
● Rule of thumb is that the way the client makes sense
● Clients are not restricted to multiple-choice or
of the inkblots parallels the way the client makes sense
true/false options
of the world
● The lack of objectivity, especially in scoring and
● Today, the psychometric foundation of the
interpreting, highlights the most frequently cited
Rorschach is still questioned:
shortcoming of projective personality tests.
○ weak reliability and validity data; scoring
CRITICISMS
and interpretation guidelines are complex, and
psychologists do not always follow them as
● projective tests rely too heavily on a psychologist’s
closely as they should; results can’t often
unique way of scoring and interpreting a client’s
distinguish those who have a particular
responses
disorder from those who don’t; moreover,
● client produces unique responses, scoring may vary
norms for the Rorschach may be inadequate
across psychologists
for some populations
STRENGTHS:
THE THEMATIC APPERCEPTION TEST
(TAT)
● projective tests, such as the fact that they aren’t as
“fake-able” as objective tests
● Published by Henry Murray and Christiana Morgan
● the TAT cards feature interpersonal scenes rather
● Research – when scored systematically and
than inkblots - the client’s task is to create a story to go
accurately, roughly equal to those of commonly used
along with each scene
objective personality tests
○ Clients are asked to consider not only what
RORSCHACH INKBLOT METHOD
is happening in the scene at the moment but
also what happened before and what may
● In 1921, Hermann Rorschach, a Swiss psychiatrist,
happen after the scene.
created the Rorschach Inkblot Method
○ They are also asked to describe what the
● Rorschach created 10 inkblots, 5 with only black ink
characters may be thinking and feeling
and the other 5 with multiple colors.
(Bellak, 1993).
● Administration occurs in two phases - the “response”
○ Although the TAT is considered a global
or “free association” phase
measure of personality by many, its strength
may lie in its ability to measure interpersonal
● The psychologist presents one inkblot card at a time,
relationship tendencies.
asks, “What might this be?”
● The TAT has 31 cards, but psychologists typically ● However, the RISB can flesh out the information
administer their own subset of cards - often about 10 or obtained through other tests, including objective
so personality tests.

● As the client tells stories, the psychologist writes BEHAVIORAL ASSESSMENT

them down, th psychologist may ask questions during
a client’s story to solicit more information and can ● According to behavioral assessment, client behaviors
remind the client of the initial instructions as well. are not signs of underlying issues or problems; instead,
those behaviors are the problems.
● Murray (1943) offered a scoring system for the TAT
emphasizing “needs” of the main characters, “press” ● Another way to state this is that the behavior a client
from the environment, and other variables. demonstrates is a sample of the problem itself, not a
sign of some deeper, underlying problem.
○ But for the most part, formal TAT scoring
systems have been “neglected or ignored.” ● Behavioral assessors argue that external, situational
Currently, the TAT is often analyzed without factors determine our behavior.
formal scoring at all. METHODS OF BEHAVIORAL ASSESSMENT
● The validity and reliability of the TAT are less well ● The most essential technique in behavioral
established than other personality tests ○ the assessment is behavioral observation or the direct,
nonempirical scoring and interpretation procedure, the systematic observation of a client’s behavior in the
TAT is not a preferred test among clinical natural environment (also known as naturalistic
psychologists observation)
● However, the use of the TAT continues, as well as ○ this practice involves taking a direct sample
the use of the related Children’s Apperception Test of the problem at the site where it occurs
(CAT) and Senior Apperception Test, based on the (home, work, etc).
hypothesis that “the stories we tell say something
about who we are.” ○ the first step in behavioral observation
SENTENCE COMPLETION TESTS involves identifying and operationally defining
the problem behavior (through interviews,
● In sentence completion tests, the ambiguous stimuli etc.)
are the beginnings of sentences.
● This process usually involves tallying the
● The assumption is that clients’ personalities are frequency, duration, or intensity of the target
revealed by the endings they add and the sentences behavior across specified time periods—first as a
they create. baseline, and then at regular intervals to measure
improvement as compared with that baseline.
● The Rotter Incomplete Sentences Blank (RISB)
tests are by far the most widely known and commonly ● Direct observation can provide a far more accurate
used assessment of problem behavior than merely asking
the client to recall or summarize it verbally during an
○ include 40 written sentence “stems” interview or on a questionnaire.
referring to various aspects of the client’s life
● Behavioral observation also typically includes
keeping a record of the events that occur immediately
before and after the target behavior.

● Behavioral observation - documenting these events

allows for clinical psychologists to understand the
functionality of a particular behavior or how the
behavior relates to the environment and contingencies
that surround it.
● The formal scoring of the RISB is not always
followed by clinical psychologists ● Interviews and questionnaires can be used in
behavioral observation – the goal is to identify the
● The scoring is highly dependent on the clinical function of the problem behavior.
judgment of the psychologist. Thus, its scientific
standing of the RSIB is questionable.
 TECHNOLOGY IN BEHAVIORAL
ASSESSMENT

● computers and other forms of technology have been

used productively by behavioral assessors

● clients often conduct self-monitoring, as a way of

either defining the target behavior or measuring
changes in it over time