This document discusses the concept of psychological assessment in clinical psychology. It defines psychological assessment as systematically gathering information about a person and their environment in order to make decisions that are in their best interest. The process of assessment involves formulating initial questions, collecting relevant data from the person and environment, making judgments based on the data, and communicating these judgments in a psychological report. Standards, such as norms or prior self-ratings, are used to interpret the data and make comparisons. The goals of assessment may include diagnostic classification, determining severity, screening for risks, evaluating treatment effects, or predicting future behavior.

1. THE CONCEPT OFTHE CONCEPT OF
PSYCHOLOGICALPSYCHOLOGICAL
ASSESSMENT IN CLINICALASSESSMENT IN CLINICAL
PSYCHOLOGYPSYCHOLOGY
Lecture 15Lecture 15

2. DEFINITION OF PSYCHOLOGICALDEFINITION OF PSYCHOLOGICAL
ASSESSMENT:ASSESSMENT:
 Psychological assessment : the process ofPsychological assessment : the process of
systematically gathering information about a person insystematically gathering information about a person in
relation to his or her environment so that decisionsrelation to his or her environment so that decisions
can be made, based on this information, that are in thecan be made, based on this information, that are in the
best interests of the individual.best interests of the individual.
 Questions for a clinical psychologist :what areQuestions for a clinical psychologist :what are
patient’s current problems and the possible resourcespatient’s current problems and the possible resources
he has ? His past life, and Significant others.he has ? His past life, and Significant others.
 Systematic evaluation of these issuesSystematic evaluation of these issues

3. STEPS IN THE ASSESSMENTSTEPS IN THE ASSESSMENT
PROCESS:PROCESS:
1.1. Formulation of initial question or set ofFormulation of initial question or set of
questions, developed in response to aquestions, developed in response to a
referral or request for help.referral or request for help.
2.2. Generating a set of goals for collectionGenerating a set of goals for collection
information----what the psychologist hopesinformation----what the psychologist hopes
to accomplish during the assessmentto accomplish during the assessment
process.process.
3.3. Identification of standards for interpreting theIdentification of standards for interpreting the

4. 4.4. Collecting the relevant data : includesCollecting the relevant data : includes
collecting information about the person andcollecting information about the person and
the environment.the environment.
5.5. Making decisions and judgment on the basisMaking decisions and judgment on the basis
of the data.of the data.
6.6. Communicating these judgments andCommunicating these judgments and
decisions in the form of a psychologicaldecisions in the form of a psychological
report.report.

5. THE PROCESS OFTHE PROCESS OF
PYSCHOLOGICALPYSCHOLOGICAL
ASSESSMENTASSESSMENT

6. STEP 1: DECIDING WHAT ISSTEP 1: DECIDING WHAT IS
BEING ASSESSEDBEING ASSESSED
 The assessment process begins with a seriesThe assessment process begins with a series
of questions.of questions.
 E.g., presence of a problem, nature of problem,E.g., presence of a problem, nature of problem,
type of problem, causes of the problem,type of problem, causes of the problem,
possible treatments etc.possible treatments etc.
 These questions are called theThese questions are called the “referral“referral
questions”------questions”------ questions that led the client toquestions that led the client to
refer to the psychologist.refer to the psychologist.

7. THE REFERRALTHE REFERRAL
 Someone—a patient, a teacher, a psychiatrist, a judge, orSomeone—a patient, a teacher, a psychiatrist, a judge, or
perhaps a psychologist—poses a question about theperhaps a psychologist—poses a question about the
patient.patient.
 It is important to understand precisely what the question isIt is important to understand precisely what the question is
or what the referral source is seeking.or what the referral source is seeking.
 The questions and concerns that a client poses at the timeThe questions and concerns that a client poses at the time
of referral do not necessarily tell the whole story.of referral do not necessarily tell the whole story.
 Furthermore, the client may purposefully or unknowinglyFurthermore, the client may purposefully or unknowingly
withhold information from the psychologist.withhold information from the psychologist.
 Thus clinical psychologists utilize theory & research toThus clinical psychologists utilize theory & research to
guide questions for a formal assessment.guide questions for a formal assessment.

8.  What does a psychologist want to know about aWhat does a psychologist want to know about a
person who is seeking help? : Multiple levels ofperson who is seeking help? : Multiple levels of
functioning that are relevant to understandingfunctioning that are relevant to understanding
any behavior. E.g., emotions with regard toany behavior. E.g., emotions with regard to
biological, cognitive, and environmental factors.biological, cognitive, and environmental factors.
 Possible targets for assessment arePossible targets for assessment are biologicalbiological
processesprocesses,, cognitionscognitions,, emotionsemotions andand
behaviorsbehaviors..

9.  BiologicaBiological andl and Psycho-physiologicalPsycho-physiological processesprocesses
include heart rate reactivity, blood pressure, galvanicinclude heart rate reactivity, blood pressure, galvanic
skin response, muscle tension, sexual arousal, startleskin response, muscle tension, sexual arousal, startle
response, and eye tracking movement.response, and eye tracking movement.
 CognitiveCognitive processes include intellectual functioning,processes include intellectual functioning,
perceptions of the self, perceptions of others, beliefsperceptions of the self, perceptions of others, beliefs
about the causes of events, and perception ofabout the causes of events, and perception of
contingency and control.contingency and control.
 EmotionalEmotional processes that are the focus ofprocesses that are the focus of
assessment include mood states, trait levels ofassessment include mood states, trait levels of
emotions, and emotional reactivity.emotions, and emotional reactivity.
 Finally, measure ofFinally, measure of overt behaviorovert behavior includeinclude
performance on standardized tasks, observations ofperformance on standardized tasks, observations of
behavior in simulated situations, and behaviorbehavior in simulated situations, and behavior
observed in the client’s natural environment.observed in the client’s natural environment.

10. Focus on EnvironmentFocus on Environment
 TheThe ProximalProximal and, orand, or ImmediateImmediate features of thefeatures of the
environment include the client’s family environmentenvironment include the client’s family environment
and the characteristics of the school or work setting.and the characteristics of the school or work setting.
 IntermediateIntermediate levels of the environment include thelevels of the environment include the
geographic region in which the individual resides.geographic region in which the individual resides.
 Finally, theFinally, the DistalDistal, or, or BroaderBroader, environment includes, environment includes
the general geographic and sociocultural environmentthe general geographic and sociocultural environment
in which the client lives.in which the client lives.

11. STEP 2: DETERMINING THE GOALS OFSTEP 2: DETERMINING THE GOALS OF
ASSESMENT.ASSESMENT.
 The second step in clinical assessment :The second step in clinical assessment :
formulation of the psychologist’s goal in aformulation of the psychologist’s goal in a
particular case.particular case.
Goals may includeGoals may include
A.A. Diagnostic classificationDiagnostic classification,,
B.B. Determination of the severity of a problemDetermination of the severity of a problem,,
C.C. Risk screening for future problemsRisk screening for future problems,,
D.D. Evaluation of the effects of treatmentEvaluation of the effects of treatment, and, and
E.E. Prediction about the likelihood of certainPrediction about the likelihood of certain
types of future behaviortypes of future behavior..

12. A. Diagnostic classificationA. Diagnostic classification
 Diagnosis is perhaps a more familiar term thanDiagnosis is perhaps a more familiar term than
assessment, but actually a subset of the broaderassessment, but actually a subset of the broader
process of assessment.process of assessment.
 The task of diagnosing implies that certain proceduresThe task of diagnosing implies that certain procedures
or tests are administered to an individual in order toor tests are administered to an individual in order to
classify the person’s problem, to identify causes andclassify the person’s problem, to identify causes and
prescribe treatment.prescribe treatment.
 Diagnostic decisions are often the first goal of theDiagnostic decisions are often the first goal of the
assessment process.assessment process.

13.  There is a close link between assessmentThere is a close link between assessment
procedures and the diagnostic system.procedures and the diagnostic system.
 Assessment involves the identification of theAssessment involves the identification of the
individual features or characteristics, whereas aindividual features or characteristics, whereas a
diagnostic system involves the groupingdiagnostic system involves the grouping
together of individual cases according to theirtogether of individual cases according to their
identifying features.identifying features.
 A diagnostic system such asA diagnostic system such as DSM IVDSM IV
represents one of the outcomes of assessmentrepresents one of the outcomes of assessment
---the classification of individuals using the---the classification of individuals using the
information that has been generated.information that has been generated.

14. B. SEVERITYB. SEVERITY
 It is not always sufficient to know that an individualIt is not always sufficient to know that an individual
meets the criteria for a particular problem ormeets the criteria for a particular problem or
disorder, because there can be substantialdisorder, because there can be substantial
differences among individuals with a similar problem,differences among individuals with a similar problem,
a concept referred t o as heterogeneity.a concept referred t o as heterogeneity.
 Or it may also be compared with the term severity orOr it may also be compared with the term severity or
variability in the disease. For example breast cancervariability in the disease. For example breast cancer
may vary from a small localized tumor (stage 1) tomay vary from a small localized tumor (stage 1) to
carcinoma that has spread throughout other partscarcinoma that has spread throughout other parts
and systems of the body (stage IV).and systems of the body (stage IV).

15.  Discrimination of the severity of problems or disordersDiscrimination of the severity of problems or disorders
requires assessment and methods that are sensitiverequires assessment and methods that are sensitive
to variation in theto variation in the frequencyfrequency,, intensityintensity, and, and durationduration
of specific symptoms.of specific symptoms.
 The degree of impairment : An important factor inThe degree of impairment : An important factor in
determining the severity of a disorder.determining the severity of a disorder.
 Example : a patient with Bulimia NervosaExample : a patient with Bulimia Nervosa
 Thus psychologists must consider the individual‘sThus psychologists must consider the individual‘s
overall life functioning and competence in order tooverall life functioning and competence in order to
have a complete understanding of the scopes of thehave a complete understanding of the scopes of the
problem.problem.

16. C. SCREENINGC. SCREENING
 Often clinical psychologists are called on toOften clinical psychologists are called on to
screen large groups of individuals, either toscreen large groups of individuals, either to
identify the presence of problems or to predictidentify the presence of problems or to predict
who is at greatest risk to develop a problem atwho is at greatest risk to develop a problem at
some point in the future.some point in the future.
 For example, efforts to screen for depressionFor example, efforts to screen for depression
have been undertaken on a large scale.have been undertaken on a large scale.
 "At risk" persons"At risk" persons

17.  Children and depression : parents' depressionChildren and depression : parents' depression
adds to the riskadds to the risk
 Adolescents and depression :associated withAdolescents and depression :associated with
somatic problems like recurrent headaches.somatic problems like recurrent headaches.
 Depression screening tools can also utilized inDepression screening tools can also utilized in
medical emergency rooms. Brief depressionmedical emergency rooms. Brief depression
questioners are used.questioners are used.

18. D. PREDICTIONSD. PREDICTIONS
 Psychologists are often called on to make predictionsPsychologists are often called on to make predictions
about how a person may behave at some point in theabout how a person may behave at some point in the
future.future.
 These predictions may span very short periods of timeThese predictions may span very short periods of time
to long-term predictions about subsequent risk forto long-term predictions about subsequent risk for
disorders.disorders.
 Example: The prediction of violent behavior, especiallyExample: The prediction of violent behavior, especially
youth violence.youth violence.
 Psychologists have been largely unsuccessful in thisPsychologists have been largely unsuccessful in this
effort because of not sufficiently understanding theeffort because of not sufficiently understanding the
complex factors that lead to acts of violence.complex factors that lead to acts of violence.

19.  Psychologists are actually effective in makingPsychologists are actually effective in making
predictions about certain problems, particularlypredictions about certain problems, particularly
if those problems have reasonably high rate ofif those problems have reasonably high rate of
occurrence in the population.occurrence in the population.
 For example patterns of aggressive andFor example patterns of aggressive and
disruptive behavior disorders in adolescencedisruptive behavior disorders in adolescence
can be predicted with some degree of accuracycan be predicted with some degree of accuracy
from information collected in early childhood.from information collected in early childhood.

20. E. EVALUATION OF INTERVENTIONE. EVALUATION OF INTERVENTION
 Effective assessment does not end once treatment begins.Effective assessment does not end once treatment begins.
Rather, assessment methods should be re-administered atRather, assessment methods should be re-administered at
regular intervals to monitor and evaluate the effects ofregular intervals to monitor and evaluate the effects of
treatment.treatment.
 Example : the ABA methodExample : the ABA method
 Evaluating change requires a few essential steps:Evaluating change requires a few essential steps:
 a. Same instruments for ABA evaluationa. Same instruments for ABA evaluation
 b. Reliable measures for gathering informationb. Reliable measures for gathering information
 c. Cut off pointsc. Cut off points

21. STEP 3: SELECTING STANDARDSSTEP 3: SELECTING STANDARDS
FOR MAKING DECISIONSFOR MAKING DECISIONS
 A psychologist must know what to do with theA psychologist must know what to do with the
information once it is collected. Making decisionsinformation once it is collected. Making decisions
about the information is essential and require points ofabout the information is essential and require points of
reference for comparison.reference for comparison.
 Standards are used to determine the presence,Standards are used to determine the presence,
severity, and duration of a problem.severity, and duration of a problem.
 Comparisons can be made to standards that involveComparisons can be made to standards that involve
other people (normative standards) or to the self atother people (normative standards) or to the self at
other points in time (self-referent standards).other points in time (self-referent standards).

22.  The individual, idiographic tradition: concerns about aThe individual, idiographic tradition: concerns about a
specific person (used to get individual’s informations)specific person (used to get individual’s informations)
 The normative, or nomothetic tradition: interest in theThe normative, or nomothetic tradition: interest in the
nature of people in general (used to compare thenature of people in general (used to compare the
individual with relevant population)individual with relevant population)
 In making normative comparisons, the psychologistIn making normative comparisons, the psychologist
must determine the degree to which a particularmust determine the degree to which a particular
individual is similar to the normative sample onindividual is similar to the normative sample on
demographic characteristics such as age, sex.demographic characteristics such as age, sex.
ethnicity, education, and economic status.ethnicity, education, and economic status.
 Example: making predictions about an inner-cityExample: making predictions about an inner-city
African American adolescent's performance, on a testAfrican American adolescent's performance, on a test
that is normed on middle and upper socioeconomicthat is normed on middle and upper socioeconomic
status Caucasian youth.status Caucasian youth.

23. a. Variability of a normative samplea. Variability of a normative sample
can be represented in several ways, but the most common iscan be represented in several ways, but the most common is
based on the mean as a measure of central tendency and thebased on the mean as a measure of central tendency and the
standard deviation as a measure of variability.standard deviation as a measure of variability.
b. Self-Referent Standardsb. Self-Referent Standards
 Some judgments do not involve comparisons to others. Rather,Some judgments do not involve comparisons to others. Rather,
it is important to consider how much or how little this personit is important to consider how much or how little this person
has changed over time or across different situations. In suchhas changed over time or across different situations. In such
instances, the appropriate criterion is the person himself orinstances, the appropriate criterion is the person himself or
herself.herself.
 Self-referent standards can also be useful in determining theSelf-referent standards can also be useful in determining the
initial goals of a client and the degree to which he or she isinitial goals of a client and the degree to which he or she is
satisfied with gains made in treatment.satisfied with gains made in treatment.

24. STEP 4: COLLECTINGSTEP 4: COLLECTING
ASSESSMENT DATAASSESSMENT DATA
 Psychologists must decide which of many methods will be usedPsychologists must decide which of many methods will be used
to assess the targets that have been selected.to assess the targets that have been selected.
 These choices include:These choices include:
 the use of structured or unstructured clinical interviews,the use of structured or unstructured clinical interviews,
 reviews of the individual's history from school or medicalreviews of the individual's history from school or medical
records,records,
 measurements of physiological functioning,measurements of physiological functioning,

25.  a wide array of psychological tests,a wide array of psychological tests,
 self-reports from the individual,self-reports from the individual,
 reports from significant others in the individual's life, andreports from significant others in the individual's life, and
 methods for the direct observation of behavior in the naturalmethods for the direct observation of behavior in the natural
environment or in simulated conditions.environment or in simulated conditions.
 Several of these methods can be used with a single case. TheSeveral of these methods can be used with a single case. The
assessment process often begins with an interview as a meansassessment process often begins with an interview as a means
of obtaining general information about the individual andof obtaining general information about the individual and
establishing rapport with the client. This initial interview may beestablishing rapport with the client. This initial interview may be
followed by psychological testing, observations of behavior,followed by psychological testing, observations of behavior,
and/or psychological assessment.and/or psychological assessment.
 The choice of methods is influenced by a number of factors. ForThe choice of methods is influenced by a number of factors. For
example, age of client, the referral question, psychologist'sexample, age of client, the referral question, psychologist's
theoretical orientation and concept of psychopathology.theoretical orientation and concept of psychopathology.

26. RELIABILITY AND VALIDATYRELIABILITY AND VALIDATY
 The accuracy of the collected data : The most fundamentalThe accuracy of the collected data : The most fundamental
concern of a clinical psychologist.concern of a clinical psychologist.
 Accuracy may be reflected in the consistency of the measureAccuracy may be reflected in the consistency of the measure
(reliability) and in the degree to which it reflects the construct of(reliability) and in the degree to which it reflects the construct of
interest (Validity).interest (Validity).
 Reliability:Reliability:
 Reliability refers to the consistency of the observation orReliability refers to the consistency of the observation or
measurements that are made.measurements that are made.
 Test-retest reliabilityTest-retest reliability
 Equivalent-forms reliabilityEquivalent-forms reliability

27.  Split-half reliabilitySplit-half reliability
 Inter-rater or inter-judge reliabilityInter-rater or inter-judge reliability
 Validity:Validity:
 Validity reflects the degree to which an assessment techniqueValidity reflects the degree to which an assessment technique
measures what it is designed or intended to measure.measures what it is designed or intended to measure.
 Content Validity (covering actual aspects of interest)Content Validity (covering actual aspects of interest)
 Predictive Validity (scores predict some behavior in future)Predictive Validity (scores predict some behavior in future)
 Concurrent Validity (relating today’s test scores to a concurrentConcurrent Validity (relating today’s test scores to a concurrent
criterion)criterion)
 Construct Validity (measuring the construct of interest)Construct Validity (measuring the construct of interest)

28. STEP 5: MAKING DECISIONSSTEP 5: MAKING DECISIONS
 The information obtained in the psychologicalThe information obtained in the psychological
assessment process is valuable only to theassessment process is valuable only to the
extent that it can be used in making importantextent that it can be used in making important
decisions about the person or persons who aredecisions about the person or persons who are
the focus of assessment.the focus of assessment.
 The goals of assessment determine the typesThe goals of assessment determine the types
of decisions that are made.of decisions that are made.

29. CLINICAL VERSUS STATISTICALCLINICAL VERSUS STATISTICAL
PREDICTIONPREDICTION
 Over 100 studies have compared the use of theOver 100 studies have compared the use of the
clinical and statistical methods in makingclinical and statistical methods in making
judgments in psychological assessment.judgments in psychological assessment.
 The evidence clearly shows the superiority ofThe evidence clearly shows the superiority of
statistical methods in making judgments,statistical methods in making judgments,
because they are reliable.because they are reliable.

30. STEP 6: COMMUNICATING THESTEP 6: COMMUNICATING THE
INFORMATIONINFORMATION
 After all steps are taken, the final step of clinicalAfter all steps are taken, the final step of clinical
assessment is communicating this information andassessment is communicating this information and
interpretations to the interested parties, typically in theinterpretations to the interested parties, typically in the
form of a written psychological report.form of a written psychological report.
 The challenges for psychologists in conveyingThe challenges for psychologists in conveying
assessment information include the need to beassessment information include the need to be
accurate, to provide an explanation of the basis foraccurate, to provide an explanation of the basis for
their judgments, and to communicate free of technicaltheir judgments, and to communicate free of technical
jargon.jargon.

31. A good psychological report has the following parts:A good psychological report has the following parts:
 an introduction to the case, including a description of thean introduction to the case, including a description of the
referral questions that were asked or the hypotheses that werereferral questions that were asked or the hypotheses that were
tested.tested.
 The methods or assessment procedures that were used.The methods or assessment procedures that were used.
 The results —a clear and succinct summary of the data.The results —a clear and succinct summary of the data.
 Finally, a discussion and interpretation of the results isFinally, a discussion and interpretation of the results is
provided, including recommendations for future assessment orprovided, including recommendations for future assessment or
intervention.intervention.

32. ETHICAL ISSUES INETHICAL ISSUES IN
ASSESSMENTASSESSMENT
 Foremost among these guidelines are:Foremost among these guidelines are:

 concerns for protecting clients from abuse by actionsconcerns for protecting clients from abuse by actions
of psychologists,of psychologists,
 ensuring the confidentiality of information that isensuring the confidentiality of information that is
obtained,obtained,
 protecting clients' rights to privacy,protecting clients' rights to privacy,

33.  ensuring the use of procedures that haveensuring the use of procedures that have
well-established reliability and validity, andwell-established reliability and validity, and
 using the results of psychologicalusing the results of psychological
assessment data in the best interests ofassessment data in the best interests of
clients.clients.
 Reliability and Validity of client’s scores.Reliability and Validity of client’s scores.