How to Deepen Your Clinical Effectiveness: The Use of Psychological Assessments in Mental Health Practice Brookhaven Hospital Seminar Series March 7, 2012 Timothy D. Doty, Psy.D. ~Licensed Psychologist~ Clinical and Forensic Psychology

Objectives Discussion of most prominent psychological ( ψ ) assessment tools you are likely to see How to be an informed clinician around the data included in prominent ψ assessments What ψ assessments can you utilize in your own clinical practice for the benefit of your clients/patients? How and when to seek ψ assessments consults to benefit your clients?

informal survey

Definitions Clinical Assessment – any method by which a mental health professional gathers data about an individual, child, adult, couple, family, group, etc. Most often takes the form of an unstructured interview

Definitions Psychological assessment - when a clinician utilizes a variety of test scores, obtained from multiple test methods, interprets the data informed by the patient’s history, referral information, and observed behaviors, in order to understand more fully the person being evaluated for the purpose of answering referral questions, and to communicate findings to the patient, significant others, and referral sources (Meyer, et al, 2001) Psychological testing – an obtained score on a particular psychological/psychoeducational test from which labels may be applied E.g., psychometric tools in the education setting

Two Sides of the Discussion We treat what our clients present to us and honor clients’ self-determination to set their own goals and discuss what they want to (including not going where they don’t want to go) If you don’t start with clear psychodiagnostics, your treatment will be less effective. Relying on unstructured or semi-structure interviews alone as an assessment misses important data

Prominent Psychological ψ Assessments Personality Tests MMPI-2 and MMPI-2- RF Millon Clinical Inventories Cognitive Tests Wechsler Tests WAIS-IV, WISC-IV, WMS-IV, WASI-II, WPPSI-IV Behavior Rating Scales Burk’s, Conners’, Achenbach, BASC Beck Depression Symptom scales (SCL- 90-R)Projective TAT, Rorschach, Projective Drawings, Bender-Gestalt Where might tests originate? Psychiatric hospital, psychologists, school/educational assessment, forensic evaluations

Screening vs. Assessment Screening Briefer, less expensive Fewer questions = Less reliable (how likely are we to obtain the same score time after time) Assessment More extensive, difficult to justify to third-party payers More reliable, greater accuracy in achieving validity (are we actually measuring constructs we intend to measure)

Tools to Consider Symptom Checklist (SCL- 90-R) Beck Depression Inventory Beck Suicide Inventory Trauma Symptom Inventory Quality of Life (QOLI) SASSI – Adult Substance Abuse Subtle Screening Inventory PREPARE/ENRICH Public Domain: Hamilton Rating Scale for Depression Rating scales developed by drug companies

How and When to Refer for ψ Assessment Consult When therapy is “stuck” When a particular diagnostic question remains elusive (is this person on the autistic-spectrum? Am I encountering a personality d/o? Why won’t my patient make suggested changes?) When having a diagnostic “label” can help encourage/motivate further treatment. Prepare clients. Let them know of potential benefits/risks.

Model for ψ Assessment Consultation Therapeutic Assessment – Developed by Steve Finn, Austin, TX Model places priority on including referring clinician in multiple stages: defining referral question, incremental feedback, final feedback and recommendations for further treatment considerations Emphasis on collaborative process between client and assessor. What goals does the client have? What would they like to learn about themselves?

References Camara, W.J., Nathan, J.S. & Puente, A.E. (2000). Psychological test usage: Implications in professional psychology. Professional Psychology: Research and Practice. (31) 2, Clair, D. & Prendergrast, D. (1994). Brief Psychotherapy and psychological assessments: Entering a relationship, establishing a focus, and providing feedback. Professional Psychology: Research and Practice. (25) 1, Finn, S.E. (2007). In Our Clients' Shoes: Theory and Techniques of Therapeutic Assessment. Routledge. Finn, S.E. & Tonsager, M.E. (1992). Therapeutic Effects of Providing MMPI-2 test feedback to college students awaiting therapy. Psychological Assessment. (4) 3,

References, cont’d Meyer, G.J., Finn, S.E., Eyde, L.D., Kay, G.G., Moreland, K.L., Dies, R.R, Eisman, E.J., Kubiszyn, T.W., & Reed, G.M. (2001). Psychological testing and psychological assessment: A review of evidence and issues. American Psychologist. ( 56) 2, Riccio, C.A., & Rodriguez, O.L. (2007). Integration of psychological assessment approaches in school psychology. Psychology in the Schools. (44) 3, Watkins, C.E., Campbell, V.L., Nieberding, R. & Hallmark, R. (1995). Contemporary practice of psychological assessment by clinical psychologists. Professional Psychology: Research and Practice. (26) 1, 54-60

Contact Tim Doty, Psy.D. Christian Family Institute 6846 S. Canton Ave., Suite 501 Tulsa, OK