1. Evidence-Based Assessment
July 19, 2007

2. Two Key “Special Issues”
Adults: Psychological Assessment, 2005, 17(3). (Hunsley & Mash)
Children: Journal of Clinical Child and Adolescent Psychology, 2005, 34(3). (Mash & Hunsley)

3. Main Points
Need evidence-based assessment to support evidence-based practice in psychology
Importance of assessment-treatment dialectic
Assessment (identification of distinguishing features of cases, problems, and disorders) related to taxonomy (organization of cases, problems, and disorders according to their distinguishing features)
Purposes of assessment (nomothetic v. idiographic)
General purpose ‘off-the-shelf’ vs. theoretically driven assessment
“For whom”? and “for what purpose”? are key questions

4. Theoretical Roots of Assessment
“Just as water cannot rise naturally above its source, and just as a measure’s reliability sets an upper limit on its potential validity, the utility of a psychological test or measure is limited by the theoretical and measurement models it serves.” (McFall, 2005)
“What have we learned from the (7) data analysis of the (6) summary statistics (5) generated by the measurement model (4) of the responses gathered by the instrumental methods (3) designed to sample the referents (2) for the formal theoretical constructs (1) supported by the basic assumptions?” (McFall, 2005)

5. What is an EBA? (Hunsley & Mash, 2005)
Some use “EBA” to refer to a systematic review
Some use “EBA” to refer to the use of assessment instruments with known reliability and validity
Still others describe “EBA” in terms of clinical utility of assessment (e.g., to predict treatment outcome or suitability)
Additional factors
Cost-effectiveness
Increased precision (e.g., reduction in dx errors)
Reduced economic and psychological cost associated with errors

6. Elements of EBA’s (Hunsley & Mash, 2005)
EBA’s are problem or disorder-specific
screening, diagnosis, prognosis, treatment planning, treatment monitoring, and treatment evaluation
Literature should elucidate main constructs relevant to a particular area
EBA’s should be sensitive to ethnic, gender, and cultural factors
Evidence for concurrent and discriminant validation
Evidence for utility and incremental validity is desirable
Empirical basis of clinician judgment needs to be independently validated (partly the goal of the “clinical expertise” lecture)

7. Benefits of Assessment
Incremental validity in diagnosis
Assessment of treatment worthiness
Assessment of treatment response
Identifying “successful” therapists
Identifying need for further treatment
Increased patient satisfaction
Provide basis for decision for service delivery
Others?

8. Issues in EBA’s Gaps in psychometric information Clinical utility
Training in EBA’s
Using EBA’s doesn’t insure evidence-based decision-making
Assessment process v. assessment methods

9. EBA’s for Anxiety Disorders (Antony & Rowa, 2005)

10. How EBA’s could be reviewed or established
Mash & Hunsley (2005) 0=nonexistent, 1=limited, 2=adequate, 3=well-established

11. Future Directions
Achenbach, 2005

12. Barriers to Dissemination (Antony & Rowa, 2005)

13. Barriers (cont’d)

14. Barriers (still more)