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Abstract-AlthoughControversy has been no stranger to the field of personality assessment, and no issue in this field has been more controversial than the scientific status of projective techniques. Indeed, the novice reader attempting to make sense of the sprawling and bewilderingly complex literature on projective techniques is immediately confronted with a striking paradox. On the one hand, during the past four decades a litany of personality assessment researchers (e.g., Anastasi, 1982;Gittelman Klein, 1986;Dawes, 1994) have come forth to decry the reliability and validity of most projective techniques (see Lilienfeld, 1999). Jensen's (1965) famous quotation, although 35 years old, still captures the sentiments of many contemporary scientists toward the Rorschach Inkblot Test and numerous other projective techniques: ". . . the rate of scientific progress in clinical psychology might well be measured by the speed and thoroughness with which it gets over the Rorschach" (p. 238). On the other hand, clinicians in the United States and to a lesser extent those abroad continue to use projective techniques with great regularity, and many contend that these techniques are virtually indispensable to their daily practice (Watkins, Campbell, Neiberding, & Hallmark, 1995). The crux of this paradox was incisively summed up by Anastasi (1982), who observed that "Projective techniques present a curious discrepancy between research and practice. When evaluated as psychometric instruments, the large majority make a poor showing. Yet their popularity in clinical use continues unabated" (p. 564).Indeed, despite the sustained and often withering criticisms directed at projective techniques during the past several decades (Dawes, 1994;Lowenstein, 1987), numerous surveys demonstrate that such techniques continue to enjoy widespread popularity among clinicians. Durand, Blanchard, and Mindell (1988) reported that 49% of the directors of clinical psychology graduate programs and 65% of the directors of clinical psychology internships believed that formal training in projective techniques is important. Watkins et al. (1995) found that 5 projective techniques, including the Rorschach and Thematic Apperception Test (TAT), were among the 10 instruments most frequently used by clinical psychologists. For example, 82% of clinical psychologists reported that they administered the Rorschach at least "occasionally" in their test batteries and 43% reported that they "frequently" or "always" administered it. There is some indication, however, that the popularity of certain projective techniques may be waning. In a recent survey of practicing clinicians, Piotrowski, Belter, and Keller (1998) reported that several projective techniques, including the Rorschach and TAT, have been abandoned by a sizeable minority of users. Some authors (e.g., Piotrowski et al., 1998; Piotrowski & Belter, 1989) have attributed the recent decline in the popularity of projective techniques to the advent of managed care, although at least some of this decline may al...

Background: Chronic Pain (CP) can have a substantial negative impact on one's life. Patients often seek Pain Management Programs (PMPs) as a means to treat their CP condition. The Michael G. DeGroote Pain Clinic, located in Hamilton, Ontario is a PMP that admits patients based on a variety of clinically important factors. Patients assessed are either recommended or not recommended into the program after consideration of these factors. Aims: The objective of this study was to examine if readiness, as assessed by the Pain Stages of Change Questionnaire (PSOCQ), is associated with a clinical judgment of readiness in recommending a person into a PMP. Additionally, to investigate whether PSOCQ scores or clinician judgment predicted readiness to attend a PMP. Methods: One-hundred and eight people were approached and recruited to this study. The 108 patients referred to the PMP in Ontario, were either recommended or not recommended into a PMP after completing an initial assessment. Associations between clinician rating, recommendation status and PSOCQ subscale scores were analyzed using independent t-tests, Pearson Correlation, and Stepwise Regression. We hypothesize that readiness assessed by the PSOCQ would be associated with clinical judgment of readiness in recommending a person into the PMP but that clinical judgment would be superior in predicting readiness to attend a PMP rather than the PSOCQ scores. Results: Those recommended to the PMP had higher assessor ratings, lower pre-contemplation and higher contemplation scores. There were significant relationships between the clinician's rating, pre-contemplation, contemplation, and recommendation status. Stepwise regression methods revealed that while there may be benefit to using questionnaire measures of readiness to change, clinical judgment was the best predictor for recommendation into the PMP. Conclusions: Clinical judgment in the initial assessment process was superior in clinical decision-making regarding a patient's readiness to attend a PMP, as compared to a self-report questionnaire.

Reviews studies on training, experience, and clinical judgment. The results on the validity of judgments generally fail to support the value of on-the-job experience in mental health fields. The validity results do provide limited support for the value of training. Other results suggest that experienced clinicians are better than less experienced judges at knowing which of their judgments are likely to be correct and which are likely to be wrong. Reasons why clinicians have trouble learning from experience are given. Recommendations are made for improving training and clinical practice.