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Previous studies have recommended that multiple measures be employed concurrently to provide converging evidence regarding the presence of suspect effort during neuropsychological assessment. However, if the tests are highly correlated they do not represent independent sources of information. To date, no study has examined correspondence between effort tests. The present study assessed the relationships between eight measures which can be used to assess effort (Rey 15-item, Rey Dot Counting Test, Rey Word Recognition Test, RAVLT recognition trial, Rey-Osterrieth Complex Figure Test effort equation, Digit Span, Warrington Recognition Memory Test-Words, and "b" Test) in a sample of 105 patients in litigation or attempting to obtain/maintain disability compensation and who displayed noncredible symptoms based on psychometric performance and behavioral criteria. Modest to moderate correlations were observed between test summary scores with only two measures sharing more than 50% score variance (Digit Span and Dot Counting). Moderate correlations were also observed between individual test scores reflecting indices of response time, free recall, recognition, and false positive errors, providing possible evidence that patients may use specific strategies when producing noncredible performances. Overall the results suggest that the use of these various tests generally provides nonredundant data regarding patient credibility in neuropsychological evaluations.

Five-year-old Joseph was referred for psychotherapy because of severe separation anxiety from his mother. He was terrified to go to his kindergarten class and was extremely worried about separating from his mother. Joseph's Korean American family identified as having a Christian faith. Joseph said that he loved God and knew God was watching him and his mother from heaven. Prayer, scripture reading, and religious discussion were common daily practices in the family. However, Joseph's religious beliefs were also tied into his separation anxiety. For instance, although he believed that God was watching over him, he also believed that if he disobeyed his mother, God might punish him by taking his mother away.Given the importance of Joseph's faith and its relevance to his presenting problem, his psychotherapist determined that the use of spiritually oriented interventions would be appropriate and make sense to Joseph SPIrItuAlly OrIented InterventIOnS In develOPmentAl COntext HeAtHer lewIS QuAGlIAnA, PAmelA ebStyne KInG, dAvId Peter QuAGlIAnA, And lIndA mAnS wAGener 4

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