This article summarizes evidence and issues associated with psychological assessment. Data from more than 125 meta-analyses on test validity and 800 samples examining multimethod assessment suggest 4 general conclusions: (a) Psychological test validity is strong and compelling, (b) psychological test validity is comparable to medical test validity, (c) distinct assessment methods provide unique sources of information, and (d) clinicians who rely exclusively on interviews are prone to incomplete understandings. Following principles for optimal nomothetic research, the authors suggest that a multimethod assessment battery provides a structured means for skilled clinicians to maximize the validity of individualized assessments. Future investigations should move beyond an examination of test scales to focus more on the role of psychologists who use tests as helpful tools to furnish patients and referral sources with professional consultation.
The authors reviewed the other articles in the special section and commented on the use of psychological assessment to plan treatment. They call this view of assessment the information-gathering paradigm, because the goal is to collect data that will aid in communication and decision making about clients. This contrasts with the therapeutic model of assessment, in which the major goal is to produce positive change in clients. The authors summarized evidence of the efficacy of assessment as a brief therapy and discussed its possible therapeutic mechanisms. The information-gathering and therapeutic models of assessment are complementary rather than mutually exclusive, and both speak to the utility of assessment. The current crisis in the clinical use of psychological assessment may be due in part to an overemphasis on the information-gathering model.
This study investigated the benefits of sharing Minnesota Multiphasic Personality Inventory-2 (MMPI-2) test results verbally with clients. Ss were randomly selected from a college counseling center's waiting list: 32 received test feedback according to a collaborative model developed by Finn (1990) and 29 received only examiner attention. Groups did not differ on age, sex, days between examiner contact, and initial levels of distress and self-esteem. Compared with the controls, clients who completed the MMPI-2 and heard their test results reported a significant decline in symptomatic distress and a significant increase in self-esteem, and felt more hopeful about their problems, both immediately following the feedback session and at a 2-week follow-up. Also, clients' subjective impressions of the feedback session were overwhelmingly positive. Although the study failed to identify specific client variables or elements of the feedback session that were related to these changes, the findings indicate that psychological assessment can be used as a therapeutic intervention.Preliminary findings from this study were presented at the 25th Annual Symposium on Recent Developments in the Use of the MMPI (MMPI-2), June 23,1990, Minneapolis, Minnesota. The research was conducted in partial fulfillment of Mary Tonsager's MA degree requirements, under the supervision of Stephen E. Finn.We thank the staff of the University of Texas at Austin's Counseling and Mental Health Center, especially the intake workers-Barbara Burnham, Vic Burnstein, Linda Ridge, and Alex Shafer-for their help in recruiting clients to the study. We also thank the director and staff of the Learning Abilities Center at the University of Texas at Austin for the use of their training facilities to conduct all the interviews and feedback sessions. Additional thanks go to Arnold H. Buss, William B. Swann, and Lee Willerman for their critical comments on an earlier draft of this article.
SynopsisThis study developed a method for measuring subjective costs and benefits of psychiatric treatments. Forty-one patients rated the relative bothersomeness of symptoms of schizophrenia and side effects of neuroleptics. Thirty-four psychiatrists made parallel ratings from the perspective of the average patient (individual utility) and of the patient's family and society (institutional utility). Psychiatrists predicted patients' ratings moderately well, but misjudged the bothersomeness to patients of 24% of side effects and 20% of symptoms. When considering the patient's perspective, both schizophrenic patients and psychiatrists rated symptoms as no more bothersome than side effects. However, psychiatrists saw side effects as significantly less bothersome than symptoms when considering costs to society. The subjective utility of neuroleptic medications for schizophrenia is most justifiable from an institutional perspective.
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