Rorschach examination in a child guidance clinic.

Abstract

H E N the Rorschach Examination is ideally used, it is extremely time-w consuming. In a busy clinic, where pressure of work is great and demands on time extreme, time becomes an important factor. The usual diagnostic or full study case, for example, requires an average of about four hours for the psychological examination, one to two hours for the psychiatric, about an hour for the physical examination, and frequently time for special tests or examinations such as the neurological, basal metabolism, aphasic status, Betts Telebinocular Test, special diagnostic tests, etc. Added to this is time needed for the social study, for clearing, correspondence, conferences, and detailed reports, not to mention time needed for treatment of some cases. With a staff that is numerically inadequate to handle the problems occurring among a million school children, and with the necessity for handling as many cases as possible with as little expense as possible, the need for economy in time becomes even more apparent. The addition of a time consuming instrument like the Rorschach must, therefore, be fully justified in terms of returns. The burden of proof is placed directly on the person employing the test.During the early days of the use of the Rorschach a t the Bureau of Child Guidance, perhaps three hours were required for each case for administration, inquiry, scoring and interpretation, and since the instrument had not as yet been established a t the clinic, the psychologists using it had to do much of the work of scoring and interpretation a t home on their own time after bootlegging the examination itself during clinic hours. I t was not long, however, before psychiatrists and social workers began to demand the Rorschach on all cases, but the necessary time still could not be found a t the clinic until perhaps a year of experience with the instrument had elapsed. Then i t was found that psychologists were able to complete the entire process in about an hour. At present, therefore, we allow about a half hour on the average, although there are many exceptions, for administration and inquiry with the patient, and are forced to find odd moments during the day to do the rest. Thus, as far as scheduled time added to the appointment of the child a t the clinic is concerned, we add only a half hour, sometimes eliminating other items for this time, and sometimes, when it can be managed, adding this to the total clinic time for each case.Naturally, a total time of one hour does not permit of elaborate, detailed and ideal interpretation. In this time we cannot extract all the possible implications of the Rorschach, and do the type of interpretation that we see so often in the literature. Only the barest essentials can be extracted. Frequently, the psychologist administering the Rorschach is compelled to enter the case conference Delivered at meeting of N. Y. Rorschach Institute, Fcb. 26, 1940, N. Y. Psychi.itric Institute. 503

Psychological tests in psychopathological prognosis.

“…None of the six Rorschach reports on the prognosis of problem children can be considered satisfactory. Four of the articles (90,152,153,154) read more like advertisements than experi-ments. The fifth (155) presents evidence for the alleged prognostic power of twelve Rorschach factors in such form that it cannot be evaluated, and the sixth (141) does not specify the Rorschach signs used.…”

Psychological prognosis of outcome in the mental disorders.

“…It is difficult to try to account for the divergent conclusions of the prognostic studies on the basis of any general characteristics, because relatively few investigators specified the important conditions which characterized their experiments. Thus, of 28 prognostic studies with the Rorschach, 19 (all but 20,22,38,40,47,56,59,66,76) did not specify the duration of illness of the patients and seven (30,34,54,55,63,67,75) failed to state the time of follow-up. 8 Of 10 MMPI prognostic studies (8,15,16,21,24,26,50,51,52,69), five reported that the prognoses applied to the broad diagnostic category of "psychiatric patients" (15,16,24,26,52), only about one third specified the duration of illness of their patients (8,21,26), and about one third did not indicate the duration of the follow-up period (8,24,69).…”

“…Comparisons of the relationships between initial CRT scores and final outcome status revealed divergent trends; initially, the im-»These 28 studies include 7,11,18,20,22,29,30,34,38,40,47,49 proved among the acutely ill patients had the higher scores while the improved among the chronically ill had the lower scores. The divergence between these relationships was found to be significant at the .05 level when tested by analysis of variance.…”

Projective Methods in the Study of Personality

“…Krugman (72,73) described its uses in the child guidance clinic and in work with children in general. Krugman (72,73) described its uses in the child guidance clinic and in work with children in general.…”