Unresolved questions concerning the effectiveness of psychological assessment as a therapeutic intervention: Comment on Poston and Hanson (2010).

Abstract

In a recent article in this journal, Poston and Hanson (2010) reported a meta-analysis of 17 studies on the use of psychological assessment as a therapeutic intervention (PATI) and concluded that "psychological assessment procedures--when combined with personalized, collaborative, and highly involving test feedback--have positive, clinically meaningful effects on treatment" (Poston & Hanson, 2010, p. 203). Although extant data suggest that PATI can sometimes exert positive effects, Poston and Hanson's (2010) meta-analysis may overstate the magnitude of these effects because the authors (a) included several studies that combined assessment with treatment components that are irrelevant to PATI, sometimes rendering it impossible to attribute any observed effects to PATI per se and (b) excluded numerous nonsignificant results. Moreover, the studies Poston and Hanson (2010) reviewed neglected to rule out Barnum effects as alternative explanations for client improvement, raising the possibility that PATI works for reasons other than those proposed by its advocates. We conclude that Poston and Hanson's (2010) review leaves a number of lingering questions concerning the treatment utility of PATI unanswered.

Translational applications of personality science for the conceptualization and treatment of psychopathology.

“…However, Lilienfeld, Garb, and Wood (2011) challenged the validity of this conclusion and argued that Poston and Hanson (2010) overestimated the effectiveness of TA. Specifically, they suggested that some included studies confounded the interpretability of TA's effect (e.g., additional treatment components), that the researchers omitted nonsignificant results, and that the authors failed to consider potential Barnum effects (Lilienfeld et al, 2011). In a response to these critiques, Hanson and Poston (2011) reexamined their data specifically with regard to these suggestions and concluded that strong positive effects on process and outcome are still robust, despite the criticisms.…”

Treatment Utility of Clinical Assessment

“…To date, investigations specific to TA have exclusively focused on these direct effects, i.e., immediate post TA. Such effects are to be attributed to administrating TA as such and the specific value of diagnostic information obtained can therefore not be disentangled from general benefits of assessment as an intervention (see Lilienfeld et al, 2011).…”

Furthering the reliable and valid measurement of mental health screening, diagnoses, treatment and outcomes through health information technology

“…Provision of counseling or behavioral therapy can be measured by number of sessions attended or modules completed, and care quality can be assessed through direct observation and critique, by measured adherence to a protocol, or by general measures of provider “quality”. To date, measurement criteria for non-pharmacologic treatment have been largely subjective and based on self-report or clinician judgment [42, 43], quality assessment of providers has been rare outside the training setting, and attention to decision-making ability has often been lacking [44]. Technology-based approaches are now beginning to overcome these limitations.…”