MODULE – II NATURE AND PURPOSE OF CLINICAL ASSESSMENT

STRUCTURE
2.0 Learning objectives
2.1 Introduction
2.2 Referral sources
2.3 Components of assessment
2.4 Planning- data gathering- analysis (qualitative, quantitative); interpretation- reporting
2.5 Factors influencing assessment.
2.6 Psychological report- purpose, nature, style, common errors.
2.7 Summary
2.8 Keywords
2.9Learning Activity
2.10 Unit End Questions
2.11 References

2.0 LEARNING OBJECTIVES

After studying this unit, you will be able to:

• Explain the various sources of referral for a clinical assessment

• Describe the process followed and factors influencing undertaking assessments

• Explain the different components of assessments

2.1 INTRODUCTION
In general, psychological assessment has been and continues to be a significant component of
clinical psychologists' training and work, as well as other types of psychologists. Early attempts
by Alfred Binet in Paris, France, to determine appropriate classroom placement for school
children based on test scores, as well as attempts in the United States to screen military recruits
to separate out those with emotional or cognitive problems, began psychological testing in the
early 1900s (Gregory, 2004). Psychological testing was seen as a useful tool for swiftly grasping
numerous facets of people's functioning and was used to predict success in a range of fields. It
was well-received by the psychological community, particularly in the United States, and it
became a significant tool for psychologists, as well as a catalyst for the continued development
of psychological evaluation as a clinical activity.
Clinical psychologists are known for playing one of the most distinctive and unique roles in
health-related activities: psychological assessment. Many forms of evaluations, including
neuropsychological, psychophysiological, and multidimensional personality assessments, are
almost solely associated with clinical psychology, and we have virtually no competition in these
domains. Other health-care professionals can treat and, in some situations, diagnose individual
patients, couples, and families, but this does not apply to psychological assessments. In addition,
assessment procedures have expanded outside the more typical mental health and educational
domains to include neuropsychology, medical, industrial, and forensic psychological professions,
with many clinical psychologists earning a solid livelihood doing so. Psychological assessment is
used by health psychologists to assess variables, rehabilitation psychologists to assess functional
status and rehabilitation potential in injuries, neuropsychologists to assess brain-related
problems, adjustment to living with chronic illnesses, and strengths in brain-injured people, and
forensic psychologists to assess various crime-related behavior and treatment. Psychologists
have proposed numerous and broad characterizations of evaluation over the years. According to
Groth-Marnat (1999), psychological assessment entails evaluating a person who is having
difficulties in order to get knowledge that can be used to solve the problem. Psychological
assessment is defined by Cohen, Swerdlik, and Phillips (1996) as the gathering and integration of
psychology-related data for the purpose of making a psychological evaluation, which is
accomplished using tools such as tests, interviews, case studies, behavioral observation, and
specially designed apparatuses and measurement procedures.
Using these definitions, we can say that psychological evaluation entails working with a clinical
psychologist who is knowledgeable about human behavior, psychological problems and
strengths, assessment tests and methodologies, and the genesis and treatment of psychological
issues. To produce and test hypotheses about behavior, the clinical psychologist obtains,
synthesizes, and integrates psychiatric, historical, contextual, and collateral (i.e., data from other
sources) data. This is done in order to come up with descriptions, explanations, predictions, and
recommendations for the psychological problems that a person is having. The ultimate goal is to
deliver high-quality information that can help with the patient's problems.
When conducting an assessment, the clinical psychologist must not only collect and analyze data
from a variety of sources in order to describe problems and characteristics, but also and perhaps
most importantly, integrate the data in order to gain a better understanding of the problems and
the person who exhibits them in order to assist that person. The clinical psychologist is seeking
to answer pretty specific questions and to involve the person, couple, or family in a collaborative
and supportive process that can begin the therapeutic process in and of it.
Assessment is the gathering and synthesis of data in order to make a decision. Almost everyone
performs some form of assessment at some point in their lives. We gather, process, and interpret
information about the backgrounds, attitudes, behaviors, and traits of the individuals we meet
whether we recognize it or not. Then, based on our past experiences, expectations, and
sociocultural context, we build impressions that govern our decisions to seek out some persons
while avoiding others.
Assessment material collected and processed by clinical psychologists is more formal and
methodical than that available to nonprofessionals.
Assessment remains an essential aspect of clinical psychologists' training and practice, even if it
is no longer their primary activity. After all, evaluation is essential to define a client's issues,
develop therapies, monitor therapy efficacy, conduct various types of research, and respond to a
variety of inquiries posed to therapists (Antony & Barlow, 2010).
2.2 REFERRAL SOURCES
Practitioners should Endeavour to grasp the unique difficulties and expectations experienced in
various referral contexts during the assessment process. Otherwise, despite their expertise in
delivering and interpreting tests, examiners may perform a series of tests that are unnecessary
and, at worst, convey meaningless information to referral sources and patients. That is, a
comprehensive study of the underlying reason for a referral can occasionally lead to the
conclusion that testing isn't even necessary.
Clinicians frequently make test interpretation errors because they do not respond to the referral
question in its entirety. As a result, requests for psychological testing are frequently vague: "I'd
like a psychological examination on Mr. Smith," or "Could you analyze Jimmy because he's
having school problems?" Although the referral source is frequently in this situation, the request
often does not identify a specific question that must be addressed or a choice that must be taken.
A school administrator, for example, may require testing to support a placement decision, a
teacher may wish to demonstrate to parents that their child has a serious problem, or a
psychiatric resident may be uncomfortable with a patient's management. The motivation for
testing at an organization can be as ambiguous as a statement that the procedure is a matter of
policy. Before physicians can deliver valuable problem-solving knowledge, more explanation is
required. Furthermore, many of these circumstances have underlying motives that psychological
testing alone may not be able to address. One of the most essential things to ask when dealing
with these situations is what decisions must be made about the patient.
The physician, who should actively collaborate with the referral source to set the client's
difficulty in a feasible context, has the obligation for examining and clarifying the referral
question. Clinicians must comprehend the referral source's decisions, as well as the available
alternatives and their ramifications. Clinicians must also clarify the psychological evaluation's
potential utility in identifying various choices and their prospective outcomes. They should
explain the benefits and utility of psychological testing, as well as the restrictions that come with
the procedure.
Clinicians should become familiar with the types of contexts in which they will be working to
help clarify the referral issue and construct a meaningful psychological evaluation. The
psychiatric setting, general medical setting, legal context, educational context, and psychological
clinic are the most common environments.
1) Psychiatrist
In a psychiatric environment, Levine (1981) listed the main variables that a psychologist
should be aware of. These referrals are usually made by a psychiatrist, who may be acting as
an administrator, therapist, or physician when asking the question. Each function has its own
set of challenges for the psychiatrist, and clinicians are in charge of developing evaluations
that directly address the difficulties at hand.
One of the most important tasks a psychiatrist plays on a ward is that of administrator. Ward
administrators must regularly make choices about issues like as the danger of suicide,
admission/discharge, and the appropriateness of a wide range of medical procedures.
Psychiatrists frequently use information from other people to help them make decisions,
while maintaining ultimate decision-making responsibility. This is a departure from the
traditional function of psychiatrists, which was primarily focused with diagnosis and therapy
40 years ago. Currently, the primary focus is on concerns of custody, patient independence,
and societal safety. This means that, from the standpoint of psychologists conducting
assessments, a formal DSM-5 (American Mental Association, 2013) psychiatric diagnosis is
frequently insufficient. A patient's diagnosis of bipolar disorder, for example, does not reflect
the level of danger the patient poses to himself or others. Many practical considerations must
be answered after patients are admitted to a mental facility, such as what type of ward to
place them on, what activities they should participate in, and what type of therapy would be
most beneficial to them.
To begin, the psychologist must figure out exactly what information the ward administrator is
looking for, particularly in regards to any patient-related choices that must be made. When
psychiatric psychologists receive ambiguous requests for "a psychological," they may
establish a standard examination based on what they've learned about what this term means
in their particular unit. They may assess the patient's defence mechanisms, diagnosis,
cognitive style, and psychosocial history without addressing the precise decisions that must
be taken, or they may simply address two or three pertinent topics while ignoring others.
Examiners must be especially aware of and attentive to psychiatric administrators' legal and
custodial responsibilities in order to enhance the usefulness of an examination.
In contrast to ward administrators' concerns, psychiatrists' usual referral questions when
evaluating a patient for possible psychotherapy include the appropriateness of the client for
such therapy, the most likely effective tactics, and the likely outcome of therapy. These
exams are usually straightforward and do not provide many challenges. Such assessments
can elucidate potential issues.
Capacity for insight, diagnosis, coping style, level of resistance, degree of functional
impairment, and problem complexity are all things that can happen throughout therapy.
However, if a referral is made during therapy, there may be a number of issues that aren't
immediately obvious from the referral question. These complicated aspects, as well as
prospective decisions that may emerge from the assessment information, must be
investigated by the evaluator. When psychiatrists strive to fulfill the duties of both
administrators (caretaker) and psychotherapist while without clearly defining these roles for
themselves or their patients, a potential conflict occurs. The patient may become defensive
and resistive as a result of the uncertainty, and the psychiatrist may believe that the patient is
not living up to the therapist's expectations. The therapist and the patient must communicate
in order to overcome this conflict, which cannot be resolved by elaborating on a certain trait
or need in the patient. This issue will not be addressed by a typical psychological evaluation
that looks into the patient's internal makeup.
A second possible difficulty area for clients who are referred in the middle of therapy is the
therapist's own nervousness and discomfort. As a result, concerns like therapist prejudice and
possible excessive expectations may be just as relevant, if not more so, than a patient's
qualities. If role ambiguity, countertransference, bias, or unrealistic expectations are detected,
they must be carefully explained and articulated.
Psychiatrists and Psychologists may have distinct mental models for defining a patient's
illness when operating in the capacity of physician. Psychologists may speak in terms of
difficulties in living with people and society, whereas psychiatrists work primarily from an
illness or medical viewpoint. Examiners must cross this conceptual divide in order to
successfully communicate the outcomes of psychological examinations. A psychiatrist, for
example, would inquire about a patient's dissociative condition; whereas a psychologist
might not think the term "dissociative disorder" is appropriate or even scientifically accurate.
However, the broader difficulty is that the psychiatrist must still make certain practical
decisions. In fact, the psychiatrist and the patient may have some of the same concerns about
dissociative disorders, but this conceptual difficulty may not be very important in the
patient's case. It may be necessary to give the patient a traditional diagnosis due to legal
restrictions or hospital policies. Antipsychotic medication, electroconvulsive therapy, or
psychotherapy may all be options for the psychiatrist. An effective examiner should be able
to look past any conceptual gaps and focus on practical issues. A psychiatrist may suggest a
defensive patient who is unable or unable to express his or her worries and inquire about the
possibility of schizophrenia. Beyond the diagnosis, there are other considerations, such as the
patient's cognitive processes and whether the person is a danger to himself or others. As a
result, a successful examiner must transform his or her findings into a conceptual model that
is both accessible to a psychiatrist and beneficial from a task perspective.
A medical setting in general
2) Physicians
It's been estimated that up to two-thirds of patients visited by doctors have predominantly
psychosocial issues, and that between 25% and 50% of those with clearly established medical
diagnosis have psychological diseases in addition to medical ones (Asaad, 2000;
Katon&Walker, 1998; McLeod, Budd, & McClelland, 1997; Mostofsky& Barlow, 2000).
The majority of these mental health issues are not diagnosed or referred for treatment
(American Journal of Managed Care, 1999; Blount et al., 2007; Borus, Howes, Devins, &
Rosenberg, 1988; Mostofsky& Barlow, 2000). Many "medical" illnesses, such as coronary
heart disease, asthma, allergies, rheumatoid arthritis, ulcers, and headaches, have also been
discovered to have a major psychosocial component (Blount et al., 2007; Groth-
Marnat&Edkins, 1996). Psychological factors are not only linked to disease, but they are also
linked to the development and maintenance of health. Furthermore, the treatment and
prevention of psychosocial aspects of "medical" complaints has been shown to be cost-
effective in areas such as surgery preparation, smoking cessation, chronic pain rehabilitation,
obesity, coronary heart disease interventions, and patients who are somatizing psychosocial
difficulties (Blount et al., 2007; Chiles, Lambert, & Hatch, 1999; Groth-Marnat&Edkins,
1996; Groth-Marnat, Edkins, &Schumaker, 1995; Sobel, 2000). As a result, a comprehensive
approach to the patient necessitates an understanding of the interactions between physical,
psychological, and social aspects (Kaslow et al., 2007; G. Schwartz, 1982). As a result,
psychologists have the capacity to make a significant contribution. Psychologists must
become familiar with medical terminology in order to function effectively in general medical
settings, which often necessitate mastering a complicated and wide vocabulary (see J. D.
Robinson & Baker, 2006). Another issue is that, despite the fact that physicians frequently
gather information from a variety of sources to aid in decision-making, they must bear
ultimate responsibility for their choices.
The presence of an underlying psychological disorder, possible emotional factors associated
with medical complaints, assessment for neuropsycho- logical deficits, psychological
treatment for chronic pain, the treatment of chemical dependency, patient management, and
case consultation are the most common situations in which physicians might use the services
of a psychologist (Bamgbose et al., 1980; Groth-Marnat, 1988; Pincus, Pechura, Keyser,
Bachman, &Houtsinger, 2006). Whether or whether a physical examination reveals a
physical cause for a patient's complaints, the physician must still come up with a treatment
plan or at the very least make an appropriate referral. This procedure is critical since a large
percentage of individuals referred to doctors have no visible medical problems and their
primary complaint is likely to be psychological (Asaad, 2000; Blount et al., 2007; Maruish&
Nelson, 2014; Mostofsky& Barlow, 2000). The psychologist can then goes into greater detail
and detail on how a patient can be treated for potential psychological issues (Kaslow et al.,
2007; Wickramasekera, 1995a, 1995b). This may necessitate the use of both standard and
more specialist assessment instruments, such as the Millon Behavioral Health Inventory or
the Millon Behavioral Medicine Diagnostic (Bockian, Meagher, &Millon, 2000; Maruish,
2000; Millon, 1997).
The psychological evaluation of a patient's cognitive condition is another field that has grown
in relevance. Whereas physicians look for physical lesions in the nervous system,
neuropsychologists have historically focused on the state of higher cerebral functions.
Another way to put it is that physicians assess how the brain functions, whereas
neuropsychologists assess how the person functions as a result of suspected brain damage.
Memory, sequencing, abstract reasoning, spatial organization, and executive abilities are
some of the most common areas of examination (Groth-Marnat, 2000b). Approximately one-
third of all psychological referrals in psychiatric and medical settings are for such referrals,
or at least screening for cognitive deficits. Neuropsychologists have previously been asked to
assist in determining whether a patient's concerns were "functional" or "organic." Rather than
making either/or decisions, the focus today is on whether the person has neuropsychological
abnormalities that may contribute to or account for observable behavioral issues (Loenberger,
1989). Physicians frequently seek to know if a test profile points to a certain diagnosis, such
as malingering, conversion disorder, hypochondriasis, organic brain illness, or depression
with pseudo neurological characteristics. The nature and extent of identified lesions,
localization of lesions, emotional status of neurologically impaired patients, extent of
disability, and suggestions for treatment planning, such as recommendations for cognitive
rehabilitation, vocational training, and readjustment to family and friends, are all topics that
neuropsycholo- gists frequently address (Lemsky, 2000; Lezak, Howieson, Bigler, &Tranel,
2012; P. J. Snyder, Nussbaum, & Robins, 2006).

A physician may also request a presurgical evaluation by a psychologist to determine the

possibility of a significant stress reaction to surgery. Finally, physicians, particularly
paediatricians, are typically concerned with recognising early indicators of significant mental
illness, which may have been brought to their notice by parents, other family members, or
instructors. In such cases, the psychologist's assessment should take into account not only the
patient's current psychological condition but also the contributing variables in his or her
surroundings, as well as a forecast of the patient's status over the next few months or years.
The examiner can then recommend the next step in the intervention process after evaluating
the patient's current state, current environment, and future prospects. A psychologist may
also consult with doctors to help them communicate the results of an examination to the
patient or the patient's family more effectively.

3) The Legal Situation

The use of psychologists in legal settings has grown in popularity, importance, and
acceptance during the last 40 years (see Goldstein, 2007; Otto &Heilburn, 2002).
Psychologists may be consulted at any point during the legal process. They may be consulted
during the investigation stage to judge the trustworthiness or quality of information supplied
by a witness. A prosecuting attorney may also need a psychologist to assess the quality of
another mental health professional's report, assess the accused's competency, or assist in
determining the details of a crime. A psychologist may be used by a defence attorney to
support an insanity plea, to assist in jury selection, or to prove brain damage. A court may
consider a psychologist's report as one of several criteria in determining a sentence; a prison
officer may seek advice to assess the type of imprisonment or level of danger; and a parole
officer may require aid in developing a rehabilitation programme.
Even if a psychologist writes a legal report, only around one out of every ten instances will
need him or her to appear in court. The growing usage and acceptability of psychologists in
legal settings has resulted in a gradual clarification of their roles (Goldstein, 2007; Otto
&Heilburn, 2002), as well as a profusion of forensic-specific evaluation instruments
(Goldstein, 2007). (Archer, 2006; Archer, Buffington-Vollum, Stredny, & Handel, 2006;
Heilbrun, Marczyk, &Dematteo, 2002). Acclimating to the courtroom atmosphere, on the
other hand, can be challenging for a variety of reasons, including the significant disparities
between courtrooms and clinics, as well as the necessity to learn specialist legal words like
reduced capacity and insanity. Furthermore, many attorneys are conversant with the same
professional literature that psychologists read and may use it to refute a psychologist's
qualifications, assessment procedures, or conclusions (Ziskin& Faust, 2008). Psychologists
must also become more sophisticated in their assessments of suspected malingering and
dishonesty (see kspope.com/assess/malinger.php for a review).

Each psychologist who appears in court must have their credentials confirmed. Clinical
experience in treating specialist illnesses and related publication credits are important factors
to examine. Psychologists' legal work is often regarded positively by the courts, and they
may have achieved parity with psychiatrists (Sales & Miller, 1994).

The practice of forensic psychology includes training/consultation with legal practitioners,

evaluation of populations likely to encounter the legal system, and the translation of relevant
technical psychological knowledge into usable information, according to the American Board
of Forensic Psychology (www.abfp.com). Child custody cases, competency to dispose of
property, juvenile commitment, Miranda rights comprehension, potential for having given a
false confession, and personal injury cases in which the psychologist documents the nature
and extent of the litigant's suffering or disability are the most common uses of psychologists
(e.g., stress, anxiety, cogni- tive deficit).
When working in the legal field, it is critical for psychologists to change their vocabulary.
Many legal terminologies have precise and specific definitions that, if misunderstood, might
have disastrous repercussions. Words like incomprehensible, mad, and reasonable certainty
may have various meanings in different court systems or states. This language, as well as the
other nuances involved in its application, must be learned by psychologists. Psychologists
may also be asked to explain the meaning of their results and how they arrived at them in
detail. Unlike the actual data that psychologists provide, the inferences and generalizability
of these findings are regularly scrutinised or even disputed by attorneys. This questioning can
come out as unpleasant or even antagonistic, but in most circumstances, attorneys are simply
trying to protect their client. In addition, according to proper legal protocol, the psychologist
must explicitly answer questions rather than responding to the implications or underlying
direction implied by the questions. Furthermore, attorneys (or jury members) may lack
training in or appreciation for the scientific method, which is a cornerstone of a
psychologist's education. Attorneys, on the other hand, are trained in legal analysis and
reasoning, which subjectively focus on the uniqueness of each case rather than a statistically
applicable normative group comparison (see Hilsenroth& Stricker, 2004).
The evaluation of insanity and the evaluation of competency are two potentially challenging
topics. Despite the fact that the insanity plea has gained a lot of attention, very few people are
aware of it, however, only a small percentage of those who do are successful. Because of the
dilemma of possible malingering in order to secure a reduced sentence and the ambiguity of
the term insanity, it is frequently difficult for an expert witness to evaluate such situations. A
person is usually judged mad under the McNaughton Rule, which holds that people aren't
responsible if they don't understand the nature and scope of their acts and can't tell if what
they did was improper in terms of social norms. In some areas, the term's ambiguity is
exacerbated by the fact that defendants can be given an insanity plea if it can be
demonstrated that they were insane at the time of the crime. Another state adds an
"irresistible impulse" element to the definition of insanity. The question of whether the
defendant is competent to stand trial is related to insanity. The ability to interact
meaningfully with the attorney, understand the aim of the proceedings, and understand the
implications of the prospective sanctions is commonly defined as competence. Specialized
assessment techniques, such as the MacArthur Competence Assessment Tool (Poythress et
al., 1999), the Evalua- tion of Competency to Stand Trial–Revised (R. Rogers, Tillbrook, &
Sewell, 2004), and the Rogers Criminal Responsibility Assessment Scales, have been
developed to improve the reliability and validity of competency and insanity evaluations (R.
Rogers, 1984).
Predicting dangerousness has also shown to be difficult. Due to the rarity of true violent or
self-destructive conduct (low base rate), any cutoff criteria will almost always result in a high
percentage of false positives (Mulvey & Cauffman, 2001). As a result, those who have been
wrongly recognised may be held, which is understandable. However, the negative
consequences of failing to recognize and respond to potentially violent people make erring
on the side of caution more acceptable. Attempts to employ particular scales on the
Minnesota Multiphasic Personality Inventory (MMPI; Overcontrolled Hostility Scale;
Megargee & Mendelsohn, 1962) or a 4-3 code type (see Chapter 7) for individual decision
making have not shown to be sufficiently reliable. However, by assessing for the presence of
antisocial features and using actuarial strategies, collateral sources, formal ratings, and
summed ratings, which include relevant information on developmental influences, possible
events that lower thresholds, arrest record, life situation, and situational triggers, such as
interpersonal stress and substance intoxication, significant improvements have been made in
predicting dangerousness and reoffending (Monahan & Steadman, 2001; Monahan et al.,
2000; Tolman &Rotzien, 2007). Individual evaluation procedures that combine recidivism
data, tests expressly designed to predict dangerousness, summed ratings, and double
administrations of psychological exams to gauge change over time are most likely to be
given weight by the legal/justice system. The Historical Clinical Risk–20 (for assessing
violence risk; Webster, Douglas, Eaves, & Hart, 1997) and the Static 99 are two often
utilized tests (for sexual reoffending risk; Hanson & Thornton, 1999). Informal clinical
interviews, on the other hand, are obviously seen as insufficient (Tolman &Rotzien, 2007).
Psychologists are occasionally called upon to assist with child custody issues. The American
Psychological Association has developed standards for preparing child custody and child
protection evaluations (Guidelines for Child Custody Evaluations in Family Law
Proceedings, 2010; www.apa.org/practice/guidelines/child-custody.aspx). The most
important factor to consider is which arrangement is best for the youngster. The parent's
mental health, the level of love and affection between the parent and child, the nature of the
parent-child relationship, and the long-term possible ramifications of various decisions on the
child are all factors to consider (M. J. Ackerman, 2006a, 2006b). Traditional testing devices
are frequently used to conduct psychological examinations on each family member. Specific
tests have also been devised, such as the Bricklin Perceptual Scales (Bricklin, 1984).
Finally, assisting with the classification of inmates in correctional environments is a
commonly requested function. The difference between simply managing a person and
attempting a rehabilitation programme is one of the most fundamental distinctions. Suicide
risk, the appropriateness of dormitory vs a shared room, potential harassment from other
inmates, and the degree of threat to others are all important management factors.
Rehabilitation recommendations may need to take into account a person's educational level,
interests, talents, abilities, and personality traits as they relate to work.

4) Academic or Educational context

Psychologists are regularly called upon to evaluate children who are experiencing problems
in school or who may require special placement. The most significant aspects are
determining the origin and depth of a child's learning issues, assessing behavioral difficulties,
developing an educational plan, estimating a child's responsiveness to intervention, and
recommending modifications in a child's programme or placement (Sattler, 2008, 2014). Any
educational strategy should take into account the relationships between a child's abilities,
diversity considerations, the child's personality, the teacher's traits, and the parents' wants and
expectations.

A typical educational placement starts with a trip to the classroom to observe a child's
conduct in natural settings. Observing the interaction between the teacher and the child is an
important part of this visit. Behavioral issues are frequently linked to the child–teacher
relationship. The teacher's response style to a student might sometimes be as big a part of the
problem as the student. As a result, classroom observations can be upsetting for teachers and
should be handled with care.

In many ways, observing the child in a larger setting runs counter to the history of individual
assessment. Individual testing, on the other hand, typically yields a limited and narrow range
of data, particularly because children are not credible self-reporters and parents or caregivers
may be biased. Additional critical data may be acquired if testing is integrated with a family
or school assessment, albeit there may be strong opposition. This opposition may be due to
legal or ethical limitations on the scope of services that the school can give or the demands
that a psychologist can make on the parents of the youngster. Often, the first focus is on the
student as a "problem child" or "designated patient," and the need to see him or her as such.
Larger, more complex, and still more important issues, such as marital strife, a disturbed
teacher, misunderstandings between teacher and parents, or a conflict between the school and
the parents, may be obscured by this focus. All or some of the individuals involved may have
a vested interest in seeing the student as the problem, rather than realizing that a
dysfunctional educational system or family issues may be to blame. With outstanding results,
an individually directed evaluation can be carried out.

The assessment may be ineffectual in tackling both the individual difficulties and the bigger
organizational or interpersonal problems unless wider circumstances are evaluated,
comprehended, and addressed.
Behavioral observations, a test of intellectual abilities such as the Weschsler Intelligence
Scale for Children–V, Stanford Binet–V, Woodcock-Johnson Psycho educational Battery–IV
(Woodcock, Schrank, Mather, & McGrew, 2014), or Kaufman Assessment Battery for
Children–II (K-ABC-II; Kaufman & Kaufman, 2004), and tests of emotional and behavioral
functioning are included in most school assessments of children. In the past, projective
techniques were commonly used to measure children's emotional functioning. Many
projective tests, on the other hand, have been found to have poor psychometric qualities and
to take a long time to administer, score, and interpret. As a result, projective instruments are
being phased out in favor of a wide range of behavioral rating instruments (Kamphaus,
Petoskey, & Rowe, 2000). The Achenbach Child Behavior Checklist (Achenbach &
Rescorla, 2001), the Conners–3 Parent and Teacher Rating Scales (Conners, 2008), and the
Behavior Assessment System for Children–3 are just a few examples (BASC-3; C. R.
Reynolds &Kamphaus, 2015). A variety of reliable objective instruments have also been
created, such as the Personality Inventory for Children–2 (PIC-2; Lachar& Gruber, 2001).
This questionnaire is identical to the MMPI, however it is completed by a child's parent. It
generates four validity scores for detecting faking as well as 12 clinical scales for depression,
family relations, delinquency, anxiety, and hyperactivity, among others. The Millon
Adolescent Clinical Inventory (MACI) or the MMPI-A can be used to assess adolescent
personality (MACI; Millon, 1993). The Vineland Adaptive Behavior Measures–II (Sparrow,
Cicchetti, &Balla, 2005), the Wechsler Individual Achievement Test–III (WIAT-III; Pearson,
2009a), and the Wide Range Achievement Test–IV are three more well-designed scales that
are increasingly employed (WRAT-IV; Wilkinson & Robertson, 2007).
Any report created for an educational context should emphasize a child's strengths as well as
his or her flaws. Understanding a child's strengths has the ability to boost a child's self-
esteem as well as effect change in a broad sense. Realistic and practical recommendations
should be made. When a clinician has a complete awareness of relevant resources in the
community, the school system, and the classroom environment, they can offer
recommendations more effectively. This is especially essential because the quality and
resources available in one school or school system may be vastly different from those
available in another. Recommendations usually state which skills must be learned, how they
should be learned, a hierarchy of objectives, and ways for minimizing difficult-to-learn
behaviors.

Only when a regular class would plainly not be as beneficial can a recommendation for
special education be made. The recommendations, on the other hand, are not the final result.
They are starting points that should be expanded and amended based on the preliminary
findings. A psychological report should, ideally, be followed up with ongoing monitoring.
Children's psychoeducational assessments should be done in two stages. The nature and
quality of the child's learning environment should be assessed in the first phase. It is
impossible to expect a youngster to perform effectively if he or she is not exposed to proper
quality training. As a result, it must first be proven that a youngster is having difficulty
despite receiving adequate teaching. The second phase entails a complete assessment battery
that includes tests of intellectual capacities, academic skills, adaptive behavior, and the
detection of any biological problems that could interfere with learning. Memory, spatial
organization, abstract reasoning, and sequencing are examples of cognitive talents. Students
will not function successfully regardless of their academic or intellectual aptitude unless they
have relevant adaptive qualities, such as social skills, adequate motivation and attention, and
the capacity to regulate urges. Assessing a child's educational beliefs and attitudes is critical
 because they affect whether the student is willing to use whatever resources are available to
him or her. Similarly, a person's level of personal efficacy plays a role in determining
whether or not he or she is capable of engaging in actions that lead to the achievement of the
goals that are important to them. Poor vision, hearing loss, hunger, excessive weariness,
malnutrition, and endocrine dysfunction are all physical issues that can make learning
difficult.
The foregoing principles clearly position children's assessment in educational settings in a far
broader context than just interpreting test scores. Relationships between the teacher, family,
and student, as well as the relative quality of the learning environment, must be evaluated. In
addition, the child's values, motivation, and sense of personal efficacy, as well as any
biological issues, must be considered. Examiners must learn about school and community
resources, as well as population-specific instruments with a high level of reliability and
validity.

5) Psychological Clinic
In contrast to medical, legal, and educational settings, where the psychologist is often
consulted by the decision maker, the psychologist working in a psychological clinic is
frequently the decision maker. There are several types of referrals that come into the
psychiatric clinic on a regular basis. Individuals who are self-referred and seeking assistance
from psychological distress are perhaps the most common. Extensive psychological testing
may not be necessary or even desirable for many of these people, as their diagnoses and
difficulties are likely to be straightforward, and time spent on testing could be better spent on
therapy.
Brief questionnaires aimed at assessing client characteristics most relevant to treatment
planning, on the other hand, can aid in the development of therapies that will both accelerate
the rate of progress and optimize the outcome (see Chapters 13 and 14). Brief instruments
can also be used to monitor therapeutic response or advise relevant changes, improving the
chances of a successful intervention (Lambert & Hawkins, 2004).
Furthermore, a psychologist may query if the treatment available at a psychological clinic is
appropriate for particular groups of self-referred clients. These customers can include those who
have serious medical issues, people who have legal issues that need to be clarified, and people
who need a greater level of care. In certain situations, psychological testing may be required to
acquire additional information. The testing's primary goal would be to assist in decision-making
rather than to provide direct assistance to the client. Others who may benefit from psychological
testing in clinics are individuals who are being seen in the clinic already, either because their
diagnoses are ambiguous or because their therapy has stagnated or plateaued. A full review could
provide clear direction in these situations.
Children, who are referred by their parents for educational or behavioral difficulties, as well as
referrals from other decision makers, are two more scenarios in which psychological testing may
be necessary. Special care must be taken before testing when referrals are made for poor school
performance or legal issues. First and foremost, the physician must gain a thorough grasp of the
client's social network as well as the reason for the referral. This comprehensive understanding
could include a review of previous therapy attempts as well as a synopsis of the connection
between the parents, school, courts, and child. A referral usually occurs at the end of a long
series of events, and it is critical to acquire information about these occurrences. The clinician
may elect to meet with other individuals who have gotten involved in the case, such as the school
principal, previous therapists, probation officer, attorney, or teacher, after the basis for the
referral has been addressed. This conference could reveal a variety of concerns that demand
decisions, such as referral for family therapy, special education placement, a change in custody
agreements between divorced parents, individual counselling for other family members, and a
change in school. All of these factors may have an impact on the testing's relevance and
methodology, but they may not be obvious if the initial referral question is taken at face value.
Referrals from other decision-makers are occasionally made to psychologists. An attorney, for
example, may wish to determine if a person is competent to stand trial. Other referrals can come
from a physician who wants to know if a patient with a head injury can return to work or drive,
or if the physician needs to track changes in the patient's rehabilitation.
So far, the focus of this discussion on the many circumstances in which psychological testing is
utilized has been on when to test and how to emphasize how tests can be most useful in making
decisions. There are a few more summary remarks that should be made. As previously stated, a
referral source may not always be able to appropriately simulate the referral inquiry. In truth, the
question of referral is rarely obvious or simple. It is the evaluator's job to examine beyond the
referral question and determine the referral's foundation in its broadest sense. As a result,
psychologists must have a thorough grasp of the client's social environment, including
interpersonal issues, familial dynamics, and the chain of events that led to the referral. A second
key aspect is that psychologists are accountable for establishing knowledge about the situation
for which they are writing their reports, in addition to explaining the referral question. Learning
the right terminology, the roles of the individuals working in the setting, the decisions faced by
decision makers, and the philosophical and theoretical ideas they hold are all part of this
information. It's also crucial for clinicians to grasp the principles that underpin the setting and
determine whether they align with their own. When working in particular circumstances,
psychologists who do not believe in aversion therapy, corporal punishment, or electroconvulsive
therapy, for example, may come into conflict. As a result, psychologists should be aware of how
the information they provide to their referral source will be used. It's critical for them to
understand that they bear a large amount of responsibility, because the judgments they make
about their clients, which are typically based on assessment results, can be key turning points in
their lives. If the information could be utilized in a way that goes against the evaluator's values,
he or she should reconsider, clarify, or possibly change his or her relationship with the referral
setting.
All of these considerations are compatible with the emphasis on an evaluator doing
psychological assessment in the position of an expert therapist rather than a psychiatrist
functioning as a technician.

2.3 COMPONENTS OF ASSESSMENT

Before clinical assessment can begin, two linked questions must be addressed (McReynolds,
1975): What exactly do we want to know, and how can we find out? The first question—what do
we want to know?—has different answers depending on who requested the evaluation and for
what reason. The referral source is the person or organization that requests the psychological
evaluation and the referral question is the topic or issue that will be addressed during the
evaluation. (We prefer to start with a referral question because the presenting problem is
frequently a longer description of the client's difficulties, whereas a particular question focuses
on the assessment target, whereas the presenting problem is often a longer explanation of the
client's difficulties.)
The referral question is crucial since it influences the clinician's assessment tool selection as well
as the interpretation and communication of results. Clinicians must consequently comprehend the
context of the referral and frequently assist referral sources in clarifying the assessment's
objective (Harwood, Beutler, &Groth-Marnat, 2011). Clinicians may need to educate others on
what a psychological exam may and cannot disclose as part of this process. They may also need
to teach them about the practical and ethical limitations.
The referral question is the first step in establishing the assessment's ultimate goal, and the
clearer the goal, the clearer the question," says the author. After the referral question and the
clinician's role have been clear, the answers to the second question—about how best can we find
out what we need to know—come into play. The physician can now start arranging data
collection procedures with a defined purpose in mind.
Although the referral question is the most essential aspect in the selection of evaluation
instruments, other factors also have a role. The quality of the assessment tool or technique is one
of them. Obviously, physicians should choose assessment methods with the best psychometric
features (e.g., reliability, validity, and usefulness), but this isn't always the case. If one test had
slightly lower (but still acceptable) reliability than another but produced more relevant
information on a specific referral topic, the physician might choose the one with slightly lower
reliability but more assessment relevance. "When deciding on exams, clinicians must also
examine the characteristics of clients, selecting instruments that are appropriate for each client in
terms of reading level, length, and other factors. Similarly, physicians must describe the
procedures and goals of the assessment to clients in language that they can comprehend.
Toorganise assessments, the clinician must think widely, balancing different qualities of
assessment instruments against practical considerations of time, context, and utility to clients and
other referral sources (Hunsley& Mash, 2010). The physician must also consider how to
combine and integrate evaluation results into a narrative that serves a specific clinical objective.
A. Data Collection for Assessment
The data-collection step of assessment can begin once the referral question has been clarified, the
proper assessment methods have been selected, and the client's cooperation has been gained.
Interviews, observations, tests, and historical records are the four basic sources of evaluation data
for clinical psychologists (case history data). However, they rarely generate a workable image of
a customer based on a single evaluation source. Instead, they use a variety of evaluation channels
to cross-validate data on a wide range of subjects. As a result, hospital records may disclose that
a patient has been in the hospital for 30 days, contradicting the patient's self-reported estimate of
two days. Indeed, until various evaluation sources are accessed, the complete picture of a client's
concerns is rarely obvious. People have been reported to be assertive in social situations while
describing themselves as generally unassertive in an interview or on a test (Nietzel& Bernstein,
1976). To distinguish people who do not engage in specific behaviors from those who cannot,
several sources of assessment are frequently used.
When the doctor evaluates the effects of treatment, another advantage of employing numerous
assessment sources comes into play. Let's say a couple goes to therapy because they're thinking
about divorce and then divorces three months later. If the only outcome measure used in this
example was "marital happiness," as indicated in interviews, the treatment could be interpreted
as worsening marital distress. Observations, third-party reports, and life records, on the other
hand, may demonstrate that one or both parties are finding their newly divorced state liberating
and developing new interests and abilities."

i) Interviews
When conducting clinical interviews, psychologists attempt to establish a comfortable
setting in which the client can discuss the difficulties that are bothering him or her. The
psychologist does not answer the phone, read text messages, or respond to emails during
the assessment interview, so there are no interruptions. Offices should ideally be
soundproofed to reduce distracting background noises. To put clients at ease, the
psychologist maintains a calm and relaxed demeanor. The clinical interview, on the other
hand, is not a social visit. It differs from conversations a client could have with friends,
the hairdresser, or a stranger on a long train journey in significant ways. Allowing
someone to simply share their tale differs from doing a clinical evaluation interview.
Empathic listening may be enough to bring brief respite to a troubled friend, but it isn't
enough to allow the psychologist to make a diagnosis or begin treatment planning.
Because an assessment interview is not an ordinary conversation, the client may feel
more at ease addressing painful or embarrassing topics than he or she might with friends.
The psychologist is in charge of organizing the session so that all pertinent subjects are
covered during the assessment interviews. The amount to which the psychologist overtly
controls the session, the way in which the questions are asked, and the topics discussed
are all determined by the psychologist's theoretical perspective and training.
Psychologists, on the other hand, are taught to ask questions in a way that encourages the
client to participate in the interview.
The distinction between open and closed questions is significant. Open questions require
more detailed responses from the client and cannot be addressed with a simple yes or no.
Closed questions, on the other hand, have a single response. Each has its own set of
benefits and drawbacks. Open inquiries allow the client to provide a more sophisticated
response without implying that a certain response is expected. Open questioning, on the
other hand, may lead to the client telling a long, tangential storey with no relevance, in
which case the psychologist must redirect the client back to the topic at hand. Closed
questions, on the other hand, provide brief, less confusing responses, allowing for quick
discussion of a wide range of topics. Exhibit 6.4 illustrates the difference between open
and closed inquiries. Many psychologists find it helpful to start a conversation with an
open-ended question and then follow up with closed inquiries that elucidate the
response's contents.
Although some individuals believe that asking questions about difficult topics like
suicide will make people more suicidal, this is not the case. Because the way a question is
phrased can influence the sort of response, psychologists avoid asking leading questions
or inserting words into the client's lips. When a client's first response to a topic is evasive
or ambiguous, the psychologist must encourage the client to expound or explain: Tell me
what you mean...; tell me more about it. In contrast to common conversational
conventions, the psychologist softly pursues a line of inquiry until the question is
answered. So, if Jessica changed the subject or made a joke when asked about her new
relationship, a friend may conclude that she didn't want to talk about it and go on to
something else, whereas a psychologist might inquire whether she noticed she was
having trouble talking about it. Because professional assessment interviews are not the
same as casual conversations, the psychologist may ask difficult-to-answer questions (for
example, what was it like for you when you had the miscarriage?). As you were forcing
yourself to vomit, what was going through your mind? When you tell someone you've
been diagnosed with schizophrenia, how do they react?). Clients may be stumped for a
response and must pause before responding. Psychologists employ silence to give clients
time to think and reflect, so they don't feel obligated to fill in the gaps in speech like they
might in a social setting.
Assessment interviews are not like typical chats, as we've emphasized countless times.
During assessment interviews, psychologists must be on the lookout for client issues.
Given the increased risk of suicide among persons suffering from a depressive disease, it
is normal to ask questions when screening a depressed client to estimate the likelihood of
a suicide attempt. Those inquiries must be based on current knowledge of the factors that
raise the risk of suicidal behavior. Suicidal thoughts, plans, and lethality, as well as
access to the means to attempt suicide, are all addressed by psychologists. Given the
substantial links between a history of suicidal behavior and the risk of future suicidality,
questions about suicide attempts must be included. Because some suicidal clients may
simply make a generic remark about their level of misery or hopelessness, the
psychologist must follow up with questions that measure the current danger. Exhibit 6.10
illustrates the types of inquiries psychologists ask when assessing the risk of suicide. If a
psychologist determines that a patient has a low risk of suicide, the psychologist should
make sure that the patient knows the phone numbers for a suicide helpline and a nearby
hospital. If the patient appears to be in danger, the psychologist may need to take them to
the nearest hospital's emergency room.
ii) Observations
The psychologist keeps a close eye on the client during the evaluation interview.
Important data can be collected by monitoring the client in addition to the answers to
inquiries. Although comments about the client's appearance and grooming used to be
common in clinical assessments, it is now only necessary to record remarkable traits that
are relevant to the evaluation. Some people find comments on a client's beauty
disrespectful because they are unrelated to the referral inquiry. The client's activity level,
attention span, and impulsivity are all noted by the psychologist. The client's speech is
carefully examined, with any difficulties or irregularities noted. Clients' bodily motions
and behaviors, as well as the ease with which they can be interacted with, are observed by
the psychologist.
Children with ADHD, for example, frequently respond effectively when given the full
attention of an unknown adult in unusual surroundings. As a result, a psychologist may
underestimate the severity of a kid's difficulties by believing that the child's behavior
during an intake interview is typical of how the child acts in general. Naturalistic
observations are used to gain information that is difficult to obtain in the office. It enables
the observation of behaviors that clients may not be able to express in interviews or
questionnaires because they are either ignorant of or uncomfortable with them. In a
familiar situation, home observations provide information about how the child and
parents behave. School observations provide information regarding the school
environment, teaching style, and a student's behavior in a classroom setting. Outside of
the clinic, permission is required to conduct observations. The parent (and, if the child is
deemed capable of consenting, the youngster) must provide their approval for the child to
be observed. Observations at school must also be approved by school personnel.
Naturalistic observations are timed to coincide with the most likely occurrence of the
issue behavior. The hours around supper, homework, and bedtime preparation are times
of conflict and struggle in many households with young children. School observations
may be organized to view the kid in both preferred and non-preferred activities, with
different teachers, during quiet study periods, and on the playground, depending on the
assessment issue.
The purpose of the observer is to be like the proverbial fly on the wall, noticing
everything while avoiding being noticed. Observers present themselves in a professional
yet unobtrusive manner. After a few brief greetings, the observer invites everyone to go
about their business as usual. The presence of a clipboard and a pen serves as a reminder
to both adults and children that this is not a typical social visit. Even though adults try
their hardest to make a good impression and act their best at first, children are
extraordinarily effective at convincing adults to act truly. Children make observations
about odd behaviors that adults may engage in in order to impress the observer,
Direct observation data is used to establish hypotheses about the child's functioning,
which are then tested against other assessment data. It would certainly be inappropriate to
make diagnostic choices simply on the basis of observations, or to assume that a child's
behavior was normal during the observation period. These observations only provide a
sliver of information on how the youngster interacts with significant others at home and
at school. Observational data, when joined with information from interviews, tests, and
other people's reports, can affirm or attenuate the developing picture of the child's
strengths and shortcomings.
People are impacted by their appearances, according to a significant corpus of
psychological studies (Garb, 1998). The idea that persons who wear glasses are cleverer
than those who do not is a well-known example. Hairstyles, grooming, posture, hand
gestures, and voice tone are among the other biases. Psychologists are not immune to
these biases, which can influence their decisions. When interacting with a new group, we
are especially prone to making mistakes. A greeting in certain parts of Canada may
consist of a barely visible nod of the head, yet in others, it may include a handshake,
kisses on both cheeks, and nose touching. According to ethical norms, psychologists must
become conscious of how their background affects their relationships with people and
their judgments of others' behavior.
The psychologists would have borrowed these systematic observation systems for use in
the clinic, given the tremendous insights we've obtained into parent–child and couple
relationships based on studies utilizing systematic observation of interactions. Despite the
fact that physicians rely heavily on observation in their assessments, they rarely employ
observational coding systems that have been standardized or proven to be reliable and
valid (Mash & Foster, 2001). Although formal diagnostic interviews produced in a
research context have been adjusted for use in clinical practice, observations have not
made the same transition from research to clinical practice. One big stumbling block is
the cost. To examine a single hour of conversation, some of the most valuable study
coding techniques need hours of coding. These charges are exceedingly difficult to justify
in a cost-conscious health-care system. As a result, academics are working on
observational methods that need less coding time. For example, the Disruptive Behavior
Diagnostic Observation Schedule (DB-DOS) is a brief observational approach that has
been demonstrated to aid in the identification of disruptive behavior problems and ADHD
in preschoolers (Bunte et al., 2013).
iii) Tests
Psychologists are experts in the creation and application of tests for the study and
treatment of human behavior. Although you can find quick tests of various concepts on
websites and magazines, creating a scientifically sound psychological test requires more
than just writing a few questions and coming up with a catchy name. The American
Educational Research Association [AERA], American Psychological Association, and
National Council on Measurement in Education (American Educational Research
Association [AERA], American Psychological Association, and National Council on
Measurement in Education, 2014) established principles for psychologists to follow when
developing and using tests and assessment procedures. A number of requirements must
be met for a psychological test to be useful in research or clinical practice, as you will see
in the following sections.
But first, let's define what a psychological test entails. Although defining a test appears to
be a simple operation, it is actually quite complicated. A test is defined as "an evaluative
device or procedure in which a sample of an examinee's behavior in a specified domain is
obtained and then evaluated and scored using a standardized process" in the Standards
(AERA et al., 2014). This description is cumbersome and may not be easily understood
by non-psychologists, despite the fact that it is broad enough to incorporate a variety of
testing procedures (including interviews, observation, and self-report). A test is defined
by Hunsley, Lee, Wood, and Taylor (2014) based on its intended usage.
(a) The clinician's intent is to collect a sample of behavior that will be used to generate
statements about a person, a person's experiences, or a person's psychological
functioning,
(b) the clinician claims or implies that the accuracy or validity of these statements is due
to the way the sample of behavior was collected and interpreted rather than the clinician's
expertise, authority, or special qualifications, then the process used is valid.
So, while you might be able to quickly create a questionnaire to evaluate some element of
human functioning, it isn't a test unless it has been shown to meet the standards of
reliability, validity, and norms.
What difference does the definition of a psychological test make? Although there are
various technical reasons for this, there is also a practical explanation that has far-
reaching real-world implications. Psychological tests are commonly employed in legal
 and quasi-legal contexts, such as when a judge must decide on child custody or when a
tribunal must decide whether to grant a disabled worker a disability pension. Without
measures to guarantee that psychological tests follow scientific criteria, any series of
questions may be referred to as a test, and the findings could be presumed to be
scientifically correct and valid. All mental health practitioners do evaluations, however
psychologists have significantly more training in testing issues and are far more likely to
employ tests than other mental health experts. Whiteside, Sattler, Hathaway, and Douglas
(2016) conducted a survey of 339 clinicians from various fields who were delivering
mental health care to children with anxiety problems. Parent-report questionnaires, child-
report questionnaires, and structured diagnostic interviews were all asked about by
participants. Respondents were then divided into groups based on how frequently they
used EBA tools. Parent-report questionnaires and child-report questionnaires were used
more frequently by doctoral-level psychologists than by licenced counselors or master's-
level social workers; both groups used structured diagnostic interviews infrequently.
Standardization
Standardization is an essential aspect of a psychological test, and it denotes consistency in the
process used to administer and score the test across clinicians and testing days (Anastasi &
Urbina, 1997). It is nearly impossible for the psychologist, or any other psychologist, to
reproduce the information acquired in an examination without standardization. Furthermore,
without standardization, test findings are likely to be highly specific to the unique elements of
the testing environment and unlikely to yield data that can be extended to other psychologists'
tests, let alone other situations in the person's life.
Reliability
In both clinical and research settings, the topic of how trustworthy a test must be frequently
arises. Internal consistency refers to whether all aspects of the test contribute meaningfully to the
data obtained (internal consistency), whether similar results would be obtained if the person was
retested at some point after the initial test (test-retest reliability), and whether similar results
would be obtained if the test was conducted and/or scored by a different evaluator (test-retest
reliability) (inter-rater or inter-scorer reliability). If we want to generalize the test results and
their psychological implications beyond the present assessment context, we need reliable results.
Stimulus standardization, administration, and scoring are all prerequisites for good test
reliability, but they do not guarantee it. A test may have too many components that are
influenced by irrelevant client characteristics, the testing situation (such as demand
characteristics related to the testing purpose), or the assessing psychologist's behavior. It's also
possible that the test's scoring criteria are too difficult or lacking in detail to allow for accurate
scoring.
Validity
When we talk about test validity, we're talking about how much evidence there is that the test
actually measures what it claims to measure, as well as how the test findings are interpreted.
Because a test claiming to measure one construct may actually be measuring another or be
misconstrued, a standardized test that yields trustworthy results does not always yield valid data.
Test validity entails ensuring that the test includes items that are representative of all aspects of
the underlying psychological construct the test is designed to measure (evidence of content
validity), that the data provided is consistent with theoretical postulates associated with the
phenomenon being assessed (evidence of concurrent validity and evidence of predictive
validity), and that the test provides a relatively pure measure of the construct that is minimally
confounded (evidence of concurrent validity and evidence of predictive validity) (evidence of
discriminant validity).
Evidence of incremental validity, which is the extent to which a measure adds to the prediction
of a criterion over what can be anticipated by other sources of data, should be addressed in
practical contexts, such as in clinical evaluation (Hunsley& Meyer, 2003; Sechrest, 1963).
Norms
It is critical to employ either norms or particular criterion-related cut-off scores to interpret the
findings collected from a client in a relevant way (AERA et al., 2014). It is impossible to
determine the specific meaning of any test results without such reference material. So, if you
were given a 44 on an emotional maturity test, you wouldn't know what it meant unless you
knew the range of possible scores and how most other people scored. In psychological testing,
comparisons must be made to either test-specific criteria (e.g., a certain level of accuracy
indicated in the exam is required for good job performance) or to some sort of norms.
Norms are established by test developers for the most part in clinical psychology. Most crucially,
choices must be made on which populations will be subjected to the test. It is possible to develop
criteria for comparing a given score to those obtained in the overall population or certain
subgroups of the general population (e.g., gender-specific norms). So, if your emotional maturity
score of 44 was significantly greater than the overall population's average, you might be rather
satisfied. It is also possible to develop rules for determining the possibility of belonging to
specific theoretical or real groups (e.g., non-distressed versus psychologically disordered
groups). It may be required to design numerous norms for a test based on the group being tested
and the testing goal, much as it is with validity issues (i.e., norms relevant for different ages and
ethnic groups).
iv) Case studies
Case studies, like case studies in medicine, have a long and illustrious history in clinical
psychology. The professional community has been enriched by descriptions of
uncommon presenting conditions or novel therapies.
A typical case study entails a detailed description of a single patient, couple, or family
that demonstrates a novel or unusual observation or therapeutic innovation. Case studies
are an effective way to make preliminary linkages between events, behaviors, and
symptoms that haven't been covered in previous studies. Case studies can provide a
wealth of research theories for causation and maintenance of illnesses. They can also
serve as the first test bed for new assessment or intervention procedures. Case studies
offer heuristic value, which means they call other professionals' attention to a situation.
Case studies have scientific importance since they can create ideas, but they don't allow
for thorough testing of theories. The most serious flaw in the case study technique is that
most concerns to internal validity go unaddressed (Kazdin, 1981). Consider the treatment
of Zach's homework-related temper tantrums as an example. Typically, the author of a
case study describes the client's symptoms or issues before and after treatment (such as
the number of tantrums and their intensity). Alternative explanations cannot be ruled out
in this modest research design, even if the author would prefer to claim that any
improvement was attributable to treatment effects. Normal developmental changes (i.e.,
maturation—the simple effects of Zach growing older or having no homework during the
holidays), the abating of symptoms that typically occurs over time (i.e., regression to the
mean), or life events outside of therapy (i.e., history effects, such as getting a new
teacher) could all account for the observed changes.
 B. Processing data and drawing Conclusions
Following the collection of assessment data, the doctor must establish what those findings mean.
If the data is to be valuable in helping the clinician achieve his or her assessment goals, it must
be changed from its raw state into interpretations and conclusions that address a referral
question. The processing challenge is daunting because it necessitates a mental jump from
known data to what is thought to be true based on those data. In general, inference becomes more
sensitive to error as the distance between data and assumption grows longer.
Consider the following: On a lawn, a young boy is chopping an earthworm in half. It would be
easy to conclude from this observational data that the child is nasty and violent, and that he could
grow up to be dangerous. These deductions, however, would be incorrect, because "what the
observer couldn't see was what the child, who happened to have few friends, thought as he cut
the worm in half: 'There!' You'll have someone to play with now' (Goldfried&Sprafkin, 1974, p.
305). In short, complex inference can be risky, especially when it is based on limited data.
It's also challenging to process assessment data because information from diverse sources must
be combined. Unfortunately, there are few empirical standards for combining data from
interviews, tests, observations, and other sources to arrive at comprehensive conclusions. As a
result, clinicians must frequently rely on clinical judgement to get their conclusions.

2.4 Planning-data gathering analysis (qualitative, quantitative), interpretation -reporting

Analyzing Quantitative Data

Quantitative data analysis is a method for gathering and analyzing measurable and verifiable data
in a systematic way. It has a statistical system for evaluating or interpreting numerical data
(Creswell, 2007). The primary goal of a quantitative research analyst is to quantify a hypothetical
circumstance. It is usually carried out by academics that are well-versed in quantitative analysis
techniques, either manually or with the use of computers (Cowles, 2005). The quantitative
approach to a phenomenon usually has two major benefits. For starters, it allows a researcher to
categories, summaries, and illustrates observations in a methodical manner. Descriptive statistics
refers to all of these mechanisms and strategies. Second, it allows a researcher to comprehend
and draw conclusions about phenomena (a sample) that is investigated in a specific, limited
population. The sample is always taken methodically from a much larger group so that the results
drawn can be applied to the entire population (Cowles, 2005). To put it another way, this
procedure sets the road for a researcher to reach findings via inductive reasoning. Inferential
statistics are used to quantify all of the procedures, approaches, findings, and conclusions.
Descriptive Statistics: Descriptive statistics is a type of quantitative data analysis that is used to
describe or display data in a quantitative format that is easily accessible (James and Simister,
2020). To put it another way, this analytical approach aids researchers in illustrating and
summarizing an observation. Furthermore, researchers choose this statistical technique since it
aids in the development of logic linked with quantification. Because it translates observations
into numerical data, statistical measurement is a preliminary phase of quantitative research. In a
broader sense (Peller, 1967), statistical measurement is the task of applying numbers to items or
events according to rules. The first category is nominal scales, which aid in the organization of
observations into confined categories, according to Peller (1967). Ordinal scales are the second
type. Ordinal scales are used to organize research variables into groups based on their relative
positions. Furthermore, interval scales are the third form of grading system. These scales use
balanced intervals to not only measure but also to represent the stage of a variable's, individuals,
or object's quality. Ratio scales are the fourth type.
The balanced intervals are also used by ratio scales to register measurements from a well-defined
zero point. Furthermore, the researchers organize their observations by using frequency
distributions or graphs to quantify them.
Frequency Distribution: The researchers rationally order each measurement from high to low
in frequency distribution. In the frequency distribution, there is also an initial step that allows a
researcher to enroll the average in a line. The line's peak represents the highest point of all, while
the line's foot represents the lowest point of all. Furthermore, the line includes all transitional
averages, including those with zero average; otherwise, the frequency division or distribution
would be much more compressed than it is (Fallon, 2016). As a result, arranging the data in a
frequency distribution aids in statistical analysis calculations.
Graph Management: A graph is a representation of data in the form of a diagram. In
quantitative research, graphs are typically used to depict the relationship between two or more
quantities, measures, or indicative figures (Creswell, 2005). The researchers benefit greatly from
the organization of the obtained research data into graphs. Although there are many other types
of graph management, the researchers mainly use frequency polygon and histogram.
Inferential Statistics: The method and practice of inferential statistics is inductive. It enables
researchers to extrapolate findings from a sample to the entire population. To put it another way,
the researchers can extrapolate their findings from one faction to the entire population. If the
samples under consideration really represent the population from which they were gathered, the
generalizations are considered to be reliable. As a result, the researchers classified sampling into
two categories: probability sampling and non-probability sampling (Kothari, 2004). 3.2
Sampling via Probability Simple random sampling, cluster sampling, systematic sampling, and
stratified sampling are the four processes used in probability sampling, which is a random
selection of a population. Each factor or ingredient in a population has an equal chance of being
randomly selected in basic random sampling. In cluster sampling, the researcher selects groups
or clusters at random from a large population to use as a cluster or sample. Furthermore,
stratified sampling entails picking a sample from various subgroups or portions of the
population. In systematic sampling, on the other hand, the researcher selects every Kth example
from a population directory.
The researcher can easily produce both the frequency polygon and the histogram in this manner.
Basic affinity is measured by the mode, median, and mean. All of these factors contribute to the
creation of a specific index that indicates the whole set of measurements' standard, regular score.
The mode is a scale or nominal statistical metric. It calculates a constant that happens
infrequently. Furthermore, when it comes to educational research, it is barely useful (Kothari,
2004). In addition, the median denotes an ordinal scale for calculating or measuring statistics. It
does not take into account the distribution of scores, but it does account for the volume of
individual scores. Finally, the mean is a reasonable statistic with a high degree of consistency. A
phenomenon's basic tendency is also shown by the methods.
Analyzing Qualitative Data
Qualitative methods are being used by an increasing number of psychology researchers.
However, scepticism about the validity of qualitative methodologies in psychology is hampered,
according to some editors, by the small number of qualitative manuscripts submitted to journals
(Kidd, 2002). A strong qualitative tradition exists in some fields, such as anthropology and
sociology. The historical development of qualitative research in these domains was fraught with
arguments and controversies akin to those that arose later in psychology (Denzin and Lincoln,
2000; Kidd, 2002; Vidich and Lyman, 2000). In psychology study, qualitative methods have
been around for a long time. Wilhelm Wundt, the founder of the first psychology laboratory in
1921, prophesied that the field will split into two sections. Psychology could be explored in one
branch as the study of basic psychological functions such as feeling and perception in the
laboratory. The study of superior psycho-logical functions above the level of individual
awareness would be the focus of the second branch of psychology.
Qualitative research is a creative and interpretive process that never stops. The researcher does
not simply return home with piles of empirical data and then write up his or her conclusions with
ease.
Content analysis, grounded theory (Glaser & Strauss, 1967), theme analysis (Braun & Clarke,
2006), and discourse analysis are some of the techniques used to make sense of qualitative data.
Content Analysis: Written, spoken, or visual communication communications are analyzed
using content analysis (Cole 1988). In the nineteenth century, it was first used to examine hymns,
newspaper and magazine articles, ads, and political speeches (Harwood & Garry 2003). Content
analysis is a technique that may be applied to both qualitative and quantitative data, as well as
inductive and deductive reasoning. The study's purpose will dictate which of these is used. The
inductive technique is advised if there is insufficient prior information of the phenomena or if
this knowledge is fragmented (Lauri &Kyngas 2005). Inductive content analysis yielded the
categories, which were developed from the data. When the structure of the analysis is
operationalized based on previous knowledge and the study's goal is hypothesis testing,
deductive content analysis is applied (Kyngas&Vanhanen 1999). According to Chinn and
Kramer (1999), an inductive data strategy advances from the specific to the general by observing
distinct occurrences and then combining them into a broader whole or general assertion. Because
a deductive approach is built on a prior theory or model, it progresses from broad to specific
(Burns & Grove 2005). Preparation phases for both approaches are similar.
Grounded Theory: In qualitative research, grounded theory is a common strategy and
technique. The term "grounded theory" refers to the "process of developing a theory based on the
collecting of facts from a variety of sources."
It is the only qualitative research method that, when necessary, incorporates quantitative data.
The grounded theory technique seeks to collect data from a textual base (for example, a
collection of field notes or video recordings) and analyze it. The database is categorized into
different variables after the interpretation process, and the interrelationships between these
variables are then examined and investigated.
In any case, the process of splitting and constructing variables necessitates a full understanding
of the literature, as well as a careful selection of the technique for doing so. "Theoretical
sensitivity" refers to a person's capacity to analyze and evaluate data. This sensitivity must be
highlighted and enhanced by the theoretician. In the 1960s, Glaser and Strauss pioneered the
grounded theory approach. The primary goals of grounded theory are as follows:
i) Because the approach consists of a series of systematic procedures and evidence is gathered
from multiple sources, it ensures that a "good theory" is produced as an output.
ii) The grounded theory method emphasizes the evaluation process. The theory's merit is
determined by this.
iii) The grounded theory method emphasizes theoretical sensitivity as well.
iv) Formulating hypotheses based on conceptual notions is one purpose of a grounded theory.
v) The researcher uses the questions to try to figure out what the participants' major problem is
and how they keep trying to fix it.
vi) It also aspires to develop concepts that explain people's actions regardless of time or location.
The purpose of the descriptive sections of a GT is to demonstrate concepts.
"GT (grounded theory) is multidimensional," according to Glaser (1998). It occurs in a certain
order, then in a different order, then in a different order, then in a different order, then in a
different order, then in a different order, and finally
However, grounded theories produce a set of probability statements regarding the link between
concepts, or an integrated set of conceptual hypotheses based on actual data, rather than a report
of facts (Glaser 1998).
Thematic Analysis: Within and outside of psychology, thematic analysis is a poorly defined and
underappreciated qualitative analytic tool (see Boyatzis, 1998; Roulston, 2001). Thematic
analysis should be considered as a foundational method for qualitative research because
qualitative methodologies are extremely diverse, complicated, and nuanced (Holloway &Todres,
2003). It is the first qualitative method of analysis that researchers should learn, as it teaches
fundamental skills that may be used in a variety of other qualitative studies. Indeed, "thematizing
meanings" is one of a few generic talents shared across qualitative analysis, according to
Holloway and Todres (2003: 347).
As a result, Boyatzis (1998) defines it as a tool that may be applied to a variety of ways rather
than a specific method. Similarly, Ryan and Bernard (2000) regard theme coding as a procedure
carried out within "important analytic traditions" (such as grounded theory), rather than a distinct
method. We believe that thematic analysis should be treated as a separate method.
Thematic analysis is flexible, which is one of its advantages. There are two schools of qualitative
analytic techniques. Those related to, or emanating from, a particular theoretical or
epistemological perspective fall under the first category. Within some of these frameworks, such
as conversation analysis ([CA] e.g., Hutchby&Wooffitt, 1998) and interpretative
phenomenological analysis ([IPA] e.g., Smith & Osborn, 2003), there is (as of yet) rather limited
variety in how the method is implemented. In essence, analysis is guided by a single recipe.
Others, such as grounded theory (e.g., Glaser, 1992; Strauss & Corbin, 1998), discourse analysis
([DA] e.g., Burman & Parker, 1993; Potter & Wetherell, 1987; Willig, 2003), and narrative
analysis (e.g., Murray, 2003; Riessman, 1993), have different manifestations of the method
within the broad theoretical framework. Second, there are procedures that are fundamentally
unaffected by theory or epistemology and can be used to a variety of theoretical and
epistemological approaches.
Although theme analysis is frequently (implicitly) characterized as a realist/experiential method
(e.g., Aronson, 1994; Roulston, 2001), it is firmly in the second camp, and is consistent with
both essentialist and constructionist paradigms within psychology (we discuss this later).
Thematic analysis is a versatile and effective research approach that may produce a rich and
detailed yet complex explanation of data due to its theoretical freedom.
Given the benefits of thematic analysis' flexibility, it's critical that we make it clear that we're not
attempting to restrict it. Because there are no clear and precise standards for theme analysis, the
"anything goes" critique of qualitative research (Antaki, Billig, Edwards, & Potter, 2002) may
apply in some cases. With this work, we seek to strike a compromise between clearly delineating
thematic analysis – that is, explaining what it is and how to conduct it – and ensuring flexibility
in its application, so that it does not become limited and constricted, and lose one of its key
advantages. Indeed, a precise definition of this method will be helpful in ensuring that those who
employ thematic analysis have control over the type of analysis they apply.
2.4 FACTORS AFFECTING ASSESSMENTS
Because counseling is a behavioral science, there are many uncontrollable elements that might
lead to assessment errors. For example, when a school counsellor uses an intelligence test to
assess a child's IQ, there are various things that can affect the real score of the student, such as
the youngster being apprehensive or being distracted by other internal issues. All of these
sources of assessment flaws cause issues that detract from the scientific validity of the
evaluation. The use of unbiased and fair exams will allow customers to receive the best
appropriate evaluation services. There are also a slew of additional elements to consider in order
ensuring efficient assessment and counselling.
i) Environmental Factors
The reliability and validity of an evaluation technique might be influenced by a variety of
external factors. Room temperature, noise in the testing room, bad lighting, imprecise timing,
malfunctioning test equipment, or even the test administrator can all have an impact on a
person's test results. As a result, the physical setup of the test situation must be optimal in order
to minimize the risk of impacting the client's test performance. The counsellor should verify that
the testing atmosphere is appropriate and that all test takers and clients receive the same
administration techniques.
The testing room should be adequately lit and well ventilated. Extremes in temperature will
make the customer uncomfortable and have a detrimental impact on the test results. The client
should be at ease so that he or she may take the test with a clear mind. The atmosphere should be
friendly and inviting. It will help the client overcome any inhibitions he or she may have and
encourage him or her to participate actively in the assessment process. As a result, the results of
the tests will be accurate. Noise and other types of disturbances should also be avoided, as they
might have a negative impact on the assessment results.
ii) Counselor Competence
Assessment is an important part of the counselling process. As a result, the counsellor must have
a thorough understanding of psychological assessment and be well-versed in various assessment
methodologies. If the counsellor is not skilled enough in the assessment process, the counsellor
may not receive a whole picture of the situation, and the problem diagnosis may be inaccurate.
As a result, the counselor's counselling or therapy delivered on this premise may not produce
effective outcomes.
The ultimate purpose of a counsellor is to look out for the client's best interests and well-being.
In order to assist the client, the counsellor must possess the appropriate skills. Individual
diversity, human development, counselling theories, assessment concepts and processes, and
ethical duties should all be covered by the counsellor. In addition, the counsellor should be
knowledgeable in personality theories, human rights, and multicultural issues. These will assist
the counsellor to get the necessary knowledge to comprehend human beings in a range of
scenarios. The counsellor should also possess the necessary skills and abilities to establish
rapport with the client and carry out the counselling procedure. To gain the client's trust and
confidence, as well as to enable the client to open up and express himself/herself in the
counselling setting, a variety of introductory and fundamental counselling abilities are required.
Counseling also necessitates a thorough understanding of counselling ethics, which ensures the
client's safety. The counsellor must genuinely care about the client's interests and well-being.

iii) The Client's Personality

The client's subjective state refers to his or her current psychological or physical state. A person's
psychological or physical state at the time of testing can affect test performance. Different levels
of worry, weariness, or motivation, for example, may have an impact on a person's test
outcomes. The client's and counselor's moods have an impact on the test situation and can
influence the test result.
As a result, as a counsellor, you must consider the client's emotional and motivational level when
delivering various assessments to them.
One must understand that the client has a variety of fears, inhibitions, expectations, fears, and
restrictions when they come to counselling. The client may be unsure of what to expect from the
counselling situation and what it entails, or he or she may have erroneous expectations or
misconceptions regarding counselling. Many clients feel that counselling is a miracle that will
solve all of their problems overnight. These erroneous views must be addressed with care and
gentleness, and the client may need to be reoriented to the reality of the counselling scenario.
The client's subjective condition is also determined by the referral source. If the client has self-
referred, i.e., arrived on his or her own, he or she is in a better frame of mind to participate in the
counselling process. Clients referred by parents, school authorities, some organizations, the
court, or social agencies, on the other hand, may not be receptive. When a client is referred and
willing to go to counselling, it is much easier to create rapport and move forward with the
counselling process. However, when a client is referred but refuses to participate in counselling,
the counsellor faces a difficult situation. These clients are said to be resistive, and their
subjective states make it difficult for them to engage in counselling. It is a significant difficulty
for the counsellor to change the client's abrasive attitude and make them more receptive to the
counselling and assessment process.
iv) Differences in Ethnicity, Linguistics, and Culture
The counsellor must consider the many ethnic and cultural groups, as well as their ethnic,
linguistic, and cultural differences. Clients' cultural backgrounds play a vital influence in
influencing how they will approach the counsellor and the counselling session itself. The client's
views, values, and attitudes are influenced by cultural differences.
You must be aware of this as a counsellor. As a result, the client will feel accepted and
understood, making the building of a relationship easier. As you may be aware, the most
important prerequisite in evaluation and counselling is to create rapport. When a counsellor
respects the client's ethnic, linguistic, and cultural distinctions, the client feels valued and
understood, and trust and confidence in the counsellor grows. The client is now ready to take part
in the activity.
V) Scoring, Administration, and Interpretation
Psychological tests are standardized behavior assessments. They use a standardized
administration and scoring system. Deviation from this may result in assessment errors.
Variations in how the test is administered and scored may have an impact on the outcomes.
Psychological examinations come in a variety of shapes and sizes. Individual and group tests can
be categorized based on how they are administered. Counselors should have a solid knowledge
and comprehension of both individual and group exam administration. Individual tests
necessitate one-on-one supervision, whereas group tests are given to a group of people. The
counsellor, on the other hand, must know how to administer the test to a group of people,
including distributing test booklets, providing instruction, ensuring that the group understands
the instruction, monitoring, collecting the test booklets and answer sheets, and concluding the
testing session. A qualified counsellor should be capable of administering and scoring tests,
ensuring consistency in the assessment process and dependable outcomes.
If tests are not administered and scored correctly, or if the results are not understood correctly,
test results may not be reliable. The interpretation of test results is also highly important.
Counselors should understand how to interpret various sorts of testing. Projective tests, for
example, are less objective in their interpretation. To get at a correct interpretation, the
counsellor must have extensive expertise and understanding in the field. Although researchers
are attempting to add more impartiality to such interpretations, some tests may not lend
themselves to complete objectivity by their very nature. As a result, the counsellor must interpret
such outcomes with caution.
People's knowledge, skills, abilities, qualities, interests, and values can all be inferred through
tests. Inferences should be rational, well-founded, and not stereotype-based. If test results aren't
properly evaluated, the conclusions made from them are likely to be incorrect, resulting in poor
decision-making.
As a result, it is critical to ensure that test results are interpreted in accordance with the procedure
outlined in the test manual. This will give the test score interpretations legitimacy and provide a
solid foundation for making counselling judgments.
vi) Test results can be deceiving
Professionally prepared tests and procedures may aid in guidance, training, and development
when utilized as part of a planned evaluation, programme. However, it is critical to recognize
that all assessment techniques are susceptible to inaccuracies, both in terms of assessing a trait
like linguistic ability and in terms of forecasting performance, such as training success. This
applies to all exams and procedures, no matter how objective or standardized they are.
Any test or procedure should not be expected to measure a particular attribute or skill with
perfect precision for every single person, and no test or procedure should be expected to predict
performance or job satisfaction with 100% accuracy. There will be instances where a test score
or technique will suggest suitability for a particular occupation when the person will not be
fulfilled in that occupation. There may also be instances where a person with a low score is
recommended against pursuing a specific career path, despite the fact that the person is capable
and hardworking. Similarly, there will be instances where a test score or technique predicts
training success for someone who does not achieve. In this context, such errors are referred to as
selection errors. In every assessment procedure, selection errors cannot be totally avoided.
Despite these flaws, why employ testing? The response is that, on average, individuals and
organizations can make more successful decisions with professionally produced evaluation tools
than they can with simple observations or random decision making. The counsellor will only
have a restricted picture of a person's professional interests or training needs if they use a single
test or process.
Furthermore, the counsellor may come to the wrong conclusion by placing too much emphasis
on a particular test result. Using a range of evaluation instruments, on the other hand, allows the
counsellor to gain a fuller picture of the individual. The whole-person approach refers to the
technique of using a variety of tests and processes to more thoroughly analyze persons. This will
lower the number of selection errors committed and improve the counselor's decision-making
efficacy.

2.5 PSYCHOLOGICAL REPORT

The psychological report is the assessment's final product. It symbolizes the clinician's efforts to
bring the assessment data together into a functional whole so that the client can solve problems
and make decisions using the information. Even the best tests are useless unless the results are
presented in a meaningful and understandable manner that satisfies the needs of the customer and
referral source. This necessitates clinicians not just providing test findings, but also interacting
with their data in such a way that their conclusions are beneficial in answering the referral
question, making decisions, and assisting in the resolution of problems. There are various ways
to write an evaluation. The style of presentation employed is determined by the report's intended
purpose as well as the practitioner's personal style and orientation. This unit's format is only a
proposed framework that adheres to standard and traditional guidelines. It covers techniques for
delving deeper into important topics such the referral question, behavioral observations, pertinent
background, impressions (interpretations), and recommendations. The professional psychologist
can convey the results of the examination in a case-focused, problem-solving manner in the
psychological report.
Its main goal is to assist the referral source in making client-related decisions. As a result, it
represents the assessment's final product. A perfect report will follow general rules and be
written in a flexible but predictable structure.
The most common types of reports are those based on intellect / accomplishment, personality /
psychopathology, and neuropsychology issues. Adaptive / functional, developmental, neuro
behavioral, aphasia, and behavioral medicine / rehabilitation are some of the less common
categories.
The most common general issues concern diagnosis and determining which type of treatment
would be most effective for a given client. Each category of assessment necessitates the use of
different types of assessment instruments, knowledge of the type of difficulty, awareness of the
context (educational, legal, medical, rehabilitation, forensic), and knowledge of the various
community resources. This information will be incorporated into the report to make it more
problem-oriented and relevant to the referral source.

Purpose
In therapeutic settings, psychological assessment serves three main functions. The initial goal is
to identify, operationalize, and assess a client's adaptive and maladaptive behaviors as well as
therapy objectives. A second goal is to identify, operationalize, and measure elements that
influence a client's adaptive and maladaptive behaviors, as well as their ability to meet treatment
objectives. A third goal is to combine assessment data so that interventions to improve a client's
quality of life can be designed and evaluated. Consider the difficult evaluation challenges that a
psychologist faces while working with a client who is experiencing severe fear, social isolation,
and frequent disagreements with a partner. First, the physician must choose an evaluation
technique that will collect and analyze these many issues throughout the intervention. In order to
understand why the client is feeling isolation, panic episodes, and conflict, the evaluation
technique must also allow the clinician to uncover crucial causal relationships connected with
these difficulties. Finally, the assessment approach and data must be integrated before being
utilized to create an intervention that will alter causal relationships in order to reduce panic
attacks, isolation, and conflict while simultaneously increasing adaptive behaviors. The clinical
and scientific applications of psychological assessment are exemplified by the aforementioned
assessment goals—the systematic measurement of a person's behavior, factors associated with
variance in behavior, and inferences and judgments based on those measures (see multiple
definitions of psychological assessment in Geisinger, 2013; Haynes, Smith, &Hunsley, 2019).
We refer to overt behaviors, emotions, cognitive processes, and physiological responses as
"behavior." Behavioral, environmental, social, and biological variables are also included in the
phrase "variables."
Fundamental assumptions, applicability, utility, and preferred assessment procedures differ
among psychological assessment paradigms. The assumptions, ideas, values, hypotheses, and
procedures approved within a psychological assessment field are referred to as a psychological
assessment paradigm. 1 At least partially explanatory are all psychological assessment models.
In other words, they're made to figure out why people behave the way they do. Some
psychodynamic frameworks, for example, may assume that the aforementioned client's terror,
social isolation, and conflict are mostly caused by historical, developmental, unconscious, and
intrapsychic processes. The client's verbal reports of perceptions when asked to see ambiguous
stimuli, such as a Rorschach or Thematic Apperception Test, are thought to be the best way to
identify these reasons in this paradigm. Some personality-based paradigms presume that a
client's issues are caused by temporally and situationally consistent patterns of cognitive,
emotional, and behavioral dispositions that can be recognized by a self-report symptom
inventory.
When it comes to psychological reports, there are a variety of models and ways to consider. The
following sections go through some of the different types of report models.
• The Test Oriented Model,
• The Domain Oriented Model, and
• The Hypothesis Oriented Model is the three models for psychological reports that will
be described.
Results are reviewed on a test-by-test basis in the Test Oriented Model. Each test is listed by
name, along with the most important results for that test. In general, each test is covered in its
own paragraph. There is little or no effort (at least not in the "Results of Assessment" section) to
compare and contrast data between the various exams. The strength of this method is that it
clearly identifies the source of each piece of information. In some cases, such as forensic reports,
this could be critical. The reader's attention is drawn to the tests rather than the client's adaptive
functioning, which is a flaw in this approach.
It also conveys to the reader that psychological evaluation is a low-level, technical skill that
entails little more than administering a test and copying interpretive remarks from a manual. It
ignores the psychologist's position as a test data integrator; a professional who brings to bear his
understanding of how the test was developed, normed, the limitations of test data
generalizability, and how to use the data in a theoretical/conceptual manner to better understand
the client. In the past, the Test Oriented Model was widely utilized, but it has grown increasingly
unpopular in recent years.
The Domain Oriented Model
This model categorizes results into abilities or "functional domains." Intellectual capacity,
interpersonal skills, psychosocial pressures, coping mechanisms, intrapersonal requirements,
motivational variables, depression, psychotic traits, and other themes usually get their own
paragraph. When there isn't a precise referral question and you're not sure how your data will be
used, this approach comes in handy. A recently hospitalized patient, for example, may have
limited background information. You have no idea why he was admitted or what circumstances
led to his admittance. As a result, determining which parts of your data will be beneficial to the
treatment team might be difficult. In neuropsychological reports, where a number of providers
may potentially become engaged in the case, the Domain Oriented Model is also used. Each
provider will concentrate on a different section of the report in order to assist with a specific
aspect of the intervention. When using evaluation to track therapy success, this strategy is also
beneficial. It enables you to keep track of changes in the client's functioning in a variety of areas'.
The reader may be given with a lot of information that has little relation to his intended
intervention, which is a shortcoming of the Domain Oriented method.
Hypothesis Testing Model
The outcomes of the Hypothesis Testing Model are concentrated on possible replies to the
referral question (s). In the "Purpose for Evaluation" section, present a hypothesis, then present
facts systematically to support or disprove the theory. Separate paragraphs in the "Results of
Evaluation" section integrate data from the history, mental status assessment, and behavioral
observations with data from all the tests to address theoretical/conceptual difficulties. Tests are
rarely referred to by their full names. For instance, data from the MMPI-2 scale 2 might be
paired with interpretive data from the MCMI dysthymia scale. It is included in a paragraph about
depression if the integration of this information is consistent with the history and mental state
evaluation. The efficiency and concise focus on the referral problem are the model's strengths.
Unrelated details do not distract the reader. The model's main flaw is that you don't submit
information that isn't linked to the "objective of the evaluation" but could be useful to other
disciplines.
A psychological report can be organized in a variety of ways. Some practitioners like to write
letters in an informal, unstructured fashion. When the report will be seen by a single referral
source and the referring person is known to the practitioner, this is very acceptable. Other reports
may be better organized around more structured headers (for example, 'Referral question,' 'Test
findings,' and 'Summary and recommendations'). Some reports may require (and practitioners
prefer to include) a detailed history, but others may want to spend more time focusing on
perceptions and interpretations. Given recent trends toward treatment planning and
demonstrating the practical, everyday relevance of assessment, some reports may devote more
time and effort to providing concrete, specific recommendations for psychotherapy, vocational
training, educational intervention, or neuropsychological rehabilitation.

Even if reports do not formally identify certain headings and subheadings, they usually contain a
consistent set of subject sections. The following is a list of common places (adapted from
GrothMamat, 1999; Williams & Boll, 2(00)):
Name:
Age (birth date):
Sex:
Ethnicity:
Report publication date:
Examiner's name:
Referred by:
Question of Referral:
Evaluation Procedures:
Observations on behavior:
Test results:
Impressions and interpretations
Background information:
Test results:
Impressions and interpretations:
 Conclusions and suggestions:
A top-of-report notification that the report is 'Confidential' is an added feature. The author's
signature, name, and title should appear at the end of the report. This is critical because it
signifies the author's formal acceptance of responsibility for the report's contents. The identifying
information (name, age, sex, etc.) is rather straightforward, but the extra features (I-VII) require
more explanation to ask the referral source what judgments they need to make about the client.
In some cases, discussing the types of questions that can and cannot realistically be answered
through formal assessment with the referral source will entail stating the types of questions that
can and cannot realistically be answered through formal assessment.
Such conversations may even lead to a consensus that formal assessment is not necessary in this
circumstance. A clearly articulated referral question will carry through to the rest of the report in
that it will provide a frame of reference for this material as well as a rationale for what should be
included in the sections on background information (history), impressions / interpretation, and,
most importantly, the summary / recommendations.
Creating bulleted points in the summary, each of which provides a clear answer to each of the
referral questions, is one useful strategy. The points must, however, be compatible with the
content offered in the impressions / interpretation section. Making a brief, succinct, orienting
statement about the client (e.g., 'Mr. X is a 36-year-old, white, right-handed, married male with a
high school education who sustained a severe, diffuse closed head injury on April 12, 1998') is a
nice way to start the referral question section (and the report in general).

Common errors
a. Validity Mismatch
Some tests are beneficial in a variety of scenarios, but no single test is suitable for all jobs
with all people in all circumstances. Gordon Paul's seminal 1967 paper shifted our focus
away from the oversimplified search for effective therapies and toward a more
challenging but important question: "What treatment, by whom, is most beneficial for
this individual with that unique illness, and under what set of circumstances?"
"Has research established sufficient reliability and validity (as well as sensitivity,
specificity, and other relevant features) for this test, with an individual from this
population, for this task (i.e., the purpose of the assessment), in this set of
 circumstances?" is a question that arises when selecting assessment instruments. It's
worth noting that when the population, task, or conditions change, so will the
measurements of validity, reliability, sensitivity, and so on.
To establish if tests are well-suited to the task, individual, and situation at hand, the
psychologist must first pose a fundamental question: Why am I conducting this
assessment in the first place?
b. Bias Against Confirmation
Information that is congruent with our attitudes, beliefs, and expectations is frequently
sought, recognized, and valued. If we establish an initial impression, we may favor
results that confirm it, while discounting, ignoring, or misinterpreting data that
contradicts it.

The logical mistake of fast generalization is analogous to this premature cognitive commitment
to an initial impression, which might build a powerful cognitive set through which we sift all
subsequent data.
To guard against confirmation bias (the tendency to choose information that confirms our
assumptions), it's a good idea to actively seek out data that contradicts our expectations and to
experiment with different interpretations of the facts.

c) Retrospective vs. Predictive Accuracy

Beginning with the individual's test findings, predictive accuracy asks: What is the
likelihood stated as a conditional probability, that a person with these results has
condition (or ability, aptitude, quality, etc.) X? Retrospective accuracy starts with the
condition (or ability, aptitude, or quality) X and asks, "What is the probability, stated as a
conditional probability, that a person with X will display these test results?" Many errors
are caused by misinterpreting the inference's "directionality" (for example, the likelihood
that those who score positive on a hypothetical predictor variable will fall into a specific
group versus the likelihood that those in a specific group will score positive on the
predictor variable).
This blunder of conflating retrospective and predictive accuracy is frequently mistaken
for endorsing the following logical fallacy:
These specific test results are extremely common in people with disease X.
These specific test results belong to Person Y.
As a result, Person Y has a high probability of having ailment X.
d) Standardized Tests Are Being Unstandardized
The standardization of standardized tests gives them their potency. Norms, validity,
reliability, specificity, sensitivity, and other comparable measures are derived from an
actuarial foundation: a well-selected sample of people supplying data (by answering
questions, doing activities, and so on) in response to a standard method under (relatively)
uniform conditions. We deviate from that standardization when we change the
instructions, the test items them, or the method they are administered or scored, and our
attempts to draw on the actuarial basis become suspect.

Standardization can be thwarted in other ways as well. People may arrive for an
assessment session without adequate reading glasses, or after taking cold medication that
makes them drowsy, or after experiencing a family emergency or loss that makes them
unable to concentrate, or after staying up all night with a loved one and now can barely
keep their eyes open. These situational aspects must be recognized by the expert doing
the assessment, as well as how they can jeopardize the validity of the assessment and how
to successfully resolve them.
Any of us who do assessments can be affected by these same situational elements and
find ourselves unable to function effectively on any given day. We can also fall short due
to a lack of knowledge. It is critical to conduct only those examinations for which enough
education, training, and supervised experience have been provided. We may do
admirably in one field (e.g., counselling psychology, clinical psychology, sport
psychology, organizational psychology, school psychology, or forensic psychology) and
mistakenly believe that our skills will simply transfer to other areas. It is our job to
acknowledge our own boundaries of expertise and to ensure that any evaluation is based
on proper knowledge of the relevant areas of practice, issues, and instruments.
e) Ignoring the Consequences of Low Interest Rates
Ignoring base rates can contribute to a variety of testing issues, but very low base rates
appear to be particularly problematic. Assume you've been tasked with creating an
assessment procedure that will detect corrupt judges so that judicial applicants can be
vetted. It's a challenging task, in part because just one judge out of 500 is (hypothetically)
dishonest. You compile all of the actuarial data you can find and discover that you can
create a crookedness screening test based on a variety of variables, personal history, and
test results. 90 percent of the time, your method is correct.
When your method is used to screen the next 5,000 judicial applicants, it's possible that
ten of them will be corrupt (because about 1 out of 500 is crooked). Nine of the ten
crooked candidates will be identified as crooked, while one will be identified as honest,
according to a 90 percent accurate screening process.
So far, everything has gone well. The issue is the 4,990 truthful candidates. Because the
screening is 10% wrong, and the only way for the screening to be wrong about honest
candidates is to label them as crooked, 10% of the honest candidates will be mistakenly
classified as crooked. As a result, 499 of the 4,990 honest candidates will be wrongly
classified as crooks using this screening procedure. So, out of 5,000 individuals
evaluated, the 90 percent accurate test identified 508 of them as crooked (i.e., 9 who
actually were crooked and 499 who were honest). Only 9 out of every 508 times the
screening procedure detects crookedness is correct. It has also mistakenly labelled 499
honest people as corrupt.
f) Dual High Base Rates Are Misunderstood
You are flown in as part of a disaster response team to work at a community mental
health facility in a city that has been ravaged by a catastrophic earthquake. Looking over
the center's records, you'll notice that out of the 200 people who have come for services
since the earthquake, 162 are of a particular religious faith and have been diagnosed with
PTSD related to the earthquake, and 18 are of that faith who have come for services
unrelated to the earthquake. Among individuals who are not of that faith, 18 have been
diagnosed with post-traumatic stress disorder (PTSD) as a result of the earthquake, while
two have arrived for services unrelated to the earthquake.
It seems self-evident that there is a substantial link between that religious faith and the
development of PTSD as a result of the earthquake: 81 percent of those who came for
services were of that religious faith and had PTSD. Perhaps those with this faith are more
prone to PTSD. Perhaps there's a more subtle link: this religion may make it simpler for
those with PTSD to seek mental health treatment.
However, inferring a link is a fallacy: religious beliefs and the onset of PTSD in this
society are both distinct causes. Ninety percent of all people seeking services at this
centre are of that religious faith (i.e., 90% of those who had developed PTSD and 90% of
those who had come for other reasons), and 90% of all people seeking services after the
earthquake have developed PTSD (i.e., 90% of those with that religious faith and 90% of
those who are not of that faith). Both factors have high base rates, so they appear to be
linked, yet they are statistically unrelated.
g) The Fallacy of Perfect Conditions
We want to assume that "everything is great," that "conditions are perfect," especially
when we're rushed. If we don't check, we might not find out that the person we're
interviewing for a job, a custody hearing, a disability claim, a criminal case, asylum
status, or a competency hearing took standardized psychological tests and completed
other phases of formal assessment under conditions that skewed the results significantly.
For example, the person may have forgotten their reading glasses, be suffering from a
severe headache or illness, be using a hearing aid that isn't working properly, be taking
medication that impairs cognition or perception, have forgotten to take needed
psychotropic medication, have had a crisis that makes it difficult to concentrate, be in
physical pain, or have difficulty understanding the language used in the assessment.
h) Financial Discrimination
Assuming that we are immune to the impacts of financial prejudice is a very human
assumption. A financial conflict of interest, on the other hand, can have a subtle – and
sometimes not so subtle – impact on how we obtain, evaluate, and present even the most
regular facts. This notion is represented in well-established forensic texts and formal
standards that prohibit liens and other forms of contingent payment based on the outcome
of a case. "Forensic psychologists do not provide professional services to parties to a
legal proceeding on the basis of 'contingent fees,' when those services involve the
offering of expert testimony to a court or administrative body, or when they call upon the
psychologist to make affirmations or representations intended to be relied upon by third
parties," according to the Specialty Guidelines for Forensic Psychologists.
 Ignoring the effects of audio or video recording, as well as the presence of third-party
observers. People’s answers (e.g., various elements of cognitive function) during
psychological and neuropsychological testing can be influenced by audio-recording,
video-recording, or the presence of third parties, according to empirical studies. Ignoring
these potential consequences can lead to a very erroneous conclusion. Reviewing relevant
research and professional norms is an important component of adequately preparing for
an evaluation that will entail recording or the participation of third-parties.

2.6 SUMMARY
 The evaluation of insanity and the evaluation of competency are two potentially
challenging topics.
 The question of whether the defendant is competent to stand trial is related to insanity.
 In many ways, observing the child in a larger setting runs counter to the history of
individual assessment.
 Furthermore, a psychologist may query if the treatment available at a psychological clinic
is appropriate for particular groups of self-referred clients.
 So far, the focus of this discussion on the many circumstances in which psychological
testing is utilised has been on when to test and how to emphasise how tests can be most
useful in making decisions.
 The referral source is the person or organisation that requests the psychological
evaluation and the referral question is the topic or issue that will be addressed during the
evaluation.
 The distinction between open and closed questions is significant.
 During assessment interviews, psychologists must be on the lookout for client issues.
 A number of requirements must be met for a psychological test to be useful in research or
clinical practice, as you will see in the following sections.
 But first, let's define what a psychological test entails.
 In order to assist the client, the counsellor must possess the appropriate skills.
 The client's subjective condition is also determined by the referral source.
  When a counsellor respects the client's ethnic, linguistic, and cultural distinctions, the
client feels valued and understood, and trust and confidence in the counsellor grows.
 The interpretation of test results is also highly important.
 The whole-person approach refers to the technique of using a variety of tests and
processes to more thoroughly analyse persons.
 A clearly articulated referral question will carry through to the rest of the report in that it
will provide a frame of reference for this material as well as a rationale for what should
be included in the sections on background information (history), impressions /
interpretation, and, most importantly, the summary / recommendations.
 However, inferring a link is a fallacy: religious beliefs and the onset of PTSD in this
society are both distinct causes.
 Both factors have high base rates, so they appear to be linked, yet they are statistically
unrelated.
 A financial conflict of interest, on the other hand, can have a subtle – and sometimes not
so subtle – impact on how we obtain, evaluate, and present even the most regular facts.
 Ignoring the effects of audio or video recording, as well as the presence of third-party
observers People’s answers (e.g., various elements of cognitive function) during
psychological and neuropsychological testing can be influenced by audio-recording,
video-recording, or the presence of third parties, according to empirical studies.

2.7KEYWORD
 Standardisation-the process of making something conform to a standard.

 Reliability – the quality of being trustworthy or of performing consistently well.

 Validity – the quality of being logically or factually sound; soundness or cogency.

 Hypothesis testing–a form of statistical inference that uses data from a sample to draw

conclusions about a population parameter or a population probability distribution

 Interpretation – the action of explaining the meaning of something.

 Epistemological- relating to the theory of knowledge, especially with regard to its

methods, validity, and scope, and the distinction between justified belief and opinion.
2.8 LEARNING ACTIVITY
1. Why is it important to have referral for Clinical Assessment

______________________________________________________________________________
________________________________________________________________________
2. Explain how internal and external factors can affect clinical assessment.
______________________________________________________________________________
________________________________________________________________________

2.9 UNIT END QUESTIONS

A. Descriptive Questions
Short Questions:
1. What is the best style to report a clinical assessment?
2. Analyse the importance of an interview as a tool for clinical data gathering.
3. What is thematic analysis?
4. What are the common errors made while writing a report of clinical assessment?
5. What do you mean by validity of assessment?

Long Questions:
1. Explain with examples the need for and the process of qualitative analysis in clinical
assessment.
2. Describe the major component of assessment.
3. Why is observation important for clinical data gathering? How is the process of
observation utilised in clinical data gathering?
4. How to analyse the qualitative data in clinical assessment?
5. Explain the importance of case study in clinical assessment.

B. Multiple Choice Questions

1. Domain oriented model categorises results into
a. Abilities
b. Aptitude
c. Learning
 d. Personality

2. Client’s subjective state refers to

a. The subject matter he or she is interested in
b. His/her current psychological or physical state
c. The subject he/she has studied
d. The feelings at a particular time

3. Assessment is an important part of

a. Referral process
b. Process of standardization
c. Counselling process
d. Interview process

4. The grounded theory method emphasises

a. Evaluation process
b. Observation process
c. Assessment
d. Interpretation

5. Inferential statistics practises

a. Deductive method
b. Inductive method
c. Reliable method
d. Sampling method

Answers
1-a, 2-b, 3-c, 4-a, 5-b

2.10REFERENCES
References book
 Aiken (2009). Psychological Testing and Assessment. Pearson.
  J F Ter Laak (2013). Understanding Psychological assessment: A Primer on Global
Assessment of the Client’s Behaviour in Educational and Organisational Setting. Sage
India
 S K Mangal (1996).Abnormal Psychology. Sterling Publishers Pvt. Ltd.
 Korchin (2004). Modern Clinical Psychology. CBS.

Textbook references
 Robert Kaplan and Dennis P. Saccuzzo (2013). Psychological Assessment and Theory:
Creating and Using Psychological Test. Cengage
 Anne Anastasy (1982), Psychological Testing. Macmillan Publishing Co. INC.
 Kaplan and Sadock. (8th Ed.), Synopsis of Psychiatry. B.I. Waverly Pvt. Ltd.
 Janet R. Matthews and Barry S. Anton (2007), Introduction to Clinical Psychology.
Oxford University Press.

Website
 https://psychology.fandom.com/wiki/Introduction_to_clinical_psychology
 https://egyankosh.ac.in/bitstream/123456789/50987/3/Unit-3.pdf
 https://opentext.wsu.edu/abnormal-psych/chapter/module-3-clinical-assessment-
diagnosis-and-treatment/
 https://www.apa.org/topics/testing-assessment-measurement/understanding