In the past those with behavioral and cognitive approaches typically used self-report measures in their assessments, whereas those with psychodynamic orientations tended to rely on pro-jective tests. Since those old days, during which the two sides crossed swords on a regular basis in the literature and in the halls of academia, we now seem more enlightened. We now tend to use each other's tools, but in a more flexible manner. For example, although psychoanalytically oriented clinicians use the Rorschach, it can also be interpreted from a more cognitive and stylistic approach. In fact, Exner has been criticized by some psychodynamically oriented psychologists for having developed an atheoretical, nomothetic system.
Tests can be interpreted using any theoretical viewpoint. For example, psychodynamically oriented psychologists sometimes interpret the MMPI-2 using a psychodynamic orientation (Trimboli & Kilgore, 1983), and cognitive psychologists interpret the TAT from a variety of cognitive viewpoints (Ronan, Date, & Weisbrod, 1995; Teglasi, 1993), as well as from a motivational viewpoint (McClelland, 1987). Martin Mayman's approach to the interpretation of the Early Memories Procedure (EMP) is from an object relations perspective, but the EMP is also used by adherents of social learning theory and cognitive psychology (e.g., Bruhn, 1990,1992).
Many psychologists believe that the use of theory in conducting an assessment is absolutely necessary because it serves as an organizing function, a clarifying function, a predictive function, and an integrative function, helping to organize and make sense of data (Sugarman, 1991). Theory serves to "recast psychological test data as psychological constructs whose relationship is already delineated by the theory in mind" (Sugarman & Kanner, 2000). In this way the interpreter can organize data, much of it seemingly unrelated, into meaningful descriptions of personality functioning, and can make predictions about future functioning. Theory often helps students make sense of inconsistencies in the data.
Students should be helped to understand that although assessment instruments can be derived from either an atheoreti-cal or a theoretical base, the data derived from any assessment instrument can be interpreted using almost any theory, or no theory at all. No test is necessarily wedded to any theory, but theory is often useful in providing the glue, as it were, that allows the interpreter to extend and expand the meaning of the test findings in a wide variety of ways. Students must ask themselves what can be gained by interpreting test data through the lens of theory. Some would say that what is gained is only distortion, so that the results reflect the theory and not the person. Others say it is possible to enrich the interpretations made with the aid of theory and to increase the accuracy and mean-ingfulness of assessment results, and that a theory-based approach often allows the assessor to make predictions with greater specificity and utility than can be made if one relies only on test signs.
LEARNING THROUGH DOING: PROFICIENCY THROUGH SUPERVISED PRACTICE
Something interesting happens when a student discusses data with his or her supervisor. The supervisee often says and does things that reveal information about the nature and experience of the client being assessed, in metaphors used to describe assessment experiences, slips of the tongue when discussing a client, or an actual recreation of the dynamics present in the relationship between client and assessor in the supervisory relationship. This reenactment has come to be known as parallel process (e.g., Deering, 1994; Doehrman, 1976; Whitman & Jacobs, 1998), defined by Deering (1994) as "an unconscious process that takes place when a trainee replicates problems and symptoms of patients during supervision" with the purpose "of causing the supervisor to demonstrate how to handle the situation" (p. 1). If the supervisor and supervisee can become aware of its presence in the supervision, it can be a powerful diagnostic and experiential tool. It is important for the supervisor to note when students act in a way that is uncharacteristic of their usual behavior, often the first clue that parallel process is occurring (Sigman, 1989). Students sometimes take on aspects of their clients' personality, especially when they identify with some facet of a patient's experience or character style.
The supervisor should always strive to model the relationship with the supervisee after that which he or she would want the supervisee to have with the client. With this approach, the supervisor becomes an internalized model or standard for the trainee. Supervisors often serve as the template for how to behave with a client during assessment because many students have no other opportunities to observe seasoned clinicians at their work. It is also important to remember that problems in the supervisor-supervisee relationship can trickle down into the supervisee-client relationship, so issues such as power, control, competition, and inferiority may arise between the supervisee and the client as well if these emotions happen to be present in the supervision relationship. Nevertheless, given the inevitable occurrence of parallel process, going over data with the student is not sufficient supervision or training. The supervisory relationship itself should be used to facilitate growth and development of the student. There must also be a good alliance between the supervisor and the student, and a sense of confidence from both parties involved that each has sound judgement and good intentions toward the assessment process and the client.
It is important for the supervisor to encourage a sense of hopefulness in the student that will translate into hope for the client that this new information will be helpful. Otherwise, it is difficult for students to know or at least to believe that what they are doing is meaningful. When the characteristics of trust, confidence, collaboration, and hopefulness are not present in the supervision relationship, this should be discussed during the supervision hour. It is crucial that the relationship be examined when something impedes the ability to form a strong alliance.
ASSESSMENT TEACHING IN GRADUATE SCHOOL: A REVIEW OF THE SURVEYS
According to the recent survey literature, training in assessment continues to be emphasized in clinical training programs (Belter & Piotrowski, 1999; Piotrowski, 1999;
Piotrowski & Zalewski, 1993; Watkins, 1991), although there is evidence that those in academic positions view assessment as less important than other areas of clinical training (Kinder, 1994; Retzlaff, 1992). Those instruments that have consistently received the most attention during graduate training are MMPI, Rorschach, Wechsler scales, and TAT (Belter & Piotrowski, 1999; Hilsenroth & Handler, 1995; Piotrowski & Zalewski, 1993; Ritzler & Alter, 1986; Watkins, 1991). Some concern, however, has been expressed about the level of training being conducted in the area of projective assessment (Dempster, 1990; Hershey, Kopplin, & Cornell, 1991; Hilsenroth & Handler, 1995; Rossini & Moretti, 1997). Watkins (1991) found that clinical psychologists in academia generally believe that projective techniques are less important assessment approaches now than they have been in the past and that they are not grounded in empirical research (see also Watkins, Campbell, & Manus, 1990).
Academic training often emphasizes objective assessment over projective techniques. Clinical training directors surveyed by Rossini and Moretti (1997) reported that the amount of formal instruction or supervision being conducted in the use of the TAT was little to none, and Hilsenroth and Handler (1995) found that graduate students were often dissatisfied with the quality and degree of training they received in the Rorschach. Piotrowski and Zalewski (1993) surveyed directors of clinical training in APA-approved Psy.D. and Ph.D. programs and found that behavioral testing and objective personality testing were expected to increase in use in academic settings, whereas projective personality assessment was predicted to decrease according to almost one half of those surveyed. In addition, 46% of training directors answered "no" to the question, "Do you feel that the extent of projective test usage in various applied clinical settings is warranted?" (Piotrowski & Zalewski, 1993, p. 399).
It is apparent that although training in assessment remains widely emphasized, this does not mean that students are well prepared, especially in the area of projective assessment. Specific qualities and approaches to training may vary widely from program to program and may not meet the needs of applied settings and internship programs. In fact, Durand et al. (1988) found that 47% of graduate training directors felt that projective assessment was less important than in the past, whereas 65% of internship directors felt projective assessment had remained an important approach for training in assessment. Such disagreement is not rare; much of the literature reflects the discrepancy between graduate training in assessment and internship needs (Brabender, 1992; Durand et al., 1988; Garfield & Kurtz, 1973; Shemberg & Keeley, 1970; Shemberg &Leventhal, 1981;Watkins, 1991). Furthermore, given the report by Camara, Nathan, and Puente (2000), who found that the most frequently used instruments by professional psychologists are the WAIS-R/WISC-R, the MMPI-2, the Rorschach, BG, and the TAT, it is clear that the discrepancy between training and application of assessment goes beyond that of internship needs and includes real-world needs as well.
ASSESSMENT ON INTERNSHIP: REPORT OF A SURVEY
Clemence and Handler (2001) sought to examine the expectations that internship training directors have for students and to ascertain the specific psychological assessment methods most commonly used at internship programs in professional psychology. Questionnaires designed to access this information were mailed to all 563 internships listed in the 1998-1999 Association of Psychology Postdoctoral and Internship Centers Directory. Only two sites indicated that no patients are assessed, and 41% responded that testing instruments are used with the majority of their patients.
Each intern is required to administer an average of 27 full battery or 33 partial battery assessments per year, far exceeding the number of batteries administered by most students during their graduate training. Of those rotations that utilize a standard assessment battery (86%), over 50% include the WISC/WAIS (91%), the MMPI-2/MMPI-A (80%), the Rorschach (72%), or the TAT (56%) in their battery. These results are consistent with previous research investigating the use of assessment on internship (Garfield & Kurtz, 1973; Shemberg & Keeley, 1974). Piotrowski and Belter (1999) also found the four most commonly used assessment instruments at internship facilities to be the MMPI-2/MMPI-A (86%), the WAIS (83%), the Rorschach (80%), and the TAT (76%).
To ensure that students are fully prepared to perform in the area of assessment on their internship, training is frequently offered to bridge the gap that exists between the type and amount of training conducted in most graduate programs and that desired by internship sites. In the Clemence and Handler study, 99% of the internships surveyed reported offering training in assessment, and three approaches to training in personality assessment were most commonly endorsed by training directors: intellectual assessment (79%), interviewing (76%), and psychodynamic personality assessment (64%). These three methods seem to be the predominant training approaches used by the sites included in the survey. This finding suggests that these are important directions for training at the graduate level, as well.
Of the topics being offered in the area of assessment training, report writing is most often taught (92%); 86% of the rotations conduct training in advanced assessment, 84% in providing feedback to clients, 74% in providing feedback to referral sources, 56% in introductory assessment, and 44% in the study of a specific test. This breakdown may reflect the priorities internship training directors place on areas of assessment, or the areas in which students are less prepared upon leaving graduate school.
Piotrowski and Belter (1999) surveyed 84 APA-approved internship programs and found that 87% of their respondents required interns to participate in assessment seminars. If the demand for training is as critical as these surveys seem to indicate, it is curious that graduating students do not appear to be especially well-prepared in this area, as this and previous studies indicate (Watkins, 1991). Training in basic assessment should be the job of graduate training programs and not internship sites, whose primary function should be in providing supervised practical experience in the field.
From our findings and other surveys (Petzel & Berndt, 1980; Stedman, 1997; Watkins, 1991), it appears that internship training directors prefer students who have been properly trained in a variety of assessment approaches, including self-report, projective, and intelligence testing. Distinct differences were found between the types of assessment techniques utilized across various facilities. The WISC and WAIS were found to be routinely used at each of the various internship facilities; the MMPI-2 and MMPI-A are used regularly at all but the child facilities, where only 36% reported using these instruments routinely. The Rorschach is part of a full battery at the majority of internships surveyed, ranging from 58% for Veterans Administration hospitals to 95% for community mental health centers, and the TAT is used in full batteries primarily at private general hospitals (88%) and community mental health centers (73%).
Was this article helpful?