Guidelines 198 Postgraduate Assessment Training 199 Assessment And Managed Care Issues 199 The Politics And Misunderstandings In

PERSONALITYASSESSMENT 200 PERSONALITY ASSESSMENT IN THE FUTURE 202 The Assessment of Psychological Health and the Rise of

Positive Psychology 202 Focused Measures of Important Personality Variables 203 Therapeutic Assessment 203 Assessment on the Internet 204 Research on the Interpretive Process 204 Expanded Conception of Intelligence 204 REFERENCES 205

We begin this chapter with a story about an assessment done by one of us (Handler) when he was a trainee at a Veterans Administration hospital outpatient clinic. He was asked by the chief of psychiatry to reassess a patient the psychiatrist had been seeing in classical psychoanalysis, which included heavy emphasis on dream analysis and free association, with little input from the analyst, as was the prevailing approach at the time. The patient was not making progress, despite the regimen of three sessions per week he had followed for over a year.

The patient was cooperative and appropriate in the interview and in his responses to the Wechsler Adult Intelligence Scale (WAIS) items, until the examiner came to one item of the Comprehension subtest, "What does this saying mean: 'Strike while the iron is hot'?" The examiner was quite surprised when the patient, who up to that point had appeared to be relatively sound, answered: "Strike is to hit. Hit my wife. I should say push, and then pull the cord of the iron. Strike in baseball—one strike against you. This means you have to hit and retaliate to make up that strike against you—or if you feel you have a series of problems—if they build up, you will strike." The first author still remembers just beginning to understand what needed to be said to the chief of psychiatry about the type of treatment this patient needed.

As the assessment continued, it became even more evident that the patient's thinking was quite disorganized, especially on less structured tests. The classical analytic approach, without structure, eliciting already disturbed mentation, caused this man to become more thought disordered than he had been before treatment: His WAIS responses before treatment were quite sound, and his projective test responses showed only some significant anxiety and difficulty with impulse control. Although a previous assessor had recommended a more structured, supportive approach to therapy, the patient was unfortunately put in this unstructured approach that probed an unconscious that contained a great deal of turmoil and few adequate defenses.

This assessment was a significant experience in which the assessor learned the central importance of using personality assessment to identify the proper treatment modality for patients and to identify patients' core life issues. Illuminating experiences such as this one have led us to believe that assessment should be a central and vital part of any doctoral curriculum that prepares students to do applied work. We have had many assessment experiences that have reinforced our belief in the importance of learning assessment to facilitate the treatment process and to help guide patients in constructive directions.

The approach to teaching personality assessment described in this chapter emphasizes the importance of viewing assessment as an interactive process—emphasizing the interaction of teacher and student, as well as the interaction of patient and assessor. The process highlights the use of critical thinking and continued questioning of approaches to assessment and to their possible interpretations, and it even extends to the use of such a model in the application of these activities in the assessment process with the patient. Throughout the chapter we have emphasized the integration of research and clinical application.

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