Students learning assessment are curious about ways to improve the accuracy of their interpretations, but they nevertheless adhere strictly to standardized approaches to administration, even when, in some situations, these approaches result in a distortion of findings. They argue long, hard, and sometimes persuasively that it is wrong to modify standardized procedures, for any reason. However, we believe that at certain times changing standardized instructions will often yield data that are a more accurate measure of the individual than would occur with reliance on standardized instructions. For example, a rather suspicious man was being tested with the WAIS-R. He stated that an orange and a banana were not alike and continued in this fashion for the other pairs of items. The examiner then reassured him that there really was a way in which the pairs of items were alike and that there was no trick involved. The patient then responded correctly to almost all of the items, earning an excellent score. When we discuss this alteration in the instructions, students express concern about how the examiner would score the subtest results. The response of the instructor is that the students are placing the emphasis in the wrong area: They are more interested in the test and less in the patient. If the standardized score was reported, it would also not give an accurate measure of this patient's intelligence or of his emotional problems. Instead, the change in instructions can be described in the report, along with a statement that says something like, "The patient's level of suspicion interferes with his cognitive effectiveness, but with some support and assurance he can give up this stance and be more effective."
Students are also reluctant to modify standardized instructions by merely adding additional tasks after standardized instructions are followed. For example, the first author typically recommends that students ask patients what they thought of each test they took, how they felt about it, what they liked and disliked about it, and so on. This approach helps in the interpretation of the test results by clarifying the attitude and approach the patient took to the task, which perhaps have affected the results. The first author has designed a systematic Testing of the Limits procedure, based on the method first employed by Bruno Klopfer (Klopfer, Ainsworth, Klopfer, & Holt, 1954). In this method the patient is questioned to amplify the meanings of his or her responses and to gain information about his or her expectations and attitudes about the various tests and subtests. This information helps put the responses and the scores in perspective. For example, when a patient gave the response, "A butterfly coming out of an iceberg" to Card VII of the Rorschach, he was asked, after the test had been completed, "What's that butterfly doing coming out of that iceberg?" The patient responded, "That response sounds kind of crazy; I guess I saw a butterfly and an iceberg. I must have been nervous; they don't actually belong together." This patient recognized the cognitive distortion he apparently experienced and was able to explain the reason for it and correct it. Therefore, this response speaks to a less serious condition, compared with a patient who could not recognize that he or she had produced the cognitive slip. Indeed, later on, the patient could typically recognize when he had made similar cognitive misperceptions, and he was able to correct them, as he had done in the assessment.
Other suggestions include asking patients to comment on their responses or asking them to amplify these responses, such as amplifying various aspects of their figure drawings and Bender Gestalt productions, their Rorschach and TAT response, and the critical items on self-report measures. These amplifications of test responses reduce interpretive errors by providing clarification of responses.
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