Given that students have had an adequate course in psycho-metrics, the next typical step in training is an introductory course in assessment, in which they learn the many details of test administration, scoring, and initial interpretation. Assessment is taught quite differently in doctoral programs throughout the country. As mentioned previously, in some programs testing is actually taught, but the course is labeled assessment. In some programs this course is taught entirely as a survey course; students do little or no practice testing, scoring, or interpretation (Childs & Eyde, 2002; Durand, Blanchard, & Mindell, 1988; Hilsenroth & Handler, 1995). We believe this is a grave error, because each assessment course builds on the previous one(s). A great deal can be learned about assessment from reading textbooks and test manuals, but there is no substitute for practical experience.
Some doctoral training programs require only one assessment course in which there is actual practice with various tests. Many other programs have two courses in their curriculum but require only one, whereas other programs require two courses. In some programs only self-report measures are taught, and in others only projective measures are taught. In some programs there are optional courses available, and in others no such opportunities exist. The variability of the required and optional personality assessment courses in training programs is astounding, especially since assessment is a key area of proficiency, required by the American Psychological Association (APA) for program accreditation. In our opinion, students cannot become well grounded in assessment unless they learn interviewing skills and have taken both an introductory course focused on the administration and scoring of individual tests and an advanced course focused on the integration of assessment data and their communication to referral sources and to the person who took the tests.
Many times the required assessment courses are determined by a prevailing theoretical emphasis in the program. In these settings, assessment techniques chosen for study are limited to those instruments that are believed to fit the prevailing point of view. This is unfortunate, because students should be exposed to a wide variety of instruments and approaches to personality assessment, and because no instrument belongs to a particular theoretical approach; each test can be interpreted from a wide variety of theoretical viewpoints.
Some programs do not include the training of students in assessment as one of their missions, despite the APA requirement. Instead, they believe that the responsibility for teaching personality assessment lies with the internship site. Relegating this important area of clinical experience to the internship is a bad idea, because students learn under a great deal of pressure in these settings, pressure far greater than that of graduate school. Learning assessment in this type of pressured environment is truly a trial by fire.
Most students do not know the history of the testing and assessment movement and the relevance of assessment to clinical psychology. We recommend that this information be shared with students, along with the long list of reasons to learn assessment, which was discussed earlier in this chapter, and the reasons some psychologists eschew assessment.
The necessary emphasis on each test as a separate entity in the first course must eventually give way to a more integrated approach. In addition, although it is necessary to teach students to administer tests according to standardized instructions, they must also be introduced to the idea that in some cases it will not be possible or perhaps advisable to follow standardized instructions. They must also be helped to see that test scores derived in a nonstandardized manner are not necessarily invalid. Although they should be urged to follow the standardized procedures whenever possible, modifying instructions can sometimes help students understand the patient better.
We believe that it is important to draw students' attention to the similarities and differences among the tests, emphasizing the details of the stimuli, the ability of different tests to tap similar factors, the style of administration, and so on. Students should be taught the relevance of the variables they are measuring and scoring for each test. Otherwise, their administration is often rote and meaningless. For example, it makes little sense to students to learn to do a Rorschach Inquiry if they are not first acquainted with the relevance of the variables scored. Therefore, conceptualization of the perceptual, communicative, and representational aspects of perceiving the inkblots, and any other stimuli, for that matter, must first be discussed. We recommend beginning with stimuli other than the test stimuli, in order to demonstrate that aspects of the stimuli to which we ask patients to respond are no different from aspects of ordinary, real-life stimuli.
In our opinion, the most important function of this first course is to discuss the reasons each test was chosen to be studied and to help students become proficient in the administration, scoring, and initial interpretation of each test. Once students have mastered test administration, the instructor should begin to emphasize the establishment of rapport with the patient, which involves knowing the directions well enough to focus on the patient rather than on one's manual.
The introductory course usually has an assigned laboratory section, in which students practice with volunteer subjects to improve proficiency. Checkouts with volunteer subjects or with the instructor are routine. Students must be able to administer the tests smoothly and in an error-free manner and then score them properly before moving on to the next course.
In many programs students are required to administer, score, and begin to interpret several of each test they are learning. The number of practice protocols varies considerably, but it is typical to require two or three, depending on each student's level of proficiency. In the classroom there should be discussion of the psychometric properties and the research findings for each test and a discussion of the systematic administration and scoring errors produced by students.
Students should be taught that each type of data collected in an assessment has its strengths and its weaknesses. For example, observational and history data are especially helpful in assessment, but these sources can also be quite misleading. Anyone who has done marital therapy or custody evaluations has experienced a situation in which each spouse's story sounds quite plausible, but the husband and the wife tell opposite stories. Such are the limitations of history and observational data. People typically act differently in different situations, and they interpret their behaviors and intentions, and the behaviors and intentions of others, from their own biased vantage points. It soon becomes obvious that additional methods of understanding people are necessary in order to avoid the types of errors described above. Adding test data to the history and observational data should increase the accuracy of the assessment and can allow access to other key variables involved in knowing another person. However, test-derived data also contain sources of error, and at times they are also distorted by extratest effects or by impression management attempts, but many tests include systematic methods of determining test-taking attitude and the kind and degree of impression management attempted. Students should be taught that because no assessment method is error-free and no test, by itself, is comprehensive, it is important to use a number of assessment methods and a number of different types of tests and to aggregate and integrate them in order to answer referral questions adequately and to obtain a meaningful picture of the person assessed. This orientation leads the students directly to the advanced assessment course.
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