Teaching Trainees to Conceptualize and Write About Personality Functioning

1. Teaching Trainees to Conceptualize and Write About Personality Functioning Wayne F. Martin, Ph.D. Bexar County Juvenile Probation Department

2. Teaching Conceptualization and Writing Skills As graduate training in psychological assessment and report writing has eroded over time, trainees more frequently arrive at internship with inadequate skills in conceptualizing and writing about personality structure and dynamics. This poster will present time saving procedures that will provide trainees a useful structure from which they can begin to organize and analyze data, and then integrate this data into a model of personality functioning. These structured training techniques will lead to greater understanding and facility with personality conceptualization, and ultimately a more structured, user-friendly assessment report.

3. Teaching Conceptualization and Writing Skills • Figure 1 is an organizational tool that helps trainees organize assessment data that was discussed and integrated during supervision • Completed before and during supervision and organized to serve as an outline for the trainee to write the personality section of the report • Repetitive use of this form allows the trainee to internalize a structure for understanding personality • This form also serves as a summary of results that aids the supervisor when editing the final report

4. Teaching Conceptualization and Writing Skills Figures 1: Sample Assessment Supervision Form MHAT ASSESSMENT SUPERVISION FORM Psychoeducational Issues IssueData Source(s) *Average IQ WASI, Clin. Interview *Poor Academic Skills WRAT3 * Emotional/Emergent Issues and Their Origins IssueData Source(s) *Depression Clin. Interview * Poor Self-Esteem Clinical Interview, SC Blank, TAT *Anxiety Clinical Interview, SC Blank, TAT *Anger File data, Clinical Interview, SC Blank, MACI, TAT Coping Behaviors/Defense Mechanisms Behavior Data Source(s) *Repression SC Blank, TAT *Denial SC Blank, TAT, Clinical Interview *Fantasy SC Blank, TAT *Avoidance SC Blank, TAT, File data *Substance Abuse MACI, Clinical Interview, File Data Interpersonal Dynamics Dynamic Data Source(s) *Seeks others to fill needs for attachment Clinical Interview, SC Blank, TAT, MACI *Will follow others in order to be accepted Clinical Interview, SC Blank, TAT *Passive aggressive toward authority Clinical Interview, SC Blank, TAT, MACI *Trust issues will hinder establishment of meaningful, supportive relationships Clinical Interview, SC Blank, TAT

5. Teaching Conceptualization and Writing Skills • Figure 2 is an annotated report outline for the personality functioning section of the assessment report • It is designed to again help trainees structure personality data, know what relevant information to present, and in what order • Repetitive use allows trainees to ultimately internalize these questions and the structure of this outline

6. Teaching Conceptualization and Writing Skills Figure 2: Annotated Outline for Personality Functioning Section of Report CONFIDENTIAL PSYCHODIAGNOSTIC INTERVIEW or PSYCHOLOGICAL EVALUATION Name/ SID#: Probation Officer: DOB ; Age: Evaluated by: Evaluation Date(s): Report Date: . . TEST RESULTS AND INTERPRETATION: -Personality Section (3 paragraphs) -Emotional and psychological functioning (current and long-standing) and apparent etiology (1 paragraph) Answer the following questions: (a) how does the probationer present him/herself to the world?; (b) what emotions and issues is the probationer struggling with at a deeper level?; (c) what, based on evaluation data, are the most likely personal/environmental sources of these deeper feelings? -Predominant coping strategies and strengths (1 paragraph) Answer the following questions: (a) what is the function of these coping behaviors?; (b) what are probationer’s predominant coping behaviors?; (c) what are the probationer’s strengths? -Interpersonal functioning (1 paragraph) Answer the following questions: (a) is the probationer drawn to relate to others/peers or not? why? Or why not?; (b) does s/he have the capacity to form trusting, meaningful relationships; (c) how does the probationer relate to authority figures? why?; (d) does the probationer relate to men/women differently? why?; (e) is the probationer likely to have specific romantic/sexual issues? why?

7. Teaching Conceptualization and Writing Skills • Figure 3 is a structured template for trainees to use when writing the personality section of their reports • Wording is chosen to both inform the reader and the writer (the trainee) about what ‘personality’ is • Repeated use of this template helps intern internalize a structure for thinking and communicating -- verbally and in writing -- about personality and emotional functioning

8. Teaching Conceptualization and Writing Skills Figure 3: Template of Personality Section of Assessment Report While Probationer presents himself/herself as a (behavioral/emotional adjectives from first sentence in paragraph above) young wo/man, assessment responses suggest that s/he may harbor deeper feelings of (list of relevant emotions). It appears that these feelings may arise due to her/his (list of probable origins of emotions named above). Given these issues, it seems plausible that Probationer perceives that his/herneeds for (list all that apply:nurturance, structure, safety, security, and positive esteem) have not been adequately met. As these deeper feelings of low self-esteem, depression, anxiety, distrust, and anger are often too intense and threatening for Probationer to recognize and address consciously, s/he attempts to cope with them in several ways. Moreover, as these coping behaviors form a predominant part of his/her behavior, others are likely to view the following as key parts of Probationer’s ‘personality’. First, Probationer …. Second, Probationer …. Third, ... Fourth,…. Finally, Probationer…. Despite these coping difficulties, Probationer has strengths that might serve as protective factors against future negative adjustment. Specifically, s/he appears to be (descriptors of protective traits) who (more descriptors), which could serve as a solid foundation for future positive growth if these strengths can be developed and focused more positively. Interpersonally, Probationer appears to be (description of level of ‘socialness’ regarding peers). (Explanation of the likely cause of this/these character traits and how it might impact his social behavior both positively and negatively). Regarding authority figures, Probationer(1-2 sentences describing likely behaviors toward authority figures; if there are likely to be different behaviors toward men and women note that here, also). Romantically, Probationer’s evaluation responses suggested that (2-3 sentences describing behaviors and issues likely to play out in romantic relationships given the emotional coping issues discussed above).

9. Teaching Conceptualization and Writing Skills General Discussion • Tools presented in Figures 1-3 are used to help trainees structure the training task of understanding and creating an internalized understanding and structure of personality • Trainees often balk at following these training guides closely and will relate “it feels more comfortable to use my own words”. We’ve found their skills develop more quickly when we encourage them to follow the structure of the forms closely

10. Teaching Conceptualization and Writing Skills General Discussion • While other stylistic issues that impact ‘readability’ may need to be addressed, use of these tools help improve the organization and clarity of trainees personality write-ups • Once trainees have internalized this basic structure/understanding of personality, they should be encouraged to develop greater complexity in their understanding and communication of personality functioning (e.g., such as how one area of functioning or intrapersonal dynamic impacts other areas) • This set of structured training tools can be adopted to almost any theoretical structure of personality

11. Teaching Conceptualization and Writing Skills References • Cohen, K.R., Krishnamurthy, R., & Vandecreek, L. (2004).Psychological Assessment: Process and outcomes in defining competence. Journal of Clinical Psychology, 60 (7), 725-739. • Wolber, G.J., & Carne, W.F. (1993). Writing psychological reports: A Guide for clinicians. Sarasota, FL: Professional Resource Press. • Hilsenroth, M (2001). Psychological Assessment on Internship: A survey of training directors and their expectations for students. Journal of Personality Assessment, 76 (1), 18-47.