Psychological Assessment

1. 1 Psychological Assessment William P. Wattles, Ph.D.

2. 2 Psychological Report The end product of assessment. More than merely test results Must �interact with the data� to make useful conclusions about Referral question Making decisions Problem solving

3. 3 Referral Question A brief description of the client general reason for conducting the evaluation

4. 4 Referral Question Orients the reader to the initial focus of the report and what follows. Clinician must clarify the referral question.

5. 5 Referral Question �Referred for a psychological� lacks focus and precision leads to �shotgun� reports A wide variety of often-fragmented descriptions in the hope that something useful can be found.

6. 6 Referral Question Example �Mr. Smith is a 35-year-old, white, married male with a high school education who presents with complaints about depression and anxiety.�

7. 7 Report Format Please follow example Add Discussion (case conceptualization) section before Impressions and recommendations.

8. 8 Discussion Section This is where you put it together.

9. 9 clarity She was attractive, well spoken, and had high mannerisms

10. 10 Translate Technical concepts Examples page 631

11. 11 Be concise Jesse S is a 23-year-old Caucasian female who presents with having the desire to feel �fully fulfilled�. She wants to feel settled in her life. The current evaluation was designed for the patient to gain personal insight regarding dissatisfaction with her current daily activities. (44)

12. 12 Be concise Jesse S is a 23-year-old Caucasian female who is dissatisfied with her daily activities and wants to feel �fully fulfilled.� (21)

13. 13 Be concise The patient answered all: The inquiries presented to him my questions.

14. 14 Simple language When this issue was further questioned, MT �. Asked to elaborate, MT �

15. 15 Simple language She displayed a euthymic mood, which she described as �great�.

16. 16 Avoid pejorative terms She was low on the Lie scale indicating that she received a normal score and appeared to answer honestly and openly.

17. 17 Avoid jargon People with this profile tend to be narcissistic, selfish, and self-indulgent.

18. 18 Seek active verbs The older sister was described as stubborn implying a strain in the relationship.

19. 19 watch for redundancy Her past work history consists of working on a local

20. 20 Seek clarity Mrs. L�s Mother is a resigned OB/GYN nurse

21. 21 Short She made no eye contact even though she was familiar with the interviewer. Her eyes focused on the hairline of the interviewer. She appeared to look over my head rather than making eye contact.

22. 22 Don�t over do quotes �we weren�t poor but we weren�t well off either.�

23. 23 quotes because �the other students think [she gets] all of the questions correct but [she] still doesn�t know everything [she feels] like [she needs] to know.�

24. 24 Be concise Given the behavioral observations, length and depth of clinical interview and MMPI-2 test profile, I believe this evaluation is an accurate assessment of TS�s current level of functioning.

25. 25 Details and examples She admits that they sometimes �overcompensate� in caring for their children because neither of them received enough attention from their parents growing up

26. 26 Be direct, don�t repeat After high school, she felt that college was the next logical step for her. She felt that �my parents were completely behind me as though it was the next natural step, but also to make sure that I did end up going to college�. She repeated many times that �you don�t really have a choice about college in my family; they make you think you do, but you really don�t�. Ms. Davis went on to say that she had been brought up thinking this, and she didn�t even consider any other options after high school. (95)

27. 27 Interpretation goes in discussion The results of CA�s WAIS-III indicates that she has above average intelligence especially with regards to her phenomenal attention span and her ability to solve visual problems using her visual motor skills. Her very high scores on her WAIS-III could be contributing to her unhappiness in her present occupation. She may feel that she is not using her strengths in the best possible fashion and that she has not lived up to her expectations.

28. 28 Case Conceptualization �S.L. is currently experiencing a great deal of subjective distress. Her current difficulties with depressive and anxiety symptoms are likely related to her self-concept, which has been shaped and distorted by her long-term interpersonal relationships with her family and her ex-boyfriend. The unreasonably high demands she places on herself set the stage for what she views as �failure�.

29. 29 Details and behavior During this time, G admitted to having been in trouble with the law. She refused to specify the type trouble. She also reported that she got into a lot of �other� trouble due to her sexual behavior. Again, she would specify what this �other� trouble was

30. 30 Initial Reports Length of papers 627-1960 words Best paper was relatively long You can check length

31. 31 Referral Section Brief Guides report

32. 32 General Comments on Papers Appearance example: wearing house slippers, relevant to psy functioning. Good use of quotes: Would keep cats �until it killed her�

33. 33 Use examples One patient had strict parents Examples help identify where the blame lies Didn�t want to �rat� on her friends

34. 34 Language Proof read. One paper good content many errors in verbs etc. Avoid slang or colloquial language (I.e., blew it off) unless they are the client�s words in quotes

35. 35 She did not display irregular emotion during the interview.

36. 36 Colloquial Language Kim was kicked out of college her freshman year because of poor grades. The university suspended Kim her freshman year due to poor grades.

37. 37 Simple language Ms. Heather presented, in the interview, congruent behaviors to that of someone with lower self-esteem. Ms. Heather shows signs of low self-esteem. Low self-esteem may contribute to her eating problems.

38. 38 Psychological Functioning Conceptualize Collect facts and observations Don�t stop there Synthesize those observations and data into a picture of psychological functioning

39. 39 Strengths and Weaknesses Important to identify strengths to use and encourage

40. 40 Example The client was alert and oriented to all spheres. Her affect was full range, and her mood was euphoric. Her speech rate, quality, and content were within normal limits.

41. 41 Observation vs Interpretation Her calm demeanor while discussing her anxiety about graduate school, and her boyfriend suggested that this client keeps her emotional reactions to herself and maintains an intellectual stance on her personal issues.

42. 42 Example Mrs. H is a 57-year-old, Caucasian, married female who presents with concerns regarding a specific goal, her future retirement in order to spend time with her grandchildren.

43. 43 Passive voice Also, should his emotional situation persist or worsen, it is recommended that Andrew seeks the help of a counselor.

44. 44 Referral Section vs. Summary C.S. states �this is not what I imagined doing with my life.� This dissatisfaction results in physical, emotional and social problems whose effects she seeks to minimize.

45. 45 Good but can we improve? The client was very articulate and well educated, but her appearance was incongruent. She was dressed in very sloppy and causal attire.

46. 46 Precise Language Articulate Expressing oneself easily in clear and effective language. Redundant Needlessly repetitive; verbose

47. 47 Example When describing her family background, however, the possible use of reaction formation became evident.

48. 48 Explore for data She also stated that she felt inferior and lacked confidence in herself as a teacher, but offered no substantial reason why.

49. 49 Example his mood changed from enthymic to closed and quiet

50. 50 Diagnosis Andrew is a 24-year-old man referred because of his current unemployment and because he has been unable to find a job. Due to this situation, Andrew is going into a state of depression

51. 51 Kim is a 23-year-old white female who presents with difficulties coping with stress brought upon her by school. Better:

52. 52 Kim is a 23-year-old white female college student complaining of stress related to school.

53. 53 Kim approached the interview very willingly and appeared to be excited to do the interview. She wore sweatpants and a tee shirt. Her hair was pulled back into a clip. She was very talkative and maintained appropriate eye contact. She was very cooperative and answered all questions willingly, many times volunteering information beyond what had been asked of her but still remaining on the subject. She willingly expanded on all of her answers, many times without being prompted.

54. 54 He is the only child of John and Vickie Xxxxxx . He has an older brother that his mother gave birth to out of wedlock prior to marrying Eric's father.

55. 55 She wore coordinating accessories and seemed very contentious of her attire and posture.

56. 56 At age ten his father became a member of AA,

57. 57 Laura C. is a 23 year old woman who is self-referred because she not happy with her current living situation. She says that she feels �so alone�. She reportedly has gained weight over the last several months. She claims it is due to her � unhappiness about being alone�.

58. 58 Laura also reports that her weight gain has not affected her relationship with her boyfriend.

59. 59 Verify with examples Her problems stem from her current occupation as a teacher. She has undergone significant life events in the last year.

60. 60 Verify with examples She reports that she makes friends easily �

61. 61 Use Examples In addition to confronting his wife�s mortality, Harold is being forced by her illness to recognize his own vulnerabilities

62. 62 Verify with examples quit her job as a registration representative at _______ because of the unfair working conditions.

63. 63 Example His affect was full range, although his mood was quite dysphoric.

64. 64 Example In an effort to alleviate her frustration and anger, and to come to a compromise with Mr. Oranda about their differences in their expected roles, Mrs. Oranda states that she has made a conscious effort to talk to, rather than argue with, Mr. Oranda.

65. 65 Example Her affect was full range, however her mood was agitated.

66. 66 Example Within normal limits.

67. 67 Example She states she has many friends, and socializes with them on a weekly basis. As for an example, quantify. As for an example, quantify.

68. 68 Example Ms. A described her high school academic performance as above average, stating that she never studied ExpandExpand

69. 69 Wordy Brittany was explicit during the interview when discussing her home environment in reference to how physically violent it is. Brittany explicitly described the violence in her home. Specifics? Exaggeration?, behavior while discussing thisSpecifics? Exaggeration?, behavior while discussing this

70. 70 Example Brittany�s academic and behavior problems began when her parents started drinking and fighting 2 years ago. Not before? Not before?

71. 71 Be succinct 38 vs 29 In order to improve her sleep schedule, she could be given information on sleep principles. For example, some principles are going to bed at the same time each night and not doing anything in the bed but sleeping. To help with fatigue she could be given information on sleep such as going to bed that same time each night and not doing anything in bed but sleeping.

72. 72 The �You� in a Report Personal opinion versus observation and hypothesis Sort through the abundant information

73. 73 Presenting problem versus reason for referral reported that she �wished to be thinner� She reports 9-10 year struggle with anorexia. As a result of this, she has had to seek medical treatment to pass four kidney stones and treat multiple stomach ulcers. Ms. Heather has had difficulty in maintaining a regular menstrual cycle and has experienced fainting spells due to low blood sugar a few times per month.

74. 74 She is approximately 5 foot tall, 100 pounds She appears � She reported that she is �

75. 75 5 feet 100 lbs is BMI 19.5 BMI Categories: Underweight = <18.5 Normal weight = 18.5-24.9 Overweight = 25-29.9 Obesity = BMI of 30 or greater

76. 76 she stated that being the only child made them �over protective� and that she hoped they would �ease up� after she finished college. She explained that the more they monitored her plate, the more stress she felt and the more creative she got with hiding her food. She is still living at home. (24)

77. 77 Questions to ask Ms. Dubose is a 22 year old white female whose reason for referral was unhappiness with current job and disappointment with her �professional direction.�

78. 78 Despite the time difference between her recent return to academia and completion of her nursing studies, Mrs. J�s performance in Francis Marion University�s graduate program is excellent.

79. 79