Discussion Question
JaMatKK2
Nystul_IntroCounseling_PPT_04.pptxIntroduction to Counseling: An Art and Science Perspective
Chapter 4:
Assessment and diagnosis
Nystul, Introduction to Counseling: An Art and Science Perspective
© 2016 SAGE Publications, Inc.
1
Assessment
Nystul, Introduction to Counseling: An Art and Science Perspective
© 2016 SAGE Publications, Inc.
Standardized tests
Interviews
Observations
Sociocultural assessment
Behavioral assessment
Environmental assessment
Access to Assessments
Nystul, Introduction to Counseling: An Art and Science Perspective
© 2016 SAGE Publications, Inc.
Mental Measurement Yearbook
Contains many tests
Provides objective critique of tests
Educational Testing Service
Publishes over 25,000 tests and research instruments
The Standards for Educational and Psychological Testing
Guidelines for proper use and interpretation of tests
Validity The degree to which a test measures what it purports to measure
Nystul, Introduction to Counseling: An Art and Science Perspective
© 2016 SAGE Publications, Inc.
Content validity
Test items cover material that applies to concept of interest
Construct validity
Degree to which test measures a construct
Criterion-related validity
How well test predicts criterion
Concurrent validity: valid with another measure
Predictive validity: criterion is available after testing occurred
Reliability The consistency of scores by the same person
Nystul, Introduction to Counseling: An Art and Science Perspective
© 2016 SAGE Publications, Inc.
Determined by:
Test-retest reliability: same test is administered twice to same person
Alternate-forms reliability: equivalent forms of a test administered at separate times
Split-half reliability: two equivalent halves administered to individual
Considerations for Testing
Norms: determine the comparison group for which the test was developed
Guidelines
Only qualified individuals administer and interpret
Counselor to explore with client how he or she felt about testing
Review purpose and results with client
Apply results and assist with developing plan
Nystul, Introduction to Counseling: An Art and Science Perspective
© 2016 SAGE Publications, Inc.
Factors Associated with Test Bias
Nystul, Introduction to Counseling: An Art and Science Perspective
© 2016 SAGE Publications, Inc.
Inappropriate content
Inappropriate standardization samples
Examiner and language bias
Inequitable social consequences
Measurement of different constructs
Differential predictive validity
Multicultural Assessment Procedure
Addressing challenges associated with multicultural assessment
Identify cultural data
Interpret cultural data to formulate a working hypothesis
Incorporating cultural data to test the working hypothesis
Arriving at a sound assessment decision
Nystul, Introduction to Counseling: An Art and Science Perspective
© 2016 SAGE Publications, Inc.
Types of Tests
Nystul, Introduction to Counseling: An Art and Science Perspective
© 2016 SAGE Publications, Inc.
Standardized measures
Have a norm group
Spans variety of psychological tests
Nonstandardized measures
No norm group
Include observations, behavioral assessments, and environmental assessments
Advantages and Disadvantages
Nystul, Introduction to Counseling: An Art and Science Perspective
© 2016 SAGE Publications, Inc.
Standard Measures
Nystul, Introduction to Counseling: An Art and Science Perspective
© 2016 SAGE Publications, Inc.
Achievement tests
Includes information on what an individual has learned
Aptitude tests
Assess an individual’s potential for success in a particular area
Personality inventories
Assess various levels of personality
Can help with diagnosis
Can be “objective” or “subjective” tests
Neuro-psychological tests
Assesses cognitive, behavioral, and psychological strengths and weaknesses
Measures are in a “full battery”
Nonstandardized Measures
Referred to as qualitative assessment
Types
Observations
Behavioral assessments
Environmental/ecological assessments
Nystul, Introduction to Counseling: An Art and Science Perspective
© 2016 SAGE Publications, Inc.
Diagnosis Benefits of diagnosing
Nystul, Introduction to Counseling: An Art and Science Perspective
© 2016 SAGE Publications, Inc.
Allows communication among clinicians
Suggests treatment possibilities
Can communicate information about etiology
Aids scientific inquiry
Definition of Mental Disorder
APA (2013)
Disturbance in cognition, emotional regulation or behavior
Effects one’s functioning
Distress results socially, occupationally or other areas
Nystul, Introduction to Counseling: An Art and Science Perspective
© 2016 SAGE Publications, Inc.
DSM-5
Nystul, Introduction to Counseling: An Art and Science Perspective
© 2016 SAGE Publications, Inc.
Organizes all mental disorders within 20 categories
Categories are sequenced from a life span—developmental perspective
Cross-referenced with the WHO-ICD-CM (9th and 10th)
Includes subtypes and provisional diagnoses
Integrates assessment and cultural factors
The Clinical Interview
Nystul, Introduction to Counseling: An Art and Science Perspective
© 2016 SAGE Publications, Inc.
Stage 1
Using listening skills
Stage 2
Taking the client’s history
Stage 3
Conducting a mental status exam
Stage 4
Using standardized and nonstandardized measures
The Clinical Interview: Stage 1 Listening
Nystul, Introduction to Counseling: An Art and Science Perspective
© 2016 SAGE Publications, Inc.
Use listening to gain a phenomenological understanding of client
Open-ended questions
Understanding of what brings client to counseling
Collect other pertinent information
The Clinical Interview: Stage 2: Client History Collected in two areas
Nystul, Introduction to Counseling: An Art and Science Perspective
© 2016 SAGE Publications, Inc.
Background regarding work, family, social relationships, and health
Counselor may use a form
Also identify strengths
Explore organic factors impacting symptoms
Background and specifics on symptoms and presenting problem
Counselor may use symptom checklists
Also assess sleep, appetite and other daily functioning that could be affected by symptoms
The Clinical Interview: Stage 3: Mental Status Exam Six areas according to Trzepacz and Baker (1993)
Nystul, Introduction to Counseling: An Art and Science Perspective
© 2016 SAGE Publications, Inc.
Appearance, attitude, and activity level
Mood and affect
Speech and language
Thought processes, thought content, and perception
Cognition
Insight and judgment
The Clinical Interview: Stage 4: Using Standardized and Nonstandardized Measures
Used to refine diagnosis
Aid in treatment planning
Incorporate client’s strengths
Formulate mutually-agreed-upon goals
Maintain positive counseling relationship
Nystul, Introduction to Counseling: An Art and Science Perspective
© 2016 SAGE Publications, Inc.
BASIC I.D.
Lazarus’ (1997) seven modalities that provide a basis for treatment planning
Nystul, Introduction to Counseling: An Art and Science Perspective
© 2016 SAGE Publications, Inc.
.MsftOfcThm_Accent1_Fill { fill:#4472C4; } .MsftOfcThm_Accent1_Stroke { stroke:#4472C4; }
.MsftOfcThm_Accent1_Fill { fill:#4472C4; } .MsftOfcThm_Accent1_Stroke { stroke:#4472C4; }
