A summary of the course Psychological Assessment. The summary consists of the lectures given and the chapters of the two books from Witteman and Van der Molen.
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Lecture 1 Introduction
What is psychological assessment?
= the process a mental health professional follows of gathering and processing information
about a client until and including the phase of establishing an indication for treatment
o Why, how and with what intended result
Goals = 2 areas of competence
o Psychological practice
Concerns systematic, substantiated diagnostic judgements and decision-
making
o Communication and professionalism in entering into a helping relationship
Concerns counselling and treatment relationships in the diagnostic context
Competence 1 – psychological practice
= shared decision-making process in which a clinician defines diagnostic questions,
formulates and tests hypotheses about the client’s functioning (emotion, cognition, behavior)
and integrates the information collected from different science-based sources and methods
in a dynamic fashion
o Resulting in a representation and understanding of the problem that is shared with
the client in such a way that relevant indications for treatment ensue
De Groot’s empirical cycle
o A scientifically sound procedure for collecting information:
Observation – collecting information
Induction – formulating hypotheses, based on theory
Deduction – derive testable predictions
Testing hypothesis and predictions
Evaluation of the process and its outcome
Witteman’s process
The classification comes from the De Groot’s cycle
Normal/abnormal – classification (= something is (not) present)
o Several classification systems
DSM-5 – categorical, more dimensional trying
ICD-11
, RDoC
HiTOP Model
o Categorical vs. dimensional approaches
Prevailing categorical approach (professionals and laypeople)
Presence/absence, should be predictive of symptoms course and
development
Cut-off based on number of symptoms distinguishing healthy from
pathological
Assumed homogenous categories
Assumed mutually exclusive categories, and exhaustive of all
possibilities
Reality: all these assumptions are false
Psychopathology is dimensional in nature
No clear-cut difference between abnormal/normal
o No consensus, intrinsic difficulty in defining human
complexity
o Risk of stigma and over-pathologizing
o Suffering and limitation in social, occupational and other
important activities
But what if justified by context
Impossible to objectively measure individual
dysfunctions
o Statistical deviation from norm
Cut-offs will always be arbitrary
Overlap across dimensions
Dynamic fluctuations over time
Competence 2 – communication and professionalism in entering into a helping relationship
Underlying attitudes in helping
o Based on the client-centered approach of Rogers
Basic principle = self-actualization
Certain conditions are needed to achieve this
Therapeutic relationship created conditions that enable client strengths,
difficulties, solutions
Caregiver facilitates and helps client to help themselves.
o Pitfall helper “I have to do something syndrome”
,o In therapy 3 conditions for growth
Unconditional positive appreciation
Appreciate client as a person with value and dignity
How?
o Show commitment towards client
Being on time, making time, privacy, trust respect
Barriers are a lack of time and lack of care
o Making effort to understand client
Empathy, questions, interest
Active listening
Unconditional acceptance
o Attitude helper to not reject thoughts/feelings client
o Not unconditionally approve, do take client’s point of view
seriously
o Assume the client’s willingness/good intentions
o Helper should (covert) check thoughts/feelings around client
with themselves
o How?
Express warmth and proximity
Reduces impersonal nature interventions or
treatment
Reflect on thought, feeling, behavior of counsellor or
client or the relationship
Helper – “glad to see you”
Helper to client – “you seem nervous to talk
about this”
Relation – “I’m glad you can share that with
me”
Try to notice transference and countertransference
Describing what is going on in the situation
Genuineness – authenticity
Helper is themselves without playing a rol
o Refers to being human and working together with a client
o Reduces emotional distance to client
o Key facets
Role behavior – no emphasis on your role, authority
and status
Congruence – words, behavior and feelings of helper
are consistent
Acknowledging negative/positive feelings in sessions
Distrust by client when detecting incongruence
Spontaneity
Not articulating every thought that comes to mind
Do express naturally and still dealing tactfully with
client
Openness and self-disclosure
Skill to be open about self vs client
Capacity client to get something out of self-
disclosure (well-being client)
Parallel to feelings of client (in terms of content and
intensity)
, Moderate level: not too much or little
Empathy
Ability to understand someone from his experience and showing that
you understand what is going on in the other person
Are you open to the client?
o Own vulnerabilities/personality, preferences and
circumstances
How to communicate verbally and non-verbally?
Contributes to the client’s feelings of security in their contact with
the counsellor
Not only mirroring
Not non-directive
General clinical communication skills
Non selective listening skills – attending behavior
o Non-verbal following
o Verbal following, silences
Selective listening skills
o Asking questions
o Paraphrasing of content
o Reflection of feeling
o Concreteness
o Summarizing
Regulating skills
o Opening the conversation and making initial contact
o Linking (back) to goals
o Clarify the situation
o Thinking out loud
o Finishing (closing) the interview
Skills in nuancing
o Interpreting
o Confront
o Positive relabeling
o Giving information
o Ending the conversation
Clarify in advance the time
Announce when close to conclusion
Use summary or ask client to summarize
Consider conducting meta-conversation (especially for first session)
Potential difficulties
Client in the middle of problematic story: anticipate near-conclusion
New hot topic brought up (door handle phenomenon): acknowledge
briefly and come back to it next time
Lecture 2
Competence 1 – psychological practice
Diagnostics = a shared decision-making process in which a clinician defines diagnostic questions,
formulates and tests hypotheses about the client’s functioning (emotion, cognition, behavior) and
integrates the information collected from different science-based sources and methods in a dynamic
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