Clincial assessment and decision
making lecture and exam notes
Lecture 1: Clincial assessment 1
Definition
Clinical / psychological assessment and
psychodiagnostics is like solving a puzzle.
Coming up with a hypothesis about
someone’s mental health.
Definition of psychological assesment
4 basic questions
1. Classification
o Does this person have PTSD?
2. Explanation
o Why does she refuse to eat?
3. Prediction and indication
o Will CBT help this person?
4. Evaluation
o Was the intervention successful?
Knowledge and skills
Required knowledge
Psychopathology and psychological theory
Instruments and their psychometric qualities
Treatment protocols
Required skills
(Self) reflection
Building therapeutic alliance (important when giving
therapy)
Conversational skills
Test skills
Toolkit for psychological assessment
Observation (starts already at the intake, also use
observations of others on the patients)
Interview (structured to let them tell all about their
problems, also others)
Tests
o Why this test?
o Which test? (what is available?)
o How to interpret the results?
Consult the cotan base = dutch committee on tests asnd
testings. Review them on criteria:
, o Availability of the test (is it available to everyone or do you have to email certain researcher
who decides?)
o Adapatation/translation for the Netheralnds (is it properly translated, also with cultural
aspects?)
o Standardization: described well or many loose ends?
o Validity (construct = does it measure what it is supposed to measure
& criterion = does it predicit a certain outcome? Intelligence test
predict school outcome for example)
Construct and criterion validity most important
o Reliability: twice test administered, same results? Items not too
long/short?
o Norms: normative data, for age, gender, school level. (normative=
deriving from a standard of norm)
What is abnormality?
What is normal and not depends on culture and time. In DSM-II sexual deviations like
homoseksuality. Culture differences frame the classification system of mental disorders.
For tests more a psychometric approach for abnormality like the normal curve (think of
intelligent scores) also normative decline when getting older in reaction time.
Disorders and personality
Vulnerability hypothesis = certain personality traits make
one vulnerable for the development of disorders
Scar hypothesis: a disorder affects ones personality
Spectrum hypothesis: personality and disorders to be
considered a continuum
Referral and first interview
Who calls for help?
My child needs help
My parent(s) need help (when older problems with
functioning)
I need help
You need help
My patient needs help
Can you accept this referral?
Is it a proper referral?
o needs to be well formulated
o is it a question that can be answered?
o Is it a mental health issue?
o Does it need treatment or care?
o Etc
Am I the right person to take it up?
o Do I have the right qualifications?
o Do I have the time?
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