Task 6
Bron: De Saeger, H., Kamphuis, J. H., Finn, S. E., Smith, J. D., Verheul, R., van
Busschbach, J. J., … Horn, E. K
Therapeutic assessment
● Semistructured approach to clinical personality assessment
● Humanistic approach to clients
● Related to collaborative assessment
● Procedures extensively documented
● Well to transfer and empirical testing
● Pretreatment TA has the potential to improve outcomes with specific psychiatric
populations
○ E.g. borderline → prior to MACT
○ Greater reductions in affective instability and suicidal ideation
■ Compared to who only MACT
● Results suggest that TA can be effective in reducing distress, increasing self-esteem,
fostering the therapeutic alliance, and, to a lesser extent, improving indicators of
treatment readiness
● Five sessions model
○ Strong protocol-guided comparison condition, based on widely applied protocol
of standard care for first line
● Goal-focused pretreatment intervention (GFPTI)
○ Had specific session-by-session agenda that emphasized goal setting and
motivation for the subsequent treatment
○ Four face-to-face sessions
○ Patients received workbook that included homework assignments and a written
explanation of the goal of each session
○ Throughout intervention, patients actively encouraged to think about most central
problem they need to address in pretreatment
■ Were asked to reflect on the question: “If your treatment were successful,
what problems would it help to solve?”
○ First session: focus on attacking demoralization and promoting hope by
providing psycho-education on dynamics of maladaptive behaviors and their
potential for change
○ Second session: aimed at main problem on which treatment will focus
○ Third session: involved examining the dilemma of change
○ Last session: focus on achieving shared re-appraisal of problems included goal
setting for remaining period prior to treatment
Results
● At the end of pretreatment intervention, compared with a protocol-driven motivational
pretreatment intervention, patients int eh TA condition reported higher outcome
expectations for their subsequent treatment, felt more on track in terms of their focus for
, treatment, and indicated a moderately stronger alliance to the therapist than those who
received GFPTI
● TA patients indicated higher satisfaction with the intervention received
○ Even when compared with highly credible control condition
● TA resulted in higher expectancy for treatment outcome than GFPTI
● TA patients being significantly more satisfied with the quality of intervention than were
GFPTI patients
○ Both groups were very positive about quality of interventions
● No differential effect between treatment groups in change in demoralization and global
symptom severity
● The present study did include
(a) guidance by two detailed session-bysession written-out protocols for each
intervention
(b) intensive supervision by specifically trained, motivated, and experienced licensed
clinical psychologists
(c) review of audio-visual recordings of sessions during supervision times. However, no
formal ratings of adherence were conducted.
Bron: Finn, S. E., & Martin, H
What is therapeutic assessment (TA)?
● Semistructured approach to assessment that strives to maximize the likelihood of
therapeutic change for the client
● Incorporated knowledge from a range of psychology to produce an evidence-based
approach to positive personal change to psychological assessment
● Rests on commonsense application of powerful insights that are efficiently available
thought reliable and valid assessment tools and techniques to a collaborative, respectful,
supportive, gentle and ultimately experiential process of self-discovery
Walking the line between self-verification and disintegration
● Self-verification: powerful human tendency to seek and attend to information that
supports established ways one understands oneself
○ Negative and self-limiting