Chapter 7

Course contents

 Concept and types of psychological assessment

 Difference between psychological assessment and testing
 Methods of psychological assessment (interview, case history, behavioral assessment, mental
status examination, psychological testing, checklist and rating scales.
 Selecting, administrating and communicating assessment results.

Concept of Psychological Assessment

Meaning of psychological assessment

Let us first define the term assessment. It can be defined as “the use of standards or systematic procedure
for observing our behavior. “Assessment describes the status of a phenomenon at a particular time; it
describes without value judgment a situation that prevails; it attempts no explanation of underlying
reasons and makes no recommendations for action. It may deal with prevailing opinion, knowledge,
practice, or conditions. The definition of assessment for our purpose can be the process of collecting
information to be used as the basis for informed decision by the assessor or by those to whom results are
communicated.
Psychological assessment usually involves a more comprehensive assessment of the individual. This
process of assessment makes use of psychological tests or other qualitative method. Therefore, it is a
process of collecting information which can be formal, informal, qualitative and quantitative.
Psychological assessment is a process that involves the integration of information from multiple sources,
such as tests related to ability, intelligence, interests or attitudes, as well as information from personal
interviews. Collateral information is also collected about personal, occupational, or medical history, such
as from records or from interviews with parents, spouses, teachers, or previous therapists or physicians.
Moreover, the psychological assessment is a structured interview that gathers information from and/or
tests a person to evaluate his or her mental health. It is “an extremely complex process of solving
problems (answering questions) in which psychological tests are often used as one of the methods of
collecting relevant data”.
The psychological assessment gathers information about the individual to provide him/her guidance and
counseling. It is the first step in any guidance and counseling situation. The process typically starts with a
key complaint or presenting problem—this is usually what prompts the person to seek help. A complete
psychological assessment should include: bio psychosocial history, neurological assessment,
psychological testing and physical examination. Once it is completed, the assessment will help to
establish either a tentative or definitive diagnosis. With this information, the counselor can inform to the
client about the results, and psychotherapy/counseling can be given. Thus, a psychological assessment is
the attempt of a skilled professional, usually a psychologist, to use the techniques and tools of psychology
to learn either general or specific facts about another person, either to inform others of how they function
now, or to predict their behavior and functioning in the future.
Maloney and Ward describe assessment as follows. It: -
1. Typically, does not involve defined procedures or steps
2. Frequently uses tests
3. Contributes to some decision process to some problem, often by redefining the problem, breaking
the problem down into smaller pieces, or highlighting some part(s) of the problem
4. Requires the examiner to consider, evaluate, and integrate the data
5. Produces results that cannot be evaluated solely on psychometric grounds
6. Is less routine and inflexible, more individualized.
The point of assessment is often diagnosis or classification. These are the act of placing a person in a
strictly or loosely defined category of people. This allows us to quickly understand what they are like in
general, and to assess the presence of other relevant characteristics based upon people similar to them.
Assessments can be both process and product oriented. Process-oriented assessments do not necessarily
produce a finished product; they are primarily tools used to guide ongoing relationships to direct activities
and plans. Of course, assessments frequently overlap in their nature and purpose. Product-oriented
assessments are assessments that result in the creation of a report or document. For example, a medical
history is required when patients are hospitalized and mental status examinations and their results
concerning emotional and cognitive functioning are documented.
Purpose of assessment
The purposes of assessment in guidance and counseling situation are as follows: -
1. Self-Understanding: The basic purpose of carrying out an assessment is for gaining insight in
helping the client understand themselves better, helping them to know what they can do and
cannot do including their strengths and weaknesses.
2. To Diagnose client’s Problem: To diagnose the client’s problem is another purpose that
assessment data fulfills. By using the data properly, we can interpret causal factors. It also helps
to identify various aspects such as family background, physical health, academic performance etc.
3. To Help in Career Planning and Education: Assessment done with the help of various
psychological tools guides the students in making choices for their career and selection of
subjects/courses.
4. To Help Predict the Future Performance: Counselors use assessment data to estimate
individual’s attitude, ability, personality, etc. that have implication for the success and adjustment
which help to predict the future performance of the individual. Moreover, the counselor can also
motivate the client in a direction where he /she can get more success.
5. To Evaluate the Outcome of Counseling: Assessment is done prior to counselling as well as at
the end of it. This gives the counselor valuable insights for further intervention and to achieve the
expected outcome.
Difference between Psychological Assessment and Psychological Testing

A term closely associated with assessment is psychological test, which Anastasi and Urbina (1997)
defined as an objective and standardized measure of a sample of behavior. Cronbach’s (1990) definition
is similar, with a test being a systematic procedure for observing behavior and describing it with the aid of
numerical scales or fixed categories. As these two similar definitions suggest, there are some
commonalities among all the definitions of assessment. They all discuss getting a measure or using some
type of measurement. In assessment, counselors often want an indication of quantity (e.g., How depressed
is the client? Are the test scores high enough to get into Harvard?). In simple terms, many test questions
are related to whether there is a lot of “something” or just a little. In counseling, practitioners are often
interested in human constructs such as emotions, intelligence, personality factors, self-esteem, and
aptitudes. These constructs, however, cannot be directly measured. For example, individuals cannot give
a pint of emotions in the same way they can give a pint of blood. Humans, for the most part, indicate their
emotions by their behavior, their statements, or even the answers they give on a questionnaire.
It is important to remember that speaking and responding to a questionnaire are behaviors. When working
with clients, a counselor must consider this sample of behavior and then reflect on two important
questions: first, is the sample of behavior indicative of how the person usually behaves, and second, are
the inferences being made correct?
Psychological assessment is similar to psychological testing but usually involves a more comprehensive
assessment of the individual. Psychological assessment is a process that involves the integration of
information from multiple sources, such as tests of normal and abnormal personality, tests of ability or
intelligence, tests of interests or attitudes, as well as information from personal interviews. Collateral
information is also collected about personal, occupational, or medical history, such as from records or
from interviews with parents, spouses, teachers, or previous therapists or physicians. A psychological test
is one of the sources of data used within the process of assessment; usually more than one test is used.
Many psychologists do some level of assessment when providing services to clients or patients, and may
use for example, simple checklists to assess some traits or symptoms, but psychological assessment is a
more complex, detailed, in-depth process. Typical types of focus for psychological assessment are to
provide a diagnosis for treatment settings; to assess a particular area of functioning or disability often for
school settings; to help select type of treatment or to assess treatment outcomes; to help courts decide
issues such as child custody or competency to stand trial; or to help assess job applicants or employees
and provide career development counseling or training.
A distinction is there in assessment and testing given by AERA, APA and NCME (1999). It defines
assessment as a broader term referring to a process that integrates test information with information from
other sources e.g., from schools, hospitals etc.
Difference between Psychological Assessment and Psychological Testing

Psychological Assessment Psychological Testing

 Assessment is a broader term  Testing is a narrow term
 Assessment is process of collecting information  Test is a standardized procedure of
through various techniques such as formal, measurement designed to measure
informal, qualitative and quantitative characteristics such as ability,
personality, aptitude, interest etc.
 Professional psychological assessment usually  Psychological testing (e.g., an
 also includes: interview, demographic intelligence test, personality test,
information, medical information, personal or mental health test) occurs as
history, observations by others part of the process of
psychological assessment
 An extremely complex process of solving  An objective and standardized
problems (answering questions) in which measure of a sample of behavior”
psychological tests are often used as one of the
methods of collecting relevant data
 Information collected about the client’s behavior  Information collected is based on
is more accurate and is detailed test only; so, little is known of
client’s behavior.
 Refers to any method used to measure  It is a task upon which people are
characteristics of people, programs, or objects asked to try their best (aptitude &
achievement tests). They measure
maximum performance
 The assessment process combines and evaluates  A test provides only part of the
all the information gathered about an individual picture about a person

Historically, testing and assessment have been important foundations of counseling and applied
psychology. Tests have important roles both as tools to facilitate the goals of counseling and for
assessment.

Method of psychological assessment/ assessment

The counselor can make use of different methods of assessment. It depends on the requirement of the
case, e.g., if the client is suffering from mental or developmental problem, the counselor may use case
study method. The various methods of assessment are interview, observation and case study. These are
described below.
a) The Interview Method
“Interview is a method for gathering data or information about individual” (Kaplan & Saccuzzo,
2005). Thus, interview is conversation with a purpose. Conversation may not have purpose and
start anywhere and stop anywhere without assignment of specific role of individuals interacting.
Although there are many types and purposes of interview, all share certain factors. Now we see
some characteristic of interview method. It is different from conversation in a number of aspects
(Refer to table below)

Differences between interview and conversation

Interview Conversation
Purpose of interview is clear Purpose is not clear
Rapport and relationship establishment is No need for any rapport
essential
Recording of information in some form is No recording is required
required
Validity of interview is assessed Validity of conversation not assessed
 Role of interviewee and interviewer is No assignment of roles
assigned

The interview is probably the most commonly used assessment tool. Counselors use interview
method to help gather information about clients and clarify results of other assessments.
Assessors must be appropriately trained. Their skills and experience are essential for the
interviewee.

Below are several aspects which must be kept in mind:

i. Verbal and face-to-face: what does the client tell you? How much information are they
willing/able to provide?
ii. Para-verbal: how does the client speak? At normal pace, tone, volume, inflection? What
is their command on language, how well do they choose their words? Do they pick up on
non-verbal cues for speech and turn taking? How organized is their speech?
iii. Situation: Is the client cooperative? Is their participation voluntary? For what purpose is
the interview conducted? Where is the interview conducted?

Characteristics of Interview

To understand the basic concept and characteristics we will discuss some essential features of
interview. 1) Attitude of interviewer and interviewee If the interviewer is understanding and
genuine then it is likely that the interview will be more valid. Also as pointed out by some
experts, communication and assessment are important functions of interviewer. It is the
responsibility of the interviewer to direct and continue interactions. The interviewer should be
an expert in this field. Many times clients do not return for a second session and this may be
related to the interviewer’s skills. For example, while taking case history if the counselor is
understanding and genuine in interaction with the client, the latter will be more comfortable
and will become less inhibited and thus open up with the concerned problems personal and
impersonal, in the interview situation. On the other hand if the client senses that the counsellor
does not understand the problem and appears insensitive, then the counselee may refuse to
part with much of the information relating to the problem and thus will leave the counselling
session half way and leave. Thus the climate built during the interview influences the degree of
client’s willingness to disclose personal information (Whiston, 2009). If the interviewer has to
obtain the required information from the interviewee then it is essential that the counselor
establishes adequate rapport with the client. Interviewee should have the ability to
communicate, translate the emotions and thoughts into words and organised thoughts. The
client is expected to be cooperative. 2) Proper atmosphere In order to help client feel
comfortable, the counselor has to create a congenial atmosphere both physical and emotional.
Physically the room should be pleasant, well aired, with privacy indicating that the client can talk
whatever comes to mind without any hesitation. In the interview, the counselor should avoid
certain questions which may cause embarrassment to the client. So also the counselor should
avoid certain responses that may put off the client and make the client clamp up. In fact the
interview should be smooth and not probing or inquisitive that might also put off the client. For
example if the person who is interviewing is found to be probing, hostile or judgmental then
obviously client will not feel comfortable and thus withhold the needed information. It is very
essential to be sensitive to the feelings of the client during the interview. Also if during the
interview the interviewer tries to give false assurance then that may make the other person
uncomfortable. This will also decrease the respect for the person who is interviewing the
person. It is not always necessary that people seek some solution when they are mentioning
their problems to someone. The responses of criticism, arguments, and authoritarian approach
etc., should be avoided. 3) Interviewer’s effective response Some responses that are
encouraging are required. Interviewer should serve as an understanding listener, allowing client
to talk freely, treat what is being said in its context, and ask questions only at appropriate times.
Open ended questions are more effective in the interview. It is important that the interviewer
keeps aside the biases and conducts the interview. One may not necessarily agree to the
content of the material that is produced in the interview, nevertrheless, the interviewer should
encourage the client to continue what he or she was saying keep the conversational flow going.
4) Measuring understanding A great deal of research has been carried out by Carl Rogers in this
regard. He has analysed the responses that are given by the client to classify them on five levels.
The basis for this is the empathy by that person. If the person has more empathy then it is likely
that he will have higher level of understanding of the client and his or her problems. Level 3 and
2 are adequate for conducting the unstructured and semistructred interview. 5) Recoding
responses Responses of client should be taken in some form. It can be taken in detail writing
while interview is in progress. It has an important advantage in that the client may feel that
whatever is being conveyed by him/her appears important as whatever the client says is being
recorded by the interviewer. This encourages the client to part with more and also in depth
information. If whatever the client says is not noted down immediately, the possibility of the
counselor distorting or forgetting certain information that the client gave is high and this can be
avoided by writing it immediately. However, writing down the information immediately has also
certain disadvantages and these include the cutting the flow of communication by the client.
Recording can also be through electronic devices. In such recording a microphone is placed in
front of the client with the client’s permission. Yet, such a device which is recording all that the
client wants to convey may make the client feel uncomfortable and thus the client may not be
as uninhibited and free as he or she would have been otherwise. Hence the interviewer /
counsellor should make sure that the client not only has no objection for recording the narration
but will not feel uncomfortable to talk freely. Ethically too this prior permission for recording is a
must. Also it must be ensured that the client if need be should get a choice to put off the
recording which is considered by the client as confidential. If the counselor chooses to write
down whatever is being told by the client, the same may be done by noting down points and not
verbatim or in detail. 6) Interveiw is different from communication The interactions of two or
more people in the interview session are very different from communication. As mentioned
earlier, Interview is interaction with purpose. Communication may not have any purpose. It
starts anywhere and stops anytime because of lack of purpose. In interview the role of
interviewer and interviewee is specified. Interviewer has the responsibility to continue the
interview and also direct the interview

Types
There can be two types of interviews: Structured and Unstructured.
 That is, the interview can range from being totally unplanned i.e., unstructured to carefully
designed i.e., completely structured.

 Structured Interview:
The most structured interviews have characteristics such as standardized questions,
trained interviewers, specific question order, controlled length of time, and a standardized
response evaluation format. A structured interview will be more reliable and valid. It is
designed to provide a diagnosis for a client by detailed questioning of the client in a
“yes/no” or “definitely/somewhat/not at all” forced choice format. It is broken up into
different sections reflecting the diagnosis in question. Often Structured interviews use
closed questions, which require a simple pre-determined answer. Examples of closed
questions are “When did this problem begin? Was there any particular stressor going on
at that time? Can you tell me about how this problem started?” Closed interviews are
better suited for specific information gathering.
 Unstructured Interview:
Interviews can also be less structured and allow the client more control over the topic and
direction of the interview. Unstructured interviews are better suited for general
information gathering. Unstructured interviews often use open questions, which ask for
more explanation and elaboration on the part of the client. Examples of open questions
are “What was happening in your life when this problem started? How did you feel then?
How did this all start?”
Major functions of interview method are:

 Description: Interview has been found to be particularly useful in providing insight into
the interactive quality of social life. The verbal interaction enables the interviewer in
understanding how people view the subject under investigation.
 Exploration: In this the interviewer tries to explore some new variable for study as it
also helps in conceptual clarity. A review of the work done in the related area also is
taken into account.
The advantage of interview method is that it allows greater flexibility in the process of
questioning. It facilitates the counselor in obtaining the desired information.
b) Observation Method
Observation method is a fundamental technique of the data collection. It refers to watching and
listening to the behavior of the client over time without manipulating and controlling it. It also
records findings in ways that allow some degree of analytic interpretation and discussion. Thus,
observation involves broadly selecting, recording and coding behavior; therefore, it is scientific.
It tells us, how does the person act – nervous, calm, smug? What do they do and not do? Do they
make and maintain eye contact? How close to you do they sit? Often, some of the most important
information you can gather from the observation of behavior. Behavioral observations may be
used clinically (such as to add to interview information or to assess results of treatment).

Type of Observation Method: -

 Naturalistic observation
 Structured observation
 Unstructured observation
 Participative observation
 Naturalistic observation: Naturalistic observation is particularly good for observing specific
subjects. It provides ecologically valid recordings of natural behavior. Spontaneous behaviors are
more likely to happen.
Structured observation: Allows control of extraneous factors and the reliability of results can be
tested by repeating the study. It provides a safe environment to study contentious concepts such
as infant attachment.
Unstructured observation: Gives a broad overview of a situation. Useful where
situation/subject matter to be studied is unclear.
Participant observation: Gives an “insiders” view. Behaviors are less prone to misinterpretation
because researcher is a participant. It provides opportunity for the researcher to become an
“accepted” part of the environment.
The advantages of the observation method are that it removes any kind of artificiality. It is one of
the valid forms of assessment as it is direct and capable of analyzing the situation or behavior of
the client.
c) Case Study Method
A case study is an in-depth investigation/analysis of a single person. Counselor uses case study to
investigate in detail a specific situation or person. Case studies are often used in clinical cases or
in situations when lab research is not possible or practical. Typically, data are gathered from a
variety of sources and by using several different methods. Experiments, interviews,
questionnaires, observations, diaries, and psychometric tests can all be used within a case study.

Case study can be based on an individual, a family, a social group, event, or series of events. The
case study research method originated in clinical medicine (the case history, i.e., the patient’s
personal history - idiographic method).

The case study method often involves simply observing what happens to, or reconstructing ‘the
case history’ of a single participant or group of individuals (such as a school class or a specific
social group). Case studies allow a counselor to investigate a topic in far more detail than might
be possible if they were trying to deal with a large number of research participants.

Therefore, it has advantages as case study method provides sufficient basal factors of the client
on which opinion can be drawn easily.

Case history interviews and MSE

After initial interview in depth information is gathered by case history interview. This is type of
structured interview with the focus of getting the details of the patient’s life. History taking is
important for diagnosis and therapy. This method of interview will be discussed here in more
details.
Basic Issues in Case History
Each field of science has different way of taking history. The way in which the lawyer takes the
case history would be different from the medical professional. Each field has a particular format
of the case history. This not only gives the understanding of the current status but it also helps
us to have understanding about the factors that have caused development of those symptoms.
This is life sketch of the person. The background and the etiological factors are obtained in the
process of case history. The rapport is established while taking the case history. If the
interviewer is a good listener, then there are more chances that the client will give details about
himself. In the first part of case history taking, details about demographic information such as
name, age, gender, residential address, education, occupation, marital status etc. are taken in
detail. All the minor things like where he stays and the area, all these things are mentioned in
details. Then details about who has referred him are taken into account. All these information
may not seem quite useful at face value, but with increasing experience we understand that this
information can be used later for the management of the case. The next part is about the
referral. Who has referred this person? The next information is about the actual problem that
the person is facing right now is taken. The sequence for this purpose is in the order that the
complaints have started. Details about how these symptoms started, how they progressed and
what is the duration of this, etc., are all mentioned. To understand if the person had difficulty in
developmental years, the details about this are taken. The person is asked about his schooling
and the education. By the time the counsellor reaches this point he is oriented to the kind of
personality the person has. To utilise the information constructively, this information is very
important. This is clinical evaluation of the personality. In most of the cases, the tests are not
administered at this point. If a formal assessment is needed then the referral is made at a later
stage. Then the interviewer asks about the medical history if any. As a psychologist we may not
be aware about the details of some of the serious physical illnesses the client might have
suffered from. As is known physical illnesses also have an impact on the mental status of the
client. However we can judge the psychological impact it has on the client. In this aspect
information centers about the illnesses, and also what treatment has worked so far, for that
person. The next issue relates to the person’s interest and attitude towards life and other
related aspects. This is mentioned in the case history. This will also include the client’s political
and religious belief system. This includes what the person prefers when he has free time.
The other important aspect of history taking is Mental Status Examination. This is also called
Present Status Examination. In this the examiner tries to confirm the information that he has
gained in the previous part of the case history. The points like persons’ appearance, his speech
and thoughts are at the beginning of this section. Then it is also considered if the person was
able to attend and concentrate on the interview. The other important aspect is regarding the
pathology. The speech sample is mentioned. The examiner also asks specific questions to
evaluate if the thinking normally. According to the phenomenology certain questions about the
hallucination and delusion are asked. The person is evaluated on this dimension. In the mental
status examination it is also essential to assess if the person is suicidal if he has had any previous
attempts. Overall this segment of the case history taking, leads to the diagnosis. And if not
diagnosis at least the clinician is able to reach the provisional diagnosis.

Case History Taking (Format)

1. Identification Data • Name: This is necessary but in certain cases it is necessary that we
assure them that their name will be kept confidential. Sometimes the client does not
want to reveal their identity. The clients may belong to some well known family or some
prestigious family so they do not want to tell their name. • Sex: This helps to understand
the person with better cultural perspective. There are specific roles that are assigned to
each gender. This is the importance of this aspect. • Age: The age of the person helps
the clinician to understand the developmental phase that he goes through. Each phase
has a developmental task. The person’s age gives us understanding of the growth of that
person. This tells us if he has attained all the tasks at the appropriate time. • Education:
The education tells us about the person’s exposure to the external literate world. This is
important also because as a clinician if there are any references in the form of reading
that we want to suggest. Education of the person does not always indicate he or she will
be reasonable, logical and rational. • School / Institute: The school is the first social
experience of the person. He understands the rules that are set by the institutions and
that he has to follow them. In that perspective the information regarding school is
important. 2) Problem Stated by i) Client: What does the client think about the problem
is very important. Others may perceive the problem in different ways than how the
client looks at it. Since the client is the one who has to deal with the problem it is
important that his understanding is shared with the counselor. Informant: This
information is given by the person who accompanies the client. He gives how he
perceives the problem that is experienced by the client. These two may not always
match with each others. These two may have different ways of looking at the same
thing. Others: In certain cases it is important that the information has to be gained on
some additional aspects. For example if the client is working at a firm and has problem
working there due to anxiety then information regarding this has to be obtained from
the employee. ii) Duration of the Problem: The details of the problems are taken into
account. The onset and duration of the problem. In most of the cases the problem arises
after there is some stressor. So the details of how the problem started are asked to the
client. iii) Intensity of the Problem: The intensity of the problem will decide the actual
therapy that is to be used. This also tells us the urgency that the client has for the
intervention. 3) Personal History • Birth and Development: The informant is asked about
the details of the birth. Since we know that delays in attaining the developmental
milestones are the good indicators of the intellectual sub normality. The ordinal position
that the person has born with affects the development of the personality. • School
History: This is the institute that the child first time faces in his life. The school
experience does have an impact on the further education of the person most of the
times. It is not always detrimental in the development of the person but it shapes the
experience of the person. • Medical History: This is not to merely make sure that there
is no medical basis for the symptoms, but it is more to understand the limitations of the
person. The person may develop certain symptoms as a result of some other physical
illness. For example a person who meets with an accident if develops phobia for the
open places then this is secondary to the medical history that the person has. • Social
History: The social development of the person tells us many things. To what extent the
client is related to the community. His position in the community is indicated by this.
 This also is a good indication of the social support that the person has. The social
development is helpful in understanding the impact of culture on the person. •
Emotional Development: This aspect tells us the person’s capacity to deal with his
problem when the counselor suggests it. This is the basis of the person’s personality.
The emotional development is a process that enables the person to deal with the matter
and stress effectively. This tells us whether the person is emotionally behaving
appropriately. • Premorbid Personality: This is the personality of the person before the
actual onset of the problems faced by the client. It includes his interests that he had and
what was his attitude towards himself. These assess what are the ways in which the
person copes with the stress. This becomes the basis for the counselor to design the
intervention for the client. • The clients’ fantasy life: This is one more aspect on which
information is obtained. This tells us about the motivations and deprivations of the
persons’ life.
The details of the daily life are also included in this. • Sexual / Occupation History This is
the information that is taken carefully from the client. The client may not be able to talk
comfortably about the sexual content. Due to the impact of the culture these are topics
that the client may not prefer talking too openly. It will depend upon the rapport that is
established with the client. The occupational history throws light on the client’s overall
personality 4) Family History Family is essential source of personality and development,
and also in many cases source of frustration. Therefore what are the family ties, what is
structure of the family? • Family Constellation:

Relation Age Education Occupation

 Socio-Economic status: The income of the family, the place where they live, the
kind of work that they do, the kind of status they have in the community in
which they live, and many such related aspects are important to understand. •
Relationship with Parents: This is especially very important when we are dealing
with adolescents problems. Family is the first and important unit in the person’s
life. This shapes many relations in life. This can be asked to the client and should
be confirmed with the parents also. Because it may happen that the client
perceives his parents in a misconstrued manner and thus forms an image of
them as supportive or non supportive towards self. This perception maybe quite
different from the one that is factual in that the parents may not be at all as the
client perceives them but may be doing things with good intention. Exactly
opposite may also happen, that is, a person may have a false image of his
parents. So in both the cases it is very important that we confirm it with reliable
source of information. • Interpersonal Relationship: (within family): This is an
important aspect of the family dynamics. How the family members relate to
each other is important. The client may not be the victim of the conflict, but he
may witness it with some other family members. So this becomes important to
see, how much the emotional tie is strong with the family in case of the client

Mental Status Examination

The mental status examination (MSE) has been used predominantly in psychiatry, clinical psychology,
and psychiatric social work for several decades, but is being increasingly used by counselors in work
settings requiring assessment, diagnosis, and treatment of mental disorders. The MSE is used to obtain
information about the client’s level of functioning and self-presentation. Generally conducted (formally
or informally) during the initial or intake interview, the MSE can also provide counselors with a helpful
format for organising objective (observations of clients) and subjective (data provided by clients)
information to use in diagnosis and treatment. This is the evaluation of the client at the time of the
interview. The clinician completes taking the case history. Then he reaches a tentative diagnosis on the
basis of the information that is provided by the client and the informant. Now this is the evaluation that
tries to confirm the diagnosis. Based on a diagnostic system the clinician asks questions. This helps him
to come to a conclusion about the diagnosis. This also confirms the clinical understanding of the
symptoms that are given by the client. • Behaviour: The behaviour of the client, if it is age appropriate
or not. How does the client behave with the examiner? What is his attitude towards the examiner?
These are all the points that are included under this heading. •. Thoughts: The thoughts are significant in
two important ways. One is assessment of these will tell us more about the personality of the person.
Second and very important is that it will also tell us if the person has any disorder of thoughts. • Speech:
This is related to the quality of speech of the client. The volume tone and other things are good
parameters of the speech quality. • Perception: These are related to all the five senses of the person.
Questions regarding this tell us if the person has any illusion or hallucination. This will tell us about the
intensity of the problem the client is facing. Higher Mental Processes • Intelligence: This is the key
factor. It helps the client to understand his own problem. If the person is aware about his surroundings
and what is his general level of knowledge is the indication intelligence. If there is any indication of low
sub normality then a particular test may be administered to assess the intelligence. • Memory: This is
also important aspect of intelligence. But this is at the same time an indication of the brain functioning.
Disturbance of this is an indication. • Attention: This is one more indication of the brain functioning of
the person. Disturbances of attention may be an indication of some problem at brain level functioning. •
Concentration: As mentioned above attention and concentration are related to each other. If the
attention can be sustained it is called as concentration. • Insight: This means the person understands of
his state. Whether he has any understanding of his illness or not.

Psychological Examination

In the following format, the test that has been used for the assessment can be mentioned in an
organised manner. This gives us quick understanding in summary of the test administered

Name of the Test Row Score Stand Score Interpretation

• Integrated Note (with theoretical base): This is the summary of the interview that is conducted by the
clinician so far. This leads to a diagnosis. These are usually the positive findings that support the
diagnosis. • Diagnosis: This is the final understanding about the client. According to the classification
system that the counselor follows, he will diagnose the client. There are two widely used systems as we
know. One is DSM IV and other is ICD-10. Since counseling is for normal people above two systems are
not used. In counseling different classification is used such as study problem, adjustment problem,
negative self concept etc. So with the help of the case history and the Mental Status Examination the
client is diagnosed. Diagnosis helps to know symptoms, etiology and therapy planning. • Prognosis: This
gives us a clear understanding of what are the chances of recovery. There are few factors which are
asset for recovery while some are negative. Counsellor considers good and bad factors and decides the
probability of recovery of problem.

Counseling Design

• Choice of therapy: After understanding all the essential aspects of the client’s problem this is the time
to actually do the intervention. The problem that the client is facing can be treated in different ways. It is
the skill of the counselor to convey to the client what he has understood about him in the language that
the client understands. At this stage with the mutual convenience of the client and the counselor the
further contracting for his therapy or counseling is done, the counselor shares this with the client. If
there is any need to involve someone in the counselling process in addition to the client, that may be
conveyed to the client and to the family member who is to be involved in the programme.

d) Psychological testing
Psychological testing is a field characterized by the use of samples of behavior in order to assess
psychological construct(s), such as cognitive and emotional functioning, about a given individual.
The technical term for the science behind psychological testing is psychometrics. By samples of
behavior, one means observations of an individual performing tasks that have usually been
prescribed beforehand, which often means scores on a test. These responses are often compiled
into statistical tables that allow the evaluator to compare the behavior of the individual being
tested to the responses of a norm group.

Psychological tests are written, visual, or verbal evaluations administered to assess the cognitive
and emotional functioning of children and adults. It is “an objective and standardized measure of
a sample of behavior.” Psychological testing is a standard procedure of measurement designed to
measure characteristics, abilities, personality, etc. They are used to measure the quantified
characteristics and have standards.

According to Anastasi (2003), psychological test can be defined as a sample of an individual’s

behavior, obtained under standard conditions and scored according to a fixed set of rules that
provide a numeric score. Test can be used to compare the same individual on one or more tests; at
the same time two or more persons can also be assessed and compared. A psychological test is
characterized by a standardized procedure of administration, scoring, and interpretation which are
uniform across the different examiner and settings.

Thus, a psychological test is an instrument designed to measure unobserved constructs, also

known as latent variables. Psychological tests are typically, but not necessarily, a series of tasks
or problems that the respondent has to solve. Psychological tests can strongly resemble
questionnaire which are also designed to measure unobserved constructs, but differ in that
psychological tests ask for a respondent’s maximum performance whereas a questionnaire asks
for the respondent’s typical performance. A useful psychological test must be both valid (i.e.,
there is evidence to support the specified interpretation of the test results) and reliable (i.e.,
internally consistent or give consistent results over time, across raters, etc.)

Purpose of psychological testing

Psychological tests are used to assess a variety of mental abilities and attributes, including
achievement and ability, personality, and neurological functioning.
For children, academic achievement, ability, and intelligence tests may be used as tools in school
placement, in determining the presence of a learning disability or a developmental delay, in
identifying giftedness, or in tracking intellectual development. Intelligence testing may also be
used with teens and young adults to determine vocational ability (e.g., in career counseling).

Personality tests are administered for a wide variety of reasons, from diagnosing psychopathology
(e.g., personality disorder, depressive disorder) to screening job candidates. They may be used in
an educational setting to determine personality strengths and weaknesses.

Tests are thus used in the selection, classification, diagnosis, prediction. The counselor makes use
of it to determine client’s behavior, know her/his personality and help the client in making
educational and vocational planning.

In short it can be said that the psychological tests are formalized measures of mental functioning.
Most are objective and quantifiable; however, certain projective tests may involve some level of
subjective interpretation. Also known as inventories, measurements, questionnaires, and scales,
psychological tests are administered in a variety of settings, including preschools, primary and
secondary schools, colleges and universities, hospitals, healthcare settings, and social agencies.
They come in a variety of formats, including written, verbal, and computer administered.

Characteristics of a good psychological test

A test used in counseling / guidance or for training and development is considered good if the
following can be said about it: -

1. The test measures what it claims to measure. For example, a test of mental ability does in
fact measure mental ability and not some other characteristic.
2. The test measures what it claims to measure consistently or reliably. This means that if a
person were to take the test again, the person would get a similar test score.
3. The test is purpose-relevant. In other words, the test measures one or more characteristics
that are important to specific career decisions or for predicting or monitoring training and
development outcomes.
4. By using the test, more effective decisions can be made by and about individuals. For
example, an interest inventory helps you to guide a client toward careers in which he or
she is more likely to be satisfied. A mechanical aptitude test may help you predict who
would benefit from mechanical training.
Thus, a good test is both reliable and valid, and has good norms. Test reliability and validity are
two technical properties of a test that indicate the quality and usefulness of the test. These are the
two most important features of a test. The counselor should examine these features when
evaluating the suitability of the test. Reliability refers to the consistency of the test results.
Validity refers to how well a test measures what it says it does. Norms are designed to tell you
what the result of measurement (a number) means in relation to other results (numbers).
The “normative sample” should be very representative of the sample of people who will be given
the test. Thus, if a test is to be used on the general population, the normative sample should be
large, include people from ethnically and culturally diverse backgrounds, and include people from
all levels of income and educational status.

A good psychological test is thus a standardized test with a manual which gives complete
information about the development of the test, administration, scoring and interpretation of the
results.

However, whenever you use a psychological test, you should keep in mind a few things.

Good test use requires: -

 Comprehensive assessment using history and test scores

 Acceptance of the responsibility for proper test use
 Consideration of the Standard Error of Measurement and other psychometric knowledge
 Maintaining integrity of test results (such as the correct use of cut-off scores)
 Accurate scoring
 Appropriate use of norms
 Willingness to provide interpretive feedback and guidance to test takers.

Types of psychological tests

The psychological tests vary in their content as well as the way they are administered. Thus, there
are verbal test and nonverbal tests; power test and speed test; group test and individual test.
Psychological tests can be of various types such as achievement tests, aptitude tests, mental
ability tests, interest inventories, personality inventories etc. Now let us know about these tests.
1. Intelligence test: IQ tests purport to be measures of intelligence, IQ (or cognitive) tests
and achievement test are common norm-referenced tests. In these types of tests, a series
of tasks is presented to the person being evaluated, and the person’s responses are graded
according to carefully prescribed guidelines. After the test is completed, the results can
be compiled and compared to the responses of a norm group, usually composed of people
of the same age or grade level as the person being evaluated. IQ tests which contain a
series of tasks typically divide the tasks into verbal and non-verbal and performance test.
Some of the important IQ tests are, Stanford-Binet Intelligence Scales, Wechsler Adult
Intelligence scale, Draw a man, Bhatia’s Battery of Performance Test of Intelligence,
Raven’s Progressive Matrices Test.
2. Tests of Interest and Aptitude: Tests of Interest assesses the likes and dislikes of the
client whereas aptitude tests aim at measuring the potential of the client in a particular
field. These are mainly used for the educational and vocational counselling. Examples of
Interest test are Strong Vocational Interest Blank and Kuder Preference Record.
Commonly used aptitude tests are Differential Aptitude Test (DAT) and DBDA.
3. Attitude tests: Attitude test assess an individual’s feelings about an event, person, or
object. Attitude scales are used in marketing to determine individual (and group)
 preferences for brands, or items. Typically attitude tests use either a Thurston Scale or
Likert Scale to measure specific items.
4. Tests of Achievement: Achievement tests measure the individual’s performance in a
particular area. It assesses the acquisition of knowledge and skills by the individual after
the completion of a course/training. Achievement tests can be standardized or informal
achievement tests made by teachers. Achievement tests help in finding out the student’s
strengths and weaknesses in particular areas and assessing student’s performance over a
period of time.
5. Neuro-psychological tests: These tests consist of specifically designed tasks used to
measure a psychological function known to be linked to a particular brain structure or
pathway. They are typically used to assess impairment after an injury or illness known to
affect neuro-cognitive functioning, or when used in research, to contrast
neuropsychological abilities across experimental groups.
6. Personality tests: Personality tests and inventories evaluate the thoughts, emotions,
attitudes, and behavioral traits that comprise personality. The results of these tests can
help determine a child’s personality strengths and weaknesses, and may identify certain
disturbances in personality. Psychological measures of personality consist of rating scale
or self-report measures and free response measures or projective tests.
7. Objective tests, i.e., rating scale or self-report measure
These have a restricted response format, such as allowing for true or false answers or
rating using an ordinal scale. Prominent examples of objective personality tests include
the MMPI, MCMI and Child behavior check list. Objective personality tests can be
designed for use in organizations for potential employees, such as the NEO-PI, the 16PF,
and the Occupational Personality Questionnaire, all of which are based on the Big Five
Factor Model of normal personality.
8. Projective tests (Free response measures)
It attempts to measure personality based on the theory that individuals tend to project
their own unconscious attitudes into ambiguous situations. An example of this would be
the Rorschach test, in which a person states what each of ten ink blots might be. Other
projective tests include Thematic Apperception Test (TAT), the House-Tree-Person Test,
Robert’s Apperception Test, and the Attachment Projective.
9. Direct observation tests
These are also used in many situations. Although most psychological tests are “rating
scale” or “free response” measures, psychological assessment may also involve the
observation of people as they complete activities. This type of assessment is usually
conducted with families in a laboratory, home or with children in a classroom. The
purpose may be clinical, such as to establish a pre-intervention baseline of a child’s
hyperactive or aggressive classroom behaviors or to observe the nature of a parent-child
interaction in order to understand a relational disorder. Direct observation procedures are
also used in research, for example to study the relationship between intrapsychic
variables and specific target behaviors, or to explore sequences of behavioral interaction.