Rhodes University – Psychology 3 – 2024 – Psychological Assessment – Jan Knoetze

Lecture Notes

PSYCHOLOGY 301
COURSE: PSYCHOLOGICAL ASSESSMENT
LECTURE NOTES COMPILED BY JAN KNOETZE ©

From the onset it is important to acknowledge that psychology as a discipline is often

informed and influenced, as well as impacted on, by popular culture; what Carol Tavris
critiques in her book Psychobabble and Biobunk [see Tavris, C. (2011). Psychobabble and
biobunk: Using psychological science to think critically about popular psychology. Prentice Hall]. By
definition, Psychological Assessment has all the potential to be the ultimate “colonising” act.
To bring this (and other prejudices) into focus, Tavris proposes eight guidelines for critical
and creative thinking. She suggests that these guidelines are useful in evaluating any
psychological practice or theory: Psychological Assessment being one of the cornerstone
functions of any professional psychology practice. However, the practice of psychological
assessment has been criticized extensively within the context of a multi-cultural South Africa.
The main criticism against assessment was actually not directed at the practice of assessment
– we shall argue that virtually all psychological intervention involves ‘psychological
assessment’ in some form – but rather at the practice of using psychometric tests and
measurements as tools rather indiscriminately within the process of assessment;
psychometric tests that were not appropriately standardised for the populations of use. The
opening line in prominent SA academics Sumaya Laher and Kate Cockcroft’s much
acclaimed book states: “Psychological assessment in South Africa is a controversial topic
primarily, but not exclusively, because of its links to South Africa’s troubled past” [see Laher,
S. & Cockcroft, K. (2013). Contextualising Psychological Assessment in South Africa. In S. Laher
and K. Cockcroft, Psychological Assessment in South Africa (Chapter 1, pp. 1 - 14). Wits University
Press]. It is therefore no surprise that the moratoria on the use of psychometric tests in human
resource development (in organisational psychology), in education, and also in other sectors,
had only recently been lifted in South Africa. Yet, it has always been argued that one should
not throw out the proverbial baby with the bath water, but critically review the area and its
usefulness.

It is for this reason that Tavris’s proposal and eight guidelines are useful when we review
psychological assessment (and any other activity or theory). The eight guidelines are:
1) Ask questions; be willing to wonder
2) Define your terms clearly
3) Examine the evidence
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4) Analyse assumptions and biases – your own and those of others

5) Avoid emotional reasoning
6) Don’t oversimplify
7) Consider other interpretations
8) Tolerate uncertainty
__________________________________________________________________________

The Psychological Assessment Course

In this course, we view Psychological Assessment as a process and not as equivalent to psychometric
testing, which is simply a tool within the process.
The table below provides a summary of the assessment process and pertinent issues in each stage, as described
in this course.
Stage 1. Referral
1.1 Receive referral 1.2 Clarify the referral
Issues and concepts: Issues and concepts:

self-referral or secondary referral presenting problem vs reason for referral

ethics of consent frequency, duration, intensity
written or verbal requests interviews, consult records
ethics of informed consent

Stage 2. Formulate hypothesis and plan the assessment process

Issues and concepts:

formulate a working hypothesis

identify domains of concern (functional areas)
create hierarchy of concerns
select most suitable tools
contextualise concerns

Stage 3 Gather and interpret information

3.1 Data gathering (act on plan of action) 3.2 Interpret the data
Issues and concepts: Issues and concepts:

collateral information score psychometric tests

psychological assessment tools: interviews; integrate and contextualise all information
psychometric tests; observation; qualitative and
quantitative information

Stage 4. Finalising: Feedback and Follow-up

4.1 Communicate outcomes 4.2 Recommendations for intervention
Issues and concepts: Issues and concepts:

feedback: verbal or written report Pragmatic and operationalise

principles in communicating outcomes Referral to other professionals

4.3 Follow-up and evaluation

Issues and concepts:
evaluate outcomes in follow-up

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Lecture Notes

ASSESSMENT DEFINED AND THE STAGES IN THE ASSESSMENT PROCESS

This is an applied and practical course on the practice of psychological assessment and the
processes involved in engaging with psychological assessment as a central activity in applied
professional psychology. However, this course is not a practical self-help guide to
psychological assessment. It is an applied theoretical course to the practice of assessment.
What I mean by this is that, in this course, we attempt to draw together the theoretical aspects
and principles of assessment and then try to operationalize these theoretical principles and
apply them to practice. It is applied in that it provides a step-by-step discussion of the
assessment process to you, the student; it is theoretical in its attempt to ground practice in
research and theory. We therefore scrutinise the assessment process as a stepwise flow
through the lens of theory informing our practice. It could be seen as a manual to guide the
practice of assessment, though it is not at all positioning assessment as a manualised activity.
On the contrary, we will consider assessment as a complex academic process of hypotheses
testing and problem solving, using a range of tools available to us.

Psychological Assessment is a foundational pillar of applied psychology. In fact, the opening

sentence of an influential article by Gary Groth-Marnat (1999, p. 781) states: “In the
beginning, there was psychological assessment” and continues to explain that “much of the
early foundation and identity of clinical psychology was dependent on assessment”. As long
ago as 1954, when the psychological assessment movement was still in its infancy, a
prominent theorist of the time, Paul Meehl came to the following conclusion after reviewing
assessment approaches of the time. Meehl (1954, p. 7) states that, when it comes to the
psychological assessment of individuals and organisations, “it is frequently more important to
use our heads instead of a formula”. This approach to assessment emphasises a view of
assessment which is not over-reliant on psychometric material, but embraces a broader
perspective, one that Shuttleworth-Jordan (1994, p. 12) calls “an academic and not
mechanistic” endeavour. So, these ideas and concepts that I want to focus on in this course
are not new and have always been understood in parallel to the psychometric focus of the late
20th century.

During the course we shall consider theoretical concepts such as validity, reliability, norm-
reference, criterion-reference and other theoretical constructs. It is important to develop a
clear understanding of these concepts since it directly informs and guides practice. The focus

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Lecture Notes

of this course is thus the practical application of assessment principles. I would however
like to start by capturing a general orientation to the practice of assessment.

In this course, psychological assessment is conceptualised as a process in which the

psychologist gathers enough relevant information through the use of a range of assessment
tools available; this information is then interpreted against theory and the body of knowledge,
and within a given life context of the person being assessed so that specific decisions can be
made in an attempt to answer the referral question or comment on the presenting concern.

We have come a long way since the days when psychological assessment and psychometric
testing were viewed as equivalent activities; where decisions could be based on the results of
a set of tests removed from the context in which these were obtained, removed from the
contexts of the lives of people directly involved in the assessment. It is interesting that the
assessment movement during its early developmental days in the 1970s, often proposed a
mechanistic over-reliance on measurement. However, in different contexts, such as South
Africa, such an approach then often led to false conclusions, comparisons drawn between
people with very different backgrounds, and the fuelling of stereotypical positions where
certain groups were marginalised erroneously based on their performance on psychometric
tests which were standardised on vastly different populations. (See Laher & Cockcroft for a
discussion of the history of psychometric assessment and testing practices in South Africa).
Our shameful history in apartheid South Africa is a pertinent example.

Defining Psychological Assessment

While measurement has always been a central part of the assessment activity in psychology,
we need to clarify certain concepts from the onset to arrive at a sound definition of
psychological assessment.

Psychological assessment is often compared to a focused research activity. Like other

research, it starts with the definition and articulation of a concern, or a (research) question. It
then proceeds to gathering enough information (through various means and methods) to come
to sensible conclusions or answers to the concerns presented in the initial question or
concern, interpreting this information against a specific context, and arriving, through this

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analysis of the data, at conclusions and certain recommendations to solve the problem for the
betterment of those involved. From this orientation, psychologists certainly do not do
assessments “to” others, but view it as a joint collaborative activity of problem solving.

So, we can define psychological assessment in many ways. One such definition comes from
Fernández-Ballesteros, et al. (2001) when they explain that:

“… ‘psychological assessment’ is a broader concept than either ‘tests’ or

‘testing’ [and refers to] the scientific and professional activity of collecting,
evaluating, and integrating information about a subject using, whenever
possible, different sources of information according to a previously-
established plan in order to answer a client’s question”.

BOX 1

Some other definitions of assessment in a psychological context over the years

“Every man (sic) is in some respects like all other men, like some other men and like no
other man.” [Hence, assessment is about describing individual characteristics, and
comparisons with other humxn beings.] (Kluckholm & Murray, 1953)

“... the set of processes used by a person or persons for developing impressions and
images, making decisions and checking hypotheses about another person’s pattern of
characteristics which determine their behaviour in interaction with the environment”
(Sundberg, 1977)

“Psychological assessment involves the classification of behaviours into categories

measured against a normative standard.”(Kaplan, 1982)

“Assessment is the systematic collection of descriptive and judgemental information

necessary to make effective decisions.” (Goldstein, Braverman, Goldstein, 1991)

“Psychological assessment is an academic, not a mechanistic discipline... it is an

hypothesis testing syndrome based clinical process.” (Shuttleworth-Jordan, 1994)

“Psychological assessment is a process-orientated activity whereby we gather a wide

array of information using assessment measures (such as tests) and information from
many other sources (such as interviews, personal history, collateral sources)” (Foxcroft
& Roodt, 2013, p. 4)

“Assessment is the process of determining the presence of, and/or the extent to which,
an object, person, group or system possesses a particular property characteristic or
attribute.” (Moerdyk, 2015, p. 3)

These are but a few attempts at defining “psychological assessment”. A genealogy of the
concept of assessment and how it was defined over the years, reflect some important core

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aspects and characteristics of psychological assessment. In summary, what we notice about

definitions of assessment is that it generally includes the following principles:

Understanding the concept of Psychological Assessment:

In a nutshell

Assessment is a process; it is about information gathering; it is

interpretative; it is often comparative (e.g. norm comparisons); there are
many tools available; it is contextual; it involves decision-making; it
solves a problem and concludes with pragmatic recommendations.

BOX 2
Assessment as a Multi-dimensional Process

Bagnato & Neisworth (1991) provide a useful framework describing assessment as a multi-
dimensional process in their proposed Convergent Assessment Model. They identify the
following important aspects in the assessment process:

• Multiple measures: different types of measures such as tests, rating scales, norm based,
criterion based, judgement based.
• Multiple domains of functioning: such as attention, cognition, language memory, spatial,
personality, achievement, performance, etc.
• Multiple sources: the individual, colleagues, parents, teachers, family, etc.
• Multiple settings: place (consulting room, work, school, home) &social arrangements
(1on1, with peers, colleagues, family).
• Multiple occasions: over a period of time to establish patterns of functioning.
• Multiple purposes: Often there is a primary purpose in mind, but assessment is pretty
useless if not linked to intervention and treatment procedures.

Also see Foxcroft and Roodt (2013, p. 7) for a summary of these above principles.

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STAGES IN THE ASSESSMENT PROCESS

Introduction

In the previous section we have argued that Psychological Assessment is a process. This
process has been defined and described in similar ways by a range of different authors. For
instance, Groth-Marnat (2003, p. 34) proposes the following process:

Phase 1: Initial data collection

Phase 2: Develop inferences
Phase 3: Reject or Modify or Accept Inferences
Phase 4: Develop and integrate hypothesis
Phase 5: Develop a dynamic model of the person
Phase 6: Understand situational variables
Phase 7: Predict behaviour

For this course, we follow a revision of the pragmatic structure described by Wise (1989, pp.
87-97) as well as Fernandez-Ballesteros et al. (2001, pp. 192-193); which is similar to the
phases that Groth-Marnat described and listed above. Wise (1989) describes Psychological
Assessment as an eight-step process which roughly aligns with the proposal of four stages
(capturing the eight steps) of this course.

XoX

Let us now proceed with a discussion of this stepwise process of psychological assessment.
(Also refer to the summary on p. 2 of this document.)

Stage 1 : The Referral

Stage 1 of the psychological assessment process starts when the psychologist is contacted by
someone and an assessment is requested. Stage one of the assessment process can be divided
into two successive steps: 1.1 Receive the referral; 1.2 Clarify the referral.

Stage 1 – Step 1.1: Receive the Referral

As argued previously, Psychological Assessment is not unlike a mini research process.

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Like any properly conducted research, all assessment starts with a question to be answered;
i.e. a problem to be solved through interpretation and analysis of collected information.
Similar to the research process, the clearer this initial question can be articulated, the more
focused the assessment process will be. However, this question seldom presents from the
onset as a focused question and is often expressed as a rather vague concern or problem to be
solved:

For example: an anxious parent approaching a psychologist with “My child is

under-performing at school”; a student in her final year approaching a
psychologist with “I need extra examination time, because I seldom finish in
time”; an HR manager asking “who is the best person for this job?”; or a
concerned lecturer approaching the university psychology clinic “I have been very
down and depressed lately and I wonder if I should be going into therapy?”.

As we can see from the above examples, the referral could be in the form of a request by the
person who needs specific information or a problem to be addressed concerning themselves
or their own performance: this is called a self-referral. Or the referral could be in the form of
a secondary referral by another concerned party, as in the case of a concerned parent or
Human Resource manager. Further examples of self-referrals would include clarification of
some learning aspect such as application for examination concessions (like extra time, or a
student requesting a scribe or a reader) or a request for assistance with career direction or a
request for therapy. Secondary referrals would include an employer’s request for an
assessment of aptitude during a job application process, or a concerned family member’s
referral for an assessment of a specific concern. Children are typically not self-referred to
psychologists, hence psycho-educational assessments are typical examples of secondary
referrals.

During this initial stage of the assessment referral process, and especially in the event of a
secondary referral, but clearly not restricted to it, one of the major considerations during stage
1 in the assessment process, when receiving a referral, is that of ethics. Ethics in
psychological assessment processes usually involves such principles of beneficence, non-
malificence, and more specifically centres around issues of confidentiality, informed consent,
best interest of the client, and others. These principles are embedded within broader concepts
of ethical conduct and ethical frameworks and are ultimately regulated by principles of

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individual morality, the professional bodies (The HPCSA Professional Board for Psychology
or PsySSA) and the law.

BOX 3
CONSIDER THE FOLLOWING SCENARIOS

1) A principal of a local preparatory school phones you, an educational

psychologist, and states that she is just coming out of a meeting with a grade
3 teacher. She requests an assessment of a child in her class who is still
struggling with the reversal of letters, impacting on his reading and writing
ability. She asks if you will test the child.

OR

2) You work as a student counsellor at a university student counselling centre.

A concerned parent emails you and requests that you contact their daughter,
a first year boarder who is struggling to keep up with the demands of
university.

OR

3) A director of a small local company requests to send two of her employees

to you for an assessment to assist with a promotion process and to find the
best candidate for the job.

Questions for consideration:

Where do you start? Who is your client? What are some of the questions you
will need to ask yourself and the school principal or parent or director, before
you can engage in the process and meet the requests? What are the most
important ethical considerations in these scenarios?

Referrals could be verbal, such as a telephone call or consultation room conversation; or it

could be a written referral, such as a letter from a doctor or school, or an email request.
Often, psychologists or institutions providing psychological services have a short referral
form (sometimes referred to as a “request to use services” form) which the referring party or
referred person is requested to complete.

BOX 4

An Example of a Referral Form (for child assessment)

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REFERRAL OF CHILD
To be completed by the parent/guardian of referred child.

(If you have any concerns or questions about any part of this form, please do not hesitate to contact
me. All information provided is treated as STRICTLY CONFIDENTIAL.)

Today’s date: _______________________________

CHILD:
Surname: __________________________ Name(s): ____________________________

Nickname (if any): ______________________________________

Date of Birth: ____________________________________ Age: _______________________________

Grade: _______ Home Language: __________________________ Language of tuition: ____________

School: ________________________________________ Number of previous schools attended:

______

Place of child in Family: Number ____ of ____ children. [E.g. 2nd of 3 children.]

Name all other people living with you and your child in the family? ___________________________

Describe behaviour or progress which is causing concern and needs attention – Reason for
Referral:

Provide a description of your understanding of abovementioned concern (e.g. when did it start,
what contributed to it, has anyone been consulted before and what was outcome, etc.)

In your opinion, how does his/her teacher feel about this i.e. is it similar at school?
__________________________________________________________________________________

May the school be contacted about this referral? YES / NO / Conditional _________________

What communication took place between home and school about this referral?
__________________________________________________________________________________

Have you consulted anyone about this before (OT, Therapist, Psychologist, GP)? YES / NO

If yes, with whom, when and what was the outcome?

__________________________________________________________________________________

__________________________________________________________________________________

Parent(s) / Guardian(s)

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Marital Status of biological parents:

______________________________________________________

If separated or divorced, state whom does the child live with and what is current marital status of
this parent? ___________________________________________________________________

Is the child a boarder? __________________ Since when? _________________________________

Father / Man

Name / Initial: __________________________ Age: _________________

Occupation: ___________________________ Working Hours:

_______________________________

Home Language: ____________ Relation to child: Biological/Step/Other: __________________

If not biological, where is biological father and describe involvement/influence in child’s life:

__________________________________________________________________________________

__________________________________________________________________________________

Mother / Woman

Name / Initial: __________________________ Age: _________________

Occupation: ___________________________ Working Hours:

_______________________________

Home Language: ____________ Relation to child: Biological/Step/Other: __________________

If not biological, where is biological mother and describe involvement/influence in child’s life:

__________________________________________________________________________________

__________________________________________________________________________________

Name any other significant people in child’s life (e.g. step parent, grandparent, etc.):

__________________________________________________________________________________

Addresses:
Home: ___________________________________________________________________________

Postal: ___________________________________________________________________________

Telephone Numbers:

Home: _______________________________

Work (Father): ____________________________ Work (Mother): __________________________

Cell 1: Number: _____________________________ Whose? ______________________________

Cell 2: Number: _____________________________ Whose? _____________________________

Other contact numbers e.g. School, Teacher: _____________________________________________

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Email address: ________________________________________

Is this secure for confidential communication with you? ___________________

Additional Information: (ANYTHING of interest you wish to mention. Continue on reverse if

necessary)
Home and Family – Please comment on family structure and relationships:

__________________________________________________________________________________

Medical – Please report on any medication, current or past; as well as general health and possible
conditions:
__________________________________________________________________________________

__________________________________________________________________________________

Birth and Developmental – Please report on birth history, any complications, developmental
milestones reached (motor and language):
__________________________________________________________________________________

__________________________________________________________________________________

Scholastic – E.g. number of previous schools, progress, scholastic history, boarding away from home,
etc.:
__________________________________________________________________________________

__________________________________________________________________________________

Personality and Social interaction – Please report on any significant aspects of friendships and
personality:

__________________________________________________________________________________

__________________________________________________________________________________

Significant life events or trauma:

__________________________________________________________________________________

__________________________________________________________________________________

Informed Consent: I am the legal parent/guardian of abovementioned child and by providing this
information I agree for my child to be assessed and consulted with by abovementioned
psychologist.

Signature: _______________________________ Completed by: _____________________________

(Name in Print)

Date: ________________________________

Thank you for your time and concern in providing this information. © JJK/Updated2014

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Stage 1 – Step 1.2 : Clarifying the Referral Problem

This step is often referred to as clarification of the presenting problem. In clinical assessment
we distinguish between the presenting problem and the reason for referral. Often, the reason
for referral is vague (“my child is struggling at school”) or ambiguous (“we need the best
person for this job”). The reason for referral might also be short and cryptic and usually does
not provide sufficient information to act upon; it often generates more questions rather than
providing a focus for what is to be done. During Step 2 of Stage 1, Clarifying the Referral
Problem, the psychologist needs to establish exactly what the concern is, which answers
would be required to solve the problem and what is the contextual history leading up to this
point in time for this concern to be referred to a professional psychologist. This is usually
done through a process of information gathering, involving the referred person, as well as
gathering collateral information. Once again, ethical considerations are of primary
importance and the psychologist needs permission from the referred person (or a
parent/guardian in case of a minor) to gather such information. For example, imagine you are
the first-year student referred to in the previous section (see example 2 of Box 3, p. 9) and
you receive a phone call from the student counselling services to ask you to come in for an
appointment, oblivious of the communication between your parent and the psychologist!
Your anger and even resentment will be justified and the process disastrous even before it
started! Usually a good starting point, if the person is not self-referred, would be to start with
the referring party and ask if the referral had been discussed with the referred person, or in
the case of a minor, their parent.

The main assessment tool during this step would be interviews: to talk with the referring
party, to talk with the referred person, and with any other person who can assist to clarify our
understanding of the concern. In addition to interviews, consulting records such as school
reports or employee appraisals could also be used. Because of the preliminary nature of the
information required before the psychologist can proceed, the collateral information could be
gathered telephonically, but once again with the explicit permission of the person referred or
their legal representative.

During this step of the assessment process, it is important for the psychologist to get a sense
of the history of the problem leading up to the referral. In clinical settings, psychologists
usually enquire into three aspects of the presenting problem. These are:

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• The frequency of the concern; i.e. how often does this behaviour or difficulty occur?
• The duration of the concern; i.e. for how long has this been an ongoing difficulty?
• And lastly, the intensity of the concern; i.e. how severe and debilitating is this
difficulty and to what extent does it impact on other people in the immediate
environment?

It is important to establish to whom it is a problem and how debilitating the concerns are to
the person referred. If the same teacher initiates the 10th assessment, out of a class group of
39, for possible attention deficit hyperactivity disorder (ADHD) in the same year, it is quite
likely that the teacher needs tranquilisers instead of prescribing Ritalin to the child! It is thus
vital to create a context for the assessment to proceed, through a detailed description of the
referral concern. This initial enquiry usually focuses on the referral and will not necessarily
include detailed descriptions of the biographical and contextual history of our client at this
early stage.

Once the psychologist has a clear idea of what the reason for referral and the history of this
presenting problem are, we can proceed to the next stage: Formulating an hypothesis and
planning the assessment.

Stage 2 : Formulating an Hypothesis and Planning the rest of the

Assessment

Based on the, often limited, information following the initial contact with the referral, the
psychologist will develop a preliminary hypothesis about the presenting problem and what
the possible difficulty or difficulties might be. This action relies on our theoretical
understanding and knowledge of the discipline of psychology and will determine the future
focus and direction of the engagement with the referred person as we proceed. Here the
skilled psychologist will decide what additional information is needed to address the
problem; and based on this judgement the best available tools to obtain the required
information are considered. The psychologist will thus develop a working hypothesis that
will guide the further steps in the process of assessment. This working hypothesis might
change as more information becomes available, however, the psychologist will in all
probability develop a hierarchy of concerns and questions to be addressed. Humans are
complex beings and the symptomatic behaviour described in the referral and presenting

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problem, might indeed be that: symptomatic. For example, a child referred for scholastic
difficulties might indeed have underlying emotional distress completely unrelated to the
symptomatic poor performance referred for assessment. It is therefore crucial for the
psychologist to consider all contextual factors when arriving at a conclusion of how the
assessment process needs to be focussed and which domains need inclusion in his or her
hypothesis. Based on this working hypothesis, a plan of action is formulated and specific
assessment tools are selected to match the concerns that need clarification. In other words,
the psychologist asks themself: what additional information do I need now that I have a
preliminary understanding of the concerns and the context of the person; and then: which are
the best tools available to gather this information? For example, if I need to judge intelligence
levels or levels of cognitive functioning, should I include an IQ test as part of my
assessment? Would observation of behaviour be necessary and indicated? What information
is necessary to obtain through further interviews? And interviews with whom? And so forth.

Example of hierarchy of concerns linked to assessment tools:

DESCRIPTION of Concern Reflecting DOMAIN Best TOOL to Assess Domain
Slow progress and learning Intelligence IQ test (but which one and what
problems norms should be used?)
Often tearful and unusually Emotional Interviews; projective
timid techniques; Emotional Quotient
Inventory; etc.

Considering the context of the person is vitally important during this decision making phase
to ensure fair and ethical practice. Although this might sometimes be a neglected step in
practice, it remains a crucial stage since much of the planning, conceptualizing and
hypothesising happens during this important stage. This stage should be understood as the
foundation upon which the rest of the assessment builds.

Stage 3 : Data gathering and interpretation

Stage 3 – Step 3.1: Act on the Plan of Action – Data gathering

As we have seen, the previous stages either involved no contact at all or limited contact with
the person referred for assessment. Stage 3, where all further relevant information is
collected, forms an extended part of the whole process. In fact, the psychologist might spend
the majority of time engaged in gathering information as described in this stage, Stage 3. This

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stage includes many different smaller steps using a variety of different psychological
assessment tools to gather relevant information. The direction and the focus of our inquiry
will be determined by the decisions made in the previous stages and guided by the working
hypothesis. In essence one could divide the gathering of information, Stage 3, into two main
parts: firstly the psychologist will now collect as much relevant contextual information as
possible through collateral interviewing and consulting available records if relevant; thus
‘collateral’ implies still not involving the client or patient directly. Secondly, direct
consultation and psychometric testing with the client (or patient) will be appropriate.

Thus, during stage 3 the psychologist will have interviews with the different people he or she
decided on to include in the assessment. These could include the client/patient themselves,
the parent(s) and teacher(s) of a child, employer(s), and other concerned parties such as a
social worker, an elder or a pastor. Clearly, our ethical code of conduct dictates that all of this
will happen with explicit consent from the person who was referred for assessment (our
primary client) and who is the focus of the assessment; whom we would have contacted
during stage 1.

As mentioned, a decision to use a selection of psychometric tests might be made. Depending

on the reason for referral and presenting problem, a range of functional areas could be
evaluated or measured in this way. These functional areas or domains, which are the focus of
further inquiry, could include a combination of the following (depending on the focus of our
assessment):

general cognitive functioning levels, arousal and attention, motor functioning,

language ability, visual and auditory perception, planning and reasoning, emotional
status, personality, social competence, scholastic or occupational functioning,
environmental influences, aptitude, values, interest, etcetera.

The psychologist might need or want to do observations at school, in the home or in the
workplace. In certain types of assessment or assessment requests it might even be necessary
to create simulated exercises to measure competence or specific skills. As we can imagine,
this stage usually involves quite an integrative and extended process of contact with the client
or in clinical settings, the patient.

When psychometric tests are used, it is important to use standardised and relevant
psychometric tests to arrive at valid and reliable conclusions (see Box 5).

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BOX 5

Guidelines for evaluating a psychometric measure

There are thousands of psychometric tests on the market and some freely available on the
internet. The HPCSA Professional Board for Psychology (2020) lists around 250 specific
psychometric tests in common use in South Africa. The difficulty therefore is: how do we
select a test as a psychometric tool that will truly assist in the process of psychological
assessment and benefit my client by providing additional and more objective information
that will contribute to solving a particular problem of the client. This checklist serves as a list
of dimensions and questions to be asked to determine the usefulness of a particular
psychometric assessment tool:

• Construct and Theoretical underpinnings: Is the construct clearly defined and

theoretically justified? Will the test measure what I need to know?
• Date: How old is the test? What is the publication date of the test and what is the date
of this particular revision? [Comment: Not all older tests are useless, however,
constructs change and will therefore impact on criteria to sensibly assess a particular
construct]
• Population: For whom was the test originally developed? Thus, who was included in the
original norming process? How similar is my client’s demographically to this original
norm population?
• Norms: Following the above, which norms do I use and are there alternative norms
available if the original norms do not match my client’s demographics?
• Age: What is the age range of this test? Does my client fall within this range?
• Psychometric Properties: What do we know about the reliability of the psychometric
test as reported in the manual?
• What do we know about the validity of the test as reported in the manual – i.e. are the
constructs measured valid in the context of my application?
• HPCSA approved: Is this test acknowledged by the Health Professions Council of SA
(HPCSA)? Not all test that are on the list of the HPCSA are however necessarily
appropriate for all South Africans from all demographic groups; and similarly, if a test
does not appear on the list of the HPCSA, it does not mean that the test is immediately
worthless – it simply means it possibly had not (yet) been rigorously reviewed by the
Psychometrics Committee. The list is to be found via the Professional Board of
Psychology website:
https://www.hpcsa.co.za/?contentId=0&menuSubId=52&actionName=Professional%20Boar
ds (open the “Test Classifications” tab on the left)
• Bias and fairness: Based on the above dimensions, what can I say about bias and fairness
of this measure as applied to my particular client?

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Once all data has been gathered using the available tools of interviews, observations,
psychometric tests, and other measures, we proceed to the next step: to make sense of this
data.

Stage 3 – Step 3.2 : Interpretation of Data and Modification of Hypothesis

Based on the previous involvement, during Stage 3.1, the assessing psychologist will now
have a lot of raw data available which needs to be processed, integrated and understood.
During this step (3.2) the ‘thinking work’ happens. The psychologist will ask questions such
as: what are the strengths of this person?; what are the weaknesses of this person?; how does
this relate to the presenting problem or referral question?; is additional information required?
and if so, how should it be gathered?; can I answer the referral question based on what I have
now and what recommendations could be made to assist with the referral request?; does the
available information support or refute the original working hypothesis; and does the
hypothesis need modification?

During this stage, psychometric tests will be scored and raw data compared to available
norms. Information will be integrated and clustered around specific domains of concern. The
psychologist will integrate all this information and should be sensitive to contradictions in the
data. Different sources of data might also confirm and support a specific hypothesis about the
referral concern. During this stage, it is vital that assessment data be evaluated against the
theoretical knowledge base of the psychologist.

BOX 6
STEPS IN THE SCORING OF PSYCHOMETRIC TESTS

• Add all the individual items and arrive at a Raw Score for each subtest or section of the
psychometric test
• Compare the Raw Score to the statistical norms and calculate a scaled score or standard
score
• Ensure the use of correct norm tables and comparison population
• Use these calculated standard or scaled scores to create a profile of strength and
weakness for the individual

The theoretical lens of the practicing psychologist will certainly inform the interpretation of
the data. The final engagement during Stage 3.2 requires preparation and translation of this

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data into a palatable format appropriate for feedback to the client and other relevant people.
The challenge here is to not use psychological jargon or overly theoretical constructs, but to
translate findings into pragmatic recommendations.

Stage 4 : Finalising the Assessment: Feedback and Follow-up

Stage 4 – Step 4.1: Communication of Results

Communication of the assessment outcomes has two components: usually the assessment
process is concluded with a verbal feedback session followed by a written feedback report.
Verbal feedback should always include the referred person. This might sound like stating the
obvious, but far too often are minors or the disempowered disregarded after having done all
the hard work during the assessment, by giving feedback to a parent or teacher or employer
only. This feedback needs not be an extended process (to children for example), but should
always include the primary client. Of course, feedback could – and it is viewed as good
practice that it should – include feedback to the referring party (employer or teacher or
parent) if the client was not self-referred. Communicating the results will involve presenting
the specific findings of the assessment and generating alternatives to solve the presenting
problem. The verbal feedback interview is followed-up by synthesising information into a
written report. Once again there are specific and clear ethical principles and conduct guiding
the sharing of information and informed consent.

Stage 4 – Step 4.2: Implementation of Recommendations

The assessment process is ultimately useless if the assessment information cannot be

translated into pragmatic recommendations to address the concerns presented during the
referral. Recommendations often involve other professionals and the psychologist frequently
implements recommendations indirectly. Thus, recommendations might involve referral to
psychotherapy or counselling, in which case the psychologist could continue his or her
involvement with the client themselves, or facilitate referral to a fellow psychologist
colleague. Or it might require the expertise of other professionals such as Occupational
Therapists, the medical profession, psychiatrists, social services or clinical remedial teachers.
It is also essential that the recommendations are pragmatic and that these make sense within
the context of the client. For example, it is pointless to refer a child living in a rural

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community for occupational therapy if the closest occupational therapist is based in a town or
city 250km away with poorly available transport services. The essence of the principle here is
that the psychologist needs to be certain that recommendations make sense within the living
context of the client.

Stage 4 – Step 4.3: Follow-up and Evaluation

This is often a neglected step in the assessment process, especially where there is not ongoing
involvement between the psychologist and the client. However, a follow-up contact with the
client to establish whether recommendations are having positive outcomes, is essential. This
contact could be in the form of a follow-up appointment some weeks or even months after the
initial assessment contact; or it could even be in the form of a simple telephone enquiry. This
might prompt a revision of the assessment process and might require follow-up assessment or
intervention.

MANAGING THE ASSESSMENT PROCESS: RESPONSIBILITIES OF THE

PSYCHOLOGIST BEFORE, DURING AND AFTER THE ASSESSMENT AND
PSYCHOMETRIC TESTING SESSION

There are a number of tasks and duties the assessing psychologist needs to attend to when
assessing individuals or groups of individuals. These tasks could be divided into 3 clusters of
duties namely:

duties and tasks before the assessment

duties and tasks during the assessment

duties and tasks after the assessment.

These tasks are also probably more focused on a psychometric testing session (and does not
necessarily reflect assessment as a process). Proper planning and execution, as well as precise
scoring and interpretation of psychometric material, are essential to ensure some level of
standardisation.

Preparation before the assessment

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• Choice of techniques and planning the sequence

• Become familiar with material and check test material

• Familiarise with Instructions of Psychometric material

• Venue characteristics

• Circumstances of the testees:

▪ Informed consent

▪ Linguistic factors

▪ Personal circumstances

Duties during the procedure

• Establish rapport

• Ensure understanding of tasks by testees

• Monitoring behaviour and progress

• Adhere to standardised instructions and time limits

Tasks and duties on completion of the assessment

• Collection of psychometric material

• Securing of psychometric material

• Scoring of quantifiable data such as psychometric tests

• Interpretation of information

• Feedback

The nature of psychometric assessment

We can identify two main forms of psychometric assessment (testing). These types of
assessment will serve different purposes. The first form can be described as ‘group testing’
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and the second as ‘individual testing’. Roughly we could describe group tests as screening
tests while individual tests are more diagnostic in nature.

The table below highlights the differences:

Group Tests Individual Tests

Screening in nature: performance is Diagnostic in nature: individual strengths

compared with others and weaknesses are identified

Simulates an instructional situation Presents a series of specific (cognitive) tasks

Could also be used in individual setting Unless adapted (to become a group test, it
cannot be used in group settings

E.g.: General Scholastic Aptitude Test E.g.: Wechsler Intelligence Scales (WISC,
WAIS)

Paper and pencil tasks, often multiple Series of open-ended cognitive tasks,
choice options questions and manipulation of objects

FACTORS AFFECTING ASSESSMENT RESULTS: THE CONTEXT OF

PSYCHOLOGICAL ASSESSMENT

If we accept that psychological assessment goes far beyond psychometric testing and the
interpretation of psychometric information (as argued in the preceding discussion), then we
could argue that psychological assessment brings the context of the person into the
microcosm of the consulting room. Claassen (1997, p. 306) succinctly states that “never can
a test score be interpreted without taking note of and understanding the context in which the
score was obtained”. I would like to go one step further: understanding the context of the
client and the context of the assessment objectives, form the very essence of interpretation of
assessment outcomes.

Therefore, if we try to identify the factors which could affect assessment outcomes, we need
to look at the contexts: 1) of the person referred, 2) of the assessment measure, and 3) of the
psychologist and the practice of assessment. The skilled psychologist will therefore not only
do a thorough investigation of the life context of the client, but will also have an in depth
knowledge of the tools and measures of the assessment, both psychometric tests and aspects

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which can impact on interviews and other interactions. Lastly, the psychologist needs to have
the capacity to introspection and acknowledge and reflect on the impact ideological and
theoretical orientations could have on the interpretation of assessment information.
Ultimately, assessment is much more subjective than we would like to believe! This however
should be embraced as a strength of assessment, rather than a weakness.

Thus, when considering the factors affecting assessment outcomes, our focus is on three
intersecting entities: the client, the psychologist and the tools.

In similar vein, Grieve and Foxcroft (in Foxcroft & Roodt (2013), chapter 17) provide a
useful framework to understand the factors affecting assessment outcomes. Moerdyk (2015)
(Chapter 7) should be read in conjunction when he addresses “fairness” in assessment
practices.

Let us now turn to the three main players described above.

The Client

When considering the contexts of the client, we can distinguish between factors within the
client him or herself, and factors surrounding the client. The factors within the client include
the Biological and the Intra-psychic contexts. The surrounding contexts include the Social
and Socio-economic contexts.

The biological context:

This refers to the physical bodily structures upon which all human functioning relies.

• Age

• Physical Impairment: speech, hearing, visual; as well as transient condition

• Cognitive Impairment

• Identity and biographical variables

The intra-psychic context:

Here we look at personal disposition, emotions, etc.; thus what and how people experience
themselves. We distinguish permanent conditions from specific situational conditions:

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• Transient conditions

• Psychopathology

The Social context:

This refers to the broader community, socio-economic status, socio-political environment,

and cultural experience.

• Schooling

• Language

• Culture

• Environmental factors

▪ Proximal factors: Home

▪ Distal factors: Poverty, SES, Urbanisation

The Psychologist

It is obvious that all of the above will or could impact on the psychologist. We need to
consider the ‘person’ of the psychologist as the most important tool in the assessment
process. It should therefore be emphasised that the capacity of the psychologist to self-reflect
is crucial to any practicing psychologist. This is a well-accepted principle in psycho-therapy,
but equally important when gathering and interpreting assessment information. The
psychologist needs to be aware of his/her own prejudices, idiosyncrasies, ideological beliefs
and identity presentations, and how these can impact interpretation of information.
Furthermore, the psychologist needs to be able to function from a strong theoretical and
knowledge base which acts as the lens through which raw assessment data will be interpreted.

The Tools

This is what Grieve and Foxcroft (2013) call “methodological considerations”. While the
focus is on aspects of the standardisation and administration of psychometric tests rather than
the individuals involved in the assessment process, we shall see that once again it goes

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beyond the mere psychometric and includes other tools such as interviews, the psychologist’s
skill and experience in administering psychometric tests and conducting assessment
procedures, as well as the compatibility between psychometric tests and measures, and the
client. A big emerging question in fairness of current assessment practices in South Africa is:

What is the “norm” and who determines this as the “norm”?

Remember our introductory cartoon?

_________________________________________________________________________

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DOMAINS OF ASSESSMENT

The topic of this lecture is “Domains of Assessment”. The assessment process involves a
number of critical areas. Clearly the purpose of the assessment will determine the focus of the
assessment and give credence to a particular domain becoming more important than another.
For example, when assessing someone for a learning disability, the focus of the assessment
will probably be on cognitive functioning levels and neurological processes. However,
assessing someone or a group of people for job placement will probably focus on aptitude
and ability, achievement and interest. This does not mean that other areas are excluded or
even less important. As we have seen earlier, an assessment should try to be as
comprehensive as possible. Taking a proper history and contextualising the individual will
always be central to our understanding of people in a psychological assessment activity.

The following domains of assessment can be identified:

• Intelligence

• Cognitive functioning (with a breakdown of domain specific areas; see MSE: Box 7)

• Achievement and aptitude

• Personality

• Emotional

• Social and family context

For the purpose of this discussion and by means of example, we are going to focus on
personality and intelligence only as illustrative of domains of assessment.

Intelligence and cognitive functioning

The definitions of intelligence are as varied as the theories describing intelligence. Before
continuing, ask yourself the question: What is intelligence?

Robert Sternberg, prominent theorist in the area, asserts that the question should rather be:
Where is intelligence? In other words: where is it located? Within the individual, in the
environment, a combination of the two? Also: is there only one “intelligence”? Or multiple
factors?

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A summary of the most important aspects in considering “intelligence” highlight the

following issues:

• Intelligence is NOT a singular construct, but accepted as being multidimensional.

• There are many different “TYPES” of Intelligence (see Howard Gardner’s work on
multiple Intelligence – refer to 1st year lectures!) Because there are many different
types of Intelligence, there are many different “DEFINITIONS” of intelligence.

• Important to the assessment of intelligence, theories of Intelligence are seldom

directly linked to the psychometric testing of Intelligence.

Let us now explore different “TYPES” of intelligence. I say types in inverted commas
because your definition of the construct, whether intelligence or personality, will largely
determine your approach in the assessment of that construct.

• Biological / Neurological

▪ Physical structure and function of brain – (reaction time)

▪ Resembles earliest work around the structure of intelligence

• Psychometric Intelligence

▪ “Intelligence is what intelligence tests measure”(Boring)

▪ Standardised tests measure functioning on certain defined

psychological constructs thru cognitive tasks

• Social / Contextual Intelligence

▪ Adaptive behaviour

▪ Is “intelligence” the same thing everywhere?

▪ … and in all circumstances?

Examples of some individual intelligence tests:

Wechsler Adult Intelligence Scale (WAIS) (Adult)

Wechsler Intelligence Scale for Children (WISC) (Primary and High School)

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Wechsler Pre-primary and Primary Scale of Intelligence (WPPSI) (Pre-School)

Das-Naglieri Cognitive Assessment System (DN-CAS) (Primary and High School)

Senior SA Individual Scale (SSAIS) (Primary and High School)

Junior SA Individual Scale (JSAIS) (Pre-School)

Raven Standard and Raven Coloured Progressive Matrices (RSPM and RCPM)

The link between theory and cognitive tests (2 examples):

Example 1: Vernon’s Hierarchical Model of Intellectual Abilities

Factors:

General (g)

Major Group Verbal-Educational Practical

Minor Group Verbal Number Spatial Psycho-motor

Specific Tasks

(subtests)

Example 2: The PASS theory and the Das-Naglieri Cognitive Assessment System

The Das-Naglieri Cognitive Assessment System (DN-CAS) is one of the new generation tests
conceptualising Intelligence as cognitive process, rather than a static measure of ability. It
draws on the PASS theory. In turn, the PASS theory is based on the neuropsychological,
information processing and cognitive psychological research of Luria. Four areas of
functioning are identified (PASS) operating from a person’s knowledge base:

• Planning

• Attention
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• Simultaneous Processing

• Successive Processing

We’ll consider this and how it translates into a test, during the lecture.

__________________________________________________________________

Personality

[Also see Moerdyk, A. (2015). The principles and practice of psychological assessment
(Chapter 11). Pretoria: Van Schaik.]

Like intelligence, personality is a difficult construct to define. Testing of personality will

often depend on the definition of the construct. Over the years, two main methods of
personality assessment have evolved. These are: projective assessment techniques (qualitative
interpretations) and structured objective psychometric testing (quantitative scores).

Test vs Technique

Projective technique is a term coined by Lawrence Frank in 1939 for psychological

assessment procedures where the respondent “projects” their inner needs and feelings onto
ambiguous stimuli. It is assumed that, because the stimulus material is rather unstructured
and relatively open ended, the structure imposed by the person is a reflection of their inner
projections and perceptions of the world, thus revealing important facets of personality. This
is the so called “projective hypothesis”.

We can divide projective tests into several categories:

• Constructive Techniques: Thematic Apperception Test (TAT and CAT)

• Completion Techniques: Rotter’s Sentence Completion Test

• Association Techniques: Rorschach Ink blots

• Expressive Techniques: Projective Drawings such as the DAP (draw a person), KFD
(kinetic family drawing), HTP (house-tree-person).

Structured Objective Tests

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• 16PF (16 Personality Field)

• MMPI

• SORT

(More detail on the construction of structured objective personality tests from class
discussion.)

New Developments: Mood Tracking Apps

Digital mood tracking applications have emerged as prominent tools for individuals
endeavouring to monitor and regulate their emotional states. The concept of mood tracking
has roots in therapeutic psychology and self-help practices, where individuals traditionally
documented their emotional states in journals or diaries. The advent of smartphones and
digital technology precipitated a paradigm shift, catalysing the development of applications
aimed at streamlining the mood tracking process, thereby enhancing its accessibility and
convenience. Digital mood tracking apps facilitate the systematic recording of users'
emotions, thoughts, and behaviours throughout the day in real time. Users can identify
patterns in their mood fluctuations, pinpoint and track triggers, and gain insights into their
mental health over a chosen period or an extended durations. These apps often incorporate
features such as mood charts, journaling capabilities, reminders, and data analysis tools to
help users understand and manage their emotions and emotional states effectively.

Being a fairly new assessment technology, mood tracking continues to develop and evolve. I
wish to highlight a few developments and current trends. First of all, many mood tracking
apps are integrating with wearable devices like smartwatches to passively track users'
physiological data, such as heart rate variability and sleep patterns, for a more comprehensive
understanding of mood fluctuations. Secondly, there is a growing trend towards
personalisation in mood tracking apps, with features like AI-driven insights and
recommendations tailored to individual users' needs and preferences. Thirdly, with increasing
awareness and destigmatisation of mental health issues, mood tracking does not focus on
problematic patterns only, but also provides opportunity to promote healthy patterns. There
is a shift towards developing mood tracking apps that prioritise mental health and overall
well-being, offering resources, coping strategies, and connections to mental health
professionals. Lastly, Data privacy and security is an increasing concern. As users become

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more aware of their data privacy, there is a trend towards ensuring that mood tracking apps
adhere to strict privacy policies and implement robust security measures to protect users'
sensitive information. Please ensure that your choice of app does not compromise your
personal data. And, as mentioned above, the option of a manual written mood diary for the
duration of the course is available by prior arrangement.

Overall, digital mood tracking apps continue to evolve to meet the diverse needs of users
seeking to better understand, manage, and improve their emotional health and well-being.

__________________________________________________________________________

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TOOLS AVAILABLE IN THE ASSESSMENT PROCESS

There are a variety of assessment tools the psychologist or psychometric counsellor can use
in trying to come to a clearer understanding of the referred person and the referral question.
The purpose and aim of the assessment will determine the extent to which these tools will
form the focus of the assessment process. For example, during clinical assessment, the
interview will probably need to be the focus of the assessment with other tools such as
psychometric tests adding to the picture. Selection assessments will probably focus more on
objective psychometric information or the use of case vignettes focusing on aptitude, skills
and competence, whereas observation in a natural environment often forms a pivotal part of
assessment in scholastic settings.

We are now considering the various tools available to psychological assessment:

Interviews

Interview techniques and concepts:

• Unstructured interview – allows for greater flexibility and possible high rapport, but
problems with reliability and validity
• Structured interview – more efficient in gathering specific types of information needed
for decision making or diagnosis
• Open-ended questions – allows interviewee’s story to unfold spontaneously in their own
words
• Closed-ended questions – asks for specific information

Content vs Process:

• Content – what is said between the psychologist and the client (the topics discussed or
subjects mentioned);
• Process – what is occurring non-verbally, the feeling reactions that are often unconscious
or unacknowledged

Clinical judgement: this refers to the use of “self” in the assessment process. “... a special
instance of perception in which the clinician attempts to use whatever sources are available
to create accurate descriptions of the client.” (Groth-Marnatt, 2003)

Factors that can negatively influence clinical judgement:

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• Lack of rapport
• Missing crucial information
• Not considering data that doesn’t support your hypothesis
• Being unfamiliar with requirements (job application) or diagnostic criteria
(DSM5 or ICD10 criteria)
• Lack of theoretical knowledge and experience
• [‘You only see what you look for and recognise what you know’]

Clinical Intake Interview

The clinical intake interview is one example of the use of interviewing in the assessment
process.

It is useful in that it:

• Provides a context in which test results can be interpreted (without this context
interpretation is virtually meaningless – see previous lectures)
• Provides an opportunity for behavioural observation
• Is useful for predicting future behaviour and prognosis
• Is effective in crisis situations
A major limitation of the Clinical Interview is that it is open to Interviewer Bias (e.g. Halo
effect, Confirmatory bias, Generalising).

The Clinical Interview provides a format for history taking (e.g. Maudsley Case History
format) and gathering information regarding a psychiatric patient’s mental state (through the
Mental State Examination [MSE]). [NOTE: You need not know the details of this format in
3rd year. Suffice to understand and describe the types of questions asked.]

BOX 7

MAUDSLEY CASE HISTORY AND MENTAL STATE EXAMINATION

CASE HISTORY

IDENTIFYING DATA
name, age, education, marital status, abode, contact details

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REASON FOR REFERRAL

Provide a brief statement of the reason for referral and who referred.

HISTORY [Report sources of information]

PRESENTING PROBLEM
A detailed coherent account in chronological order of the problem, from the earliest time
at which a change was noticed. Ask yourself the question, “What has brought this patient
to seek help at this time?” Let the patient tell his or her story in his or her own way. Any
associated problems should be noted. Note also motivation for treatment.

SIGNIFICANT LIFE EVENTS

A list of the events that have caused significant changes, impacts or disturbances (either
positive or negative) in the client’s life during the last few years.

HIGHEST LEVEL OF ADAPTIVE FUNCTIONING

Highest level of adaptive functioning achieved during the last year.

FAMILY HISTORY
Construct a genogram including grandparents and close family members.

Grandparents: Biological parents: Siblings: Other significant figures:

Home atmosphere and influence: Familial psychiatric and medical illness:

PERSONAL HISTORY
Inclusive of Pregnancy and birth, Early development, Neurotic symptoms in childhood,
Health during childhood, Sexual inclinations and practices, Menstrual history, Friends and
intimate relationships, Marriage, Education: School and Further education and training,
Occupation, Activities, Habits, Medication, Present home circumstances, Previous
illnesses

BASIC PERSONALITY

PSYCHOMETRIC TESTS [Report previous results]

MENTAL STATE EXAMINATION

GENERAL APPEARANCE, BEHAVIOUR AND SPEECH

Appearance – grooming, neatness, mode of dress and unusual features.
Behaviour – eye contact, posture, psychomotor activity such as agitation, excitement or
abnormal slowness, irreverent or embarrassing behaviour, distractibility, objective
evidence of hallucinations, mannerisms or stereotypes, catatonic symptoms.
Speech – this refers to and may range from muteness through slowness, delayed
responses and restricted quantity to rapidity and pressure of talk. Note tone of voice,
clarity and speech difficulties.

AFFECT AND MOOD

Affect (The objective, external manifestations of internal feeling judged from the patient’s
general demeanour, face and expressed ideas.) Mood (The patient’s subjective pervasive
feeling tone not related to an object.)

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THINKING
Organisation of Thought, Possession of Thought, Content of Thought

PERCEPTION
Distortion, Illusions, Hallucinations

COGNITIVE FUNCTIONS
Awareness
Orientation
Memory
– Immediate recall
– Short-term recall
– Intermediate-term recall
– Long-term recall
Capacity for abstract thinking
Intelligence
Insight
Judgement

Observation

As part of the assessment of behaviour, observation could be part of the general assessment
process, such as observation during the interview or testing session, or it could be a specific
technique, such as observation in natural settings (class room, playground, work place).

Furthermore it could be incidental (during the procedural course of the assessment),

situational in specifically designed settings (through the use of ‘planned incident procedures”
such as role plays, vignettes, etc.) or structured (through the use of rating scales).

Psychometric Tests

Please refer to Box 5 on p. 16 of this course pack to review the considerations before a
psychometric test is used. Important concepts that we need to consider and will discuss in the
lecture time are: Validity, Reliability, and Fairness.

A Definition:
“A psychometric test is a standardised procedure to obtain a sample of certain
aspects of human behaviour and to quantify and/or evaluate these aspects (of
behaviour).”
Source: De Villiers, L. Coetzee, H.B., & Venter, R.K. (1991) Manual for A-Test Users. Pretoria, South
Africa: HSRC.

We shall “unpack” this definition in class.

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“Types” of Psychometric Tests

Psychological tests fall into several categories; however, these are often clustered into main
categories such as ability testing (inclusive of mental capabilities and aptitude) and
personality testing (inclusive of behaviour and emotions). What follows is a very brief and by
no means exhaustive summary of some of the kinds of measures:

Achievement and aptitude tests: are usually seen in educational or employment settings, and
they attempt to measure either how much you know about a certain topic (i.e., your achieved
knowledge), such as mathematics or spelling, or how much of a capacity you have (i.e., your
aptitude) to master material in a particular area, such as mechanical relationships.

Intelligence tests: attempt to measure your intelligence, or your basic ability to understand
the world around you, assimilate its functioning, and apply this knowledge to enhance the
quality of your life. Intelligence, although it correlates with achievement, is not a measure of
what you’ve learned (as in an achievement test), and attempts to not be influenced by culture.
However, the question remains: What is intelligence within various cultural milieus?

Neuropsychological tests: attempt to measure deficits in cognitive functioning (i.e., your

ability to think, speak, reason, etc.) that may result from some sort of brain damage, such as a
stroke or a brain injury. Cognitive functions similar to intelligence tests.

Occupational tests: attempt to match your interests with the interests of persons in known
careers. The logic here is that if the things that interest you in life match up with, say, the
things that interest most engineers or teachers, then you might make a good school teacher or
engineer yourself.

Personality tests: attempt to measure your basic personality style and are most used in
research or forensic settings to help with clinical diagnoses. These tests are usually divided
into 2 groups: Projective Tests and Structured or Objective personality Tests.

Specific clinical tests: attempt to measure specific clinical matters, such as your current level
of anxiety or depression.

Psychological tests are usually administered and interpreted by a psychologist because

academic courses and supervision in psychological testing are an integral part of the master’s

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degree in professional psychology. A registered counsellor with the appropriate academic

training and supervision may administer certain psychometric tests (some of which only
under the supervision of a registered psychologist). Academic courses and supervision in
psychological testing are usually not a part of a psychiatrist’s medical training, so most
psychiatrists can ethically administer only some specific clinical “tests” that are straight-
forward check-lists of symptoms.

Psychometric Properties

To ensure fairness and the correct unbiased application of such an important and powerful
assessment tool as psychometric tests, Psychometric Tests are not randomly applied, developed
or selected: Psychometric tests are standardised tests.

Standardisation means that these tests are statistically developed in a fair way and the
implementation is standardised in the form of uniform instructions and scoring. Standardisation
thus happens on three levels: In test development; in test instructions; and in test scoring.

During the standardisation process of test development, careful attention is paid to the
psychometric properties of the measure. Psychometric tests need to be reliable and valid.

Reliability refers to the consistency of the measurement. Does the psychometric test provide
consistent results across time and across raters, thus minimising error?

Validity refers to the accuracy of the measure. Does the psychometric test measure what it
proposes to measure? In other words, are the results a true reflection of the defined construct
to be measured, thus minimising irrelevant aspects of the construct?

(Psychometric properties, reliability and validity will be discussed in detail in class. Refer to
Moerdyk Chapters 4 and 5 for a detailed discussion of these concepts.)

_________________________________________________________________________

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 Rhodes University – Psychology 3 – 2024 – Psychological Assessment – Jan Knoetze
Lecture Notes

FINAL PHASES OF THE ASSESSMENT PROCESS: SCORING, INTERPRETING,

INTEGRATING INFORMATION AND PROVIDING FEEDBACK

Interpretation

Once one has gathered information through various means, such as psychometric test results
and interviews, you have to come to certain conclusions around the meaning of such results.
A test score on its own is meaningless and interpretation has to be contextual, considering
ALL possible available information.

Interpretation of psychometric and other assessment results could happen from various
positions. Here are 4 stances to interpretation:

1. Descriptive interpretation: Here the psychologist will simply describe the person
as they were behaving or as they performed. It is not an attempt to interpret a
performance based on prior ability or in terms of future prediction. The focus is on
description of the observable and is based on currently available information. For
example: “X’s performance on the Senior SA Individual Scale – Revised (SSAIS-
R), an indication of intellectual functioning levels, was average.” (where the IQ
score was 100)
2. Causal interpretation: Here we attempt to describe what causes an individual to
perform in a particular way. Test scores and other information are interpreted in
relation to past development and background history. In this way certain
conditions, such as neurological conditions, can be described as causing specific
problem behaviour or functioning. For example: “X’s significantly low score on
visual spatial subtests of the Wechsler Adult Intelligence Scale (WAIS) could be
explained by a head injury sustained in a Motor vehicle accident 2 years ago.”
3. Predictive interpretation: Here we use test scores and other information to predict
performance. Criterion referenced tests are often the best tool in this context. For
example: Predicting career success – “X’s performance on a variety of aptitude
and cognitive tests reveals strong numerical ability, three-dimensional reasoning
and mechanical insight which make her a perfect candidate for engineering
career.” or predicting school readiness – “On all the developmental tasks, Y
performed age appropriately. This in addition to a strong social-emotional

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 Rhodes University – Psychology 3 – 2024 – Psychological Assessment – Jan Knoetze
Lecture Notes

presentation during interviewing, indicates that he is ready to enter formal

schooling (grade one) next year.”
4. Evaluative interpretation: Here the psychologist’s clinical judgement is important.
For example Z is an intelligent person but with serious reading and spelling
difficulties. The following interpretation could be made: “Despite Z’s above
average intellectual functioning on a standard intelligence test, it is not
recommended that she follows a career as a journalist, because of serious reading
difficulties.”
Interpretation of test results could be done on a continuum from mechanical analysis of
psychometric test results to a much more flexible and less rigorous subjective interpretation.

TO
mechanical non-mechanical
psychometric (profile analysis) contextual
objective/standardise subjective interpretative
statistical clinical

Principles governing the sharing of assessment results

 Ethical Considerations
▪ Invasion of privacy
▪ Assessment should be a collaborative process
 Confidentiality
▪ Who should have access to information?
 Accountability
▪ Proper training and scope of practice
▪ Proven Competence
 Test-takers “Bill of Rights”

Respect and Dignity ALWAYS

Fairness Unbiased measures and use of test data
Informed Consent Agreement; knowledge of use and benefit;
right to refuse
Explanation of outcomes (results) Clear and understandable
Confidentiality Explicit permission to share
Professional Competence Training
Labels Category descriptions should not be
offensive
Linguistic Language should not compromise
assessment
Disability Disability should not compromise
assessment
Source: Grieve, K.W. (2013). Interpreting and Reporting Assessment Results. In C. Foxcroft & G. Roodt
(2013). Psychological Assessment in the SA context, pp. 257 – 267. Cape Town: Oxford University Press.

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 Rhodes University – Psychology 3 – 2024 – Psychological Assessment – Jan Knoetze
Lecture Notes

Two ways of sharing assessment outcomes

Psychological assessment outcomes are usually shared as a written report discussed in a

feedback interview with the primary client and the referring third party (if appropriate).

 Feedback Interview

o Within context of a relationship

o Respectful (refer to ‘Test-takers Rights’)

o Serving the original purpose/answering the referral question

o Understandable general descriptive terms (vs numerical)

o Fully considering the life context of the client

 Written Reports

o No ‘standard’ way of writing feedback reports (see Foxcroft and Roodt (2005)
p. 222 for some pointers)

o The ‘audience’ is important – who is the report for?

o Best not cluttered with irrelevant info,

o Yet comprehensive enough with a clear argument and conclusion

o Provide meaningful recommendations that are pragmatic and executable

When Recommendations are made:

 A priority order of recommendations i.e. which domains need intervention most?

 Clusters of intervention might include: medical, educational, psychological, social,

etc.

 Balance the ideal with the practical and pragmatic: consider context of the client and
available resources

 NOW we consider:

o Precipitating factors (The why now?-question)

o Predisposing factors (leading up to this referral)
o Perpetuating or Maintaining factors (keeping the problem a problem,
‘functional’, difficult to change)
o Protective factors that can be utilised to make change possible

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 Rhodes University – Psychology 3 – 2024 – Psychological Assessment – Jan Knoetze
Lecture Notes

Implement recommendations & Follow-up

 Issues to consider:

o Where does your responsibility as psychologist to the person end?

o What steps can we take to assist with implementation?

o Means of follow-up… appointment or phone call

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References

Claassen, N. c. W. (1997). Cultural Differences, politics and Test Bias South Africa. European
review of applied psychology, 47(4), 297-307.
Fernandez-Ballesteros et al. (2001). Guidelines for the Assessment Process. European Journal
of Psychological Assessment, 17(3), 187–200.
Foxcroft, C. & Roodt, G. (2013). Introduction to Psychological Assessment in the SA context.
Cape Town, SA: Oxford University Press.
Groth-Marnat, G. (1997). Handbook of Psychological Assessment. (3rd Edition). New York,
NY: John Wiley.
Meehl, P. (1954). Clinical versus statistical prediction: A theoretical analysis and a review of
the evidence. Minneapolis: University of Minnesota Press.
Moerdyk, A. (2015). The principles and practice of psychological assessment. Pretoria, South
Africa: Van Schaik.
Shuttleworth-Jordan, A.B. (1994). The teaching of psychological assessment in clinical
psychology. Clinical Psychology Forum, Leading Article, November, 12-13.
Wise, P. S. (1989). The Use of Assessment Techniques by Applied Psychologists (Chapter 6).
California, CA: Wadsworth Inc.

the end
©jjknoetze, updated 30/06/2023

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