Clinical Assessments

Posted on 29 August 2016
Blog by Issa Coultas

Clinical psychology focuses on identifying, preventing, and relieving psychological distress and dysfunction. Psychological assessment is vital to the practice of clinical psychology as a tool to help identify the presence and severity of psychological issues. In conjunction with psychotherapy, psychological assessment can help provide an objective lens for baseline evaluation and for tracking therapeutic progress. Additionally, psychological assessments benefit clinical psychology by providing an avenue to gather pertinent information from individuals who find it difficult to open up to medical professionals.

Mind Garden offers many psychological assessments for clinical uses. Ranging from anxiety and depression inventories to personality assessments to an abuse screening survey, we cover areas of interest to psychotherapists, researchers, and social service workers. I’ve had the opportunity to become familiar with several of these instruments. I’ve picked out four clinical assessments that I feel represent the benefits of psychological assessment in the clinical field.

State-Trait Anxiety Inventory

The State-Trait Anxiety Inventory (STAI) was developed by Dr. Charles D. Spielberger to determine anxiety in a specific situation (State Anxiety) and anxiety as a general trait (Trait Anxiety). Depressed individuals tend to have higher anxiety as a general trait scores, and therefore the STAI can be used as a tool to help differentiate anxious thoughts due to consistent depression and anxious thoughts due to inconsistent triggers. The STAI is used in clinical diagnosis to distinguish cases of depression from cases of anxiety – important distinctions to make for the treatment process.

I appreciate the STAI for a couple of reasons. First, it takes less than 10 minutes to complete (40 items) and can easily be completed as a pre-intake assessment. Because State Anxiety is dependent on a specific situation, the STAI can be taken multiple times to track anxiety changes over time and in different situations. For instance, my State Anxiety while getting ready to move to college was higher than my State Anxiety starting my junior year two years later, but equal to my State Anxiety while getting ready to move out of my college house at the end of my senior year. Clearly, changing environments or living situations heightens my anxiety. This type of information is useful in clinical psychology to help identify triggers and behavior patterns, and help the patient prepare how to handle their own reactions to future similar situations.

The second reason I appreciate the STAI is because of the report. After revealing State and Trait Anxiety scores, the report provides a workbook that explains what anxiety is and how to cope with anxiety. While this information may be readily available from a psychotherapist, the inclusion of exercises for controlling and lessening anxiety can act as a guide and/or supplement to psychotherapy sessions. These exercises range from worksheets that help identify your triggers, your beliefs that make those triggers meaningful, and how those beliefs translate into anxious consequences, to relaxation techniques that help decrease the physical symptoms of anxiety. Although I have never had an issue with high anxiety, the information in the report still helped me understand anxiety and learn new ways to cope with overwhelming problems. I can see how this report would greatly help someone who is facing high levels of anxiety.

Inventory of Interpersonal Problems

The Inventory of Interpersonal Problems (IIP), developed by Leonard M. Horowitz, Lynn E. Alden, Jerry S. Wiggins, and Aaron L. Pincus, measures the degree to which a person exhibits characteristic difficulties in relating to others. Interpersonal difficulties are often reported by individuals seeking psychotherapy; the understanding and resolving of interpersonal problems is considered an important step for alleviating common symptoms like depression and anxiety. The IIP can help determine if the individual is sufficiently distressed to justify treatment for interpersonal problems, and is particularly useful for establishing a baseline at the beginning of therapy and for evaluating changes at the end of treatment by retaking the IIP.

In addition to determining if the individual needs treatment for interpersonal problems, the IIP can also help clinical psychologists connect with patients who are less distressed about interpersonal difficulties. The IIP is comprised of eight scales – each measuring the severity of a specific problematic interpersonal behavior. While less distressed patients will have lower scores on all scales, their interpersonal characteristics will still be revealed as the highest score. The difference between connecting with a patient who has a higher – but not severe – score on Cold/Distant interpersonal behavior versus a patient who has a higher score on Overly Accommodating interpersonal behavior is quite significant. Therefore, even if the IIP reveals that a patient is not in need of treatment for interpersonal problems, the inventory still provides essential information for how to implement psychotherapeutic treatment.

Personality Adjective Check List

The Personality Adjective Check List (PACL) was developed by Dr. Stephen Strack as a measure of Theodore Millon’s eight basic personality patterns: Introversive, Inhibited, Cooperative, Sociable, Confident, Forceful, Respectful, and Sensitive. While the PACL is targeted towards assessing personality in “normal” individuals and counseling psychotherapy clients, the PACL also screens for individuals with personality problems that may warrant further testing for personality disorder.

To interpret PACL scores, I highly recommend using the report. The PACL report describes personality styles with language that closely resembles that found in the Diagnostic and Statistics Manual of Mental Disorders – Fifth Edition (DSM-5; American Psychiatric Association (APA), 2013). The report provides very specific interpretation of an individual’s PACL scores by considering the two highest scores and the individual’s gender. The interpretation includes a description of the individual’s interpersonal style and self-perception, vocational interests and behaviors, and treatment considerations for his or her specific style. The report also includes three validity indices for the individual’s scores: random response, favorable response, and unfavorable response. Knowing how likely the individual gave an honest and unbiased response is crucial before beginning treatment based on possibly biased results.

Abuse Risk Inventory for Women

The Abuse Risk Inventory for Women (ARI) was developed by Dr. Bonnie L. Yegidis as a quick and objective screening tool to help identify women who are abused or at risk for abuse. This inventory is particularly useful in helping professionals obtain information about a woman and her abusive situation without the necessity of discussing her experience with, most likely, a complete stranger. The ARI collects information about what kind of abuse may be occurring, how severe the abuse is, and socio-demographic information and history such as age, race, length of relationship, and marital status. The higher the score, the more likely the woman is to be experiencing – or is at risk for – abuse. By reviewing the inventory directly, the social service worker or health care professional can identify what type of abuse is occurring and how severe that abuse is.

Dr. Yegidis, with M. Elizabeth Vonk, created a workbook to supplement the ARI called Abuse Risk Inventory for Women Workbook: Understand and Getting Free of Abuse (Published by Mind Garden, Inc., 1996). The workbook clearly indentifies abuse in all forms and provides worksheets to help women assess their own relationship and brainstorm their options for decreasing their risk for abuse – including the possibility that they are not safe in their relationship. If abuse is occurring, the workbook also outlines tips for how women can end their abuse and how they should prepare to take those steps. The workbook recognizes that ending abuse is a difficult and scary task and one that no woman should do alone. By emphasizing the importance of admitting abuse is happening, building support systems, and acknowledging that she deserves an abuse-free life, this workbook helps women build their foundation for ending abuse.

Closing Thoughts

Each of these four psychological assessments has significant value to the clinical field. They all provide important information for identification, severity assessment, and treatment of psychological distress and dysfunction. These four are just a sample of what psychological assessment has to offer the clinical field. For a complete list of clinical assessments published by Mind Garden, click here.