Clinical Assessment:

Interview and Intelligence

Assessments
Zoltan Kovary PhD
ELTE PPK
Department of Clinical Psychology and Addictology
2015/16 Autumn Semester

The
Assessment
in Clinical
Psychology

The definition of
psychological assessment
Psychological assessment
is a process of testing that
uses a combination of
techniques to help arrive
at some hypotheses about
a person and their
behavior, personality and
capabilities.

Jane Framingham, PhD

Psychcentral.com

Historical outline

After WW 2
The clinical psychologist, as
expert of
diagnosis/assessment
1960s & 70s
Decline in interest therapies
1980s
Renewal and growth
New areas

forensic psychology
neuropsychology
DSM III

Definition & purpose

An ongoing process
Evaluation of an individuals
strengths and weaknesses
Conceptualization of the problem
Identifying etiological factors
Prognosis
Prescription for alleviating the
problem (indication &
contraindication)
Assess the suitability of the
patient for therapy

The referral/clinical question

The referral question: starting

point
Most important issues
Abnormal
mental/psychological state
Abnormal traits
Psychodynamics
The level of adaptation
Coping
Intelligence
Depends on the clinicians
theoretical commitment!

Tools of clinical
psychological assessment

Interview (first, never miss)

Intelligence assessment
IQ level
Structure of intelligence
At the last occasion, to avoid the
effects of performance
orientation!

Behavior assessment

Personality assessment (tests)

Objective tests

Traits

Projective tests

Psychodynamics

The interview

General characteristics of
interview

Interaction

Personal conditions of the interviewer

Not ordinary conversation, but a

planned and goal oriented interaction
To elicit data, information, beliefs and
attitudes
Professional knowledge
Skills
Sensitivity

Basic forms

Structured, unstructured,
semistructured

Interviewing Essentials and

Techniques

Physical settings
Privacy
Protection from interruptions
Time frames
Nature of the patients
Skills: training & supervision
Documentation
Note taking?
Recording?

Rapport

The quality of relationship between patient

and clinician
A comfortable atmosphere and a mutual
understanding of the purpose of the
interview
Characteristics

Can be achieved in many ways, there are no

certain tricks
It does not require to like the patient or
befriending with her/him
It is a relationship founded on respect,
mutual confidence, trust, and a certain
degree of permissiveness
Rogers: therapeutic triad

Empathy
Unconditioned positive regard
Congruency

Communication

To ensure maximum
communication
Beginning a Session a
casual question
Use a language that the
patient can understand

Avoid jargon
Avoid infantilization
Dont identify with the patient!

Questions

Avoid interrogation!
Become progressively more
structured as the interview
proceeds

Interview Question Types

Communication

Silence
Can mean many things!
Assess its meaning and function in
the context of the specific
interview
The response
Listening
Be an active listener!
Gratification of the self
You must resist the temptation to
shift the focus to yourselves
Clinicians should avoid discussing
their personal lives or opinions
The impact, background & values of
the clinician can count!

Things to avoid during the

sessions

Expression of consternation
Excessive worry
Moral judgement
Punishing behavior
Criticism
False promises
Personal references, boasting
Scaring the patient
Charging the patient with our
own problems
Intolerance
Argues (political, spiritual)

Persiflage
Dispraise
Blaming for failures
Rejection
Prejudices
Dogmatic templates
Early, deep interpretations
Dogmatic dream analyses
Forcing the exploration of
traumatic contents
Flattering
Unnecessary encouragement

Frames of references

The Patients

Beliefs
Expectations
Goals vs advantages of
illness
External pressure
Anxiety
Psychological games

The Clinicians

Preparedness
Purposes
Objectivity vs coldness,
aloofness
Has to give feedbacks
and form a plan

The content and structure

of the interview

The most important contents

of the interview

Actual/ cross sectional

part

The history of the

patients
illness/disorder/problems

Longitudinal section

The history of the

patients life

Cross sectional part

Identifying
The main complaints
The history of the illness/problem
Formation
Its role in the patients life
Personal coping
Previous interventions
Actual social and existential
status
Personal impressions

Personal life history

Early childhood, family roots

Childhood
Kindergarden
School
Adolescence
Sexual maturation
Identity
Adulthood
Profession
Marriage/family life

Sources of the information: The three layers

of the content according to Argelander

Objective informations
Verifiable data
Subjective informations
The personal meaning of
events
Scenic informations
The experience of the
situation
Behavior
The interviewer is involved
The clinician has to integrate these kind of informations!!!

The three logical levels of the

interview

Judgement about the

present situation &
emergency decision
Anamnesis and
personality diagnostics
Psychodinamic
understanding

1. Judgement about the present situation &

emergency decision

Prior knowledge
Observation

Scenic behavior
(Argelander)

Empathy
It should be able to
quote later

Decision about what?

Crisis
Suicide risk
The need for
hospitalisation

Toxication
Acut psychosis

Medication
Psychotherapy
Manifesting in action

2. Anamnesis and personality diagnosis

Reconstruction of the
problems and complaints
Objective and subjective
informations (Argelander)
Psychological, social and
existential status
Coping
Developmental aspects

3. Psychodynamic understanding

Ego-strength
Defence mechanisms
Regression
Primary and
secondary gains of
illness
The meaning of
illness
Requires empathy

Varietes of interviews

The intake-admission interview

The crisis interview

Depends on the purposes of diagnosis

The case history interview

E.g. juristic cases

The diagnostic interview

Immediate intervention
Flexible frames

The mental status examination interview

Orientation
Information

Deatiled life history

First interview in psychotherapy

Psychodynamic
Cognitive

Assessment of Intelligence

Intelligence

A. Binet (1857-1911)

Intelligentia quotiens (IQ)

Ch. Spearman (1863-1945)

Verbal and performative

intelligences (VQ & PQ = IQ)

R. Cattel (1905-1998)

Seven primary mental abilities

D. Wechsler (1897-1981)

Special and general intelligences

L. Thurstone (1997-1955)

Mental age/biological age X100

Crystallized & fluid intelligences

H. Gardner (1943)

Multiple intelligences

ALL OF THESE ARE CONSTRUCTIONS, INTELLIGENCE IS WHAT

INTELLIGENCE TEST MEASURE!!!

Raymond Cattels theory of

crystallized and fluid intelligence

Gardners theory of multiple

intelligences

IQ levels

The structure of intelligence

according to Wechsler test

Assessment

What is the clinical question?

Dementia?
Choice: Mini Mental State
IQ? (Compos mentis)
Choice: Raven
Progressive Matrices
https://www.raventes
t.net/
Intelligence structure?
Intelligence deficit type?
Choice: Wechsler (WAIS
III, IV)

WAIS IQ Verbal subtest

WAIS IQ Performance subtests

Thank you for your

attention!