On the Way to Collaborative Psychological Assessment

The Selected Works of Constance T. Fischer

Constance T Fischer

• Publisher: Routledge
• Year: 2016
• ISBN:
  9781317485629
• Edition: 1
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

This collection of articles by Constance T. Fischer represents many of her major contributions to Collaborative Therapeutic Assessment. Fischer's work on the conceptual foundations and practices for individualized/ collaborative psychological assessment are assembled in this volume. Also included are her thoughts about how to teach individualized assessment to students. This monograph will serve mental health professionals interested in Collaborative Therapeutic Assessment and instructors and students in graduate courses on psychological assessment.

Part I

The Development of Collaborative/Individualized Assessment

Chapter 1

The Testee as Co-evaluator¹

The basics of an existentially oriented view of man are proposed as the foundation for an alternative to the determinism and medical models of human functioning. This view is identified as implicitly underlying ethics codes, the movement toward greater client direction of clinical relationships, the social learning and reeducation conceptions, and the advocation of clinical work by nondoctoral persons. Recommendations arising from the existential position are made for psychological testing: coadvisement (client and tester discuss their perspectives on the testing situation), sharing impressions (about the client), writing everyday language, client’s critique of the written evaluation, and client’s designation of report receivers.

Criticism of the prevailing medical model of “mental illness” is articulate and widespread (e.g., Albee, 1968; Mariner, 1967; Szasz, 1960). However, the only thoroughgoing alternative seems to have been a general social learning model of the sort described by Bandura (Bandura, 1965; Bandura & Walters, 1963) or the behavior therapy learning model (cf. Eysenck, 1960). Where these have been posited as a framework for successful rehabilitation efforts in the field rather than in the laboratory, scrutiny reveals inadequate correspondence with rigorous learning theory (cf. Breger & McGaugh, 1965, 1966). The learning model, at least in its present form, which is rooted in animal research, has not been a convincing alternative. What is required is an explicit foundation for psychology as a uniquely human science. A systematic alternative to the medical model could then be developed from this foundation, to be followed by concrete recommendation for practice. In turn, the consequences of these practices would serve as criteria for research and subsequent validation, development, or refutation of the new model.

The present paper presents the rudiments of an existentially oriented view of man as the foundation for psychology as a human science. Concrete recommendations for psychodiagnostic psychology are then drawn. Most of these will be recognized as similar to ones now appearing in professional literature. However, there the justifications are given in terms of ethics, democracy, and the need to circumvent legislative regulation. The first two of these, at least, are not consonant with the prevailing emphasis on stimulus-response determinism and medical disease analogues. They are, however, singularly consonant with an existential perspective. Indeed, they reflect an implicit recognition of its validity. So also does the current reeducation analogue of psychological practice (Albee, 1968; Hobbs, 1964). Further, many individual clinicians actually work in greater accord with the existential view than with the theories to which they give lip service.

The existential perspective has implications for all the fields of psychology, and already has been actualized significantly in the area of psychotherapy and counseling, although often without systematic rationale. However, the recommendations proposed here are directed to psychological, especially psychodiagnostic, testing. The latter typifies use of determinism and medical assumptions. For example, the psychological tester usually has received a referral requesting a differential diagnosis, evaluation of a disorder’s degree of severity, or a measurement of potential – in units of IQ, language skill, or whatever. The psychologist is as scientifically objective as is humanly possible as he examines the testee through complex, theoretically grounded, empirically validated instruments. He synthesizes the results in technical, professional idiom in a written report. This is sent to the referring psychiatrist, therapist, school official, or employment officer. The recipient may interpret the outcome to the testee. The report is filed permanently and marked “Confidential – Qualified Personnel Only.” The above sequence usually flows undisrupted. But what of a testee who asks to read the report himself? Or who receives a verbal resumé, and insists that the psychologist is wrong? What of the person who requests that the report be available only to those whom he specifies, or that the report specifically be unavailable to, say, his child’s teacher? What of the testee who refuses to pay for an evaluation he has not seen? All of these efforts are usually rebuffed by disclaiming psychology as either a business or as merely a personal service. Diagnostic psychology is instead said to be a science of the causes and signs of disordered behavior, humanely and judiciously practiced. Like medicine, its complex knowledge and skills simply must be trusted by the layman. The professional will tell him as much as he needs and is ready to know. The layman’s responsibility is to try to accept and abide by professional judgment, although of course he may seek additional judgments.

Man as Co-constitutor of His Experience

The present paper posits that the above tradition is inadequate for man as more-than-body. Further, it holds that such practice impedes the client’s positive growth. The basic assumption of an existential perspective is presented below as a constructive alternative, and as a source of concrete recommendations for testing practice.

Specifically, then, it is proposed here that (a) a person behaves in accordance with his own experience, that is, the meaning to him of his relationships with persons, objects, events. He is never a passive recipient in his relationships, but instead co-constitutes their meanings. That is, he can experience “things” only from his own perspectives. To put it another way, “things” cannot exist for a man outside of the way they are for him. His perspectives, of course, can and do change by narrowing or growing. It is also proposed that (b) a person can be capable of multiple perspectives, and that his openness to meanings is his uniquely human nature. To the extent that this relationship with the surrounding world is truncated, a person is less fully human. Relative fullness is psychological “health”; the various forms of constriction are “abnormality.”

The general implications of the above position for psychological evaluation of a client is that to understand his past behavior, predict his future behavior, or identify feasible possibilities, the client’s perspectives must be understood. They must be understood as closely as possible as his experience in his relationships. Preconceived constructs are inapplicable and irrelevant to the experiences in accordance with which he continues his living. Further, it is the client himself who is in the best position to confirm or clarify the evaluator’s impressions.

There are also implications for an evaluation’s effects on the client. If the evaluation is to facilitate positive change, the client must experience his limited possibilities for experience and behavior, as identified by the psychologist, as constrictions in his own way of living. And he must then experience any recommendations as desirable new variations of his own way of life, ones of which he feels at least minimally capable. Furthermore, if he is to grasp these suggested means of expanding his mode of life as feasible, he must experience them through positive relationships. The first of these should be his relationship with the evaluator, through which he can find himself as capable of further actualizing the perspectives which even now are broadening.

On the other hand, the psychological evaluation can have negative, narrowing effects. If the report is not directed to the client, but instead is received in various forms by, say, teachers, family, and administrators, then these persons may actively delimit his range of experience. For example, he may be classified as mentally retarded, and hence not be given a chance to attend regular schools and social functions, or to try to mow the lawn or play sandlot ball. As another example, the client might be classified as harboring unconscious hostility toward authority figures, and subsequently his complaints and critical observations would not be taken in their own right; he would not participate in authentic dialogue.

The client’s relationships also can be limited indirectly through the ways in which the report receivers relate with him. He is his relationships with others. If he finds himself in these relationships as, for example, the inferior one, the crazy one, or the hostile one, then he is indeed at least partially these things. Further, these then become possible personal modes of relating with persons other than the report receivers.

The Testee as Co-evaluator

To the extent that the above view of man as co-constitutor of his experience is valid and is to be fruitful for clinical psychologists, a congruent, systematic revision of testing procedures must be attempted:

1. Coadvisement. If the client is to experience the testing situation as one through which he may come to expand his life then he must be actively involved to that end. On the one hand, the tester advises him of the referral’s source and apparent reasons. In layman’s language, he explains his role, the use of his tests, their merits and limitations, what sorts of information will go in the report, and finally, who might read the report. Subsequent agreement to be tested is an important affirmation of the mutuality of the testing endeavor. On the other hand, the tester asks the client to express his view of the purpose of testing and its possible outcomes. The significance of pursuant test responses is to be comprehended within this context. To repeat the key theme of this paper: The person behaves in accordance with his grasp of a situation; to understand that behavior the tester must be aware of that particular grasp. Also important, but difficult to ascertain directly, is the client’s perception of the tester (cf. Leventhal, Gluck, Slepian, & Rosenblatt, 1962). Indeed, it has been established empirically that differences in such perceptions yield variations in performance (cf. Fiske, 1967; Sattler & Theye, 1967) – the client responds not to objectively standardized materials and procedures, but through his co-constituted experience of them.

“The psychologist believes in the dignity and worth of the individual human being.” It may be that the preamble to the American Psychological Association Code of Ethics (1963) expresses implicit recognition of the individual’s co-constitution of his experience. Unless the validity of personally co-constituted experience is recognized, the person does not stand as an individual; his particular dignity and worth cannot be affirmed until he is understood from his perspectives. The same implicit recognition may be seen in Principles 7d and 8 of the Code: Testing proceeds

… only after making certain that the responsible person is fully aware of the purposes of the interview, testing, or evaluation and of the ways in which the information may be used [p. 57].

The psychologist informs his prospective client of the important aspects of the potential relationship that might affect the client’s decision to enter the relationship [p. 58].

These standards, too often ignored in practice, frequently are classified as “ethics,” in a different realm from psychological theory. This nationally accepted code remains closer to universal experience – the original foundation of codes and theories alike – than do most of our overly reductive theories.

2. Sharing impressions. By the end of the testing session, the psychologist has begun to “make sense of” the client. But the latter behaves in accordance with what is real for him, and not with what the psychologist thinks is real for him; the tester must now dialogue rather than diagnose, in order to approximate the client’s experience. This is not to say, however, that the person’s experience is a reflected one, one of which he was or is conscious and able to articulate. Hence, the psychologist must ask himself such questions as, What sort of relationship must this person have with the kind of material on these Wechsler Adult Intelligence Scale subtests that these behaviors and levels of performance could emerge? Obviously, the narrower the psychologist’s experiences and the more rigidly he adheres to them, the less competent he is to comprehend the other person’s world.

A sample of the psychologist (P) and client (C) sharing impressions is given below:

P:	Did you notice you didn’t do as well on the arithmetic part and the part where you said numbers back to me? You know, on both those kinds of problems, you had to figure in your head. I wonder if you have trouble with those same things out in life, like on the job?
C:	Well, yeah, that’s right. But it doesn’t matter about numbers – it’s doing it in my head. I just always know that I can’t get things to work out when I’ve got to keep numbers in my head, or like those block pictures.
P:	I hadn’t thought of that. I guess you did do better on the first half of the test where you were telling me answers about everyday things than you did on the last half where you had to quietly figure out the answers to abstract, new kinds of problems, and then tell me the answer.
C:	Sure, I’m always at my best when I’m talking to people. It’s like I know where I stand. Like in a business conference, I can talk up a really great idea, and everybody’s impressed. But I’m sure not the guy to write it out by myself, or figure out a cost analysis. I just know I’m beat before I start – so I don’t.
P:	So when jobs call for you to work on your own you see that as equivalent to certain failure. Therefore, you never try to do them?
C:	That’s what I just said.

The psychologist would continue in a similar manner, bringing in observations from the other tests and techniques until mutual closure is reached. Presuming that by this time he has some familiarity with the client’s life situation, he can now discuss possible new experiences through which the client might develop broader perspectives. For example, the above psychologist might offer, along with other suggestions, a programmed sequence of mathematics homework, beginning at a level where the client feels quite capable. In this way, he might gradually come to experience “loner,” intellectual tasks in a light that permits positive challenge and confidence to emerge. Implied here is that insight is not necessarily requisite to broadening of perspectives; new experiences can be adequate.

At least one psychologist has published a test based in part on the above points. McMahon (1969) presents true-false “personality” items in couplet fashion, so that the person can qualify the significance of his response. Then, he and the counselor review the items together in a joint delineation of problems as the client sees them.

3. Writing everyday language. If the report receivers are to comprehend the client’s world as he experiences it, then that is what the report should describe. Professional jargon reduces the client to predetermined categories, and despite their increasing popularization, they cannot encompass the person’s experiences as his own. “Repressed hostility is displaced toward inanimate objects, and is released in impulsive outbursts” leaves the reader guessing as to the concrete referents of each term. He can do little more than guess at how such information could be helpful to the person; indeed, the implication of much s...

Table of contents

• Cover
• Endorsement
• Half Title
• Series Information
• Title Page
• Copyright Page
• Table of contents
• List of works
• Foreword
• Preface
• Introduction: Carrying On Toward Individualized/Collaborative/Therapeutic Psychological Assessment
• Part I The Development of Collaborative/Individualized Assessment
• Part II Practicing Collaborative/Individualized Assessment
• Part III Teaching Collaborative/Individualized Assessment
• Index