Evidence-Based Psychological Assessment

ABSTRACT

In recent years there has been increasing emphasis on evidence-based practice in psychology (EBPP), and as is true in most health care professions, the primary focus of EBPP has been on treatment. Comparatively little attention has been devoted to applying the principles of EBPP to psychological assessment, despite the fact that assessment plays a central role in myriad domains of empirical and applied psychology (e.g., research, forensics, behavioral health, risk management, diagnosis and classification in mental health settings, documentation of neuropsychological impairment and recovery, personnel selection and placement in organizational contexts). This article outlines the central elements of evidence-based psychological assessment (EBPA), using the American Psychological Association's tripartite definition of EBPP as integration of the best available research with clinical expertise in the context of patient characteristics, culture, and preferences. After discussing strategies for conceptualizing and operationalizing evidence-based testing and evidence-based assessment, 6 core skills and 3 meta-skills that underlie proficiency in psychological assessment are described. The integration of patient characteristics, culture, and preferences is discussed in terms of the complex interaction of patient and assessor identities and values throughout the assessment process. A preliminary framework for implementing EBPA is offered, and avenues for continued refinement and growth are described.

Notes

¹ EBPP also has roots in Witmer's (1907/1996) early writings, was reified in the Boulder Model (the “scientist-practitioner model”) developed shortly after World War II (Shakow et al., 1947), and has since been elaborated and refined extensively (e.g., Hollon et al., 2014; Spring, 2007).

² Most process-focused studies of test score validity document the existence of underlying processes by introducing manipulations designed to alter those processes, then assessing the impact of these manipulations on test scores. For example, Bornstein, Bowers, and Bonner (1996) used a mood manipulation to demonstrate that affect state helps shape RIM dependency scores, but not self-report dependency scores. Arntz, Klokman, and Sieswerda (2005) used an emotional arousal manipulation to document the impact of negative emotionality on responses to self-report indexes of borderline pathology. Brand and Chasson (2015) used instructional manipulations to quantify the degree to which respondents' deliberate self-presentation strategies affect Minnesota Multiphasic Personality Inventory–2 (MMPI–2) scores and profile configurations. Detailed discussions of procedures for assessing process-focused test score validity are provided by Bornstein (2009, 2011).

³ Obtaining feedback regarding the accuracy and informativeness of assessment data is feasible only for certain types of patients; children, psychotic patients, dementia patients, and others whose thought processes and communication skills are compromised might not be able to provide useful information in this area.

⁴ There are currently 15 recognized competencies in psychology (see Kaslow et al., 2009; Kaslow et al., 2007). Seven of these (Professionalism, Reflective Practice, Scientific Knowledge and Methods, Relationships, Individual and Cultural Diversity, Ethical and Legal Standards and Policy, and Interdisciplinary Systems) are considered foundational; the other eight (Assessment, Intervention, Research and Evaluation, Supervision, Administration, Advocacy, Consultation, and Teaching) are functional.

⁵ The PCMH model, currently being implemented in the United States, evolved in part as a response to high costs and modest outcomes associated with the traditional insurance-based health care model (McDaniel & DeGruy, 2014; Squires & Anderson, 2015). Thus, these conclusions might apply most directly to health care practice (including psychological assessment practice) in the United States. As Schablosky (2008) noted, however, certain elements of the PCMH are characteristic of other nations' health care systems as well. Moreover, just as changes to accommodate increasing health care costs in the United States have influenced health care policy in other countries, aspects of other countries' health care models are gradually being integrated into the U.S. health care system (see Squires, 2011; Wallace, 2013).

⁶ Finn's (2007, 2011) TA model is based in part on Swann, Chang-Schneider, and McClarty's (2007) self-verification theory, which contends that most people are motivated to seek confirmation that their perceptions of self and others are accurate. Thus, too direct a challenge to the patient's status quo might be unsettling, but assessment feedback provided gradually, in manageable “doses,” has the potential to motivate patients to engage the assessment process more deeply, and understand themselves better. With this in mind, Finn (1996) argued that assessment feedback should be offered to patients in a stepwise manner, moving from information that is generally consistent with the patient's self-concept toward information that increasingly challenges the person's understanding of himself or herself.