If you're a psychologist and a patient comes to see you, how do you know what is wrong? In this lesson, we'll look at clinical psychological assessments and how psychologists use them.
Imagine for a moment that you are a successful psychologist. Cynthia comes to see you because she's having a problem. How do you treat her? How do you even know what's wrong with her?
Clinical assessment is a way of diagnosing and planning treatment for a patient that involves evaluating someone in order to figure out what is wrong. There are many types of psychological assessments, all of which have their own strengths and weaknesses.
What's the point of assessment? To answer that, let's go back to the moment that Cynthia walks into your office. She tells you that she's feeling very stressed out and anxious because she keeps forgetting things. She used to be really on top of things, but recently she has trouble remembering where she parked her car or what she did just a few minutes ago.
What's wrong with Cynthia? There are many things that can cause memory loss. The only way that you can find out what's wrong with her is to do some sort of evaluation. Clinical assessments help you, the psychologist, to know what might be causing problems for your patient.
Let's look closer at three common types of clinical assessments: clinical interviews, neurological and biological testing and intelligence testing.
Okay. So Cynthia comes to your office and complains of how she's been forgetting things. The first place that many psychologists start with a patient like Cynthia is with a clinical interview.
A clinical interview is a discussion in which the psychologist asks specific, open-ended questions in order to assess a client's thoughts, behaviors and feelings. It is often referred to as a conversation with a purpose.
When Cynthia comes into your office, you sit down with her and begin by asking what brought her to see you. This is when she first complains of her memory loss. From there, you can ask her many other questions to get more information. You could ask her for specific examples of when she's forgotten something, when the memory loss began, what other symptoms she's experiencing, what has been going on in her life and many other questions.
The essence of the clinical interview is to get a good grasp on how the patient sees his or her situation and to try to get a clear picture of what the patient's thoughts, feelings and behaviors are when she is not in your office.
Clinical interviews can be done in many different ways. The structure, formality, medical discussion and time all depend on the specific situation and what you, as the psychologist, are trying to understand about your patient.
After you interview Cynthia, you believe that she might be suffering from dementia, a special type of memory loss and cognitive dysfunction that can be caused by many different things. So, like many psychologists, you decide that the clinical interview is not good enough. In this case, you want more assessments to be done.
Neurological and Biological Tests
Another type of clinical assessment is neurological and biological testing, which consists of an examination of the patient's brain and/or physical body to try to diagnose psychological issues.
In Cynthia's case, you know that dementia might be caused by problems in the brain. A brain scan can show you where Cynthia might have problems, such as lesions caused by a stroke. Seeing Cynthia's brain can help mental health professionals understand underlying causes of some disorders.
If Cynthia's brain scan shows a problem, the first step in treatment would be to try to treat the physical cause. For example, if Cynthia's brain scan showed that she had lost significant brain mass, then she might have Alzheimer's disease. While there is no cure for Alzheimer's, there are several treatments that could help slow the degeneration and help with her dementia.
But, what if Cynthia's neurological and biological tests come back normal? Does that mean that she doesn't have a problem? Well, not exactly. There are still many psychological problems dealing with memory that might not show up in physical tests. In fact, dementia itself could be caused by something that doesn't show up in Cynthia's medical tests.
One other type of psychological assessment that might help you figure out what's happening with Cynthia is intelligence, or IQ, tests. Intelligence testing looks at how close to normal a person's mental skills and abilities are.
Though there are many valid criticisms of intelligence testing, it can be a valuable tool for assessment in some individuals. For example, people who fall very far at either ends of the scale (meaning that they are particularly skilled or very lacking) can be identified. In fact, some psychological disorders, such as mental retardation, are diagnosed based on intelligence testing.
But, there's an even more useful tool in intelligence testing. Because scores on intelligence tests are adjusted for age, comparing a person's scores over time can give psychologists a good view of whether they are losing mental capacity or not.
Remember Cynthia? If you had an IQ test that she had taken several years ago, you could compare her scores back then to her scores today. If there's no difference, then her forgetfulness might just be normal or a reaction to stress. But, if she scores quite a bit lower, that means that she's losing mental ability. This can help clue you in to a cognitive problem she might be having, like dementia.
In order to diagnose patients, psychologists rely on clinical assessments, or tests that help them understand what the patient is going through. A clinical interview is often the first assessment that a psychologist administers, and it involves talking with a patient in a focused way to gather information about their issues. Neurological and biological testing might be necessary to find underlying medical causes of psychological problems. Finally, intelligence testing can tell a psychologist whether a patient is far below average in mental capacity and/or if she has lost mental capacity over time.
After you have finished with this lesson, you'll be able to:
- Identify the importance of clinical assessments
- Describe three types of clinical assessments: clinical interview, neurological and biological testing and intelligence testing
- Explain how comparing a person's intelligence tests throughout their life can be a good indicator of mental capacity