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FOR INFORMATION: Copyright  2014 by SAGE Publications, Inc.

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Psychological assessment and report writing / Karen
SAGE Publications Asia-Pacific Pte. Ltd. Goldfinger, Andrew M. Pomerantz. — Second edition.
3 Church Street
#10-04 Samsung Hub pages cm
Includes bibliographical references and index.
Singapore 049483

ISBN 978-1-4522-5910-9 (pbk. : alk. paper)

1. Psychology—Methodology. 2. Behavioral assessment.

3. Report writing. I. Pomerantz, Andrew M. II. Title.

BF38.5.G65 2014
150.28′7—dc23   2013002598

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Brief Contents

Acknowledgments xiii

PART I: PREPARING TO CONDUCT A

PSYCHOLOGICAL ASSESSMENT 1
Chapter 1 Introduction 2
Chapter 2 Context: The Framework for the Report 12
Chapter 3 Cultural Competence in Psychological Assessment 29
Chapter 4 Evidence-Based Psychological Assessment 40

PART II: GATHERING INFORMATION AND

DRAWING CONCLUSIONS 51
Chapter 5 Gathering Information 52
Chapter 6 Gathering Information: Measures of Intellectual,
Academic, and Neuropsychological Functioning 66
Chapter 7 Gathering Information: Measures of Personality 80
Chapter 8 Gathering Information: Clinical Interviews,
Review of Records, and Measures of Behavioral
and Emotional Functioning 96
Chapter 9 Technological Advances in Assessment 113
Chapter 10 Drawing Conclusions 123

PART III: COMMUNICATING ASSESSMENT RESULTS 141

Chapter 11 Form and Content of the Assessment Report 142
Chapter 12 Feedback After Psychological Testing 166
Chapter 13 Writing Style 178
PART IV: ETHICS AND LEGAL ISSUES 189
Chapter 14 Ethics of Assessment and Report Writing 190
Chapter 15 Legal Issues in Assessment and Report Writing 206

References 213
Index 225
About the Authors 241
Contents

Acknowledgments xiii

PART I: PREPARING TO CONDUCT

A PSYCHOLOGICAL ASSESSMENT 1
Chapter 1 Introduction 2
A Brief History of Psychological Testing and
Assessment and Some Definitions 2
Difficulties in Mastering Psychological Assessment 4
Purpose and Goals of This Book 5
How to Use This Book 8
Chapters and Their Contents 8
Chapter 2 Context: The Framework for the Report 12
Initiation and Funding of the Assessment 13
Why Was the Client Referred? Implicit and Explicit
Reasons for Referral 15
Primary and Secondary Audiences for the Findings 19
Client and Clinician Attributes 20
Systems Issues 22
How Do These Factors Frame the Report? 24
Context Worksheet 24
Chapter 3 Cultural Competence in Psychological Assessment 29
Cultural Competence in Assessment: The Larger Context 29
What Is Cultural Competence? 30
What Constitutes a Culture? 33
Cultural Competence in Clinical Interviews 35
Cultural Competence in Testing and Report Writing 36
Chapter 4 Evidence-Based Psychological Assessment 40
Evidence-Based Assessment: The Larger Context 40
What Does Evidence-Based Assessment Mean? 41
Defining Evidence-Based Assessment 41
The Day-to-Day Meaning of Evidence-Based Assessment 43
 What Is the Purpose of Evidence-Based Assessment? 44
How Do Psychologists Learn About
Evidence-Based Assessment Techniques? 44
Evidence-Based Clinical Interviews 45
Limitations of Evidence-Based Assessment 47

PART II: GATHERING INFORMATION AND

DRAWING CONCLUSIONS 51
Chapter 5 Gathering Information 52
The Functions of Information 52
Challenges in Gathering Information 54
Limitations of the Clinician 54
Limitations of Tests and Techniques 55
Steps in Gathering Information 56
Identify the Referral Questions 57
Learn About the Problem 57
Review Records 58
Identify the Domains of Functioning
That Need to Be Assessed 59
Select Tests and Other Assessment Procedures 61
Administer, Score, and Interpret Tests 61
Determine Reliability, Validity, and
Usefulness of the Data 63
Case Example 63
Chapter 6 Gathering Information: Measures of Intellectual,
Academic, and Neuropsychological Functioning 66
Intelligence Tests 66
Defining Intelligence 66
Wechsler Intelligence Tests 67
Stanford-Binet Intelligence Scales 68
Other Tests of Intelligence 69
Achievement Tests 70
Wechsler Individual Achievement
Test-Third Edition (WIAT-III) 70
Wide Range Achievement
Test-Fourth Edition (WRAT-4) 70
Other Achievement Tests 71
Neuropsychological Tests 71
Brief Neuropsychological Screens 72
Wechsler Memory Scale-Fourth Edition (WMS-IV) 73
Factors to Consider in Selecting Tests of Intelligence,
Achievement, and Neuropsychological Functioning 73
The Referral Question 74
The Client’s Culture and Language 74
 The Client’s Age 75
Time Restrictions 75
What to Include in the Assessment Report and
How to Include It 76

Chapter 7 Gathering Information: Measures of Personality 80

Objective Personality Tests 80
Minnesota Multiphasic Personality
Inventory-Second Edition (MMPI-2) 81
Minnesota Multiphasic Personality
Inventory-Adolescent (MMPI-A) 82
Personality Assessment Inventory (PAI) 83
Millon Clinical Multiaxial Inventory-Third Edition
(MCMI-III) 83
NEO Personality Inventory-Third Edition (NEO-PI-3) 84
California Psychological Inventory-
Third Edition (CPI-III) 84
Projective Personality Tests 85
Rorschach Inkblot Method 85
Thematic Apperception Test (TAT) 87
Rotter Incomplete Sentences Blank (RISB) 88
Kinetic Family Drawing (KFD) 88
Factors to Consider in Selecting Tests 89
The Referral Question 89
The Client’s Culture and Language 90
The Client’s Age 91
Time Restrictions 91
What to Include in the Assessment Report and How to Include It 92

Chapter 8 Gathering Information: Clinical Interviews,

Review of Records, and Measures of Behavioral
and Emotional Functioning 96
Clinical Interviews 96
Interviewing Parents and Guardians 99
Interviewing Collateral Informants 100
The Mental Status Exam 100
Review of Records 101
Symptom and Behavior Checklists 102
Broad-Based Symptoms and Behavior Checklists 102
Symptom Checklist-90–Revised (SCL-90-R) 102
Child Behavior Checklist (CBCL) 102
Targeted Symptom and Behavior Checklist 103
Beck Depression Inventory-II (BDI-II) 103
Beck Anxiety Inventory (BAI) 103
Conners-Third Edition (Conners-3) 104
Eating Disorder Inventory-3 (EDI-3) 104
 Vineland Adaptive Behavior Scales-
Second Edition (Vineland-II) 104
Behavior Assessment System for
Children-Second Edition (BASC-2) 105
Behavioral Assessment 105
Factors to Consider in Selecting Assessment Methods 106
The Referral Question 106
The Client’s Culture and Language 107
The Client’s Motivation 107
The Likelihood of the Assessor Conducting
Therapy With the Client 108
Time Restrictions 109
What to Include in the Assessment Report and
How to Include It 109
Chapter 9 Technological Advances in Assessment 113
Technological Advances in Test Administration 114
Technological Advances in Interviewing 115
Technological Advances in Test Scoring and
Reporting of Results 116
Technological Advances in Test Interpretation 117
Technological Advances in Report Preparation 118
Technological Advances in Behavioral Assessment 119
Ambulatory Assessment 119
Virtual Reality 120
Conclusion 120
Chapter 10 Drawing Conclusions 123
Find the Focus 124
Identify the Domains of Functioning 125
Organize and Integrate the Data 125
Deal With Disparities 127
Deal With Incidental Findings 132
Answer Referral Questions 133
Simple 133
Moderate 133
Complex 133
Develop Recommendations 134

PART III: COMMUNICATING ASSESSMENT RESULTS 141

Chapter 11 Form and Content of the Assessment Report 142
Form 143
Content 146
Identifying Information 146
Reason for Referral 146
Procedures 146
 Background Information 147
Behavioral Observations and Mental Status 149
Test Results and Interpretation 150
Reporting Interpretations of Test Scores
and Other Test Data 151
Summary and Recommendations 155
Sample Psychological Assessment Report 157

Chapter 12 Feedback After Psychological Testing 166

Definition of Feedback 167
Challenges and Opportunities 168
Theories, Evidence, and Guidance From the Literature 168
Strategies for Conducting a Feedback Session 171
Before the Meeting 171
During the Meeting 172
Additional Considerations for Child Evaluations 173
Case Examples 173
Simple 173
Moderate 174
Complex 175

Chapter 13 Writing Style 178

Clarity 178
Grammar 179
Wording 180
Readability 180
Accuracy 181
Test Administration 181
Interview and Record Review 182
Scoring and Interpretation 183
Reporting 183
Persuasiveness 183
Making Your Writing a Pleasure to Read and Finding Your Voice 185

PART IV: ETHICS AND LEGAL ISSUES 189

Chapter 14 Ethics of Assessment and Report Writing 190
Competence in Assessment 195
Confidentiality in Assessment 196
Obtaining Informed Consent to Assessment 199
Selecting Assessment Techniques 200
Drawing Conclusions and Communicating Results 202
Test Security Issues 203

Chapter 15 Legal Issues in Assessment and Report Writing 206

Forensic Psychology 206
Individuals With Disabilities Education Act 207
 Section 504 of the Rehabilitation Act of 1973 208
Family Educational Rights and Privacy Act 208
Health Insurance and Portability Accountability Act 209
Civil Rights Act of 1964 and Civil Rights Act of 1991 209
Americans With Disabilities Act 210
Right to Privacy 210
State Regulations 210
Enforcement of Laws, Regulations, Standards, and Guidelines 211

References 213
Index 225
About the Authors 241
Acknowledgments

Acknowledgments From Karen Goldfinger

The second edition of this book could not have been completed without the help of
numerous colleagues and friends. Stacey Sparks, a writer and editor, was my first
collaborator and helped me shape my ideas into book form. Lynda Smith, Lynn
Abrahamson, and Joy Alter Hubel were enthusiastic supporters from the beginning.
Jeff Turner reviewed the work in its early stages and gave me needed advice about
going forward with a proposal. Joshua Goldfinger and Martin Cieri provided a much
needed “writer’s retreat,” and I will be forever grateful to them for their support.
Marinus Tijl helped me think through some of the most complicated material, and
the resulting chapters would not have been nearly as effective without his input.
Shelly Pelletier and Pam Huebner contributed their wisdom to the chapter on
feedback, and I am grateful for their help. I also want to thank the editors at SAGE
for providing me with the opportunity to revise and expand the text, and I thank the
reviewers who gave such thoughtful commentary. I continue to be appreciative of
the opportunity to learn from my assessment clients and their families. I learned
about the needs of students from my supervisees and the doctoral students who took
assessment with me at the University of Hartford, and I thank them for teaching me.
Finally, the second edition of this book would never have been completed without
the hard work and talent of my coauthor, Andy Pomerantz, and I continue to be
appreciative of his willingness to collaborate with me on this project.

Acknowledgments From Andy Pomerantz

First and foremost, I would like to thank Karen Goldfinger for the opportunity to
participate on this revision. I truly appreciate her vision, expertise, patience, and
collaborative spirit. My wife, Melissa, always inspires me and supports all my efforts
through her love and friendship. My kids, Benjamin and Daniel, bring joy to my life
and meaning to all my work. My parents, Bill and Carol Pomerantz, have provided
a lifetime of love and support for all my efforts. Reid Hester and his colleagues at
SAGE provided great direction and support—many, many thanks to them. I have
learned a great deal from Mary Ellen Lepionka about textbook authorship, and to

xiii
xiv   PSYCHOLOGICAL ASSESSMENT AND REPORT WRITING

her I am indebted. The SIUE Department of Psychology allows my writing to

thrive. My graduate professors and supervisors from Saint Louis University and my
undergraduate professors at Washington University sparked my interest in clinical
psychology. The reviewers of the prospectus and chapter drafts of this book—listed
below—provided valuable feedback and enhanced the book in numerous ways:

Julie Taylor, University of Cumbria

David M. Feldman, Barry University
Victoria Wiese, Mount Mary College
Robin Steed, Louisiana State University at Shreveport

And finally, I thank my clients, especially my assessment clients, from whom

I have learned a great deal.
PART I

Preparing to Conduct
a Psychological
Assessment
 CHAPTER 1

Introduction

A Brief History of Psychological Testing

and Assessment and Some Definitions
Margaret came into the psychologist’s office wearing an old-fashioned housedress,
the kind that is a faded plaid and has snaps instead of buttons. She was accompa-
nied by a man in a business suit, her son Peter, who told the psychologist, “My
mother’s doctor told me to bring her in for the appointment and that you would
know what to do.” He was right. Dr. Shaw had called earlier in the week and told the
psychologist that he was concerned about Margaret’s memory and wanted her
tested to rule out dementia. On the day of the appointment, the psychologist had
Margaret and Peter complete the necessary paperwork. She began the assessment
with interviews. She then gave Margaret a brief battery of cognitive and memory
tests and a self-report depression inventory. When they were finished, she made a
follow-up appointment with Margaret and Peter to review the findings, and later in
the week she prepared a written report to send to Dr. Shaw.
Psychologists routinely conduct assessments, such as this one with Margaret, to
understand behavior, make decisions about people, manage risk, and develop treat-
ment plans. Human beings have made efforts toward these goals for centuries, across
civilizations and cultures. One can imagine that even in aboriginal tribes, leaders select
individuals to fulfill roles based on a relevant set of criteria, whether it is how fast they
can run, how accurately they can hit a target, or their leadership abilities. We know that
tests of one sort or another were used in both ancient Greece and ancient China to
select individuals to fulfill roles important to those cultures (see Matarazzo, 1990).
Psychology is a relatively new profession, but from its earliest days, assessment of
people to make decisions about them was one of its functions. Standardized tests of
intellectual functioning were developed early in the 20th century to make decisions
about educational placements, and personality assessment was first used in the early
1900s for employment selection. During World War I, soldiers were famously adminis-
tered intelligence testing in a group format, the Army Alpha and Beta series. The

2
 Chapter 1  Introduction   3

Rorschach was introduced in 1921, the Wechsler scales in 1939, and the MMPI
(Minnesota Multiphasic Personality Inventory) in 1940. These instruments, in revised
forms, are the most widely used tests in psychology today (Camara, Nathan, & Puente,
2000). Behavior rating scales, self-report inventories (e.g., Beck Depression Inventory II
[BDI-II]), and structured interviews are relatively new additions to the field and are
growing in popularity among clinicians (Kamphaus, Petoskey, & Rowe, 2000). A selected
list of psychological tests used with children, compiled by these three authors, includes
83 items. Camara and colleagues (2000) selected 120 tests to be used in a survey of
clinicians (clinical and neuropsychologists) and added 9 more that were written in
by clinicians. New tests are developed every year, and old ones are revised. A quick look
at publishers’ test catalogs suggests that psychological testing is a growth industry.
Psychological testing—the act of administering, scoring, and interpreting results
of a test that measures any one of a number of psychological functions, such as
cognitive ability, memory, or personality traits—is a straightforward process.
Psychological assessment is not. In psychological testing, the interpretation of
results is limited to description of the meaning of a score, and the only other data
that are relevant are concerned with the validity and reliability of that score based
on the relevance of normative data and the test subject’s behavior. However, scores
on an individual test, no matter how carefully it is chosen, administered, scored,
and interpreted, rarely provide sufficient information on which to base significant
decisions or an understanding of complex problems. In the reasonably straight-
forward scenario described above, Margaret would be poorly served if the psychologist
gave her a memory test, or even a battery of memory tests, and interpreted the
results without benefit of interviewing her and her son. Perhaps she has depression,
low intellectual functioning, or an anxiety disorder, any of which might affect test
results. Furthermore, careful interviews of Margaret and Peter add depth and eco-
logical validity to the findings and allow the psychologist to provide useful and
meaningful recommendations to Dr. Shaw and the patient’s family. As Meyer and
others (2001) note, “A psychological test is a dumb tool, and the worth of the tool
cannot be separated from the sophistication of the clinician who draws inferences
from it and then communicates with patients and other professionals” (p. 153).
Psychological assessment, in contrast to psychological testing,

is concerned with the clinician who takes a variety of test scores, generally
obtained from multiple test methods, and considers the data in the context of
history, referral information, and observed behavior to understand the person
being evaluated, to answer the referral questions, and then to communicate
findings to the patient, his or her significant others, and referral sources.
(Meyer et al., 2001, p. 143)

Joseph D. Matarazzo (1990), then president of the American Psychological

Association, noted in his presidential address that “assessment of intelligence,
personality, or type or level of impairment is a highly complex operation that
involves extracting diagnostic meaning from an individual’s personal history
and objectively recorded test scores” (p. 1000).
4   PART I  PREPARING TO CONDUCT A PSYCHOLOGICAL ASSESSMENT

Difficulties in Mastering Psychological Assessment

Learning how to administer, score, and interpret test results is a challenge in itself;
and a psychologist needs to know a great deal more to conduct a psychological
assessment. It is not a simple task, and for many students, one that they never
embrace. Students need to know the following:

•• Test and measurement theory

•• The specifics of administering, scoring, and interpreting a variety of tests
•• Theories of personality, development, and abnormal behavior
•• Details related to the purpose and context of the evaluation, such as legal
issues in a forensic evaluation or special education regulations in an assess-
ment for a school
•• How to conduct an interview and mental status examination
•• What to look for when they observe the client’s behavior
•• The legal and ethical regulations governing their work

They also need to have a working knowledge of psychopathology, including

Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.) [DSM-IV-TR]
diagnosis and, at least at a rudimentary level, brain functioning; and they need to
bring effective thinking and communication skills to the task.
The psychologist faced with evaluating Margaret, the client described above,
additionally needs to know the following:

•• What to ask the referring party, Dr. Shaw, and what to tell Dr. Shaw about the
evaluation process
•• What to tell Margaret and Peter about the assessment
•• How to develop rapport with Margaret and Peter
•• What to ask in the interview and how to ask it
•• How to choose which tests to administer and strategies for administering the
tests to someone who may have significant deficits
•• How to interpret test results and integrate test results with other information
in order to address referral questions
•• How to develop suitable recommendations
•• How to write a formal report and provide feedback to Margaret and her son

It is not surprising that students often respond to the challenges of learning assess-
ment skills defensively by avoiding it (“Why do I have to learn this? . . . I’m never
going to do assessments . . . they are a waste of time.”) or by overstating their abilities
(“Assessment is easy; why do we have to spend so much time learning and practicing
it?”). There is a lot to learn. The benefits of learning to conduct effective assessments
go beyond writing a good report for an assigned client and obtaining a strong recom-
mendation from a supervisor. First, developing a thorough understanding of complex
human behavior and being able to write about it effectively is a highly useful skill in
all psychological work, even that which does not involve formal assessment. Second,
the practice in thinking and communication skills that assessment requires enhances