In Our Clients' Shoes Theory and Techniques of Therapeutic
Assessment, 1st Edition
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In Our Clients’ Shoes
Theory and Techniques of Therapeutic Assessment
Stephen E. Finn
Psychology Press Psychology Press
Taylor & Francis Group Taylor & Francis Group
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New York, NY 10017 Hove, East Sussex BN3 2FA
© 2007 by Taylor & Francis Group, LLC
Psychology Press is an imprint of Taylor & Francis Group, an informa business Originally published
by Lawrence Erlbaum Associates
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Contents
Foreword
Constance T. Fischer
Preface
Acknowledgments
Part I
The History and Development of Therapeutic Assessment
1
Introduction: What Is Therapeutic Assessment?
2
Appreciating the Power and Potential of Psychological Assessment
3
Therapeutic Assessment: Would Harry Approve?
4
How Therapeutic Assessment Became Humanistic (written with Mary E.
Tonsager)
Part II
Specific Techniques of Therapeutic Assessment
5
Testing One’s Own Clients Mid-Therapy With the Rorschach
6
Giving Clients Feedback About “Defensive” Test Protocols
7
Assessment Feedback Integrating MMPI—2 and Rorschach Findings
8
Assessment Intervention Sessions: Using “Softer” Tests to Demonstrate
“Harder” Test Findings With Clients
9
One-Up, One-Down, and In-Between: A Collaborative Model of Assessment
Consultation
10
Therapeutic Assessment of a Man With “ADD”
11
Collaborative Sequence Analysis of the Rorschach
12
Using the Consensus Rorschach as an Assessment Intervention With Couples
13
“But I Was Only Trying to Help!”: Failure of a Therapeutic Assessment
14
Collaborative Child Assessment as a Family Systems Intervention
15
Teaching Therapeutic Assessment in a Required Graduate Course
Part III
Theoretical Developments
16
Please Tell Me That I’m Not Who I Fear I Am: Control-Mastery Theory and
Therapeutic Assessment
17
Challenges and Lessons of Intersubjectivity Theory for Psychological
Assessment
18
How Psychological Assessment Taught Me Compassion and Firmness
19
Conclusion: Practicing Therapeutic Assessment
References
Author Index
Subject Index
Descriptive Contents
Foreword
Constance T. Fischer
Preface
Acknowledgments
Part I
The History and Development of Therapeutic Assessment
1
Introduction: What Is Therapeutic Assessment?
The basic concepts and procedures of Therapeutic Assessment are
introduced.
2
Appreciating the Power and Potential of Psychological Assessment
Psychologists are challenged to acknowledge the life-changing power of
psychological assessment. The author tells about his first clinical
assessment as a psychology graduate student, through which he became
convinced that assessment could affect clients in profound ways.
3
Therapeutic Assessment: Would Harry Approve?
Links are drawn between the interpersonal theories of Harry Stack
Sullivan and the procedures of Therapeutic Assessment. The author’s
study of Sullivan helped shape Therapeutic Assessment.
4
How Therapeutic Assessment Became Humanistic (written with Mary E.
Tonsager)
The overlap is described between Therapeutic Assessment and Humanistic
Psychology. Humanistic procedures were incorporated into Therapeutic
Assessment because they proved to benefit clients.
Part II
Specific Techniques of Therapeutic Assessment
5
Testing One’s Own Clients Mid-Therapy With the Rorschach
Traditionally, assessors have been cautioned against giving the Rorschach
to their own psychotherapy clients. The author talks about instances when
this practice can be useful and provides four case examples.
6
Giving Clients Feedback About “Defensive” Test Protocols
Therapeutic Assessment views guarded or “defensive” test protocols as
signs that clients have conflicting motivations regarding an assessment.
Specific guidelines are presented about how to talk to such clients about
their test results.
7
Assessment Feedback Integrating MMPI—2 and Rorschach Findings
The MMPI—2 and Rorschach tap different levels of clients’ experience, and
this fact is important in understanding patterns of agreement and
disagreement between the two tests. Guidelines are presented for giving
feedback to clients with different patterns of scores and the author
illustrates these guidelines with a detailed case example.
8
Assessment Intervention Sessions: Using “Softer” Tests to Demonstrate
“Harder” Test Findings With Clients
This chapter details the steps in “assessment intervention sessions” in
Therapeutic Assessment, in which psychological tests are used in non-
standardized ways to help clients discover new insights suggested by
standardized testing. Several case examples are discussed.
9
One-Up, One-Down, and In-Between: A Collaborative Model of Assessment
Consultation
Therapeutic Assessment can be a useful way to consult to other clinicians
about clients they find puzzling or difficult. The author discusses ways to
structure such consultations to make the most impact on the client-
therapist system.
10
Therapeutic Assessment of a Man With “ADD”
This is a detailed case study of an adult therapeutic assessment, with
partial transcripts of a number of sessions. The case illustrates how to help
clients discover new insights about themselves that might otherwise be
rejected at the end of an assessment.
11
Collaborative Sequence Analysis of the Rorschach
A case is presented illustrating the usefulness of a collaborative extended
inquiry following a standardized Rorschach administration. The session
described was a turning point in a difficult couples assessment.
12
Using the Consensus Rorschach as an Assessement Intervention With
Couples
The Consensus Rorschach has a long and venerable history. In therapeutic
assessments of couples, a modified version of this procedure is used to help
partners become aware of their individual and joint contributions to
u
problematic relationship dances. ”
13
“But I Was Only Trying to Help!”: Failure of a Therapeutic Assessment
Therapeutic Assessment defines “failed” assessments as those after which
clients feel diminished or traumatized. The author recounts one such
assessment in detail and draws lessons for psychological assessment in
general.
14
Collaborative Child Assessment as a Family Systems Intervention
In Therapeutic Assessment, psychological assessments of children and
adolescents are seen as potential therapeutic interventions on a whole
family system. The author discusses 10 ways for assessors to collaborate
with parents and their potential effects on a family system.
15
Teaching Therapeutic Assessment in a Required Graduate Course
The principles and techniques of Therapeutic Assessment are applied to
working with graduate students in a required course on psychological
assessment. By structuring the course as a chance for students to learn
about themselves as new clinicians, the author helps them experience a
therapeutic assessment first hand.
Part III
Theoretical Developments
16
Please Tell Me That I’m Not Who I Fear I Am: Control-MasteryTheory and
Therapeutic Assessment
Control-Mastery theory is a relatively new psychodynamic theory that
helps understand the process through which clients change in
psychotherapy. This theory helps us understand why clients benefit from a
therapeutic assessment.
17
Challenges and Lessons of Intersubjectivity Theory for Psychological
Assessment
Links are drawn between Therapeutic Assessment and the psychodynamic
theory of intersubjectivity. Constance Fischer’s phenomenological
approach to collaborative assessment addresses major challenges of
intersubjectivity theory for psychological assessment.
18
How Psychological Assessment Taught Me Compassion and Firmness
Psychological assessment, especially when it is collaborative, challenges
assessors to grow personally in order to better understand their clients.
The author shares several life lessons from his years practicing
Therapeutic Assessment.
19
Conclusion: Practicing Therapeutic Assessment
This chapter concerns practical matters involved in conducting therapeutic
assessments: When are they appropriate? How does one bill? How does one
get referrals? How does one learn the method and get ongoing support?
References
Author Index
Subject Index
Foreword
Some 15 years ago, as I read and reread the inch-thick handout that Steve
Finn had given me from his Society for Personality Assessment workshop,
tears eased their way down my face. They were the tears that accompany
being in touch with shared core but vulnerable values. This man whom I had
just met had explicitly incorporated aspects of my Individualizing
Psychological Assessment into his independently developed practices. I
found throughout the handout that after Steve had reflected thoroughly on
test patterns, theory, research, and what he already knew of the person’s
situation, he posed his impressions to the client in that person’s terms. He
collaborated respectfully, so as to truly individualize his descriptions, all the
while helping the person to realize greater possibilities. I was moved by the
openness and depth of his care for and faith in his clients, and by their
profound experiences while working with Steve. I had always thought that
collaborative/individualized assessment was necessarily growthful for
clients as well as immediately helpful to readers of assessment reports. But
Steve often went further, planning for clients to experience therapeutic
insights—lived as well as understood. That workshop handout presaged what
Steve soon named “Therapeutic Assessment.”
I’ve often been asked whether Therapeutic Assessment is appropriate for
when clients have been referred by professionals who are unfamiliar with it.
I reply that even when clients are referred more traditionally, therapeutic
insights are not only helpful to the clients but provide the referring party
with understandings of the clients’ openness to new experience. Many
persons self-refer and many professionals do refer their clients for this
service.
The title of this book, “In Our Clients’ Shoes,” evokes for me the
collaborative assessor’s practice of exploring the client’s world by traveling
with that person, through tests and talk, catching glimpses of his or her
goals, horizons, hopes, and perceived dangers and obstacles. The therapeutic
assessor accompanies and guides clients into test-related experiences
through which they come to personal discoveries that are comprehended
both affectively and conceptually. Clients grasp connections with the
questions that were presented for the assessment, and also apprehend
personally viable means of altering course to their goals. The assessor has
not unilaterally presented clients with “feedback” nor told them what to do.
Indeed, Steve’s quiet, receptive presence to clients, evident in the case
excerpts in this book, often has reminded me of Buber’s “encounter” with the
other—a profound respect for the other’s being and for the intangible
“between.”
I am appreciative of and grateful for Steve’s brave, creative, enthusiastic,
unstinting, and effective outreach—giving national and international
workshops, making his Therapeutic Assessment approach accessible through
filmed excerpts, invitational writings, symposia, and extensive supportive
consultation with students and colleagues. He has developed charts showing
concrete steps for conducting Therapeutic Assessment, published articles
that integrate diverse theories into collaborative practices, provided a broad
range of clinical examples, and published and encouraged research on the
outcomes of collaborating with assessment clients. Steve regularly seeks
consultation with colleagues on theory and on clinical cases, always
evolving his own understandings and practices. Due primarily to Steve’s
dedicated efforts, collaborative and Therapeutic Assessment practices are
being adopted, adapted, and advanced by practitioners across the country
and in many international settings.
In Our Clients’ Shoes illustrates Steve’s steady development of
Therapeutic Assessment’s approach and practices. Every chapter is readily
understood and helps the reader to imagine undertaking Therapeutic
Assessment practices in his or her own way.
Constance T. Fischer
Duquesne University
