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Career Counseling_ Assessment_ and Diagnosis

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					   Career Counseling,
Assessment, and Diagnosis


 Psy 340: Section 3
Section 3: Goals

 Understand major career counseling
  theories, philosophy, tools, and place in
  psychology
 Gain an overview of assessment:
  theory, types, uses, key personality and
  intellectual assessments
 Role of diagnosis, DSM, uses and
  criticisms
Career Counseling Theories

   Frank Parsons (1909)
    – Knowledge of self, world of work (wow)
      and match the two
    – Evolution of P-E fit models
 John Holland (1985): Holland’s
  Hexagon
 Social Cognitive Career Theory (SCCT)
                Holland’s Theory

 People and careers can be described in
  terms of 6 dimensions
 RIASEC
    –   Realistic
    –   Investigative
    –   Artistic
    –   Social
    –   Enterprising
    –   Conventional
         Holland’s Theory (cont)
   Holland Code
    – 3 letter combination (people and work)
 Person-Environment congruence
 Congruence
    – Match between person and environment
    – predictive of satisfaction, not stability and
      achievement
   Major theory
    – Tests
    – Generated lots of research
    Social Cognitive Career Theory
               (SCCT)
 Lent, Brown, & Hackett, 1994
 Relationship with Bandura & Social
  Learning Theory
 Role of
    – Person Factors
    – Environment Factors
   Interests to Goals to Actions
SCCT Model
               SCCT Summary

   Who you are and where you are influences
    learning experiences
    – Person and environment factors
    – Shapes interests and expectations


   Interests don’t always result in actions
    – Interests may shape goals and one may or may
      not act on goals
    – Barriers may impact interests translated to goals
    Career Counseling: Same as
Personal-Emotional (PE) counseling?
 Roots and emphasis in counseling
  psychology
 Venn Diagram
    – Personal
   Career choices in relation to personal
    life
    – Are they really that different? Isolated?
   Use different theory and assessments
          Assessment in Career

   Strong Interest Inventory (SII)
    – Uses Holland’s theory
 Self-Directed Search (SDS)
 Card sorts – qualitative assessment
    – Occupations
    – Values
    – Majors
   Myers-Briggs Type Indicator (MBTI)
            Career Resources

 Occupation Outlook Handbook
 O-Net
 Career Counseling
    – University Counseling Center
    – Pre-Major Advisement (PM students only)
   Career Services
    Career Counseling Summary

 Career counseling is central to counseling
  psychology’s development and current focus
 Similar to PE counseling, with additional
  theories
 Holland’s Person-environment congruence
 SCCT
    – Person and environmental factors
    – Importance of self-efficacy and expectations
         Assessment Overview

 Everyday assessment vs. psychological
  assessment
 Psychological assessment requirements
    – Systematic
    – Objective
    – Accurate
   Scientific method to understand others
    – Explain and predict behavior
So what is assessment??

   Gathering information!!
    – Behavior
    – Functioning
    – Personality
   Typically thought of a psychological “tests”
    – Quantitative data
    – Empirically tested
    – Tests have norms to allow for comparison
              Types of assessment
   Assessment may cover:
    –   Personality
    –   Interests
    –   Intelligence
    –   Behaviors
   Modes of assessments:
    – Tests
         • procedure or instrument used gather information
    – Interview
         • Very common
   Quantitative and Qualitative assessment
      Quantitative vs. Qualitative
             Assessment?
   Quantitative                 Qualitative
    – Usually using “tests”       – Holistic/ integrated
      or standardized             – No norms, standards
      measures
                                  – Assessment during
    – Norms and                     the counseling
      standards for                 process
      comparison
                                  – Flexible
    – Specific and
      structured
       Building Blocks of Testing

   Standardization
    – Set procedure and testing environment to insure
      similar test administrations
   Norms
    – scores generated from large standardized group
    – How most people do on test
    – Allow for comparison
   Reliability and validity
    – Is the test scientifically reliable?
             Reliability of Tests
   Reliability
    – Consistency of a measurement device
    – Are the same results obtained each use?

   Types of reliability
    – Test-retest: Does the test give the same results at
      different times?
    – Internal consistency: Do different parts of the test
      give the same results?
    – Interrater reliability: Do different people using the
      measure come up with similar answers?
               Validity of Tests
   Validity
    – Does the test measure what is supposed to?
    – Appropriateness of test interpretation

   Types of validity
    – Face validity: does it look like it is measuring what
      it is supposed to measure?
    – Predictive validity: how well do tests score predict
      behavior that the test should predict?
    – Concurrent validity: correlation of score with
      scores on established test
    – Construct validity: the degree to which the
      measure reflects the structure of the hypothesized
      construct
    Expanded View of Assessment

   Spengler et al. (1995) – assessment is
    everywhere
    – Continual assessment, beyond testing
    – All assessment is subjective, value judgments
   Goldman (1990,1991)
    – Benefits of qualitative assessment
    – Types
    – Qualitative assessment as a piece of the puzzle
       • Combination, not replacement
Qualitative Assessment

   How does it stand up to??
    – assessment requirements of
       • Systematic
       • Objective
       • Accurate
 Is it reliable? Valid?
 What role does qualitative assessment
  play?
          Steps of Assessment

   Referral question
    – Deciding what is being assessed
    – What is the best means of assessment?
    – Determine goals of assessment

   Collecting data
    – Tests, interviews,varied sources
    – Always reference referral question
     Steps of Assessment (cont.)

   Interpretation
    – Make decisions and judgments using data
   Diagnosis
    – To facilitate treatment and communication
      among the treating professionals
   Psychological report
    – Communicate the results
         Diagnosis and the DSM
   Emil Kraepelin developed 1st classification
    system
    – ID and labeled symptom sets
    – Specific cause, course, outcome
   Diagnosis
    – After assessment
    – Identify disorder that fits symptom profile
   Role in the medical model
    – Problem identification
    – Discover cause of problem
    – Treat problem scientifically
         DSM and Multi-axial
            Assessment
   Diagnostic and Statistical Manual of
    Mental Disorders (DSM)
    – Evolved through revisions
    – Politics of inclusion
    – Current DSM-IV-R
 First DSM in 1952
 Diagnosis on 5 axis to capture the
  complexity of psychological disorders
    Multiaxial Assessment in DSM
   Axis I: Clinical syndromes
    – Typical labels (e.g. bi-polar)
    – Can be temporary
   Axis II: Personality Disorders
    – Long-standing, enduring characteristics
   Axis III: Physical Conditions/Disorders
    – Injuries, chronic illnesses
 Axis IV: Severity of Psychological Stressors
 Axis V: Global Assessment of Functioning
  (GAF)
     DSM Uses and Criticisms

USES                     CRITICISMS
 Communication           Sexist
 Research                Culturally biased
 Unified fields          Defining categories
 Facilitate treatment     more political than
                           scientific
                          Problems with
                           labeling, stigmas
          DSM Discussion

 Is diagnosis necessary?
 Is the DSM necessary?
 What purpose does the DSM serve?
 Pros and cons of labeling
 What are some other options other than
  the DSM that could meet similar needs
  but be an improvement?
      Personality and Behavioral
        Assessment Overview
   Interview
    – Intake, Mental Status,Case history
   Projective personality tests
    – Rorschach, TAT, etc.
   Objective personality tests
       • MMPI, NEO-PI, MBTI
   Behavioral assessment
            Therapeutic Interview

   Dual purpose
    – Gather info and help client
   Intake interview
    –   Determine nature of problem and fit w/ agency
    –   Initial information used for case assignment
    –   Varying timing and format (structure)
    –   General information gathered
         • Basic info, problem onset, current functioning, coping,
           attempted solutions, etc.
     Therapeutic Interview (cont)
   Mental Status Exam
    – Formal assessment of mental functioning
    – Often performed in ER
    – Covers several areas of functioning
       • (e.g., appearance, speech/thought, mood, memory,
         attention, etc) see pg 102
   Case history
    – Gathers info on personal and family history and
      social situation
    – Covers broad areas
       • (e.g., current situation, family history, health, education,
         marriage/ current family,etc.) see pg.103
       Projective Personality Tests
   Rorschach Inkblot Test
    – 10 inkblots, tell what is, ID specific aspect
   Thematic Apperception Test (TAT)
    – 31 cards with vague pictures to illicit themes
    – Make up story about the picture
   Kinetic Family Drawing (KFD)
    – Draw members of family doing something
   Rotter Sentence Completion
    – Oral or written form
    – “I hate….”; “Mothers are ….”
   Reliability, validity, clinical usefulness debate
      Objective Personality Tests
   Objective vs. subjective
    – Similar to qualitative vs. quantitative
   Scale construction methods
    – Empirical (external)
       • Administer items and see what items differ between what
         groups
    – Inductive
       • Administer items and analyze mathematically how items
         “hang together”
    – Deductive
       • Theory/definition before create test
       • Items created to “fit” theory
           MMPI and MMPI-II

   Developed with the Empirical approach
    – 1930’s-40’s to diagnose psychopathology
    – Items that designate between groups make the
      scales
   Several hundred statements about life,
    opinions, likes/ dislikes, etc.
    – Forced choice T/F
    – “I am happy most of the time”
   Revised in 1989 as MMPI-II
        MMPI-II Clinical Scales
   Hypochondriasis          Paranoia
    – Preoccupation with     Psychasthenia
      body
                                – Obsessions/compulsi
 Depression                      ons
 Hysteria
                             Schizophrenia
 Psychopathic
  deviate                    Mania
    – Antisocial behavior    Social introversion
   Masculine-Feminine
                  MMPI-II (cont)
   Validity scales
    –   ? – number of omitted items
    –   L – tendency to lie, self in favorable light
    –   F – unusual items, “fake bad”
    –   K – defensiveness, corrective factor
 Graph of scores
 Highest codes
    – Give profile of person
    – Use of “cookbooks”
        NEO-Personality Inventory
              (NEO-PI)
 Based on Costa & McCrae’s five factor
  personality theory
 Measurement of normal personality
 Five Factors (OCEAN)
    –   Neuroticism
    –   Extraversion
    –   Openness to experience
    –   Agreeableness
    –   Conscientiousness
   240 statements, 4-point Likert scale
    indicating extent of agreement
     Myers-Briggs Type Indicator
              (MBTI)
 Developed with the deductive approached
 Based on Jung’s 4 dimensions of personality
    –   Extraversion-Introversion
    –   Sensing-Intuition
    –   Thinking-Feeling
    –   Judging-Perceiving
   Code/ Profile for people, 16 codes
           Behavioral Assessment
 From behaviorism and behavior therapy
 Look at observable rather than underling
  personality
 Techniques
    –   Behavioral assessment interviews
    –   Observation (naturalistic, analogue, participant)
    –   Self-Monitoring
    –   Behavioral questionnaires
    –   Biofeedback
             Issues in Assessment
 IQ testing
 Computer generated scoring
    – Validity, reliability?
    – Professional responsibility
   Training requirements
    – Test administration
   Ethics
    – Releasing and maintenance of results
    – Use of testing (e.g. MMPI for hiring?)
         Intellectual Assessment

 Problem of defining intelligence
 Fluid intelligence
    – Non-verbal, relatively culture free mental skills
    – E.g., the capacity to adapt to new situations
   Crystallized intelligence
    – Skills and knowledge acquired through repeated
      exposure and practice
   Verbal vs. Performance intelligence
               Intelligence Scales
   Stanford-Binet Intelligence Scale
    – Developed to predict which children would do well
      in school
   Skills areas and standards for each
    –   Verbal reasoning
    –   Quantitative reasoning
    –   Abstract/Visual reasoning
    –   Short-term memory
 Age norms
 Raw scores transformed into “IQ”
    – IQ of 100 is average, 16 standard deviation
         Intellectual Assessment
   Weschler Tests
    – Weschler Intelligence Scale for Children (WISC-III,
      1991)
    – Weschler Adult Intelligence Scale (WAIS-R, 1981)
   All tests divided into two aspects
    – Verbal (e.g., vocabulary & comprehension)
    – Performance (e.g., puzzles & copying designs)
 Full scale IQ = verbal IQ + performance IQ
 Mean of 100, standard deviation of 15
 Used to assess learning disabilities and
  neuropsychological disorders
Neuropsychological Assessment
 Neuropsychology studies relationship b/w
  brain and behavior
 Neuropsychological assessment
    – Set of procedures to detect presence, extent, and
      type of brain damage/ impairment
    – Evaluate behaviors that are linked to specific brain
      functioning
 Brain damage is increasing in society
 Research on the brain and behavior has
  increased due to technology
    – X-rays, EEGs, CAT scans, PET scans
    Revisiting Assessment Steps

 Referral question
 Collecting data
 Diagnosis
 Psychological report
    – Communicate the results
            Psychological Report
   Written summary of impressions and
    assessment results to guide client
    conceptualization and treatment

   Always consider
    –   Referral question
    –   What is the purpose
    –   Who is the audience
    –   What is the necessary information
    –   What (if any) information could harm the client
        currently or in the future
     Psychological Report (cont.)

   Aspects included
    – Referral question
    – Presenting problem/ Background information
    – Assessment results
       • Behavioral assessment
       • Testing results and observations
    – Diagnosis
    – Integrated summary and suggested treatment
           Review of the Goals
 Career counseling theories, philosophy, tools,
  and place in psychology
 Overview of assessment
    – Theory
    – Types (Qual. And Quant.)
    – Uses and instruments (Personality, Interests,
      Intelligence, Behavioral, etc.)
    – Testing basics
    – Communicating findings
   Role of diagnosis and DSM
    – uses and criticisms