The Validity of the Role Construct Repertory Test as a Measure of Sexual Identification

Although the majority of research on Therapeutic Assessment (TA) discusses the application of TA in research or private practice settings, we found that the model could be applied in a community mental health setting. We argue that when implementing this model with racially diverse, low socioeconomic status children, it is essential to integrate issues of class, privilege, and race into the assessment process. A case is presented that illuminates the specific concerns and struggles of adapting this model to a community psychology population. This analysis includes the interface with systems, placement stability, and consideration of culturally responsible treatment. We also demonstrate how the support of a treatment team helps the individual clinician process and integrate the levels of trauma and pain with which these families present.     

Why did she put nail polish in my drink? Applying the Therapeutic Assessment model with an African American foster child in a community mental health setting

Although the majority of research on Therapeutic Assessment (TA) discusses the application of TA in research or private practice settings, we found that the model could be applied in a community mental health setting. We argue that when implementing this model with racially diverse, low socioeconomic status children, it is essential to integrate issues of class, privilege, and race into the assessment process. A case is presented that illuminates the specific concerns and struggles of adapting this model to a community psychology population. This analysis includes the interface with systems, placement stability, and consideration of culturally responsible treatment. We also demonstrate how the support of a treatment team helps the individual clinician process and integrate the levels of trauma and pain with which these families present.     

Therapeutic Assessment With Children: A Pilot Study of Treatment Acceptability and Outcome

Therapeutic Assessment (TA) with children is a hybrid of psychological assessment and short-term intervention. It uses the ongoing process and results of psychological assessment to enhance parents' understanding of their child and to facilitate change. Clinical reports and single case studies suggest that TA with children is an acceptable and effective brief intervention. However, no aggregate data have been published to support this claim. This pilot study investigated the acceptability and preoutcome–postoutcome of TA with 14 clinically referred children with emotional and behavior problems and their parents. Results indicated high treatment acceptability as well as significantly decreased child symptomatology and enhanced family functioning as reported by children and mothers. In addition, mothers demonstrated a significant increase in positive emotion and a significant decrease in negative emotion pertaining to their children's challenges and future. The findings, although limited due to the design and small sample size, support assertions from published single case studies that TA is possibly an efficacious child and family intervention for children with emotional and behavioral problems and should be studied in a larger, comparison design.     

Children's response to community violence: What do we know?

This article presents a framework for understanding the developmental significance of violence-related trauma in the lives of young children. It emphasizes the importance of the distinction between acute and chronic trauma. Acute trauma is more readily dealt with through “psychological first aid” and a “therapy of reassurance.” Chronic trauma requires a more systematic reconstruction of the child's “social map” of the world. The socioeconomic and demographic correlates of violent trauma predict an accumulation of risk factors in the child's life that compounds the problem of developmental disability. The problem community violence poses for the child must be understood in the larger context of greater risk for family disruption (including less than secure attachment) as well as domestic violence, poverty, and minority group status. The increasing incidence and prevalence of community violence poses a major challenge to the mental health of children.     

Interaction of therapeutic process and alliance during psychological assessment

Utilizing a collaborative therapeutic assessment (TA) model proposed by Finn and Tonsager (1997), we examined the interaction between therapeutic alliance and in-session process during the assessment phase of treatment. This study compares the utility of the TA model (n = 38) versus a traditional information gathering model (n = 90) of assessment. The results of this study indicate that the use of a TA model may decrease the number of patients who terminate treatment against medical advice. The Session Evaluation Questionnaire (Stiles & Snow, 1984), Combined Alliance Short Form (Hatcher & Barends, 1996), and Penn Helping Alliance Questionnaire-Revised (Barber & Crits-Christoph, 1996) can reliably measure the patient's experience of the assessment. The psychological assessment process may impact the patient's experience of assessment feedback and aid in the development of a therapeutic alliance. The therapeutic alliance developed during the assessment was found to be related to alliance early in psychotherapy. We discuss the theoretical, clinical, and research implications of these findings.     

Introduction to the Special Section on Cultural Considerations in Collaborative and Therapeutic Assessment

Issues of culture abound in the conduct of psychological assessment. This special section brings together a collection of articles from expert practitioners in the Therapeutic Assessment (TA) model to discuss cultural considerations. The special section is comprised of a conceptual discussion of the cultural influence of the assessment situation itself, 3 case examples illustrating the way in which culture enters into assessment, and the ways that the TA paradigm can be useful in mitigating the potential negative effects; and a comment on the 4 articles. In this introduction to the special section, I discuss 2 interrelated concepts that are helpful in framing the articles that will follow: the need to practice assessment with multicultural competence, and the potential benefits of using an assessment model (e.g., TA) that is itself culturally responsive. As the world continues to become more culturally diverse through changing demographics and the recognition and evolution of different subcultures, the need to practice assessment using these concepts will only become more central.     

Context Matters: Commentary on Papers by Aschieri,Chudzik, Evans,and Fantini

This article discusses articles by Aschieri, Chudzik, Evans, and Fantini (this issue) that address cultural considerations in Therapeutic Assessment (TA). The importance of the cultural context in which a TA is conducted is highlighted. Among the themes highlighted are the conceptualization of psychology, and more specifically psychological assessment, as a culture in and of itself and the importance of shame (Aschieri), the way the cultural values influence the practice of assessment (Chudzik), the importance of understanding the meaning of one's experience within their culture (Evans), and the role of subcultural differences (Fantini). The role of culture is seen as an important variable across these articles that explore varied conceptualizations and influences on assessment psychology. Cultural sensitivity and responsivity is seen as a crucial factor in the avoidance of misalliances. The articles in this special section are viewed as important contributions to the TA literature and demonstrate how the TA paradigm can help assessors overcome potential cultural influences that could affect the benefit of a psychological assessment.     

Assessment of Trauma History and Trauma-Related Problems in Ethnic Minority Child Populations: An INFORMED Approach

Youth who experience traumatic events are at risk for a range of negative outcomes, including posttraumatic stress disorder, other anxiety disorders, depression, substance use, and health risk behaviors. It is important to identify valid methods to assess individuals for exposure to traumatic events, as well as the types of problems or symptoms they may be experiencing as a result of these events.

An individual's cultural values, beliefs, and practices can affect the ways that trauma-related sequelae are manifested and presented upon evaluation. Obtaining information about a child's ethnic background, including cultural beliefs and practices, can be a useful component of a trauma assessment. In this paper, the authors will (a) review standard guidelines for assessment of trauma in the general population; (b) present an argument for modification of standard trauma assessment strategies used with culturally diverse populations; (c) describe the culturally INFORMED model, comprised of 8 empirically based recommendations for modifying trauma assessment of culturally diverse populations; and (d) provide an example of how this model has been applied to a trauma assessment protocol with a Mexican immigrant population. Implications of how culturally modified assessment can be used to inform culturally modified cognitive-behavioral treatment of trauma symptoms in children also are addressed.     

Exposure to community violence in adolescence: trauma symptoms

This research explored the relationship between exposure to violence and psychological stress among adolescents. It focused on the cumulative experience of recurring community violence during the high school years, differentiated victimization from witnessing violence, and examined four conceptually separate psychological symptoms of trauma (anger, anxiety, depression, and dissociation). Considerable exposure to recurring community violence, but also considerable variation in the amount of exposure, was found in the sample of 455 first-year students at an urban college. Exposure to recurring community violence was moderately correlated with the manifestation of psychological trauma symptoms. Further, being victimized and witnessing violence had independent (as well as overlapping) relationships with trauma symptoms. It was concluded that attempts to account for psychological stress among adolescents must include exposure to community violence.     

Moral Injury: A Mechanism for War-Related Psychological Trauma in Military Family Members

Recent research has provided compelling evidence of mental health problems in military spouses and children, including post-traumatic stress disorder (PTSD), related to the war-zone deployments, combat exposures, and post-deployment mental health symptoms experienced by military service members in the family. One obstacle to further research and federal programs targeting the psychological health of military family members has been the lack of a clear, compelling, and testable model to explain how war-zone events can result in psychological trauma in military spouses and children. In this article, we propose a possible mechanism for deployment-related psychological trauma in military spouses and children based on the concept of moral injury, a model that has been developed to better understand how service members and veterans may develop PTSD and other serious mental and behavioral problems in the wake of war-zone events that inflict damage to moral belief systems rather by threatening personal life and safety. After describing means of adapting the moral injury model to family systems, we discuss the clinical implications of moral injury, and describe a model for its psychological treatment.     

What Torture Survivors Teach Assessors About Being More Fully Human

This article illustrates the complex sociocultural components in the forensic psychological assessment of a young Ethiopian woman's claim for political asylum due to a well-founded fear of persecution and for relief under the Convention Against Torture. It draws attention to the subtle social and cultural influences in the practice of forensic psychological assessment with an emphasis of reflective practice, which is contextualized in the interpersonal theory of Sullivan. In the interpersonal approach, the essential work of the assessor is to pay careful attention to the microinteractions between the client and the assessor as reflections of the interpersonal (meaning social and cultural) processes, eschewing the illusion of objectivity.

In this case study, I illustrate the particular cultural dilemmas for client and assessor in conducting a forensic assessment of psychological trauma, including cross-cultural, gender, and legal difficulties in arriving at an informed, objective, and compassionate assessment of an individual seeking asylum after an especially brutal experience of torture. I argue that collaborative therapeutic assessment methods adapted for forensic practice offer an approach to assessment of psychological trauma that provides more accurate and compassionate assessment than so-called neutral standard forensic assessment practice.     

Trainee and Client Experiences of Therapeutic Assessment in a Required Graduate Course: A Qualitative Analysis

Surveys indicate that practice and training in psychological assessment, and personality assessment (PA) to a lesser degree, has been stable or increasing over the past quarter-century. However, its future arguably remains threatened due to changes in doctoral training programs and beliefs in the field concerning the utility of PA for treatment success. To increase interest in and use of PA, studies of training methods that include trainees' perspectives are needed. This study evaluated the experiences of 10 graduate trainees and their clients who were trained in and conducted a brief Therapeutic Assessment (TA). Qualitative responses to a self-evaluation administered post-TA were coded using directed content analysis. Results indicated that trainees viewed TA/PA as having clinical utility; they had positive feelings about TA/PA, and they desired or intended to use or continue learning about TA/PA. Clients' responses reflected positive feelings about the TA, having gained new self-awareness or understanding, and having a positive relationship with the assessor. The findings suggest that teaching PA from a TA perspective could produce positive benefits for psychology trainees.     

Training Therapists to Treat the Psychological Consequences of Terrorism

Abstract

In the wake of 9/11, the mental health community began to develop a model for recovery and preparedness. A public information campaign regarding the psychological consequences of terrorism was launched, and it succeeded in reducing the stigma of utilizing mental health services. However, as this campaign began to succeed, it became clear that most clinicians in the community had little training in evidence-based assessment and treatment procedures for the psychological sequelae of terrorism. This article describes the development, delivery, and initial assessment of one attempt to correct this problem by broadly disseminating an effective treatment for Post Traumatic Stress Disorder (PTSD). Using models of behavior change, we were able to study trainee attitudes and the training process in ways that will help improve training effectiveness beyond what traditional Continuing Professional Education (CPE) has been able to do.     

Differences in mathematical reasoning between typically achieving and gifted children

Mathematical giftedness refers to mastery in a specific mathematical domain at an earlier than expected age. The present study examined which cognitive processes accounted for differences in mathematical reasoning between gifted children (MRG) and their typically achieving peers (TA). Naming speed, phonological awareness, short-term memory, executive functioning, and working memory were examined in 51 children aged approximately 7 years. A series of stepwise regression models, using a contrast variable to capture differences in mathematical reasoning between MRG and TA children, were created to examine which cognitive domains accounted for differences in mathematical reasoning. Short-term memory (r²?=?.08) and visual-spatial working memory (r²?=?.39) emerged as the only cognitive predictors within a model that included gender, age, and fluid intelligence. This model captured all of the variance distinguishing mathematics reasoning between MRG and TA children, explaining an overall contribution of 70% of the variance in mathematical reasoning.     

Shame as a Cultural Artifact: A Call for Self-Awareness and Reflexivity in Personality Assessment

It has become common for assessors to face therapeutic impasses and dilemmas when practicing within the Therapeutic Assessment (TA) model. This is due to the explicit goal of producing therapeutic changes in clients. In this article the author discusses the importance of assessors being aware of how their clinical practices relate to their assessment outcomes. To enhance such awareness, the author reviews the characteristics of psychological assessment practices as derived from 3 paradigms developed almost 1.5 centuries ago in Europe by the forefathers of psychology as a scientific discipline. Current assessment practices are deeply ingrained in specific cultural, social, and political frameworks originating in these paradigms. Being aware of such a historical and cultural background might help the assessor avoid blindly reenacting the values, norms, and latent relational schemas implied by different assessment methods, and instead use assessment tools as potent aids in the service of clients' change. Finally, the author illustrates how the experience of clients' shame in psychological assessment might also be understood as a by-product of the specific cultural and historical background of certain common assessment practices.     

Sharing Knowledge and Shared Care

Summary

This concluding article presents the main themes that emerged from this volume within a multidimensional, multidisciplinary integrative framework conceptualizing the consequences of the trauma of terrorism and informing optimal prevention and intervention methods. It reviews short- and long-term findings of the effects of terrorism on adults, children, families, communities, and societies and makes numerous research recommendations. Viewing terrorism as psychological warfare against the community, it advances community-based, culturally congruent interventions, with a public mental health approach, in an ongoing, integrated network of services promoting community and individual resilience, specialized training, international collaboration, and continued dialogue concerning the role of the media.     

Therapeutic Assessment With Child Inpatients

Growing evidence supports Therapeutic Assessment (TA), a collaborative and therapeutic approach to psychological assessment, as an effective method for enhancing motivation for and engagement with psychotherapy across a variety of clinical populations and treatment settings. However, to date there are no known studies assessing the use of TA in child psychiatric inpatient settings. This article briefly reviews the structure of child and family TA, enumerates the challenges and risks associated with short-term inpatient stays, and proposes a path for integrating TA into these units as a way to enhance the quality of care and reduce the risk of rapid rehospitalization. The authors provide three case examples from a child psychiatric inpatient unit, each using a modified version of TA and each integrating assessments into brief family interventions. The authors conclude with suggestions for best practice for child psychiatric inpatient TAs.     

Children's reactions to serial murder

This study examined the psychological reactions of children who lived in a community exposed to serial murder. The research also examined how parents coped with their children's psychological responses. Thirty-four parents of 64 children between the ages of 5 and 18, inclusive, were asked to identify changes in their children since the serial murders. Data collection began 4 weeks following the murders and included assessment of emotional, cognitive and behavioral aspects of the child's responses. Follow-up data collection occurred at 9 months and 18 months after the murders. Results indicated that children, as a group, experienced a number of psychological changes following the murders, even though none of the actual victims were children. The most frequently reported symptoms were anxiety-based (fear of being alone, difficulty falling asleep and wanting to sleep with patents). Most children showed a significant decline in symptoms across time. The most popular parent coping strategies involved discussing issues of risk minimization, talking about the murders, and spending more time with children.     

A model for brief assessment of attachment and its application to women in inpatient treatment for trauma-related psychiatric disorders

We adapted self-report measures of attachment style to the psychological assessment of women in specialized inpatient treatment for trauma-related disorders. The study employed 2 measures of adult attachment style, the Relationship Questionnaire (Bartholomew & Horowitz, 1991) and the Adult Attachment Scale (Collins & Read, 1990) as well as our Current Attachment Relationships questionnaire, which assesses the extent of social support in secure attachments. We administered these measures to 99 patients and to a convenience sample of 154 women in the community. We found modest correspondence between the 2 attachment style measures and substantial relations between attachment styles and range of secure attachment relationships. Women in the trauma sample reported insecure attachment styles and relatively few secure attachment figures. We discuss the implications of these findings for clinical assessment.     

Exposure to community violence and trauma symptoms in late adolescence: comparison of a college sample and a noncollege community sample

This paper presents a comparison for two samples (college and noncollege) of older, urban African-American adolescents of correlations between two measures of exposure to community violence (victim and witness) and four types of psychological trauma symptoms (anger, anxiety, depression, and dissociation). The central issue is the generalizability of previous findings about these relationships obtained from beginning college students of traditional age. The two samples did not differ in the magnitude of either the zero-order correlations or the multiple correlations between the two types of exposure to community violence and the four types of symptoms of trauma. The conclusion is that findings regarding the relationship of exposure to community violence with psychological symptoms of trauma obtained from college students may tentatively be generalized to older adolescents who are not in college.