Évaluation thérapeutique et obligation de soins

This article presents an application of therapeutic assessment in a mandatory treatment setting. Assessment has been traditionally considered as specially important in this setting. Following previous works (Chudzik & Aschieri, 2013) about the therapeutic relationship in this setting, we show that TA is useful to avoid some common pitfalls and make a real psychotherapeutic process possible. We consider the specificity of each step of TA in this setting and we illustrate it by a clinical case.     

L’évaluation thérapeutique : description de quatre modèles

Since its development, therapeutic assessment (TA) has been used in many different settings and adapted accordingly. There are four different TA models: adult, couple, child and adolescent. This article presents the steps of each model and addresses the specific similarities and differences between them.     

Vers une métrique absolue dans les épreuves d'évaluation subjective: La méthode fonctionnelle

The functional method is a new construction method of subjective evaluation tests such as personality, values or competences. Its approach differs from the usually used methods that are directly inherited from the works of Spearman that are tests of maximal performances. The latter tests were developed (almost one hundred years ago) for selection purposes in a differential perspective that suggests certain “underlying” aptitudes from which the level is simply obtained by a sum of the right answers. Thus, the subjective evaluation tests have no unique underlying aptitude and do not give a sum of correct answers, but it shows a global and multidimensional vision of oneself. The functional method points out this multidimensional specificity and offers a model of the subject's answers that reveals his or her strategy that is projected into a hyper-spherical measurement space defined by the characteristics of the items. This measurement space allows the calculation of scores that are the projections (scalar products) of vectors onto one another. The very interests of this method are a better reliability, a clinical intra-personal evaluation of the subjects (that are much more efficient than the simple differential approach that is also described in the article) and, finally, a more informative control upon the intake conditions (test biases, suitability of the test for a person, etc.).     

Les représentations mentales de l’enfant chez les parents : situation,illustrations et réflexions sur les catalyseurs de changements en évaluation thérapeutique de l’enfant

Therapeutic assessment of the child (TA-C) is a model of psychological assessment that allows for collaborative work with parents and child on their reasons for consultation, a collaboration that breaks away from a traditional double separation (parent/assessor, and assessor/therapist) in child assessment. This paper, grounded in a contemporary psychodynamic viewpoint, presents clinical illustrations to support a conceptualization of change processes in TA-C. It is argued that, in order to revitalize empathy in parents, work focusing on the parents’ mental representation of their child is central. We propose a hierarchy of assessment/therapeutic goals that allows for a better distinction between TA-C and standard assessment in work with children.     

L’évaluation du risque de récidive et l’intervention basée sur les données probantes : les conditions nécessaires à l’implantation de méthodes structurées d’évaluation et d’intervention efficaces

The results of different studies on the best practices of the prevention of recidivism are clear: it is possible to reduce the risk of recidivism of offenders through efficient intervention. Structured risk assessment combined with practices based on risk, need and responsivity principals may reduce the risk of recidivism by up to 30%. These programs, developed primarily in Canada, require adaptations to better suit a French context. The present article proposes to revise the main stages essential to the introduction of a new evaluation and intervention strategy based on evidence, namely, the exploration, the preparation of the establishment, the creation and implementation themselves, the sustainability approach and the introduction of evaluative research studies. The advantages of considering such an implementation strategy are discussed.     

L’évaluation psychologique en situation transculturelle : une révision de la littérature

Human migration provokes transcultural clinical encounters that may challenge the way clinicians see themselves and how they proceed in their usual practices. In the field of psychology, psychological assessment is an important tool to better understand the patients’ needs and to design psychological interventions. Considering that most diagnostic tests and manuals have been developed in the Western context, the application of these tools with other populations remains controversial. The present literature review aims to describe the state of current knowledge on psychological transcultural assessment. Specifically, we will address: (1) the use of psychological tests in transcultural contexts, (2) the development of the Cultural Formulation Interview (CFI, DSM-5) and (3) the clinical interview: language, therapeutic relationship and participation of interpreters. In the first section, we discuss the international norms for scales and tests translation and adaptation, as well as the cultural issues that may bias the test’ application and interpretation. In the second section, we describe the creation of the CFI, and its use in recent studies. The CFI is composed by four clusters: (1) cultural definition of a problem, (2) cultural perceptions of cause, context, and support, (3) cultural factors affecting self-coping and past help seeking, and (4) cultural factors affecting current help seeking. The revised studies indicated that the CFI has a positive impact on the cultural sensibilization of mental health professionals, also improving the relationship between the patients and professionals. The cultural formulation may also prevent misdiagnosis. Beyond the use of tests and structured interviews, the clinician also faces other challenges during a transcultural assessment. We discuss in the third section the transferential and countertransferential relationship in a transcultural situation. Several elements may influence this relationship, at an individual, institutional and societal level. The evaluation of these elements may allow the clinician to better understand results of the psychological assessment. We also describe the current guidelines for the use of interpreters during health consultations in France. In conclusion, several advances have been made in the field of transcultural psychological assessment, among other things the development of guides for good translation and cultural adaptation of tools, as well as the integration of cultural issues into the DSM. However, research and changes in clinical practice are still needed, as the evaluation of cultural biases in cognitive tests and the expansion of cultural competences training among clinicians.     

L’enfant réfugié en consultation : quelques considérations cliniques sur l’évaluation interculturelle

This article provides some cues to develop intercultural competency in clinical practice with migrant children and their families. Specific difficulties of refugee children in terms of psychopathology, school achievement and acculturation process are pointed out. A clinical vignette concerning a psychological assessment of an 11-year-old girl is presented to illustrate critical points. Some strategies to improve clinician's ability to provide services to people from diverse cultural backgrounds are discussed.     

L’évaluation de la formation à l’harmonisation travail-vie personnelle : bilan et perspectives de recherche

The present article offers a review of the literature evaluating work-life balance training (which includes work-family balance training). The research, spanning over 43 databases, allowed the identification of 17 pertinent peer-reviewed articles. The selected studies are analysed in light of their main characteristics (design, sample, intervention, outcomes, etc.). The analysis shows that the offering of work-life balance training benefits both employees and managers. The methodological presuppositions and limitations of the selected studies are then critically examined. Lastly, possible topics for further research, such as the importance of conducting comparative researches and of adopting quasi-experimental and experimental protocols, are suggested in manner of conclusion.     

L’évaluation structurée du risque de récidive des personnes placées sous main de justice : méthodes et enjeux

Although the prevention of recidivism in France is currently undergoing numerous transformations, the evaluation of the risk of recidivism of individuals under the justice system is a major issue. The absence of structure and standardization in current evaluation procedures raises doubts regarding their validity and underlines the necessity to determine evaluation methods that are clinically and scientifically validated. The professionals and their administration would benefit largely from a range of strategies that would aid in executing the most just, transparent and coherent evaluation possible. This article will trace the evolution of the evaluation of the risk of recidivism, the principal strategies and methods, the most common risk factor families used, as well as illustrations of two typical strategies of evolution of the risk of recidivism; integrated evaluation with the LS/CMI and evaluation based on structured professional judgment guided by the HCR-20.     

Modéliser l’évaluation des processus de changement en counseling d’orientation : une perspective constructiviste et intégrative

The purpose of this paper is to contribute to design models that are used to assess the effects of career counseling. The article is part of the constructivist perspective in the emerging new paradigm of counseling psychology in the 21st century. Dialogue is seen as the strategic point in the change process of intervention practices. Through an analytical synthesis of different theoretical and empirical work on dialogue and an exploratory study of its reflexive dimension, the article points out the contribution of constructivist approaches while suggesting a constructionist and integrative perspective. It thus opens a discussion on the relevance of an interdisciplinary approach for dialogic and reflexive phenomena involved in the self-transformation process.     

Perception de la maladie et adhérence thérapeutique chez des enfants asthmatiques

This study had two objectives. The first one was to adapt and validate the Revised-Illness Perception Questionnaire (IPQ-R) for children and their parents. The second one was to assess the influence of parent's and children's asthma perception and parent's involvement in treatment on adherence among children suffering asthma. One hundred and forty-six asthmatic children (8–12 years old) and ninety-two parents completed the Revised-Illness Perception Questionnaire and a therapeutic adherence scale. Children who have a good understanding of their illness and who think that their treatment control their asthma, have a better therapeutic adherence. The originality of this research lies in the use of the Illness Perception Questionnaire among children; this could be used in other chronic pediatric diseases.     

Indice d’aptitude général et indice de compétence cognitive pour le WISC-IV : normes empiriques versus normes statistiques

IntroductionThe General Ability Index (GAI) was developed within the WISC-III to measure general cognitive ability. The GAI can be used as a substitute for the FSIQ. Recently, the Cognitive Proficiency Index (CPI) was developed. The GAI and CPI tables for the French WISC-IV were recently created using statistical approximation. However, it has been suggested that tables created with statistical approximation were less proficient than tables created using samples.ObjectiveThe objective of this study was to compare GAI and CPI normative tables of the French WISC-IV which use a statistical approximation procedure, to tables based on a sample.MethodTo explore the validity of the GAI and ICC scores, we studied 182 children aged from 8 to 12-years-old.ResultsCorrelations between both types of tables were 0,997 for GAI and 0,999 for CPI, and the absolute mean difference was 5.38 points and 2.24, respectively. For the children presenting a GAI_S lower than 89, GAI_E suggested that it is likely that their scores are lower about 8-10 points than that indicated by GAI_S.ConclusionResults of this study support the use of GAI and CPI to provide different views of children's cognitive abilities.     

La cross-évaluation : une approche d’évaluation et de développement des processus de travail inter-équipes

Organizational agility has become an increasing focus for companies and has led to the emergence of new developmental methods. This article presents the cross-evaluation as an approach to evaluating and developing inter-team interface efficacity. Though 360 degrees feedback collective processes are being evaluated, and during reflexive workshops they decide what improvements to make in their team functioning. Based on a literature review and more specifically on the theories of social identity and groupthink this article describes the scientific bases of the cross-evaluation method and the biases that can be involved and how to reduce them. It suggests new avenues of research and practical suggestions for practitioners about an inter-team development method.     

Période périnatale et Rorschach : normes,indicateurs, mentalisation et perspectives théorico-cliniques

ObjectiveThe perinatal period is a maturation phase characterised by the appearance of a radical psychological and identity crisis, little studied by projective methods, in particular the Rorschach inkblot test. The objective of this article is to offer a list of Rorschach norms and indicators adapted to the perinatal population. This is to comprehend the psychological modifications occurring during pregnancy.Materials and methodThe projective Rorschach inkblot test was presented to a representative sample of 54 pregnant primiparous French women. Based on the scoring and analysis methods of the Parisian School, the quantitative norms from the analysis of the psychogram, the chosen cards, and the mentalization indicators were compared to those of the general population.ResultsWith the exception of F +% and H%, all the normative data for the perinatal population are significantly different from those related to the general population (p .005). On a qualitative level, the interpretation of the data highlights the presence of major inhibition mechanisms, associated with a preconscious functioning stasis.ConclusionThe normative data in Rorschach of the perinatal population should be specifically used for the study and psychological support devoted to this population. It also allows a better understanding of the feminine psychologic modifications during pregnancy.     

L’insertion professionnelle des travailleurs handicapés en France : principes et réalités

The principle underlying positive discrimination – or “affirmative action” as the phrase went in the US, essentially targeting “racial” discrimination – consists in giving more to those who have less, and defines how we understand the ways handicapped persons can get a job. This translates into policies which, despite being updated many times since their first implementation between the two world wars, have remained true to their initial, protective purpose. Over those past decades, their target groups have grown more and more diverse, but identifying them has always been the work of social and medical organisations where the State and local communities are uniting forces. Simultaneously, the professional insertion of the physically or mentally challenged has been made possible through three actions. One was to clearly define the protected segment of the most handicapped to prevent any doubt on status, while allowing the segment to grow. Another was to multiply placement organisations, such as the Cap-Emploi network, dedicated to rationalizing their own procedures for better performance while improving how they can help the handicapped to better access the ordinary job market. Yet another was to implement innovative instruments such as the AGEPFIPH. Finally we will insist on how employers are reluctant to hire individuals with limited employability. In other words this article proposes to evaluate collective objectives, notably public policies as perceived through the threefold aspect of identification-insertion-reception of the handicapped. Exploring the factors of the all-too-frequent low employment rate of handicapped workers, this article demonstrates how the policy instruments, despite their increasing number, fail to address their own negative impacts, such as the segmentation and substitution of targeted groups. It therefore questions the various logical distortions assumed by the instruments available when confronted with population limits and recipients’ demands. It therefore examines the issues regarding the status and collective management of this unskilled labor force in a context of critically changing working conditions in jobs that remain a very remote perspective.