How to Build a Rocketship: Tips and Strategies for Conducting a Psychological Assessment
Lesley-Rose Gutter is a second-year student in the Psy.D. Program. In the Fall, Lesley-Rose completed her first Psychological Assessment Course with Dr. Skillestad Winans, Associate Professor and Co-Director of Clinical Training for the Psy.D. Program. From the first day of class Dr. Skillestad Winans challenged her 14 students to think of learning how to conduct their first psychological assessment as “Building the Rocketship!” Remote learning and COVID-19 could not stop these Rocketship Builders. After 15 weeks of hard work and 8 class sessions, 14 “Rocketships” were launched! Lesley-Rose shares some of her tips on how to master this feat. You can read her important insights below so that you too can build a Rocketship.
How to Build a Rocketship: Tips and Strategies for Conducting a Psychological Assessment
By: Lesley-Rose Gutter
The following suggestions are not designed to be a “copy and paste” template, but rather a reflective “tips and strategies” guide. These tips and strategies are meant to guide the assessment process as you personalize your own approach and learn what method works best for you as a clinician in training.
1. Initial Clinical Assessment: Conducting a Thorough Clinical Interview
Aside from the tests, the clinical interview is the most crucial part of the assessment process. Without a thorough clinical interview, it is nearly impossible to paint the picture of your client beyond test scores. Of course, the test scores are important because they provide insight into what may be ailing the client. However, the clinical interview helps make sense of the test scores and offers further insights into the client's life experience. If the test batteries are the peanut butter, the clinical interview is the jelly, honey, and glass of milk. A peanut butter sandwich can always do the trick, but often the jelly or honey plus a glass of milk can enrich the experience.
Therefore, take the time to create a word document that covers as much as you need to know about your client. I would strongly suggest starting with the A. Jordan Wright text and personalizing it as you go throughout the semester. In my experience, I spent about 4-5 hours, creating a clinical interview that would work for me. I prefer to handwrite notes; thus, my report was tailored to be more minimalistic in its details, leaving room to write down what the client said. However, when writing the report, I found myself wishing I had asked questions that were not in my initial clinical interview. With every new question I thought of, I added it to the clinical interview and continued the fine-tuning process. By the end, my clinical interview had gone from 9 to 16 pages.
2. Administering and Scoring the Test
Practice, practice, practice. I am not confident that I can stress how critical it is to practice. Whether you get to administer to one or eight clients, practice will make you better. First, no matter how confident you may feel going into your first assessment, nerves are sure to set in, and the way to combat nerves is to be prepared. There is built-in class time to practice, but it is difficult to practice the entire battery of tests during class; thus, practicing outside of class is crucial. To start, invest in a stopwatch, preferably one that does not beep loudly. A stopwatch prevents you from the distractions that accompany a cellular device, plus it is professional. I would suggest purchasing a non-clear clipboard to help score accurately.
Additionally, practice as often as you can, and when possible, find a colleague to practice with, as the examiner and examinee. This gives you the opportunity to experience what your client will be doing and solidify your understanding of each subtest. If you do not have a partner, practice by yourself and pretend you have a client. This way, when you administer the test for the first time, even though you are a student, your professionalism will be evident. If you do not practice, it will be noticeable to you and your client.
As far as tests go, spend as much time as you can mastering the WAIS-IV; it is the crème de la crème of psychological assessments. Once you have a grip on administering the WAIS-IV, you will have a much easier time learning how to administer other tests. Additionally, test all 15 subtests on the WAIS-IV and all other tests for that matter, at least once, so you are familiar with them.
Finally, remember to write down everything you observe during the test administration down to what your clients are saying. These observations will help you explain the client's test results and why they may have performed as they did.
3. Writing the Report
Writing the report will, by far, be the most challenging part of this process. Again, lean on the A. Jordan Wright text for this portion. Dr. Wright offers tremendous and straightforward guidance. The first time you write the report will be the hardest. However, after your first attempt, you will have a roadmap, template, and crucial feedback from your professor on approaching each subsequent report. Again, conducting a thorough clinical interview, having detailed notes and observations both from the interview and test will help you in writing the report.
As you are writing each section, you want to provide supporting evidence for the statements you make regarding your client. For instance, if your client seemed nervous during a section of the test, you will need to have supporting evidence explaining why you thought they were nervous. If your client displays significant strength or weakness in their performance, you will need evidence to explain the results. The basic rule of thumb is this: for every statement you make about your client's behavior or performance, you will need to provide supporting evidence explaining the behavior and performance. Ideally, the evidence will help paint a picture of your client's experience during the test and in their life. To successfully do this, you must be thorough in your clinical interview and astute in your observations.
Additionally, you will be discussing what core themes emerge for your client. Like everything else, capturing your client's themes accurately will require practice and patience. To this end, I strongly suggest using a clinical inference map to help you conceptualize these themes. A clinical inference map is a truncated tool that visually lays out your observations and hypothesis summarizing your clients' overall functioning. Additionally, the clinical inference map will help you see what themes emerge for your client. As I gained experience, I began creating my clients' themes in my head from the beginning of the assessment. That way, by the time I gathered all my data, I had several ideas percolating in my brain to pull from.
4. Other Suggestions
- Recruit clients as soon as you are able and have back-ups. These assessments are very time consuming, so be transparent about the time commitment and ready with a plan B in case a client is unable to commit.
- Administer each test (i.e., WAIS-IV, WMS-IV etc.) at least once, that way you are familiar.
- Lean on your colleagues and be generous to each other.
- Remember that you are just beginning, and you will not be perfect. So, embrace this experience and trust the process.
- Most importantly, have grace for yourself. It gets easier.