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

Contextual Influences

Personal InputsSelf-Efficacy

Learning Interests Choice Choice PerformanceExperiences Goals Actions

Background OutcomeContextual Affordances Expectations

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– Usually using “tests”

or standardized measures

– Norms and standards for comparison

– Specific and structured

Qualitative– Holistic/ integrated– No norms, standards– Assessment during

the counseling process

– Flexible

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 Communication Research Unified fields Facilitate treatment

CRITICISMS Sexist Culturally biased Defining categories

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– Preoccupation with

body Depression Hysteria Psychopathic

deviate– Antisocial behavior

Masculine-Feminine

Paranoia Psychasthenia

– Obsessions/compulsions

Schizophrenia Mania Social introversion

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