Monday, November 5, 2012
Utilizing Personality Assessment to Inform Diagnosis
Affects of personality on therapy.
Utilizing personality assessment to inform diagnosis can help identify and define personality issues that may easily become entwined with other psychological challenges and convolute the therapeutic process (Whiston, 2008). It may be advantageous to consider clients' personalities prior to making judgments regarding their perspectives, perceptions, and behaviors. Prior to case conceptualization, designing intervention strategies, and making decisions in treatment, counselors should be fully apprised of the individual's personality tendencies. To make reliable and valid judgments, it seems prudent to consider the unique context of the individual's personality (Whiston, 2008).
Affects of personality on communication.
Because personality can have a tremendous influence on how individuals take in information, and how they see the world in general (Whiston, 2009), understanding general personal tendencies may improve communication between the client and the counselor, or between two or more clients in couples or family counseling. For example, Dr. Patton used the MBTI to help increase communication between himself and his two clients (Laureate Education, Inc., 2010). Understanding personality may lead to more accurate communication.
The inaccuracies of self-reporting.
A disadvantage of personality assessment may be in the inherent flaws of questionnaire-type assessments in which self-reporting is used. Symptoms, as reported by the client, may be better or worse on the day he or she is asked to complete the inventory. Bowling (2005) found that with questionnaires, responses can be influenced by the environment in which it is taken, as well as the mood of the test taker at the time of the test. Self-report questionnaires are highly susceptible to lying, over and understating, and malingering. and in tests that use adjective selection, word choices may be affected by mood changes (Craig, 2005).
Creating counselor bias.
When counselors use assessments during the initial phase of therapy, they are, in effect, laying the foundation for the whole of the therapeutic process (Whiston, 2009). As such, care must be taken that as counselors piece together the impressions, individual contexts, and unique personality aspects of the client, that they do not create an immovable or inflexible perception. Certainly there is no benefit in basing any aspect of treatment on skewed or biased information. Furthermore, basing case conceptualization or treatment planning on such information could be ineffective, even harmful to the client (Whiston, 2009).
Counselors are advised to use assessments as a single component of conceptualizing the client (American Counseling Association (ACA), 2005) rather than presume, for example, that a personality assessment presents a holistic representation of the client. In exploring aspects of a client's personality, counselors should understand the harm in making a diagnosis that depends primarily on such an assessment (Whiston, 2009). Although a personality evaluation may contribute to the counselor's more accurate understanding of the client, this type of evaluation cannot, in and of itself, provide a diagnosis. A variety of information sources, including the personal interview, self-reported symptoms, the client's fundamental belief systems, and the results of structured and non-structured assessments should be contributing factors in determining a diagnosis (ACA, 2005; Owen, 2008). Furthermore, when assessing personality aspects, it is prudent to consider the influence of culture on personality formation (Association for Multicultural Counseling and Development (AMCD), 1996).
Although an assessment may be reliable and valid in one population, it may not necessarily be so for all populations (Sedlacek, 1994). If the chosen assessment has not been normed on a population similar to the clients, it may be an unreliable measure of the constructs it typically measures (Sedlacek, 1994). The main purpose of assessments is to provide valid and reliable measurements (ACA, 2005). Counselors must use caution when using an instrument that has not been validated on the client's population (ACA, 2005).
Furthermore, counselors must guard against believing in the universality of psychological constructs and when interpreting the results of an assessment, the results must be perceived within the cultural context of the individual (Stewart, 2002). Unless the assessment has been tested as an accurate representation of personality aspects for the client's population, it is invalid and unreliable (Whiston, 2008). Culturally competent counselors should be trained in the appropriate use of assessment instruments (AMCD), 1996). Functioning in the best interest of their clients, counselors understand assessment technicalities and maintain an awareness of the limitations of the instruments they utilize (AMCD, 1996), including those that evaluate personality.
American Counseling Association. (2005). ACA Code of Ethics. Retrieved from http://www.counseling.org/Resources/CodeOfEthics/TP/Home/CT2.aspx
Association for Multicultural Counseling and Development (1996). AMCD multicultural counseling competencies. Retrieved from http://www.counseling.org/Resources/Competencies/Multcultural_Competencies.pdf
Bowling, A. (2005). Mode of questionnaire administration can have serious effects on data quality. Journal of Public Health, 27(3), 281-291. doi: 10.1093/pubmed/fdi031
Craig, R. J. (2005). Assessing personality and mood with adjective check list methodology: A review. International Journal of Testing, 5(3), 177-196. doi: 10.1207/s15327574ijt0503_1
Laureate Education, Inc. (Executive Producer). (2010). Assessment in counseling and education, part 1, introduction to assessment. Baltimore, MD: Executive Producer..
Owen, J. (2008). The nature of confirmatory strategies in the initial assessment process. Journal of Mental Health Counseling, 30(4), 362-374.
Sedlacek, W. E. (1994). Issues in advancing diversity through assessment. Journal of Counseling and Development, 72, 549-553.
Stewart, J. B. (2002). Using the culture grid in culture-centered assessment. Guidance & Counseling, 18(1), 10-17.
Whiston, S. C. (2009). Principles and applications of assessment in counseling (3rd ed.). Belmont, CA: Brooks/Cole, Cengage Learning