PSYCHODIAGNOSIS MIDTERM ASSIGNMENT

Part B

Submitted to

Dr. Kehkashan Arouj

Submitted By

Aqsa Mehar Khan

402-FSS/MSCP/F19

International Islamic University, Islamabad

May 20, 2020

RORSCHACH INKLBOT TEST IN THE TIME OF COVID-19

Clinical psychologists and neuropsychologists whose practices focus on the
delivery of testing evaluation and face-to-face test administration and scoring
services are facing substantial challenges during the COVID-19 national crisis.
However, efficient decision making on part of clinical psychologist is now more
important than ever regarding what tests and assessment techniques should be
opted for and what should be withheld.

Preference of Administering Rorschach Inkblot Test during the Pandemic

Rorschach inkblot is a projective test which requires one-on-one interaction

between the psychologist and the client. Administering RIT via online or tele-
assessment can be a tricky task. Rorschach requires showing of inkblot cards to
the client after which then they must report back what they make of or perceive
from the design. Online sessions are sometimes difficult to pull off. There can be
several issues of connection, audio, video, graphic resolution which can hinder
the assessment process. The client might not comply completely with the
clinician’s instruction or he/she might not be able to fully comprehend or perceive
the cards. The psychologist also must take care of the fact that he/she doesn’t risk
the security of the test hence they cannot send high quality pictures of the cards
to the client either. Our preference of administering RIT during a pandemic would
be in case of extreme necessity if the situation absolutely requires administration
of this particular test. Otherwise, the measures should be taken in order to
compensate the need for projective analysis with other easy and less-complicated
alternatives for instance, RISB or drawing tests (HFD, HTP etc.)

Challenges in Convincing the Client to Take Rorschach

Resistance

The client may resist being assessed and might show reluctance as to
whether he/she needs the diagnosis or not. The clients could also be
uncomfortable by the online therapy or he/she could be trying to still figure out
the way to get used to new mode of therapy. All factors should be considered
when trying to convince the client to take a test.

Inconvenience due to long-distance therapy

the unnatural/unconventional way of therapy style might also hinder

client’s complete participation in the process. Online communication can be very
cumbersome sometimes as there can be issues with connection, audio and video
transmission. The client could also be overwhelmed by the ongoing pandemic
situation and might not be able to focus completely. Their pre-existing condition
and added stress of the pandemic situation could also lead to their non-
compliance.

Difficulty of the Test

Since Rorschach is a pretty complicated test it would be quite difficult

to administer it effectively online. The client might hesitate in reporting the
responses back to the clinician. The client might also express his/her uneasiness
with the test and could ask for an alternate test.

APA’s Guidelines on Tele-Assessment and Online Therapy in The Time of Covid-

19

While some psychologists may pause their psychological assessment

services during the COVID-19 crisis, others have time-sensitive, high-needs or
high-stakes testing that needs to continue. A new guidance on tele-assessment
from APA’s Div. 12 (Society of Clinical Psychology) provides some advice on
practicing in this time.
Some standardized testing administration methods will need to be altered.
Altering these administration procedures should be done carefully, thoughtfully
and deliberately, with special attention paid to how the alterations themselves
may modify the data. These six principles will help psychologists continue
providing tele-assessments within the current physical distancing constraints.
Do Not Risk Test Security

While some test materials and procedures will need to be modified to allow
for physical distancing, psychologists should be sure they do not jeopardize test
security. For example, sending stimulus materials (copies of psychomotor task
stimuli or record forms) may not be approved by test publishers.

Do the Best You Can with What Is Available to You (Mindfully and Ethically)

It is important for the psychologist to know the limits of tele-testing and to

consider whether this approach is appropriate given the referral question,
evidence, client characteristics/ preferences and clinician expertise. Do your best
to keep the administration procedures as close as possible to the traditional, in-
person procedures. Remote audio-visual monitoring of the test administration,
even with self-administered instruments, is essential.

Be Rigorously Mindful of Data Quality

To date, there is limited research and evidence for equivalence of testing in

a remote, online format compared to a traditional, face-to-face format.
Psychologists should think through every single task administered and decide just
how much the quality of the data are likely affected by the alternate
administration format.
Think Critically About Test and Subtest Substitutions

There will certainly be some tests or subtests that are not possible to
replicate via telehealth. However, psychologists can consider tasks that tap similar
constructs. Remember that the most robust and meaningful scales in multi-
faceted tests are typically the overall “full scale” indices, rather than their
subscales. That means that slight data problems may not be as important,
meaningful or disruptive because they are only partially contributing to the larger,
overall score.

Widen “Confidence Intervals” When Making Conclusions and Clinical Decisions

Psychological assessment requires psychologists to use their clinical

judgment to interpret test scores, including their margin for error, within the
context of individual and contextual factors, including presenting problems,
diversity considerations and other factors. Integrating test data derived from non-
standardized administration procedures broadens the margin of error. It is
important for psychologists to be deliberate and explicit about the broader
confidence intervals and potential for errors in the administration process,
interpretation and in the write-up of results.

Maintain the Same Ethical Standards of Care as In Traditional Psychological

Assessment Services

The ethical principles that underlie the APA’s Ethics Code are built on the
foundation of doing good, avoiding harm and being faithful and just in our work.
These principles remain intact during this crisis period. This includes ensuring that
the process of informed consent is thorough, clear and ongoing. It is important to
be transparent in reports about the novel circumstances under which the
assessment was conducted, as well as the considerations that went into how data
are interpreted, with consideration to alterations, and integrated with other
information.