Psychology  STANDARDS ON ASSESSMENTS AND THERAPY

PART1-Due ThursdayRespond to the following in a minimum of 175 words:Review this week’s course materials and learning activities, and reflect on your learning so far this week. Respond to one or more of the following prompts in one to two paragraphs:Provide citation and reference to the material(s) you discuss. Describe what you found interesting regarding this topic, and why.Describe how you will apply that learning in your daily life, including your work life.Describe what may be unclear to you, and what you would like to learn.PART2-Case Study Seven WorksheetRespond to the following questions in 1,250 to 1,500 words.1. Why is this an ethical dilemma? Which APA Ethical Principles help frame the nature of the dilemma?2. To what extent, if any, should Dr. Vaji consider Leo’s ethnicity in his deliberations? Would the dilemma be addressed differently if Leo self-identified as non-Hispanic White, Hispanic, on non-Hispanic Black?3. How are APA Ethical Standards 1.08, 3.04, 3.05, 3.09, 7.04, 7.05, and 17.05 relevant to this case? Which other standards might apply?4. What are Dr. Vaji’s ethical alternatives for resolving this dilemma? Which alternative best reflects the Ethics Code aspirational principle and enforceable standard, as well as legal standards and obligations to stakeholders?5. What steps should Dr. Vaji take to ethically implement his decision and monitor its effects?ReferenceC. B. (2013). Decoding the ethics code: A practical guide for psychologists. Thousand Oaks, CA: Sage.PART3-Develop an 2-slide Microsoft® PowerPoint® presentation with detailed speaker notes on the selection process of a culture-neutral assessment. Include examples of when culture-biased assessments have been problematic.Use a minimum of 2 peer reviewed (scholarly journal articles) sources.(I WILL ADD MORE DETAILS FOR PART 3 BY TUESDAY)REFERENCEChapter 12 Standards on Assessment 9. Assessment9.01 Bases for Assessments©iStockphoto.com/voinSvetaPsychological assessment serves the public good by providing information to guide decisions affecting the well-being of individuals, families, groups, organizations, and institutions. Psychologists who base their conclusions about information and techniques on the scientific and professional knowledge of the discipline are uniquely qualified to interpret the results of psychological assessments in ways that merit the public trust. However, the public and the profession are harmed when psychologists provide opinions unsubstantiated by information obtained or drawn from data gathered through improper assessment techniques (Principle A: Beneficence and Nonmaleficence; Principle B: Fidelity and Responsibility). Standard 9.01a of the APA Ethics Code (APA, 2010b) prohibits psychologists from providing written or oral opinions that cannot be sufficiently substantiated by the information obtained or the techniques employed.The standard is broadly worded to apply to all written and oral professional opinions, irrespective of information recipient, setting, or type of assessment.Information RecipientThe standard prohibits unfounded professional opinions offered to, among others, (a) individual clients/patients or their representatives; (b) other professionals; (c) third-party payors; (d) administrative and professional staff at schools, hospitals, and other institutions; (e) businesses, agencies, and other organizations; (f) the courts; (g) the military or other governing legal authorities; and (h) callers to talk radio programs or those interacting with psychologists via the Internet or through other media.Need to Know: Assessment in Child Protection MattersForensic examiners retained in response to an accusation of child abuse and neglect need to obtain competencies relevant to the intersecting interests of the child, the parents, and the state, including laws on parental termination and the role of kinship and policies favoring child placement with extended family members in favor of foster care (Standard 2.01f, Competence; APA, 2013b). The primary purpose of the assessment is to help government agencies and courts determine whether a child’s health and welfare may have been and/or may be harmed. Consequently, in addition to the broader parent–child “fit” considerations typical of custody evaluations, psychologists need to select assessment techniques sufficient to address the particular vulnerabilities and risks of maltreatment associated with specific child characteristics (e.g., children with developmental disabilities or other medical needs) and the need for and likelihood of success of clinical interventions for problems associated with abuse, maltreatment, or neglect. This may include familiarity with techniques for assessing the role of specific cultural patterns of parenting, impact of familial separation, and foster and kinship-based alternative care. In interpreting results, psychologists must also refrain from assuming a child advocacy role and gather information impartially based on reliable methods established in the field (Standard 2.04, Bases for Scientific and Professional Judgments).SettingStandard 9.01a applies to (a) diagnostic opinions offered orally in the office of a private practitioner; (b) written reports provided to clients/patients, other practitioners, or third-party payors through the mail, the Internet, or other forms of electronic transmission; (c) testimony provided in the courts; and (d) opinions about an individual’s mental health offered over the Internet, radio, television, or other electronic media.Types of AssessmentThe standard pertains to all unfounded opinions claiming to be based on any form of evaluation, including but not limited to (a) standardized psychological, educational, or neuropsychological tests; (b) diagnostic information gained through clinical interviews; (c) collateral data obtained through discussions with family members, teachers, employee supervisors, or other informants; (d) observational techniques; or (e) brief discussion or correspondence with an individual via radio, television, telephone, or the Internet.Violations of this standard are often related to failure to comply with other standards, including Standards 2.04, Bases for Scientific and Professional Judgments; 9.01b, Bases for Assessments; and 9.02b, Use of Assessments. For example, psychologists should not use test scores as sole indicators for diagnostic or special program placement but instead use multiple sources of information and, when appropriate, provide alternative explanations for test performance (AERA, APA, & NCME, 2014). The following are examples of opinions based on insufficient information or techniques that would be considered violations under this standard:Psychologists who knowingly provide unsubstantiated opinions in forensic, school, or insurance reports fail to live up to the ideals of Principle C: Integrity and may also find themselves in violation of Standard 5.01, Avoidance of False or Deceptive Statements (see Hot Topic “Avoiding False and Deceptive Statements in Scientific and Clinical Expert Testimony,” Chapter 8). However, psychologists should also be alert to personal and professional biases that may affect their choice and interpretation of instruments. For example, in a survey of forensic experts testifying in cases of child sexual abuse allegations, Everson and Sandoval (2011) found that evaluator disagreements could be explained, in part, by individual differences in three forensic decision-making attitudes: (1) emphasis on sensitivity, (2) emphasis on specificity, and (3) skepticism toward child reports of abuse.©iStockphoto.com/voinSvetaStandard 9.01b specifically addresses the importance of in-person evaluations of individuals about whom psychologists will offer a professional opinion. Under this standard, with few exceptions, psychologists must conduct individual examinations sufficient to obtain personal verification of information on which to base their professional opinions and refrain from providing opinions about the psychological characteristics of an individual if they themselves have not conducted an examination of the individual adequate to support their statements or conclusions. As video conferencing and other electronically mediated sources of video communication become increasingly common, appropriately conducted assessments via these media may meet the requirements of this standard if the psychologist has had the appropriate preparatory training and the validity of the video methods of assessment has been scientifically and clinically established for use with members of the population tested (Standards 2.01e, Boundaries of Competence; 2.04, Bases for Scientific and Professional Judgment; 9.02, Use of Assessments).Standard 9.01b also recognizes that in some cases, a personal examination may not be possible. For example, an individual involved in a child custody suit, a disability claim, or performance evaluation may refuse or, because of relocation or other reasons, be unavailable for a personal examination. The standard requires that psychologists make “reasonable efforts” to conduct a personal examination. Efforts that would not be considered reasonable in the prevailing professional judgment of psychologists engaged in similar activities would be considered a violation of this standard. Consider the following two examples of potential violations:When, despite reasonable efforts, a personal interview is not feasible, under Standard 9.01b psychologists in their written or oral opinions must document and explain the results of their efforts, clarify the probable impact that the failure to personally examine an individual may have on the reliability and validity of their opinions, and appropriately limit their conclusions or recommendations to information they can personally verify. Psychologists may report relevant consistencies or inconsistencies of information found in documents they were asked to review (see Standard 9.01c below). However, they should avoid offering opinions regarding the personal credibility or truthfulness of individuals they have not examined or when basic facts contested have not been resolved through assessments (APA, 2013b).This standard applies to those assessment-related activities for which an individual examination is not warranted or necessary for the psychological opinion. Such activities include record or file reviews where psychologists are called on to review preexisting records and reports to assist or evaluate decisions made by schools, courts, health insurance companies, organizations, or other psychologists they supervise or with whom they consult. Record reviews can be performed to (a) determine whether a previously conducted assessment was appropriate or sufficient; (b) evaluate the appropriateness of treatment, placement, employment, or continuation of benefits based on the previously gathered information and reports; (c) adjudicate a disability or professional liability claim based on existing records; or (d) resolve conflicts over the applicability of records to interpretations of federal and state laws in administrative law or due process hearings (Bartol & Bartol, 2014; Hadjistavropoulos & Bieling, 2001).Reviewers provide a monitoring function for the court or a function of forensic quality control so the court will not be misled by expert testimony of evaluators that is based on flawed data collection and/or analysis (Austin, Kirkpatrick, & Flens, 2011). According to Standard 9.01c, psychologists who provide such services must clarify to the appropriate parties the source of the information on which the opinion is based and why an individual interview conducted by the psychologist is not necessary for the opinion.Simply complying with this standard may not be sufficient for psychologists who are in supervisory roles that carry legal responsibility for the conduct of assessments by unlicensed supervisees or employees. In many of those instances, psychologists may be directly responsible for ensuring that individuals are qualified to conduct the assessments and do so competently (see Standard 2.05, Delegation of Work to Others).☒ Testifying on the validity of a child abuse allegation based on the results of an idiosyncratic, improperly constructed parent checklist of child behaviors☒ Diagnosing an adult with impaired decisional capacity as developmentally disabled without taking a developmental history☒ Providing preemployment recommendations on the basis of a personality test with no proven relationship to job performance☒ Submitting a diagnosis of neurological impairment to a health insurance company based solely on information derived during therapy sessions☒ Informing parents that their preschooler is autistic on the basis of a single observational session☒ Recommending a child for special education placement solely on the basis of scores on a standardized intelligence test☒ Offering a diagnosis of PTSD based on a 5-minute discussion with a listener who calls in to a radio program hosted by the psychologist☒ Offering a diagnosis of bipolar disorder based on an individual’s comments on the psychologist’s blog☒ Submitting for health insurance reimbursement a diagnosis of dementia in an elderly patient complaining of memory lapses, without conducting a neuropsychological assessmentDigital Ethics: Use of Mobile Phones for Treatment Adherence MonitoringFor some mental health disorders such as anorexia nervosa, borderline personality disorder, and substance dependency, downloadable mobile phone applications (mHealth) for client/patient self-monitoring can be a valuable adjunct to in-person psychotherapy, as they can reduce vulnerabilities of memory and help clients/patients reflect critically on their thoughts and behaviors (Aardoom Dingemans, Spinhoven, & Van Furth, 2013; Ambwani, Cardi, & Treasure, 2014; Dimeff, Rizvi, Contreras, Skutch, & Carroll, 2011; Dombo et al., 2014). When deciding whether mHealth is clinically indicated for a specific client/patient, psychologists should consider (a) whether the client/patient can effectively use the technology without supervision, based on diagnostic assessment as well as conducting an in-office assessment of the client’s/patient’s ability to utilize the technology, and (b) the likelihood that clients/patients will become overdependent on the mobile technology in ways that jeopardize their ability to implement behavior management skills independent of the technology (Ambwani et al., 2014; Standards 2.04, Bases for Scientific and Professional Judgments, and 3.04, Avoiding Harm). To ensure appropriate confidentiality protections, psychologists should (a) assess risks to confidentiality that may be inherent in the client’s/patient’s home, work, and other treatment management–related environments; (b) utilize behavior management mobile applications and/or Internet sites with adequate security protections; and (c) provide clients/patients with instruction on how to protect their privacy and confidentiality (Standards 4.01, Maintaining Confidentiality; 4.02, Discussing the Limits of Confidentiality).☒ A psychologist testified about a parent’s psychological fitness for visitation rights, drawing his opinion solely from comments made by the child and divorced spouse in the absence of an individual examination of the parent.☒ A psychologist contracted by an insurance company to evaluate an individual’s mental health as part of a current disability claim provided an opinion based solely on job performance evaluations written by the insured’s immediate supervisors and diagnostic information collected by another psychologist prior to the incident cited in the claim.☒ A psychologist working in a correctional facility who was asked to recommend whether a prison guard’s mental status was a risk to prisoner protections did not personally examine the guard but instead gave an opinion based on reports by facility administrators, staff, and prisoners.☒ A psychologist was contracted by a prison to evaluate the job potential of guards hired for a probationary period. Without conducting an individual interview, the psychologist wrote a report concluding that emotional instability of one job candidate made him ineligible for full-time employment. The psychologist justified the lack of a personal examination on the fact that several coworkers had claimed the guard was too dangerous to interview.☒ A psychologist hired by the attorney of a husband engaged in a custody suit provided court testimony on the wife’s parenting inadequacies without having interviewed her personally. The psychologist claimed that the wife had not responded to the psychologist’s letter requesting the interview. On cross-examination, it was revealed that the letter written by the psychologist included the following language seemingly designed to discourage agreement to be examined: “I have reason to believe from interviews with your spouse and an examination of your children that you are responsible for the children’s current mental health problems and would like to conduct an examination to confirm or dispute these assumptions.”☑ A court-appointed psychologist attempted to contact the biological parent of a child currently in foster care to make recommendations regarding parental visitation. The parent was no longer at the last known residence and had not left a forwarding address. In testimony, the psychologist described the current mental health status of the child, the child’s statements regarding the biological parent, and the observed relationship between the child and foster parents. In referring to the biological parent, the psychologist informed the court of efforts to contact the parent, described how failure to interview the parent limited any conclusions that could be drawn regarding the parent’s psychological characteristics and parenting competence, and clarified that recommendations regarding visitation were based on the child’s attitudes, mental health, and foster care arrangements.Review of Data From Surreptitious Investigative RecordingThere are instances when forensic psychologists may be asked to evaluate past mental states from audio or video recordings of a defendant’s behavior at the time of the alleged offense or surreptitious recordings of a plaintiff’s behavior in a personal injury, insurance disability, or divorce case (Denney & Wynkoop, 2000). Before agreeing to review such recordings, psychologists should make sure that the surveillance information was obtained legally at the time it was recorded, that the party requesting the psychologist’s evaluation has the legal right to share such information, and that inadmissibility of such information will not compromise the psychologist’s findings. Psychologists should also take reasonable steps to ascertain that they have been provided with all legally available recordings and other available information relevant to the forensic opinion. The psychologist’s oral testimony or written report should clarify the source of the information and why an individual examination is not warranted or necessary for the type of evaluation requested.9.02 Use of Assessments©iStockphoto.com/voinSvetaThe appropriate use of psychological assessments can benefit individuals, families, organizations, and society by providing information on which educational placements, mental health treatments, health insurance coverage, employee selection, job placement, workers’ compensation, program development, legal decisions, and government policies can be based. The inappropriate use of assessments can lead to harmful diagnostic, educational, institutional, legal, and social policy decisions based on inaccurate and misleading information.Standard 9.02a is concerned with the proper selection, interpretation, scoring, and administration of assessments. It refers to the full range of assessment techniques used by psychologists, including interviews and standardized tests administered in person, through the Internet, or through other media. According to this standard, ethical justification for the use of assessments is determined by research on or evidence supporting the purpose for which the test is administered, the method of administration, and interpretation of scores (AERA, APA, & NCME, 2014). To comply with the standard, psychologists should be familiar with and be able to evaluate the data and other information provided in test manuals detailing (a) the theoretical and empirical support for test use for specific purposes and populations, (b) the test’s psychometric validity, (c) administration procedures, and (d) how test scores are to be calculated and interpreted. Psychologists should also keep themselves apprised of ongoing research or evidence of a test’s usefulness or obsolescence over time (see also Standards 2.03, Maintaining Competence; 2.04, Bases for Scientific and Professional Judgments; 9.08b, Obsolete Tests and Outdated Test Results). The standard also requires that psychologists adhere to standardized test administration protocols to ensure that test scores reflect the construct(s) being assessed and avoid undue influence of idiosyncrasies in the testing process (AERA, APA, & NCME, 2014).Violations of Standard 9.02a occur when psychologists use assessments in a manner or for a purpose that is not supported by evidence in the field (see also this chapter’s Hot Topic “The Use of Assessments in Expert Testimony: Implications of Case Law and the Federal Rules of Evidence”).Modifications for Individuals With DisabilitiesTest administration for individuals with disabilities may require modifications and adaptations in testing administration to minimize the effect of test taker characteristics incidental to the purpose of the assessment. Standard 9.02a permits departure from a standard administration protocol if the method of test adaptation can be justified by research or other evidence. For example, converting a written test to Braille for an individual who is legally blind, physically assisting a client with cerebral palsy to circle items on a written test, or providing breaks for an individual with a disability associated with frequent fatigue is acceptable if the particular disability is not associated with the construct to be measured by the test and there are professional or scientific reasons to assume that such modifications will not affect the validity of the test (AERA, APA, & NCME, 2014). However, such accommodations are not appropriate if the disability is directly related to the abilities or characteristics that the test is designed to measure. Any modifications to testing and potential limitations in interpretation must be documented. Federal regulations relevant to the assessment of individuals with disabilities include IDEA (http://idea.ed.gov), Section 504 of the Rehabilitation Act of 1973, revised 2006 (http://www.hhs.gov/civil-rights/for-individuals/disability/index.html), and ADA (http://www.ada.gov).Digital Ethics: Internet-Mediated AssessmentsPsychologists administering assessments via the Internet need to remain up-to-date on research demonstrating the assessments’ validity or lack thereof for use in this medium (Montalto, 2014; Standard 2.03, Maintaining Competence). Verification of the examinee’s age, gender, and honesty of disclosures is important to the assessment’s validity and reliability (Alleman, 2002). Some assessments developed for in-person administration require verbal, auditory, or kinesthetic clues for accurate diagnosis (Barak & English, 2002). When assessments have not been validated for use via the Internet, psychologists should make every effort to conduct an in-person evaluation. When this is not possible, psychologists should select instruments that research or other evidence indicates are most appropriate for this medium, implement when possible information-gathering techniques that can best approximate in-person settings (e.g., video and auditory interactive technology), and acknowledge limitations of the assessment in interpretations of the data (Standard 9.06, Interpreting Assessment Results). Technology-based testing is also related to concerns regarding standardized administration and construct validation. Psychologists need to be aware of limitations in administration and interpretation for examinees who may not have access to or are unfamiliar with the use of new technologies or will be using older computers or devices with slower processing speed (AERA, APA, & NCME, 2014; Standard 3.01, Unfair Discrimination).☒ A psychologist contracted to conduct employment testing for an organization administered a series of personality inventories with little or no validity evidence supporting the link between scores on the inventories and actual job performance.☒ A counseling psychologist working with an isolated rural community administered a series of tests over the Internet without previously establishing whether the Internet-mediated scores measured the same construct as scores from the paper-and-pencil version (Buchanan, 2002).☒ A school psychologist working under pressure to meet the school system’s quotas for weekly testing gave the same battery of tests to all students irrespective of their grade level or presenting problem.☒ A neuropsychologist conducted a forensic examination of a prisoner in a room occupied by other prisoners, thereby compromising the validity of score interpretation based on norms established under standardized distraction-free testing environments.Need to Know: Assessment of DementiaThe APA Guidelines for the Evaluation of Dementia and Age-Related Cognitive Change (APA, 2012d) stress the importance of using age-normed standardized psychological and neurological tests, being aware of the limitations of brief mental status examinations, and estimating premorbid abilities. The Guidelines also describe the following key elements that should be obtained to ensure accurate diagnosis of conditions associated with cognitive decline (p. 5):The onset and course of changes in cognitive functioningPreexisting disabilitiesEducational and cultural background that could affect testing variabilityGeneral medical and psychiatric historyPast neurological history, including prior head injuries or other central nervous system insults (strokes, tumors, infections, etc.)Current psychiatric symptoms and significant life stressorsCurrent prescription and over-the-counter medication useCurrent and past use and abuse of alcohol and drugsFamily history of dementiaPresence of Third Parties to AssessmentsStandard 9.02a requires that psychologists administer tests in a manner consistent with procedures and testing contexts used in the development and validation of the instruments. Many psychological assessment instruments and procedures are validated under administration conditions limited to the presence of the psychologist and testee. In rare instances, psychologists may judge it necessary to include third parties to control the behavior of difficult examinees (e.g., parents of young children, hospital staff for psychiatric patients with a recent history of violence). In such situations, psychologists should select assessment instruments that are least likely to lend themselves to distortion based on the presence of a third party and include in their interpretations of test results the implications of such violations of standardized testing conditions.Psychologists providing expert forensic consultations in relation to a criminal case, tort litigation, insurance benefits, or workers’ compensation claims may find that the assessment validity of tests is compromised when third parties are present as mandated by state law, institutional policy, or a judge’s ruling. For example, in neuropsychological assessments related to workers’ compensation cases, the presence of the plaintiff’s legal counsel, family members, or company representatives may distort the testing process or render test scores and interpretations invalid if the third party influences the test taker’s motivation or behavior or the psychologist–testee rapport (American Academy of Clinical Neuropsychology, 2001). The use of data from such assessments may be unfair to individuals if it leads to invalid test administration or misleading interpretations of the testee’s responses (Principle D: Justice and Standards 1.01, Misuse of Psychologists’ Work; 1.02, Conflicts Between Ethics and Law, Regulations, or Other Governing Legal Authority; and 9.06, Interpreting Assessment Results). When there is no legal flexibility to deny third-party presence during an assessment, psychologists should select those tests and procedures found to be least susceptible to distortion under such conditions and ensure that their written reports highlight the unique circumstances of the assessment and the limitations in interpretation.Trainees and Interpreters as Third PartiesThird parties may observe evaluations for training purposes or serve as interpreters when translation is necessary to ensure accuracy and fairness of assessments (Standard 9.02c, Use of Assessments). In such instances, psychologists must select procedures that research or other evidence has demonstrated can be applied appropriately under these circumstances, ensure that trainees and interpreters are trained adequately to minimize threats to the proper test administration, and include in their reports any limitations on conclusions due to the presence of the third parties (Standards 2.05, Delegation of Work to Others; 9.06, Interpreting Assessment Results).The central idea of fairness in psychological and educational testing is to identify and remove construct-irrelevant barriers to maximal performance and allow for comparable and valid interpretation of test scores for all examinees (AERA, APA, & NCME, 2014). The proper use of tests can further principles of fairness and justice by ensuring that all persons benefit from equal quality of assessment measures, procedures, and interpretation (Principle D: Justice; Standard 3.01, Unfair Discrimination). Fair applicability of test results rests on assumptions that the validity and reliability of a test are equivalent for different populations tested. Validity refers to the extent to which empirical evidence and psychological theory support the interpretation of test data, that is, whether the test measures the psychological construct it purports to measure. Reliability refers to the consistency of test scores when a test is repeated for an individual or for a given population (see AERA, APA, & NCME, 2014).A test that is a valid and reliable measure of a psychological construct in one population may not adequately measure the same construct in members of a different population, especially if members of the population of interest were represented inadequately in the normative sample or if test validity has not been established specifically for that group. Standard 9.02b requires psychologists to select assessment instruments whose validity and reliability have been established for use with members of the population tested. This standard applies to psychological assessment of any population, including clients/patients, students, job candidates, legal defendants, and research participants.To comply with this standard, psychologists, when selecting a test, must be familiar with the specific populations included in the standardization sample and the test’s validity and reliability estimates. At minimum, psychologists should determine the applicability of a test to an individual of a given age group, ethnicity/culture, language, and gender and, where applicable, disability or other population characteristic when scientific or professional evidence suggests that test scores may not be psychometrically, functionally, or theoretically comparable to scores for the reference groups on which the test was normed (Landwher & Llorente, 2012).Psychologists should also be familiar with relevant federal laws on the selection and administration of nondiscriminatory assessment and evaluation procedures (e.g., IDEA, 34 CFR 300.30[c][1][i]).The dynamic and evolving nature of this country’s cultural, political, and economic landscape creates situations in which population-valid and reliable tests of a psychological construct may not be available for the individual or group tested. Psychologists asked to evaluate individuals from such groups should select tests validated on other populations with caution because they may produce results that do

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