Chris Piotrowski

Assessment practices in the era of managed care: Current status and future directions

This article reviews recent research to determine the impact of managed health care policies on assessment practices of psychologists. The author presents findings from several test use surveys of the 1990s, summarizes available empirical data on the managed care-assessment nexus, and shares his personal views on the effects of managed care constraints on practice and training in clinical psychology. Investigations to date seem to indicate that managed care has adversely affected testing and assessment practices with the result that clinicians are performing less testing overall and are restricted in terms of their pool of assessment instruments. Personality assessment appears to be most affected with a shift away from lengthy measures toward more brief, symptom-focused testing instruments.

THE STATUS OF THE BECK ANXIETY INVENTORY IN CONTEMPORARY RESEARCH

The author performed a comparative analysis on the research output of 6 popular clinical measures of anxiety. The results of a citation analysis of the database from PsycINFO for the years 1991–1998 indicated that the Beck Anxiety Inventory presently ranks third, behind the State-Trait Anxiety Inventory and the Fear Survey Schedule, in terms of use in research.

Perspectives on death: a developmental study

While prior research has focused on death anxiety in general, more recent studies have recognized the need for multilevel measures for assessing the fear of death. A 12-item questionnaire used in the present cross-sectional investigation produced three factors--Evaluation of Death in General (Factor I), Belief in the Hereafter (Factor II), and Death Anxiety Related to Self (Factor III). The sample consisted of 874 Ss categorized into six age groups from young adult to old age. A two-way ANOVA on each of the factor scores was performed for the variables age and sex. Middle-age and late middle-age persons were significantly less anxious in regard to Evaluation of Death in General than their younger and older counterparts. Old age groups showed the least Death Anxiety Related to Self. Sex differences were found for Factors II and III. Future research should differentiate the concept of death from the process of dying.

How Popular is the Personality Assessment Inventory in Practice and Training

A review of recent survey data indicates that the Personality Assessment Inventory ranks among the most frequently used objective personality tests in practice and clinical training.

The status of projective techniques: or, wishing won't make it go away

Analyzed predicted decline of projective techniques in usefulness and emphasis when viewed from several different perspectives: the academic community; members of APA Division 12; internship centers; the applied clinical setting; and private practitioners. An extensive review of empirical, survey, and position studies over the past two decades supports the utility of projective techniques, with the exception of the clinical academic setting. The apparent loss in status of projective assessment is attributed, in part, to changing roles and functions of clinical psychologists. Implications for graduate training are discussed.

A review of the clinical and research use of the Bender-Gestalt Test.

The Bender Visual-motor Gestalt test has been an integral part of the standard test battery for the past 50 years. However, the test has been extensively critiqued on issues of inappropriate administration, scoring schemes, and clinical interpretation. In an analysis of recent surveys on test use, the Bender-Gestalt remains quite popular in a variety of clinical settings across all age groups. Secondly, the test has a respectable level of research interest, based on a citation analysis of the Psychological Abstracts database.

Social-Emotional Assessment Practices in School Psychology

This study examined the social-emotional assessment practices of a random sample of school psychologists in the United States. For each assessment instrument, respondents indicated frequency of use, rationale for use, information gained, importance, and scoring system used. Results indicate that projective tests remain popular, are used primarily to generate hypotheses about social-emotional functioning, are viewed as important in the assessment process, are applied for a range of purposes, and often are scored with personalized systems. Most objective tests are used to confirm hypotheses about social-emotional functioning, also are viewed as important in the assessment process, and are applied for various purposes. Surprisingly, a considerable percentage of school psychologists use personalized systems to score some objective tests. Implications of the findings are discussed.

Internship Training in Psychological Assessment: Has Managed Care had an Impact?

Training directors of 84 APA-approved internship programs in psychology responded to a survey on the current status and recent changes in internship training in psychological assessment. There appears to be a slight decline in emphasis on assessment in general, although it is still considered to be an important component of training. There was a surprising endorsement of traditional assessment instruments as important for clinical practice, in spite of a trend toward decreased emphasis on projective methods. The majority of programs have maintained the same degree of emphasis on objective measures, intelligence tests, behavioral methods, and the interview, while increasing emphasis on neuropsychological assessment. Less than half (43%) of the training directors reported that their programs have been significantly affected by managed care, suggesting that the majority of internship sites are somewhat insulated from present trends in marketplace pressures regarding reimbursement for psychological testing. The implications of potential future trends are discussed.

Projective Techniques: An International Perspective:

This is a review of findings from four recent surveys on use of clinical tests in the United States, The Netherlands, Japan, and Hong Kong. The preliminary analysis indicates that projective techniques are popular in the assessment of personality worldwide. Obviously, projective tests are ‘universal’ in that unstructured stimuli serve as the basis for assessment and do not pose a language barrier. Also, reliance on projective methods may reflect problems in access to adequately translated and standardized objective tests. More data are needed from developed countries before firm conclusions on the international status of projective techniques can be affirmed.

On-line Literature Retrieval: An Alternative Research Strategy

The efficacy of using comprehensive database search strategies in performing a literature retrieval is investigated. The DIALOG service was used with DIALINDEX subject category options as the major search vehicle. Databases from the DIALINDEX subject categories PSYCH (which includes PsycINFO) and MEDICINE were accessed with two sample searches. The results indicated that databases other than PsychINFO provided relevant citations. Overlap of citations among databases was negligible. The findings suggest that on-line literature retrieval involving psychological topics should include comprehensive database strategies. Several major commercial services offers such options.