Clinical psychologists' opinions about and uses of tests, assessment, and clinical intervention applications : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University

Abstract

A replication of two North American studies done in 1995, on the contemporary practice of psychological assessment and clinical intervention training, was conducted with New Zealand clinical psychologists currently registered and practising. One hundred and thirty seven subjects, of whom one third were in private practice, were asked their opinions about clinical assessment and their use of instruments. They were also asked about their professional experience with common, mostly empirically-validated, clinical interventions. It was found that over half of assessment-active clinical psychologists used six procedures, and a third or more used another eight. The clinical interview was top (and used by 87%), and the first five procedures were used most across nine work settings also. The respondents used assessment to answer specific questions, and recommended that clinical students learn about assessment procedures in order to incorporate the results into therapy and thereby facilitate the therapeutic process. Thirty-seven percent of their clients received objective testing procedures and 3% received projective testing. Half or more of the respondents used, and recommended that students learn to administer, the Wechsler Scales, the Beck Depression Inventory, and the State-Trait Anxiety Scale. The most used projective method was Sentence Completion (by 33%) but only 12% recommended that students should learn to use it, and whilst a quarter of clinical psychologists used and recommended that the TAT be learned, another quarter believed that students need not be competent in projective testing methods at all. Over half the clinical psychologists identified themselves as practising from a cognitive-behavioural orientation and this was reflected in their endorsement of cognitive, behavioural, or cognitive-behavioural empirically-validated clinical interventions. Eighteen of the most used 20 treatments were so described, the remaining two being the psychodynamic therapies which were ranked at positions 10 and 19, brief and longterm respectively. The most taught, supervised and utilised empirically-validated treatments were therapies for anxiety, depression, and chronic pain, and skills training for marital partners and for parents of children with oppositional behaviour. The single most used intervention, by 74%, was Applied Relaxation for Panic Disorder. The results of the study suggest that New Zealand clinical psychologists have developed a methodology of assessment originally patterned on North American practices but have evolved pragmatically in a distinctly cognitive-behavioural direction whilst still valuing the importance of traditional assessment instruments such as the MMPI and the Bender-Gestalt. Likewise their clinical intervention preferences tend to be cognitive-behavioural whilst still retaining the psychodynamic and psychoeducational approaches and embracing the "nineties" narrative evolution as well. The lack of success in obtaining information about the training content of programmes and internship requirements for clinical students should be remedied, in order to inform the profession, and research is also needed into yet-to-be-validated clinical interventions such as narrative therapy.