Topic 8: Appraisal of Personality {by 10/29}

Based on the text reading and lecture recording due this week consider the following two discussion points: (1) How can accurate personality assessment help the therapeutic relationship and treatment?  (2) Discuss your concerns about the continued use of projectives impact on clients and/or the mental health field.

 

Your original post should be posted by 10/29.  Post your two replies no later than 10/31.  *Please remember to click the “reply” button when posting a reply.  This makes it easier for the reader to follow the blog postings.

67 Comments (+add yours?)

  1. Tanya Nair
    Oct 24, 2020 @ 15:20:56

    Although no assessment can accurately measure any personality, it is important that this is considered to make the therapeutic relationship and treatment smoother. Accurate personality assessment can contribute towards the structure of the counseling relationship. For instance, getting to know a client’s personality may influence how a therapist decides to conduct the session. According to a clients’ personality, one individual may prefer a more laid-back approach whereas another individual may prefer a more structured approach. Identifying a client’s personality can also assist in making decisions about interventions and treatments. For example, an individual’s personality can change treatment preferences and cause some interventions to be ineffective compared to others. Personality assessments also give the therapist more clarity when it comes to identifying client problems. This is because a client’s personality can tell a lot about their problems and how they might react or be sensitive to certain things.

    Projectives are personality tests where clients are asked to describe, tell a story, or respond in a way to unstructured stimuli. This is to possibly reveal any hidden emotions and internal conflicts projected by the individual. An example of this is the inkblot or Rorschach test where individuals are analyzed according to what they make out of a certain inkblot. There are many concerns to using this type of approach to access personality. This is because these tests have poor reliability and validity and are said to have little to no evidence-based approaches. These tests often can lead to inaccurate ideas about an individual’s personality and may need additional caution when interpreting results. There is also a lack of normative data and it is seen to have false positives especially when interpreting individuals from various races and ethnicities. Overall, projectives should be taken with a grain of salt when being used as the only diagnosis of a clients’ personality.

    Reply

    • Zoe DiPinto
      Oct 26, 2020 @ 16:47:59

      Hey Tanya! I liked your perspective in how accurate personality assessments can have an affect on how a counselor chooses to run sessions. I focused more on how it may be able to build a comfortable rapport between the counselor and client, but I agree that it could also be a great tool in how a counselor chooses to phrase questions or give insights. As you said, maybe a personality assessment will show a client responds better to laid back conversation and suggestion, or maybe better to confrontation and challenges. Nice perspective!

      Reply

    • Beth Martin
      Oct 26, 2020 @ 19:06:45

      Hi Tanya,

      I think the use of personality assessment to structure how we talk to our clients make them worth it, regardless of the actual personality information we receive! As someone who’s learning how to alter how I communicate with others depending on how I perceive their communication style, that information would be a goldmine. I get worried that I’m not accurately assessing whether they are open, closed, prefer to be more formal etc., and having an assessment that has stated that they’re laidback and incredibly open would definitely help remove some of my anxieties there.

      I liked that you brought up projectives having no evidence based approaches. I’ve seen some people say that their assessments of a Rorschach from some online quiz were incredibly accurate and therefore they can’t be inaccurate… completely forgetting that we need actual studies and evidence to prove that they work!

      Thanks for posting!

      Reply

    • Lilly Brochu
      Oct 27, 2020 @ 12:37:38

      Hi Tanya,

      Personality assessments are an important tool in understanding the client and can help to make the therapeutic relationship better. They are useful for the clinician because they can get a greater understanding of the client from the assessment along with other information gathered from their individual sessions. It is important to note that one’s personality could be indicative of a presenting problem the client may have or is experiencing. In my opinion, the projective techniques are interesting, but they are not necessarily accurate. They are subjective and results can differ from person to person. I think that the concept of using inkblots to interpret and assess personality sounds strange to begin with, and it is relieving to know that majority of clinicians or psychologists do not use these types of tools to diagnose people. I agree that projectives should be taken with a grain of salt, and that there should be various other explanations for one’s diagnosis, or behavior besides an interpretation from an inkblot or a drawing they made.

      Reply

    • Destria Dawkins
      Oct 27, 2020 @ 15:42:54

      Hi Tanya! I like that you pointed out the fact that accurate personality assessment can contribute to towards the structure of the counseling relationship. I also like that you pointed out the fact that accurate assessments can help therapists choose how to conduct future sessions with the client, depending on certain personality traits. It definitely benefits the therapeutic relationship when the client feels respected and understood by the therapist.

      Reply

  2. Cassie Miller
    Oct 25, 2020 @ 21:34:08

    Personality assessments can be useful but should never be relied on completely when assessing an individual’s personality. This is due to their lack of specificity since an individual can be impacted by their personality, as well as, by environmental influences. It is important to remember that certain contexts can completely alter personality and that no personality assessment can be completely reflective of one clients personality (since there is so much differentiation amongst individuals). However, personality assessments can be used to allow for clarification of client problems, to help aid the clinician towards developing a treatment plan, and to further inform the development of therapeutic rapport. A clinician can use the information gathered from a personality assessment to make sense of the information they are gathering in the counseling process. They can also scope out differences and try and understand why they may exist/develop questions for the clients about these differences. These assessments can also help the clinician gauge client preferences and begin to alter their communication/treatment techniques to better match their client. This rapport is so necessary in being able to make a difference in a client’s life because if they do not trust you, or like your techniques, your treatment will most likely be ineffective. In addition, most of us in the class will mainly be using descriptive assessments which help us to understand symptoms and their relationship to the client/their lifestyle. Thus, these assessments can be used to supplement other information that we have already gathered on our client.

    There are some major concerns when considering the use of projectives with clients since they can have a significant impact on their mental health. It is first important to remember that projectives have very minimal reliability and validity since they are not evidence based approaches. Projective techniques often require the client to respond to an unstructured stimulus by either making an observation or coming up with a story to describe that stimulus. The goal is for the clinician to learn something about that individuals unconscious, even though these practices are not evidence based. One of the common techniques used in projective assessment is the Rorschach Inkblot Test where the client is presented with 10 inkblots and asked to give a response based off of what they think the inkblots look like/represent. Obviously, this measure is not reliable and should not be responsible for diagnosing a client with a mental disorder. This lack of validity and reliability is rather concerning due to the impact that the interpretation of results may have on the client. These tests can produce false positives, as well as, false negatives which can have a significant impact on an individual’s livelihood. Furthermore, these tests can have significant race/ethnicity biases based off of the norming groups used to make the assessment (which often times is not diverse enough). For example, a client could be diagnosed with an anxiety disorder as a result of their answers to these subjective tests, when really in that individuals culture they are more self-conscious and weary of standing out (so this behavior is normal to them). The purely subjective nature of these tests make them a very significant point of concern (since they do not truly predict behavior) and if they are used on a client the results should be evaluated skeptically.

    Reply

    • Tanya Nair
      Oct 26, 2020 @ 11:07:16

      Hi Cassie! aI like how you emphasize that no true personality assessment exists because there is much differentiation between individuals. I think this is a great way to introduce the topic as it is definitely not a one size fits all type of assessment but more of a way of understanding an individual in a different light to then modify interventions and treatments. You did a great job elaborating on the use of projectives which goes to show that you have a good understanding of this topic. I also appreciated your example towards the end that spoke towards culture. I enjoyed reading your post!

      Reply

    • Zoe DiPinto
      Oct 26, 2020 @ 16:52:31

      Hey Cassie! You used a term that quickly peaked my interest: Trust. I think a major concern I have as a learning helper is that I will not be able to establish adequate trust with my clients, especially if they have a personality disorder. Personality disorders may result in a likelihood to push back upon a helper’s perspective. However, I think you are correct that by gathering information from a personality assessment and having open conversations about the results may open a door for the helper to be able to point out problematic behavior such as aggressiveness within the session, especially if the assessment predicted such behavior.

      Reply

    • Abby Robinson
      Oct 28, 2020 @ 13:22:12

      Hi Cassie! In your post about the concerns of the use of projectives I like that you included information about false positives and false negatives. This is super concerning because since the results can be interpreted differently by different counselors, there is no reliability! A diagnosis from one of the projectives is concerning because if the interpretation is off, then a false positive or a false negative may be a result which will greatly effect the client’s life and treatment plan.

      Reply

  3. Zoe DiPinto
    Oct 26, 2020 @ 16:43:07

    1)Although getting an accurate result of a personality assessment may be difficult, providing an assessment will inevitably give the therapist and client more information. Accurate results from a personality assessment may provide clarity to the client in what behaviors can be identified as problems. This will be able to start a conversation between the client and therapist about the immediate concerns which will strengthen the counseling relationship. The information from the assessment will also result in a clearer direction for selecting interventions, making goals, and treatment plans. For example, if a client took the NEO-PI-3 and found that they scored “abnormally” on a scale for Openness, this gives the therapist more direction in attempting to get the client to explore their relationship to new experiences. This will create a conversation, and an informed and agreed upon goal for the future.

    2) Projective techniques seem to have benefits with children in uncovering information they otherwise may not share. These techniques don’t, however, magically uncover anyone’s unconscious beliefs, experiences, or desires. The lack of reliability and validity in testing alone should be enough evidence to question the use of these tests in counseling sessions. In addition, most are largely outdated assessments that do not take into account an individual’s cultural, racial, SES, or education status. A good assessment will be able to prove reliable and valid results while also factoring in contextual experience.

    Reply

    • Beth Martin
      Oct 26, 2020 @ 19:02:40

      Hi Zoe!

      I think you make a great point in that personality assessments are also great for opening dialogue! Not only can a clinician point to a specific measure and use that as an opener, but they’re also armed with information that allows them to cater their conversational styles to their client, encouraging them to be open and honest. I think we both touched on how projectives can have their uses in also opening and facilitating conversation, but that they most certainly should not be used for assessment. One of my colleagues would regularly use the picture cards from the Children’s Apperception Test (CAT), but not the actual assessment tools themselves. She’d make up funny stories, use voices etc., that really warmed the children up to her and started building the rapport. So, I suppose they shouldn’t all be thrown in the trash completely… we can repurpose their materials!

      Thanks for posting!

      Reply

    • Connor Belland
      Oct 26, 2020 @ 22:49:55

      Hi Zoe, I think the points you made about the problems with projectives are very important. Like you said these assessments are very outdated and they fail to account for many important factors that we know now can influence a persons personality. You mentioned culture and that is one of the most important influencing factors on many different aspects of psychology so it should be accounted for when it comes to testing for personality.

      Reply

    • Tayler W
      Oct 28, 2020 @ 14:36:35

      Zoe, I think you’re right that projective-LIKE techniques are useful with children. That is, pictures, drawings, play and telling stories, among other things, are very appealing to children. I don’t, however, think that using these with children qualifies as a projective technique. If you draw alongside a child, does that mean you’re examining their drawing for unconscious desires? I don’t think so. I think the only time these would be used is if the child says/does something wildly unexpected, like draw their house on fire. This might reveal a child’s anxieties, but I don’t think it’s obvious just from the drawing that it is an anxiety – maybe they were just watching a TV show they shouldn’t have been! So I think that while techniques that are useful with kids resemble projectives, I don’t think they’re actually projectives.

      Reply

  4. Beth Martin
    Oct 26, 2020 @ 18:58:36

    An accurate personality assessment, though difficult to attain, can help the therapeutic relationship and treatment in a number of ways. Regarding treatment, having a good grasp of how an individual’s personality may hinder or enhance treatment techniques is crucial to make sure that treatment goes smoothly, and does not deter the client from returning to therapy. An individual who presents as very tightly-wound, for example, will require a different approach than one who is laid back, in assessment techniques, rapport, and treatment. Personality assessment also gives the clinician more information on their clients’ presenting problems; if an individual’s personality assessments reveal them to be more neurotic than they have previously suggested, said neuroticism may be affecting the presenting problem more than the clinician had otherwise thought. This information then informs a treatment plan, allowing a clinician to select treatment options that match their client’s personality (e.g., a client who scores low on openness in the NEO-PI-3 may not respond well to treatment that requires them to ‘open up’ immediately). However, personality can be impacted by the environment an individual is in, or has previously lived in, and though stable, some traits can change over time. Therefore, personality assessment should not be used as a sole means of assessing a client or building a treatment plan, and should be re-assessed after periods of time.

    My concerns about the continued used of projectives and their impact on clients/the field are twofold: that they can falsely label and contribute to the worsening of a client’s condition, and that they add to the ‘quack’ stereotypes many have about our field. While I do believe that some projectives have their place as a tool – a previous colleague regularly used TAT cards to get more reserved/quiet clients to talk, focusing their attention on one specific stimuli, but never used them for actual assessment – using something such as a Rorschach to diagnose mental disorders is beyond dangerous. There is very little inter-rater reliability, with clinicians having very different assessments of clients using them. A projective being the sole measure on which a label/diagnosis is built leads to the potential of a client having a stigma carried with them that they a) do not fit and b) treatments that actively worsen their condition as it isn’t actually treating what they need. Additionally, there are already a number of people that avoid therapy as they believe it’s still Freudian, lying down on the couch being forced to answer questions about their mother. This obviously isn’t the case, but it’s a prevailing view of what therapy and mental health care consists of. Adding in projectives that seem mystical and cannot be explained to the client adds to that layer of nonsense, further making mental health care seem dated and like something very narrow that doesn’t work for everyone.

    Reply

    • Tanya Nair
      Oct 26, 2020 @ 22:16:24

      Hi Beth! I liked how you gave clear examples about the topic which shows you have a great understanding. I think it is very important that you bring up that personality can change over time as I did not consider this aspect in my response. This is a great point to emphasize as although it may not be the sole means of assessing a client or building a treatment plan, it also is more than likely to change due to factors in the environment or certain situations. You bring up an interesting point relating the Freudian approach to projectives and how if this is how we are going to access personality it is not going to work. I enjoyed reading your post!

      Reply

    • Connor Belland
      Oct 26, 2020 @ 22:38:12

      Hi Beth, I really like the points you make when it comes to concerns with projectives. These often unreliable assessments can be affected by things as small as the test environment and can give inaccurate results. These results can then change the way a therapist looks at a client and like you said they can even go on to affect the treatment plan which could be very bad.

      Reply

    • Destria Dawkins
      Oct 27, 2020 @ 15:54:11

      Hi Beth! I like that you pointed out the fact that projectives can falsely label and contribute to the worsening of a client’s condition and that they add to the stereotypes about the mental health field! I agree that since these types of tests are highly subjective, it is easy for helpers to fall into the trap of falsely labeling a client’s condition. This can have a negative impact on both the client and helper because the helper may become discouraged in moving forward with helping the client and the client may now have a false image of themselves and now their problems are worsening.

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    • Anne Marie Lemieux
      Oct 28, 2020 @ 19:11:43

      Hi Beth, I think your point about environment having an impact on personality is very note worthy. As well as your comment about not having personality assessments be the sole means of assessing a client or creating a treatment plan. I believe that we are all born with personality traits but they can change over time or can be influenced by environment. Personality is only a small part of who we are and it can often be assessed very subjectively. Therefore, utilizing other forms of assessments to guide treatment is the best practice.

      Reply

  5. Connor Belland
    Oct 26, 2020 @ 22:16:04

    Personality assessments can be used in many therapy sessions as a way to learn even more about the client. We know how important it is for the therapist to know the client and how much more effective the therapeutic relationship is. Assessments that measure personality can help the therapist see even deeper into what’s behind the client as well as possibly helping the client coming to their own realizations. Personality assessments can clear up some problems with the client and influence interventions, and form therapeutic rapport. Personality tests can often be very subjective to the client which can affect the reliability and validity. The environment of the assessment as well as how the person is feeling that day can affect the results of a personality assessment which makes them less reliable. Giving a personality assessment at the beginning of therapy could also be used to get an idea of how the client is feeling that day and how to proceed with therapy based on some of the clients results. It can show their current mood and give insight into their presenting problems. Knowing this information will benefit the therapeutic relationship.
    There are many concerns about continued projective’s impact on the mental health field. Many of these tests are outdated and don’t take many important factors like culture and educational influences. Not too mention they are not very reliable or valid from a scientific standpoint which makes them not a very viable option for a strong assessment. They are very subjective tests and can be affected by many different factors like environment and the clients mood while the tests leave out key factors that could give a more accurate result. These unreliable results can then be interpreted wrong and a client could be mismanaged and mislabeled.

    Reply

    • Lilly Brochu
      Oct 27, 2020 @ 12:53:33

      Hi Connor,

      Personality assessments are so helpful when it comes to learning more about your client. There may be things that the clinician learns through the assessment that may have not come up in session that is helpful to the client’s presenting problems. I liked that you made a comment that related to the client gaining insight or another perspective on themselves and how they act through personality assessments. This could definitely move the therapeutic relationship along and make the client more aware of how they are. As for the projective techniques, they do not include important race/ethnic, social, or cultural considerations of the modern day. For example, projectives that include racist or sexist illustrations can prove to be problematic when given to people of different backgrounds, and this could create negative feelings or potential problems in the therapeutic relationship. It is also very important to consider the mood of the client that day or the environment the client is in when these assessments or projectives are given because results can easily be skewed or swayed. Great post!

      Reply

  6. Lilly Brochu
    Oct 27, 2020 @ 11:25:57

    Personality assessments can be helpful for the therapeutic relationship and future treatment plans. It is important to examine the nature of the therapeutic relationship as well as any information gathered from the personality assessment to gain a complete perception and understanding of the client. A client’s personality is made up of their own individual qualities and traits, but is also subjective to environmental influences and what context they are placed in. Context is very important to note because regardless of one’s personality, it may shift based on the situation they are placed in. For example, someone who is around their significant other may come off as extroverted (e.g., talkative, open) whereas in a formal or clinical setting with a doctor or therapist, they could seem more introverted (e.g., quiet, closed off). Looking at a client’s personality is helpful because their own personality may interact or perhaps, cause problems or conflict in their life. For example, on the NEO-PI-3, if a client had measures of low extroversion, we could conclude that the client has trouble opening up or does not appear to be sociable. However, the client may actually be outgoing in more comforting environment and feels shyer in a clinical setting. The clinician could use the information gathered on their personality assessment to guide the therapeutic relationship, or treatment plans going forward to make the client feel more comfortable. Hopefully, this would lead the client to being more open and at ease with their clinician.

    As interesting as using projective techniques may be for some people, they have several concerning factors to them. Projectives were commonly used when the psychodynamic theory was most dominant. Today, we know that many techniques of the psychodynamic theory are not evidence-based, such as dream interpretations. Because these projective techniques are ambiguous, it is very hard to obtain reliable or valid findings. Additionally, many of these projectives lack normative data, meaning that some results may be interpreted differently when compared to the original norming group. Out of all of the issues that projective techniques pose, the racial and ethnic biases are the most troubling. It does not make sense to continue to use projective techniques that incorporate racist or sexist pictures. Many of our ideals and social norms have changed and so should the assessments we use today as well. In general, assessments should not be limited to specific race, socioeconomic classes, etc., but rather, should be inclusive to all walks of life. I think that many clients would find it concerning or offensive if their therapist continued to use outdated projective techniques because it could create negative feelings towards their therapist or affect their comfortability going to future sessions.

    Reply

    • Lina Boothby-Zapata
      Oct 31, 2020 @ 20:02:06

      Hi Lily,
      I think your post about the limits of the projective test is assertive touching the points about limits is reliability and validity, and the difficulty to measure. I will add to this that these instruments cannot be score and the only path that they have to provide information to the clients is with “interpretation”, which is very problematic. Counselor’s interpretation can end it up being judgments because of the counselor’s values. Science also stated that investigators who lack sleep and are hungry, their interpretation are altered and no objective. Hence, something else to add to the limitations of the projective tests.

      Reply

  7. Destria Dawkins
    Oct 27, 2020 @ 15:00:58

    1. Just like any other assessment, accurate personality assessment provides clarity for clients and the problems that they are facing in their life. Some clients may be unaware of the problem within themselves and providing feedback can open up a new door of change. Clients may feel that they are the only ones facing the type of problems that they are facing and may feel that no one understands what they are going through. Providing clarity and individual feedback can help a client feel more at ease, knowing that there is someone who does in fact understand what they are going through. Accurate personality assessments can help by providing you with information about your client that you may not have already known or may have missed in sessions. Accurate personality assessment can also help point the helper in the right direction of what types of interventions may be necessary.
    2. One concern that I have about the continued use of projective tests is that the scoring of these types of tests are highly subjective. This means that the interpretations of specific answers can vary dramatically from one helper to the next. Another concern that I have would be that because the scoring is highly subjective, these types of tests may lack validity and reliability.

    Reply

    • Anna Lindgren
      Oct 30, 2020 @ 11:57:07

      Hi Destria,

      You raise a really good point that personality assessments may bring up an issue a client isn’t completely aware of, and certainly can bring to light some aspects of the client that the counselor hasn’t picked up on yet through therapy. There may be aspects of personality that for one reason or another the client has gotten good at hiding from others and even from themselves.

      Reply

  8. Elizabeth Baker
    Oct 27, 2020 @ 18:23:31

    1) Accurate personality assessments can help the clinician learn more about the client, holistically. That is, clinicians will be able to gain an understanding of how the client acts outside of the therapeutic session. Having that understanding can allow clinicians to create and incorporate assessments that fit the client’s unique personality and needs. It can also allow the clinician to understand how the client’s personality is contributing to the problem/situation. Treatments, as we know, are never a “one size fits all”; each treatment is specifically designed to attend to the unique needs of each specific client. Clinicians should also refrain from pigeonholing clients. That is, clinicians should always see if the client is willing to try treatments that may be outside of their comfort zone.
    Regarding the therapeutic relationship, as a starter, a clinician could use the personality assessment to ask the client to talk about themselves, which can potentially lower the nervousness the client may be feeling when first meeting their counselor. Clinicians can also change their nonverbal behavior once they’ve gathered a general idea of their client’s personality. For example, a client that seems more timid, talks quietly, and doesn’t make eye contact; a clinician could alter their nonverbal behavior (e.g., looking away from the client when they are thinking or speaking) to help the client feel more comfortable. It’s important to note, using personality assessments should be done more than once to grasp a “true” representation of the client. By that I mean, sometimes clients may act differently during sessions compared to how they act outside of the session. A client may be very quiet and fidgety during the session, and on the other hand, be loud and talkative with their friends or outside of the session.

    2) Projective techniques seem to be a very helpful strategy when consulting children and individuals who are non-verbal. My concern would be the interpretation of the results because there are so many reasons for the responses of the client, clinicians may misinterpret the results. This may happen due to clinicians not asking the client more questions about why the client has provided their response, or due to the client not knowing how to properly explain their responses. Misinterpretation of information can impact the general understanding of the client’s situation, and the clinical decisions of treatment.

    Reply

    • Abby Robinson
      Oct 28, 2020 @ 13:28:15

      Hi Elizabeth! I really like your post about personality assessments really give counselors an idea of who the client is and how they are outside of the sessions. This really stuck out to me because understanding personality of the client projects who they are. It is important for the counselor to know how the client acts beyond the sessions in the outside world because they only spend a small quantity of time in sessions together. Using this information is important for the counselor because they can then make a realistic treatment plan and goals because the counselor has an idea of who the client is outside of the sessions and if the client is going to be able to use the treatment techniques outside of the sessions. This will effect the progress and outcome of the treatment!

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    • Tayler W
      Oct 28, 2020 @ 14:33:07

      Elizabeth, I love that you say personality measures give an assessment of the client outside a session. One problem with therapy is you only interact with the client for such a small amount of time, in such a controlled setting. Personality measures do give the therapist a good idea of how the client behaves outside of that, plus how they perceive themselves. Pigeonholing is also a huge concern, as within the small sample of therapy, a client may act extremely similarly (or very different), which can make it more difficult for a clinician to see the client as they might be outside the session. I also like that you say personality assessments can help prevent using the same treatment for every client, with no adjustments – I wonder if Openness scores can even be used to help a therapist gauge how experimental a client might be willing to be!

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  9. Abby Robinson
    Oct 28, 2020 @ 13:58:56

    Accurate personality assessments can be very help in gaining insight or knowledge about the client. Personality assessments can help benefit the therapeutic relationship because it can help show the presenting behavioral problem(s) with the client. This is helpful because personality may effect how the client is coping with the behavioral problems, which is important information for the counselor. Personality assessments may also be able to show important information about the client to the counselor. It may show information such as how the client responds to environmental stimuli, how the client handles important relationships and how the client feels about the presenting problems. The therapeutic relationship will continue to grow throughout the process of gathering this information because the client can express himself or herself without feeling judged and the counselor will know how to interact appropriately with them; as Dr. V says ‘matching too’. Getting personality information will also be important in developing a treatment plan because it helps shape realistic expectations for the client. Knowing the client’s personality will effect the treatment goals and how they will cope with the plan.

    The continued use of projectives is concerning because there is too much room for interpretation from the counselor. This leads to inconsistency and bad reliability. There are too many outside factors that may effect the interpretation of the result. For example, if the counselor had a rough start to their day and was stuck in traffic on their way into work and spilled coffee on them, they may interpret the projection differently if their day was better. Same goes with the client. The client could’ve gotten into a big fight with their best friend and their responses to the pictures or questions may be altered by their state of mind. There isn’t one way to interpret the results from the projections because it’s based off of the counselor’s ideas and thoughts, which isn’t reliable. With the projectives being too subjective and not consistently predicting behaviors, there isn’t any evidence that can show certain results from the test means the client has or doesn’t have a diagnosis.

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    • Pawel Zawistowski
      Oct 29, 2020 @ 12:14:39

      Hey Abby, your point about spilled coffee on your way into work sounds all too familiar! I agree that there can be so much inconsistency and poor validity and reliability when it comes to projective assessments. There are too many factors that can influence a client’s response to use them accurately and explore someone’s unconscious. Results from such assessments should not be used to make a diagnosis and should be interpreted very carefully.

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    • Elizabeth Baker
      Oct 31, 2020 @ 23:17:49

      Hello Abby!
      I enjoyed reading your post! You made very good points about what clinicians can gain from personality assessments. Your pointer on understanding any behavioral problem(s) and personality, it was something I did not think about. There are so many unknown benefits to using personality assessments, they can be used for more than assessing personality. I wonder if clients or students laugh at the idea of personality assessments, since they do not know how useful it is in the counseling field. My question is, did you know that personality assessments could have so many benefits?

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  10. Tayler W
    Oct 28, 2020 @ 14:29:36

    1. Accurate personality assessment can help the therapeutic relationship (which in turn helps treatment) by making the client feel listened to. As a client, I think many people want to know that their therapist has a good grasp on the client’s personality, etc., as there isn’t a good way to describe yourself to your therapist in terms of personality – it’s kind of awkward to say “I am very open to new experiences/introverted/etc.” in the context of an introduction. While many of these details would likely come out during therapy, I think clients would like to know their therapist understands them early in the process. Plus, it provides a good place for the client and therapist to get to know each other’s style in a lower stakes assessment and discussion. For example, if the therapist said “It says here you’re very open to new experiences. Do you think of yourself that way?” it gives the client an avenue to describe themselves without feeling awkward. In addition, a personality assessment is a good way for the therapist to notice any problem areas, or differences in perspective that might be useful later on. If a client isn’t very introverted, it might be useful for an introverted therapist to keep that in the back of their mind, especially during disclosures and suggestions. 2. Projectives are problematic in the mental health field because they are not very valid and have such a strong propensity for bias that they might lead counselors and/or clients astray. It is important to make sure that a measure which could be racist is not used to diagnose any client (not just clients from an ethnic or racial minority), especially if that measure isn’t actually useful for diagnosis. I personally think the biggest concern is that a client will be diagnosed with something they don’t have, which can increase the burden of therapy. Also, using projectives may not be good for the therapeutic relationship because an inaccurate or poorly used measure might make a client feel uncomfortable talking to their therapist. Projective measures give the mental health field a bit of a bad name – comics and other forms of mockery often focus on seemingly inane assessments like the Rorschach test, and how ridiculous it is that people think they can glean anything from a few blobs (in the popular mindset). These measures make mental health seem like magic or divination – aka, outdated, incorrect, and not useful. If a client’s first therapist uses some of these measures, the client may not go to another therapist because of how aversive they can be, and thus they might miss needed therapy! Finally, I think it’s incredibly problematic that people are paying for these measures, whether through insurance (which hurts the aggregate) or out of pocket (which wastes that person’s money), even though we know they don’t work!

    Reply

    • bibi
      Oct 28, 2020 @ 19:20:44

      Hey tay!
      I love what you added about the importance of personality assessments in helping the client and therapist set the stage for treatment. I mentioned this in my response too and added how you can learn a lot about the client through personality assessments and how they might have different responses to the therapeutic relationship and treatment based on their personality. I feel like this point was huge and I loved that you really hit on that too.

      Reply

    • Brianna Walls
      Oct 28, 2020 @ 20:18:58

      Hi Tayler, I agree I too think my biggest concern would be having a client diagnosed with something they don’t have. In addition I would also be concerned if the client wasn’t diagnosed with something he/she does have. In other words I think a false positive and a false negative would both be detrimental to the client. In regard to your statement about how a client may not return to therapy due to a bad first experience I too think this could be harmful to the client, especially if he/she needs treatment.

      Reply

  11. Carly Moris
    Oct 28, 2020 @ 15:41:16

    Accurate personality assessment can help with the therapeutic relationship and with treatment because it provides the clinician with more information about the client. Though it is important to keep in mind that personality assessments aren’t perfect and even the big five personality traits don’t have the highest correlation. However they can still be helpful as long as the clinician doesn’t rely on them entirely. For example if you gave a client the NEO and they scored high on neuroticism this suggests that they may have low emotional stability. This is useful information because you could follow up with another assessment that is meant to measure different aspects of emotion and the expression of emotion. You could also use this information to guide your session with the client and ask them more about their emotions in order to gain a more complete picture. A clients score on openness could also provide helpful information. If a client scores low on openness to new experiences this suggest they may not be as open to hearing clinician interpretations or challenges, or trying certain interventions as someone who scored high on openness. While you don’t want to use this information to stereotype clients or just assume they are not ready to move to the insight stage, it may be important to proceed a bit more tentatively. Until you know how the client will react and how far they are comfortable being “pushed”. Though you should still keep this in mind with patients who scored high on openness. Clients scores on personality tests can give you helpful info about areas that should be explored more, or potential traits to keep in mind. But they shouldn’t be used in isolation or taken as absolute truth. It is important for clinicians to use other measures or change their opinion/approach if new information doesn’t match the personality assessment.

    There are a number of valid concerns about the continued us of projective assessments and their impact on clients and the mental health field in general. I think one of the most concerning is that these assessments have poor reliability and validity and little to no evidence supporting them and they are still being used. What is the point of using an assessment if it does not test what it claims to or measure traits reliably? I would also say that it is unethical to use tests that do not have good reliability or validity. Clinicians use the results of these assessments to make diagnoses which can have a huge impact on the clients life. You cannot make an accurate diagnoses if the measures you are using don’t have good reliability and validity. For example tests like the Rorschach have low inter-rater reliability. Two clinicians can give the same person the Rorschach and come up with two entirely different diagnoses, which is extremely unethical. A number of these projective assessments also tend to diagnoses individuals from minority populations with mental disorders when they do not have one. This is extremely problematic and unethical, and it’s very concerning that they are still being used today. The fact that there are clinicians who still use these assessments when they have been proven not work and have a tendency to falsely diagnose individuals from minority populations reflects very poorly on the whole field. When there are clinicians who do not use good measures and use ethically questionable practices it makes people the field as a whole. This can be dangerous because it could lead people to believe that psychotherapy in general is not a valid practice.

    Reply

    • Brianna Walls
      Oct 28, 2020 @ 19:14:13

      Hi Carly! I agree, why are clinicians still using projectives if they have poor reliability and validity? In addition there is little to no evidence that supports projectives. I too believe that it could be unethical to use projectives due to the fact that clinicians use them to diagnose their clients and if they are diagnosed wrong this could have a huge negative impact on the client’s life. I also agree, clinicians are unable to make correct diagnoses while using projectives due to the fact that they have poor reliability and validity.

      Reply

    • Bibi
      Oct 28, 2020 @ 19:19:06

      Hey Carly, I love how you added the information specifically about the low inter rater reliability in the Rorscharch. I think that the overall idea that the reliability is low in a lot of projective tests is really important. However, the fact that two clinicians might interpret the results of a test completley differently is huge! I feel like this is where a lot of clinical judgement, suggestion, and interpretation can come into play. I feel like its important to note that these tests aren’t generalizable at all! They don’t work for different populations and if two raters have different opinions about the results of a test, you could also think about how two people of different races might interpret the results differently and the impact that that could have overall in treatment.

      Reply

  12. Bibi
    Oct 28, 2020 @ 19:14:59

    1. Information that is gathered from personality assessments can help explain factors involved in the therapeutic relationship. A measure of a specific personality type and traits of personality are likely to be displayed by the client in relation to the therapeutic relationship. For example, a highly extraverted person is more likely to be social, active and talkative in the relationship while someone low in extraversion is more likely to be quieter. The results from a personality assessment can explain more about how a person is going to act in the therapeutic relationship as well as explain to a therapist why a person might be acting in a certain way. In addition, different personality traits are going to impact how people respond to and participate in their treatment. Someone who is high in neuroticism has a tendency to cope poorly with stress and might have more difficulty changing as a result of treatment compared to someone low on this trait. The results of the personality test can give a lot of information about areas in which the therapist may need to work more carefully with the client.
    2. I worry about the power of suggestion that can be evident in projective tests. I feel like this is a situation that could quickly turn into a therapist suggesting certain things to a client and getting those responses out of a client. Also, projective tests seem to have a lot less empirical support surrounding them compared to move structured, formal personality assessments. It is mentioned both in the book and the lecture that there is a lack of reliability and validity evidence. I don’t really understand why you would want to then use a projective test given that it doesn’t have much evidence supporting it. I think that the results of the projective test can also be really open to clinical judgment and thus opens the door to problems with interpreting the results. This is another place where I feel like the power of suggestion can also become a problem with the therapist suggesting that a projective shows certain results and the client believing the therapist and then causing problems in the relationship as well as treatment.

    Reply

    • Anne Marie Lemieux
      Oct 28, 2020 @ 20:17:55

      Hi Bibi, I think your point about the power of suggestion is valid. Using an assessment that has low reliability or validity can only be interpreted subjectively. Quality assessments can provide important information that can be useful in better understanding and treating a client. However, when that information is being obtained in a way that is not evidence-based it is too easy for the power of suggestion to lead the results or interpretation.

      Reply

    • Elias Pinto-Hernandez
      Oct 31, 2020 @ 08:42:19

      Hi Bibi,
      I have the impression that many of us have the same concern regarding the proyectives. Why does a clinician would use non-evidence-base testing and therapeutic approach? Traditional beliefs, maybe, hard to tell. Great pots!

      Reply

    • Carly Moris
      Oct 31, 2020 @ 23:06:02

      Hi Bibi!
      I think you bring up a really good point that projective tests could end up being suggestive. We don’t want to have our own biases influence the client especially when it comes to diagnosis. If we influence a clients response to a screening we won’t end up with accurate information. I also agree that when you take into account the lack of reliability in projective instruments, they are not good instruments to use!

      Reply

  13. Brianna Walls
    Oct 28, 2020 @ 19:57:24

    1. Accurate personality assessments can help the therapeutic relationship and treatment for a few reasons. One being that these assessments can further the treatment process by aiding in the decision of therapeutic goals and help create more effective treatment plans. In addition personality assessments can help the client and the clinician get to the root of the problem more efficiently. Subsequent to the client taking the personality assessment the clinician will meet with them to discuss the client’s results. With this information the client and clinician will discuss how the results can be incorporated into the therapeutic work together. Personality assessments can also be very helpful in determining the client’s characteristics and traits, this will then help the clinician better understand them as a whole. Once the clinician has a better understanding of their client’s personality, this information will guide the client and clinician to better discussions and will aid in the development of the therapeutic rapport. In addition once the clinician is aware how one perceives and acts based off of his/her personality it will be less difficult for the clinician and client to facilitate a treatment plan.
    2. There are many concerns about the continued use of projectives and their impact on clients. One reason why there is concern about the use of projectives is because they have poor validity and reliability. In addition there is too much room for the therapist to interpret the client wrong. Extensive training is needed to use projectives appropriately and in addition there is no professional consensus on how these techniques should be specifically interpreted. Another reason why the use of projectives concerns me is because there are too many outside factors that can contribute to the interpretation given by the clinician, the clinician’s interpretation could be biased based off of their mood at the time. Also there are so many concerns about the continued use of projectives because clinicians use these to diagnose their clients and if there was a wrong diagnosis this could have a great negative impact on the client and may cause a series of more problems in the future. In addition there are a lot of false positives due to race/ ethnicity biases.

    Reply

    • Nicole Giannetto
      Oct 29, 2020 @ 18:12:39

      Hey Bri! I wrote very similar points to what you had. First, I agree that accurate personality assessment is great because it can help the counselor steer the therapeutic process and improve treatment plans in a more effective way. Regarding your second response, I also agree that there is poor reliability and validity in personality assessment which can impact therapy as well as the mental health field in general.

      Reply

  14. Anne Marie Lemieux
    Oct 28, 2020 @ 20:09:47

    I think that utilizing accurate personality assessments could help the therapeutic relationship and treatment by confirming your initial clinical judgements about a client. Observational assessments can be very subjective. Comparing your hypothesis of a client’s personality against an assessment can be a good way to confirm or challenge your thinking. As noted in the textbook, “health practitioners tend to be biased when interpreting observations”. It also notes that practitioners can have ‘themes’ of concern. The more information you have about who your client is the better ability you have to accurately treat them. Also, if you have an accurate portrait of the client’s personality it can help you to match your therapeutic style to build rapport.
    My major concern of the continued use of projectives in the mental health field are that they have low reliability evidence and no validity. The lack of scientific evidence in ambiguous testing leaves too much room for misinterpretation. They are subjective which can be dangerous when they are being used to indicate mental illness. Projective techniques are also outdated in the sense that the norming groups were primarily white and have not been updated. This can create false positives for blacks, native americans, and spanish americans leading to the misdiagnosis of mental health issues. The most concerning issue is the idea that they can be used to assess sexual abuse even though there is no scientific evidence that it accurately identify that.

    Reply

    • Pawel Zawistowski
      Oct 29, 2020 @ 12:09:17

      Hi Anne, personality assessments can be useful in confirming clinical judgments, but they can also help you develop your clinical judgment and provide more information. They can also provide support that your clinical judgment may have been misguided in some ways. I think they are useful ways of pointing our character strengths and weaknesses, but they should not be used as a measurement of personality because that is very hard to do.

      Reply

    • Christina DeMalia
      Oct 31, 2020 @ 19:06:47

      Hi Anne Marie,

      I really like the way you worded “Comparing your hypothesis of a client’s personality against an assessment can be a good way to confirm or challenge your thinking.” Confirming your suspicions about a clients personality can be very useful, but I think it is even more interesting when an assessment is able to challenge a therapists way of thinking. As you said, a therapist can never be completely objective. Although we may work towards not projecting onto our clients, there is always a possibility that we can make false assumptions about them. Using a personality assessment could be especially useful if it helps the therapist to recognize a false belief they have developed about their client to better understand them and adjust their treatment planning accordingly.

      Reply

  15. Lina Boothby-Zapata
    Oct 29, 2020 @ 09:54:10

    The most common test to assess personality is the MMPI 2. This instrument evaluates a number of the major patterns of personality and, at the same time, of emotional disorders. Hence, the MMPI-2 is commonly utilized to support the counselor to diagnose emotional disorders, and it is also proposed for non-diagnostic activities. The MMPI-2 contains the following clinical scales; 1 Hypochondriasis. Scale 2 Depression. Scale 3 Conversion Hysteria. Scale 4 Psychopathic Deviate. Scale 5 Masculinity – Femininity. Scale 6 Paranoia. Scale 7 Psychasthenia. Scale 8 Schizophrenia. Scale 9 Hypomania. Scale 0 Social Introversion. With this instrument assessment, the counselor obtains information about the client, who the client is, and what is her/his personality. Also, during the reading, I noted that Dr. Whiston states that personality assessment results can be utilized for identifying the client’s problems; it can also be utilized in selecting the type of treatment, goals, specific interventions for the client, take individuals items of the scales that rank high and bring those items into the therapy process to talk about them during the session, and to build rapport. In general, this is how we have learned to utilize the instruments during the class.

    I can see scenarios like; having a client that has a high score in Antisocial behavior, and the Externalizing Scale shows that the youth has Juvenile Conduct Problems, immediately I can infer about this youth that direct guidance and confrontation will no work for him/her during the therapy and will have a negative impact in the rapport. Another scenario is if the client has a high score in aggression and the client has denied in the past to talk about his volatile behavior at home, as a counselor, I can use the MMPI-2 to show him his score and how representative it is, then I will invite him/her to talk about it because “science is saying that he has a problem.” The MMPI-2 has an old language, and curios to know how we can rename terms like Conversion Hysteria, Psychasthenia, and Hypochondriasis.

    During the reading, I identified the following limitations with the projective instruments; first, they called themselves test, but there is no score for these types of instruments; I found this very problematic because the tests by definition are measuring and scoring and providing an outcome. However, the way that they can obtain results is with the counselor’s interpretation. For science, the interpretation tends to be problematic because it falls into subjectivity, and investigation has shown that lack of sleep and hunger affect the examiner’s judgment. Second, reliability and validity are quite low, meaning that there is a higher proportion of error. Third, test like the Rorschach Inkblot Test has the purpose of looking for unconscious and deeper thoughts that the client could identify in the present, hence this test is limited to a counselor with a psychodynamic orientation. Third, there is no consensus about how these techniques should be interpreted; again there is standardization about the test. Therefore, counselors should be cautious about the interpretation and well trained for the application of these techniques. I am incline of drawing especially for children as a strategy to open conversations and build rapport.

    Reply

  16. Elias Pinto-Hernandez
    Oct 29, 2020 @ 09:55:43

    1) An accurate personality assessment will provide the mental health professional with an” accurate” or a better view of the client’s thoughts, feeling, needs, and strengths during an evaluation. With that information, the provider can educate the client, establish rapport, provide a diagnosis, and develop an appropriate treatment plan. In most cases, it is a relive to the clients to understand that they have a mental disorder, that they are not the only ones with the condition, and something has been done about it.
    During therapy, the client can learn about their condition and how to manage or to cope. Also, receive social skills training. With the insights and knowledge gained by an accurate personality assessment, the clinician will be able to provide the client with healthy ways to manage their symptoms and reduce behaviors that interfere with their performance and relationships.

    2) The purpose or objective behind psychological assessment is to provide the mental health professional with an insight and a better understanding of an individual.. The provider uses the tool in an effort to measure (e.g., behavior, skills, thoughts, and personality) and there is a conflict with the proyectives. The text highlights the significant subjectivity in the interpretation of the proyectives; the extensive training needed to use the tests, and that there is no consensus on how the proyectives should be interpreted. My major concern is that I do not see the science supporting the proyectives, yet some providers are administering them. That raises the question: What would be the repercussion for inaccurate diagnoses and treatments based on proyectives?

    Reply

    • Cailee Norton
      Oct 29, 2020 @ 14:59:11

      Elias,

      You raise an imperative question at the end of your post: what are the repercussions with the use of projective techniques on treatments and diagnoses. This is something that I hope will be used less and less within our field, as the subjectivity and limitations in my opinion far outweigh any possible gains of unconscious analysis. By continuing to improve structured personality instruments (clearly they have more work to do in terms of racial biases) I hope that projective techniques will become less and less prevalent within the field. I was shocked to learn the amount that such techniques are used in our field, considering their limitations in diagnoses and treatments. To answer your question about the repercussions, I would have to say that the biggest risk is our clients well-being. The subjectivity of these tests could leave out possible diagnosis and treatment options that would be better paired with that client than the serious issues of selective recall, selective interpretation, and preexisting assumptions that clinical observations can have. For me, the knowledge gained from structured personality instruments far outweigh projective techniques limited pool of information.

      Reply

    • Maya
      Oct 29, 2020 @ 21:36:03

      Hey Elias,
      I think you touched on a great point that some clients may feel relieved to hear they have a diagnosable disorder and that there isn’t just something “wrong” with them. It may be comforting to hear that others have the same disorder as well and that there is a treatment plan specific to them and their personality type. I also thought your question was very intriguing… I do wonder what the repercussions would be, either with the therapist’s career, or the client themselves. It is safer to not use practices that haven’t been backed mostly by science and have proven to be successful. Not only are we talking about administering a projective but also diagnosing someone based on one?! I’m sure one of the repercussions with the client would be that they felt misdiagnosed and misunderstood, leading to a worsening therapeutic relationship.

      Reply

  17. Pawel Zawistowski
    Oct 29, 2020 @ 11:52:21

    When using personality assessments, it is important to know that measuring personality is nearly impossible as it is an all-encompassing construct and includes many different traits and qualities about a human being. Personality is also not an end all way of assessing a human being’s life, tendencies, and behaviors. Environmental factors also have a huge impact on the development and quality of life of a human being. However, they can still be useful tools in therapeutic relationships and treatment. First, it can provide useful insight about a client and how they themselves perceive themselves. They can help identify problems that a client is dealing with and select interventions for those problems. For example, a personality assessment may address how the client handles social situations. If it appears to be a problematic thing for the client, the therapist can develop interventions and treatment based on what they discover about the client’s issue. This makes them useful in making treatment decisions. Finally, personality assessments can contribute to structure of counseling relationship.
    One of the big concerns around using projective techniques is that they have poor reliability and validity. Research suggests that it is very inconsistent in diagnosing and assessing the mental state of a human being. Many of them such as the Rorschach and the Thematic apperception test (TAT) are ambiguous and use unstructured stimuli to uncover something about a client’s unconscious mind. They are a psychoanalytic method designed to discover things going on in the id, ego, and superego. Many of these tests look for aggressive or sexualized patterns of thinking. The problem with that is that many people to some extent think sexually or aggressively, and so uncovering such pattern can be insignificant. Some of the images can have cultural bias and even come off as racist and may be uncomfortable to administer which can result in a negative impact on the therapeutic relationship with your client. They are also known to have negative biases—can have false positive results for those who are not white (e.g. African American, Hispanics). I personally believe there is potential for useful clinical utility, however, these tests should be reconstructed and results should be interpreted carefully.

    Reply

    • Elias Pinto-Hernandez
      Oct 31, 2020 @ 08:56:16

      Hi Pawel, you mention some of the limitations of the proyectives, and I cannot agree more. I understand the uses of those tests in the last century, but I do not see their clinical uses nowadays. I believe that it would be beneficial for the client and the profession if mental health providers avoid using tests that have poor reliability or validity and promote evidence-based practices.

      Reply

    • Carly Moris
      Oct 31, 2020 @ 23:21:38

      Hi Pawel!

      I agree with you there are a number of concerning problems with projective tests. I thought you brought up a good point that many of these tests are based off of psychoanalysis and look for aggressive or sexualized patterns of thinking. I agree with you that this can be problematic because it’s normal for people to have some sexual or aggressive thoughts. Depending on how the clinician interprets these responses and reports their findings to the client, it can make the client believe there is something wrong with them for having these thoughts. Making our clients feel worse is definitely something we should avoid as counselors.

      Reply

  18. Christina DeMalia
    Oct 29, 2020 @ 14:12:04

    (1)
    As we have discussed many times, the outcomes of treatment are often correlated with the therapeutic relationship between the therapist and the client. If there isn’t a good relationship between the two, it is possible the sessions will be less effective and the client will have worse outcomes. Accurate personality assessments are one important thing that can be used to help build a solid therapeutic relationship. An example of this might be someone who is quiet, closed off, and not actively participating in sessions. A therapist might become frustrated with this if they think the client is just refusing to engage in the process or being lazy. However, if a personality assessment was used on the client, it might show that the client rates low in areas such as extroversion and openness. This would indicate that it isn’t necessarily the client’s resistance to the process, but that they are instead more reserved and quiet. When these personality traits are recognized, the therapist can adjust the treatment accordingly. They might go back to the beginning and work on building more rapport and trust before moving forward with any treatment plan. Once the client becomes more comfortable, they would likely be more open and talkative, and therefore treatment could move forward more effectively.

    (2)
    It was very surprising to me to learn that projectives continue to be used despite their many limitations. It seems to me that projectives are based on a lot of subjectivity and guesses. When looking at them, they reminded me in a way of something like palm reading. Although there may be people who do palm readings professionally, there is commonalities used across that field, and the skills to read palms can be taught and shared, we know that ultimately there is no science to back it up. Some people will argue there are other ways to prove palm reading work, just as people will argue projective tests work because of some common themes found. The difference is, when you go to get your palm read, you know that it can’t be confirmed by science, and chose to get a reading of your own volition. When you are in therapy, however, you are a client of a licensed mental health professional, and therefore should be able to safely assume that the things being used to treat you have some scientific basis to support them.
    Projectives such as the Rorschach Inkblots lack reliability and validity, lack normative data, and can be left widely open to interpretation. On top of that, there are race and ethnicity biases that exist within the tests which makes them no longer appropriate for use, in my opinion. When a projective test is used on a client, there is no way to verify if the results they receive are truly accurate. As we have discussed many times, there can be dangers associated with inaccurate results being used to treat a client. On one hand, the client may be assumed to have a disorder they don’t really have. This could lead to them receiving unnecessary treatment or developing negative thoughts about themselves based on the results. On the other hand, a client could have a disorder, but because of these unreliable results, not be given the correct diagnosis. This is even more concerning because an unrecognized and untreated disorder could lead to further emotional distress for the client of worsening of symptoms. In serious cases this could lead to the client being a harm to themselves or others. This is why it is so important to use reliable assessments with good validity and well established norms.

    Reply

    • Cailee Norton
      Oct 29, 2020 @ 14:50:59

      Christina,

      I too look very poorly at the Rorschach test in terms of its continued use within the mental health field. Many of the projective techniques have a degree of interest, but due to their limited reliability and validity I think any continued use is counterproductive in the continuation and progression of the mental health field as a scientifically based field of study. I really love that you bring up palm reading, as it has a lot of similarities to the projective techniques discussed in the chapter. While it is super interesting (in a spiritual and other-worldly way) and appeals to a large variety of individuals, the fact that it has little (if any) scientifically confirmed utilization. While some proponents of projective techniques believe it has the capability of providing unconscious aspects of personality, the fact remains that science does not support its application and any information gained from the technique cannot accurately provide information to better treat an individual than a structured personality instrument wouldn’t be better prepared to do. Great argument I enjoyed reading your post!

      Reply

    • Lina Boothby-Zapata
      Oct 31, 2020 @ 20:16:47

      Hi Christina,
      I agreed with you in some aspects of the Projective Tests, I disagreed to give them equality of hand reading. I think, Dr. Whistom noted the limits of the Projective tests saying that they can’t be measure, and validity and reliability are not possible in these instruments. However, she stated that because they are instruments “measure by interpretation” the Counselor really needs to be very well trained to take the risk of applying these instruments. I read in Beth Martin post replied that a colleague used this the CAT to build rapport with the client/child. I have not used those but with children, our intervention needs to be different, creative, and look for different alternatives where the child can communicate his/her own history. I am wondering if the Rorschach Inkblots can provide this alternative.

      Reply

  19. Cailee Norton
    Oct 29, 2020 @ 14:40:53

    1. An accurate personality assessment can do a lot for the therapeutic relationship. For starters it can open up direct treatment pathways for a client, in which specific treatments could be implemented for the betterment of that client. Another benefit to the completion of a personality assessment is the sheer amount of information that can be garnered from it including the influences of coping styles, the needs and desires of that particular client (some of which could be subconscious to that individual and in turn lead to further exploration and insight), typical responses to environmental stressors and situations, patterns of interpersonal relationships, as well as intrapersonal sensitivity. As a clinician this is a load of information that can only better the relationship between yourself and the client, but also lead to development of different skills (coping skills, interpersonal skills, responses to stress) as well as exploration on the part of the client. Having an accurate assessment allows the client and clinician to have an intensified level of understanding of that individual that can lead to better discussions that are geared to that clients’ needs rather than continuous exploration and potential overlooking of various topics of discussion.
    2. There are several concerns about the use of projective techniques and how they can impact clients as well as the entire mental health field. The sheer lack of validity and reliability is a huge problem, as it tears away the field from scientifically based and tested forms of assessments. This does not help the reputation of the field, and our work could be further discredited by other communities for its lack of validity and reliability. While some may see this as a means of guarding against “faking” evaluations, the point of discovering latent aspects of personality can be better measured through structured personality instruments which have large scientific backings. One of the more “known” projective techniques is the Rorschach. This test has been shown to have significant amounts of racial bias in misleading disorder diagnoses, but the scoring reliability is abhorrent within the test. Therapists disagree completely on at least half of the variables within the test, making any of the scoring unreliable for diagnosis. It’s also been shown that the test may accurately diagnose schizophrenia and other severe thought disorders, it fails to spot other disorders such as depression disorders, anxiety disorders, psychopathic personality disorders, and violent or criminal tendencies. This test is a perfect example of the potentially harmful effects of using instruments with poor validity and reliability in being unable to use its application with any degree of certainty. This could lead to clients experiencing unnecessary emotional distress due to a lack of diagnosis, improper treatment prescription, and in serious cases could lead to harm on behalf of the client or others. While these tests in my opinion have the face value of interest in comparison to a lengthy test like the MMPI-2, such projective techniques with little validity or reliability pose more of a risk than reward in the mental health field.

    Reply

  20. Anna Lindgren
    Oct 29, 2020 @ 17:00:23

    Personality is extremely complex and multifaceted, therefore no assessment can completely capture every aspect of a client’s personality. It can, however, be both interesting to the client and help the counselor better understand particular traits and possible areas of concern. For example, if a client has a high “neuroticism” score on an instrument, that could be something that the counselor will want to discuss with them in therapy. It can also help the counselor learn more about how their client may like to interact in the therapeutic relationship and help them match their interaction style. For example, if a client scores highly on extroversion, the counselor may take that cue to have some small talk or banter at the beginning of the session if the client seems receptive. Personality assessments can also help the counselor decide on effective interventions and treatments for their client.

    My biggest concern about projective techniques is the clear biases they have been shown to have when administered to people of color because of a lack of diversity in the norming groups. Additionally, the fact that these tests are about a century old lends itself to more racial bias and false-positive results for people of color. Many of the images in the Thematic Apperception Test are stereotypical and problematic in many ways and can be alienating to clients right off the bat. Another concern is the lack of reliability and validity with projective techniques. The wide variation in how different counselors may interpret the same answer means that this is not a valid type of assessment and can make the field as a whole look less scientifically based.

    Reply

    • Maya
      Oct 29, 2020 @ 21:46:56

      Hey Anna,
      I liked your point to use the results of the personality assessment to help better the therapeutic relationship and style. It is a great idea to use that knowledge to interact with the client better, or more naturally for them. As helpful as assessments are, we can’t assume them to always be accurate and it good to take a tentative approach like you mentioned and see if the client is receptive. Lastly, I think you bring up an important concern that there is a lack of diversity in projectives. However, there also tends to be a lack of diversity in many assessments, I wonder where we draw the line to what will and won’t be helpful for the client. I agree it could be triggering to use some of the TATs because of the systemic racism and way it may be portrayed in a scene. Certainly seems as though there are better techniques to use for now.

      Reply

    • Christina DeMalia
      Oct 31, 2020 @ 19:18:28

      Hi Anna,

      I completely agree that just how old the Rorschach test is, is an area for concern. So much of the field of psychology and mental health has shifted from an area of philosophy to a scientific study. With that shift, so many other aspects of mental health treatment have changed and become based on new research. With new assessments and treatment methods being constantly developed and the constant adaptations being made, it seems strange that we would continue to use an outdated assessment method. The racial biases in the norming methods also further demonstrates how outdated that projective method is. When you combine this with the overall concerns for projective assessments in general, it is surprising that people would continue to use the Rorschach test in treatment.

      Reply

  21. Tim Cody
    Oct 29, 2020 @ 17:40:01

    What therapists and counselors need to understand is that personality is not an accurate assessment to judge someone regarding mental health. If someone scores high on Neuroticism on the NEO – Personality Inventory – 3, does not mean that they have an inability to control their emotions. Just because someone scores High on Introversion, it does not mean that they are depressed. A person’s personality may be coupled with their problems and issues, but it is not the cause of it. There are many different personality techniques and assessments, some of which are formal and informal. The reason for this is because clients may respond well to certain inventories and assessments. It is important to evaluate the data collected by the counselor regarding personality assessment in order to determine the forthcoming counseling sessions. These assessments are only used in order for the counselor to get to know the client more and help them to better understand the type of person they are, how they would prefer the relationship to go forward, and what type of treatment to provide. Just as someone may react to a certain inventory either well or poorly, they may have a similar reaction to the treatment at hand.

    Some projective techniques that are still in use today for personality assessments are both outdated and do not provide genuine results. Some of these projectives such as the Rorschach Inkblot Test, which was first used in the early 1920’s, provides a poor assessment of personality. While it may allow the counselor to interpret what the client sees and how it is related to their everyday life, it does not provide the counselor with their personality or mental health. Other assessments, such as the Thematic Apperception Test, also an outdated study, merely provides the client with pictures when there is so much more that can be assessed. These pictures even depict some social or racial/ethnic stereotypes that can rub off the wrong way. It is important for counselors to know that these tests do not provide accurate representations of a client’s personality, but rather can be a stepping stone to their underlying issues.

    Reply

    • Elizabeth Baker
      Oct 31, 2020 @ 23:24:26

      Hello Tim!
      You make good points in your post! Even though there are a lot of benefits to using personality assessments, to understand how the client acts outside of sessions, for example, there are also cautions when using personality assessments. It is definitely important for clinicians to interpret and understand the scoring for various personality assessments, so they don’t give their client treatments that have nothing to do with their current situation. It also should never be used to assess someone’s mental disorder, as you said. Using an assessment for something it is not designed for is a critical problem in the counseling field. That could create so many misdiagnoses and misinterpretations, and the client could pay for treatment that s/he does not need! Great job in pointing that out, that is why clinicians need to make sure they read over the purpose of assessments before having their clients take them.

      Reply

  22. Alexa Berry
    Oct 29, 2020 @ 17:43:30

    Accurate personality assessment is important to both the therapeutic relationship and treatment for various reasons. Personality assessment should be part of the counseling process because individual’s personalities are typically linked with their problems and/or issues. Sometimes, personality assessments can aid in identifying client problems. Personality also influences coping styles, needs and desires, responses to environmental stressors, interpersonal patterns, and interpersonal sensitivity. Thus, it is also important to take clients’ personalities into consideration when making treatment decisions and picking interventions. By taking personality and personality assessment into consideration, counselors can use this information when structuring the therapeutic relationship. Overall, a counselors understanding of their clients personality through assessment can strengthen their therapeutic relationship, when assessed accurately.

    Although projectives are used as a formal personality assessment, there are some major limitations associated with these techniques. The reliability evidence for projective techniques is low, which means there are higher proportions of error when compared with other measures. Another issue associated with projective techniques relates to the influence the examiner has on results. Both the examiner and the situation can influence the process. For example, in interpreting the results of the TAT, clinicians often rely on their clinical experience. However, this is problematic because research shows that situational conditions like lack of sleep and hunger can influence performance. If clinicians rely on their own experience to interpret assessments, results can vary from clinician to clinician, and can even produce conflicting results. Validity is another issue with projective techniques, as the validation information on most projective techniques is insufficient. Due to issues with reliability, validity, and clinician influence on projective assessment results, it seems as though these types of assessment should not be used as a primary means of personality assessment. As stated in the text, it would likely be more beneficial to clients and the mental health field for these assessments to be used in conjunction with other clinical tools. In other words, they should not be the primary form of assessment, but instead should be used to further identify hypotheses related to personality.

    Reply

    • Anna Lindgren
      Oct 30, 2020 @ 11:46:23

      Hi Alexa,

      It’s true that personality affects so much of a client’s life, from how they view themselves to how they interact with others. Knowing more about the personality of your client can give you a better understanding of how they interact and how you can best work with them.

      I agree with your concerns about projective techniques. Since there is almost no way to standardize administration and interpretation, there seems to be far too much variability from clinician to clinician, let alone from client to client taking these assessments.

      Reply

  23. Nicole Giannetto
    Oct 29, 2020 @ 17:58:59

    1. Accurate personality assessment can help the therapeutic relationship and treatment by informing the counselor more about their client and their personality. For example, on the MMPI-2, the client may give more answers that correlate with anxiety and fear symptoms rather than with obsessiveness and family problems. From that information, the clinician can better understand that their client is feeling symptoms of anxiety and fear, and that it has less to do with obsessiveness or with their family problems. Instead of spending too much time asking the client about their family (which is still important when gathering background information), the clinician can focus on probing their client for different areas in their life that trigger their anxiety. These accurate assessments improve therapy because they can help the clinician narrow their treatment by eliminating aspects that do not seem to be related to their client’s experience, needs, and symptoms.

    2. One issue that comes to mind when thinking about possible concerns for the use of projectives and their impact on clients/the mental health field is that it is not guaranteed that the client’s most true and honest form is what comes through in their responses. Different factors such as anxiety, shame, guilt, suspicion etc. may influence what the client projects in their responses which may not show the truth of who they are and how their experience has been. Someone who feels shame from being depressed may express that they feel fine, etc., and unless there are obvious symptoms that they are depressed or if their clinician can read minds, it would be difficult to get accurate information from the client’s projective. Projections remind me of when researchers rely on self-report to collect data. It is not always reliable, and so it lacks strong validity. Not everyone is completely comfortable being vulnerable and sharing everything about themselves and so it can impact therapy and research.

    Reply

    • Cassie Miller
      Oct 30, 2020 @ 17:32:17

      Hi Nicole,

      I like how you mentioned question focus in your response. We often forget that spending time on one topic for too long may disengage our clients. Clinicians have limited time in their sessions and need to make sure that they are asking the right questions; really getting to the root of the clients problems. This will also allow the client to feel more satisfied in a session and help to tailor your focus to their specific needs. Also I like how you used the example of family problems in your response because this is known to impact anxiety levels. However, like you mentioned, a client that does not identify this as a significant influencer may become offended or confused if you keep asking them these family-oriented questions. Thus, highlighting the importance of distributing a personality assessment in the first place.

      Reply

  24. Maya Lopez
    Oct 29, 2020 @ 21:26:10

    (1) How can accurate personality assessment help the therapeutic relationship and treatment?
    An accurate assessment of personality would aid the progression of a healthy therapeutic relationship and treatment because if the therapist can truly see the issues and severity the client is dealing with and can reflect that knowledge the client will feel heard and understood. It would be impossible to treat a client without fully understanding the type of person they are working with. Depending on the assessment results we can draw conclusions and act on them. A person with psychopathic tendencies would be viewed and treated differently from a person with compulsive lying tendencies. The ways of working through each would be different thus, it is important to know how to navigate different personality types.
    (2) Discuss your concerns about the continued use of projectives impact on clients and/or the mental health field.
    It is concerning to think about projectives still being used for sexual abuse indicators. With a subject so delicate, one should not depend on the client’s unconscious ability to mention something relating to sexual abuse. In the case, that one has been abused and the projectives do not show that it would be devastating to the client. Projectives should only be used in the mental health field to gain further possible knowledge to explore only for diagnoses that have already been established. By no means should projectives work to be a diagnostic tool. It is interesting to think that our unconscious thoughts could be uncovered so simply but could be a mistake to assume everything has an unconscious meaning as psychoanalysts would.

    Reply

    • Cassie Miller
      Oct 30, 2020 @ 17:19:12

      Hi Maya,

      I like the point you brought up in the beginning of your response about the ways in which a counselor works with each individual client. Even though personality assessments are not completely representative of a client’s personality, it is important to closely examine each individual response as you may gain more insight about their specific preferences. Furthermore, you can alter your rapport to better match your clients style so that they feel comfortable enough to share more genuine information with you. However, I do want to emphasize that a counselor should not rely on a personality assessment as a full representation of their client. These assessments lack specificity and often ignore environmental influencers that are very important in shaping personality.

      Reply

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Adam M. Volungis, PhD, LMHC

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