Topic 8: Assessments for Depression and Broadband {by 6/29}

Post your responses to the Assessment Review Reflection Questions (Likes/Strengths, Dislikes/Weaknesses, Clinical Utility) for the following assessments: (1) Beck Depression Inventory – II (BDI-II), (2) Automatic Thoughts Questionnaire, and (3) Outcome Questionnaire (OQ-45.2).

 

Your original post should be posted by 6/29.  Post your two replies no later than 7/1.  *Please remember to click the “reply” button when posting a reply.  This makes it easier for the reader to follow the blog postings.

31 Comments (+add yours?)

  1. Madi
    Jun 21, 2020 @ 17:21:59

    1. BDI-II
    a. The strength here come from the 0-3 scale. I find the heading of each question a strength and a weakness. For personally I like things with heading I think it makes it more organized and easy to read. But I also think it gives away too much of what the question is assessing. Another weakness is some of the answers might have a cause unrelated to mental illness. I also think the shortness of the assessment is key, which ties into its clinical utility. The shortness makes it easier for the client to take and for the counselor to score.
    2. Automatic thoughts questionnaire
    a. I really like this test. I like how there is a frequency 1-5 and a degree to belief 1-5. I also like how short the items are. This test, even though there are 30 items, would be quick and easy to take. I find this characteristic to be the key point in the clinical utility. The test is also very pleasing to the eye. A possible weakness I find with this is that by taking this assessment the racing thoughts might become worse.
    3. OQ-45.2
    a. My initial reaction to this assessment was immediate dislike. The greatest weakness of this assessment is the look of it. I like the 4-0 scale. The items are well worded. I like hoe they target different concepts. But the font is so tiny and it just looks daunting. This assessment shows that the look of a test is just as important as the actual test. I’d say it has moderate clinical utility. It is not easy to look at which might make it hard to score and to understand. But I also find most of the information could be gathered through counseling sessions.

    Reply

    • Althea Hermitt- Mcpherson
      Jun 27, 2020 @ 19:16:19

      Hi Madi- I also like the BDI-II scale, I, however, don’t like the fact that it’s disjointed with instructions withing the scale it makes it very obvious what its asking and could be misunderstood due to the number of directions based on answers. Its a widely used assessment and therefore must be getting the job done nonetheless. The fact that it was revised to incorporate DSM-5 criteria is very good. I totally agree with you, the fact that the scale is able to pick up illnesses unrelated to mental illness might make it misleading. Another important point is that it doesn’t discriminate between past and presents depression which I think is important information to have.

      Reply

    • Michelle McClure
      Jun 29, 2020 @ 21:26:11

      Hi Madi. I completely agree I had the same reaction to the Outcome Questionnaire. My first thought was that it was long and I could tell immediately it would be more complicated to score. I personally really appreciate assessments where scoring is fast and easy. I am pretty sure that it is one of those “the more you do it, the easier it gets” type of things and I am sure that it is a helpful assessment to a clinician who is treatment planning and /or thinking about discharging a client. I think this assessment is one where the more you use it the more you like using it and the easier it is to administer and score.

      Reply

  2. Francesca DePergola
    Jun 25, 2020 @ 00:28:50

    Likes/Strengths, Dislikes/Weaknesses, Clinical Utility) for the following assessments:

    (1) Beck Depression Inventory-II (BDI-II)
    I liked how this was a relatively short assessment that is both easy to complete and easy to score. I also liked how there was a differing sentence structure within the answers of the item. They were similar enough to ask the same thing, but the more intense there was almost an added layer whereas other assessments focus on frequency and keep the sentence structure almost identical. The only weakness I saw within this is that it is obvious of what it is testing, there is not a lot of subtlety. Although the lack of being subtle, I thought this had great clinical utility as it is fast to take and score, as well as it also stated that its reliability and validity was high.

    (2) Automatic Thoughts Questionnaire
    I have never seen an assessment like this that has multiple answers within the item. I thought that was interesting and something I liked because you not only get how frequently these feelings and thoughts are occurring but also the degree in which they believe it. I did not like how similar the items were. The items’ shortness was nice, but I also feel like it is a weakness as well because it does not go as in-depth as other assessments do. I also thought that it could be a possibility that some clients would not want to admit to either believing some of these or thinking about them as frequently, especially with items like “I’m a loser.” This assessment has clinical utility because it seems to give a lot of insight into what the client is thinking and feeling because it asks two questions within one item. It is also not too short, but not too long, to the point, and easy to take, score, and communicate to the client.

    (3) Outcome Questionnaire (OQ-45.2)
    I personally liked the organization of this assessment because to the counselor it looks as if it easy to score and there is only one page to look at. I liked the variety of questions asked and how they are not looking at one aspect, but many as it will give a good picture of what the client is experiencing in multiple scenarios. I especially liked the grouping on the side to help with the scoring. On the other hand, if I were the one who was given this to I would not like the looks of it. It almost reminded me of the SAT bubbles which immediately elicited this anxiety. I think the client could be easily overwhelmed with this, especially because it is a 45-item assessment and only one page. I think this could have clinical utility; it just depends on how the client reacts to this. It was a little confusing to score and seemed intimidating to take, so If it were organized differently, I think its utility could improve.

    Reply

    • Haley Scola
      Jun 27, 2020 @ 19:16:21

      Hi Francesca,
      I thought it was very insightful that you pointed out the differing sentence structure measuring the same thing for the BDI-II. I didn’t point this out in my post but I completely agree with what you said that this is very helpful and allowed for two levels of intensity measuring the same thing. I too loved the ATQ because as the clinician you not only get the frequency of the thoughts but also how firmly the client actually believes it. This allows the clinician for beneficial insight into the client and can be very useful in the client’s treatment plan and therapeutic process. I disagree on your point that you liked the organization of the OQ-45.2. I thought it was confusing and allowed for a lot of confusion. I thought your points backing your opinion up were very insightful though and allowed for me to see a different perspective. I did agree that the clinical utility of this assessment depends on the clients reaction to the questions asked and if they get overwhelmed by how intimidating it looks.

      Reply

  3. Madi
    Jun 25, 2020 @ 17:22:23

    Hi Francesca,
    I had basically the same reaction you did to the assessments. I really liked the ATQ though. I loved the layout and how there was frequency and degree. I thought the set up was very easy to read and very pleasing to the eye. As I have a client with racing thoughts, I immediately wanted to give this to the client. For topics such as racing thoughts the frequency and degree are two vital components.

    Reply

  4. Selene Anaya
    Jun 26, 2020 @ 17:40:52

    (1) Beck Depression Inventory BDI-II
    This assessment was very short and to the point. I can understand why it is widely used. I also enjoyed the categories of symptoms. It allowed for the answer choices to be more specific and clear about what is being assessed. It was cool to see how they gave two sides of a possible answer like changes in sleeping and appetite patterns. Scoring was also super easy which is helpful when we want to score while we are beginning the session with the client. The only weakness I noticed as I was taking this was that when I read some of the items, I found myself questioning my answer because I knew this was for depression but my changes in sleeping patterns have just been because I have more time to sleep and want to catch up. The changes are controllable. The clinical utility of this assessment is strong because it is feasible, reliable, and has strong validity (.93). The interpretation of score to severity is also clear, as long as clinicians know not to get caught up on differentiating between scores that are close to the cutoff (28 for moderate and 29 for severe).

    (2) Automatic Thoughts Questionnaire
    This assessment was very interesting. I found myself thinking a lot about the questions when I first answered them and then thinking even deeper to answer the degree of belief. The focus on negative thoughts was clear, so I am sure the test has strong content validity. The questions were all very similar. I felt myself looking back to the previous questions to see if I already answered it, but I can see that as a positive in the fact that it can prove something to be true if the answers are the same. Scoring for this questionnaire in its entirety doesn’t really matter. The scores help with scanning through and finding the high-frequency thoughts and then moving over to the degree. This can be effective for pinpointing specific thoughts and addressing the ones that seem to affect the individual the most. The reliability was strong, and the concurrent validity was “good”. I would like to see more about the validity coefficients, especially content validity. I can see this assessment being most helpful for both clients and individuals to reveal what the client is actually thinking. A client can tell the clinician many thoughts and feelings they might have, but this assessment can pinpoint the thoughts more specifically especially when there is a scale for the degree of belief. We can see which thoughts the client is really having versus the ones they aren’t.

    (3) Outcome Questionnaire (OQ-45.2)
    I liked the variety of questions that this assessment offers. I also enjoyed how the total score is interpreted as well as the subscales that each have different meanings. I also liked the inclusion of some critical questions that are mixed in with not-so-critical questions. This way a client can be so into the assessment and answering truthfully, it’s not as obvious what exactly those questions are assessing. The way the scoring portion is set up can lead to some issues. I found myself messing up my place and putting in the wrong score. I think the organization of the assessment can be improved to avoid these simple errors that can impact multiple interpretations. I also caught myself referring back to what each box meant. The scores next to the boxes can also be a little confusing, but it is very helpful for the clinician, so they don’t have to go back and check which scores to reverse. The assessment covers a lot of areas, so it is good either as an initial assessment or if a client has multiple problematic areas. These questions are also for the young adult/adult population as it includes many questions regarding interpersonal relations and that has its own subscale.

    Reply

    • Haley Scola
      Jun 27, 2020 @ 19:08:58

      Hi Selene,
      I also had similar points about the BDI-II in terms of its clarity and easiness in scoring/interpreting. I thought it was very helpful that you pointed out the organization would also be a flaw since it is clear to the client at what is being measured and could make the client overthink the question and not answer how maybe they would if it wasn’t outlined as what exactly is being measured. For the OQ-45.2 I found myself messing up the scoring as well and found it pretty confusing. I think the clinician would need to figure out every aspect of this assessment before the use it with a client since it can be easily confused. Overall, I agreed with almost every point you made and I made the same ones in my blog post.

      Reply

    • Althea Hermitt- Mcpherson
      Jun 27, 2020 @ 20:10:12

      Hi Selene: I also found the ATQ-B to be interesting because it was scoring two different things side by side. I liked that the ATQ-B can also be used to assess various psychopathologies and that the questions are simple and easily understood. I like that you focused on the various type of validity and reliability that the scale has and also once that you felt were lacking. I also agree with you that the thoughts and beliefs captured by this scale are very important and may be hard to capture in sessions. However, the scale intricately captures and pinpoint specific thoughts and degree of beliefs. I think this scale is great as it helps to get information that is not easy to talk about.

      Reply

    • Madi
      Jun 29, 2020 @ 11:34:46

      Hi Selene,
      I really liked your take on the ATQ and how you focused on how helpful it could be. While some information can be gathered through sessions, you make a good point about how helpful this assessment can be. I also thought a strength of the assessment was the fact that there was degree of belief.

      Reply

    • Michelle McClure
      Jun 29, 2020 @ 21:31:25

      Hi Selene. I completely agreed with you about the Automatic Thoughts Questionnaire. I really liked it immediately. I too spent a lot of time thinking about each question and questioning myself about how strongly I may or may not believe each statement. I can see where a client could learn a lot about their thoughts and beliefs just from taking the assessment alone. I think this would be a great assessment to do with a client during an intake or early on in therapy as it would provide so much valuable information to both the client and the clinician.

      Reply

  5. Althea Hermitt- Mcpherson
    Jun 27, 2020 @ 17:09:29

    (1) Beck Depression Inventory-II (BDI-II)

    Likes/Strengths: Beck Depression Inventory is a self-report instrument that measures the extent and severity of clients’ depression. The depression scale can be used on a wide age range from 13 through to 80 years old. Even though the assessment is 21 questions it probably doesn’t take more than 10 minutes to complete. Another strength is that it is easy to understand and doesn’t require training to administer. The BDI-II is a revision of the BDI developed in 1996 to incorporate DSM -IV criteria. The scoring of the test is easy, where anyone can follow and get an accurate score. The Beck Depression Inventory is also available in Spanish and is widely used throughout many practices.

    Dislikes/Weaknesses: Some questions capture physical symptoms that can be present in certain medical conditions. The BDI-II doesn’t discriminate between past and presents depression as it only assesses symptom presentation within the last 2 weeks. The assessment basically states what it’s assessing, therefore individuals can easily give miss information if they have an agenda.

    Clinical Utility: TheBDI-II is short and easy to scoring. Also, construct validity and test-retest reliability is high.

    (2) Automatic Thoughts Questionnaire

    Likes/Strengths: The Automatic Thoughts Questionnaire measures the frequency of automatic negative thoughts experienced by individuals. The ATQ-B assesses frequency and degree of belief on the same assessment is genius. ATQ-B can also be used to assess various psychopathologies. I like that the questions are easily understood and simple. The scale from 0-5 gives responders a wide range to express their thoughts.

    Dislikes/Weaknesses: I think that a scale with 30 items is a little bit long. The questionnaire doesn’t discriminate between past and present negative thoughts as it only assesses negative thoughts within the last week. Assessing frequency and beliefs on the same assessment might be confusing for some people.

    Clinical Utility: The assessment questions are organized and concise, it is easy to understand and arrive at the total score. The assessment answers a number of questions about thoughts and feelings and beliefs which are sometimes hard for clients to talk about. The reliability and validity of the assessment is high, therefore, clinicians can communicate scores with more confidence and generalizability.

    (3) Outcome Questionnaire (OQ-45.2).

    Likes/Strengths: The OQ-45-2 is a standardized, self-report instrument that can be administered to individuals 19 yrs and older. This adult outcome measure can be used throughout treatment, and at the end of treatment to assess functioning levels and changes over time as it is sensitive to subtle changes. The OQ-45-2 measures 3 subscales which include symptom distress, interpersonal relations, and social roles and clinicians can use this to target clients’ problem areas. I also like how the scale is scored, it gives the subscale scores and then an overall score so clinicians can know what subscale is problematic. The questions seem to contain risk assessment items that can determine suicide potential, violence potential, and substance abuse. It’s also available in numerous languages. The assessment used a scale of 0-4 which gives responders a wider range to express their thoughts.
    Dislikes/Weaknesses: A 45 question scale is very long. The interpretation of the scores required visiting specific critical items or questions, therefore on top of scoring the instrument, special considerations need to be given to suicide and substance abuse items to determine if further investigation is needed. This might be confusing for some people to score.

    Clinical Utility: The OQ-45-2 is easy to score however due to the 3 subscales it might be confusing. The interpretations of score and attention to critical items for suicide, workplace violence, and substance abuse might be missed or confusing. It does have cut-off scores which are great for interpretations of each subscale and total scores. The instrument has been extensively researched and standardized.

    Reply

    • Francesca DePergola
      Jun 29, 2020 @ 22:51:04

      Hi Althea,

      Regarding the BDI-II, I thought it was odd too that it focuses on symptoms presenting in the last two weeks. It would be interesting to see an assessment like the ATQ where it asks two things within one item. I also thought the ATQ was a very cool assessment not only asking about frequency but the degree of belief. I feel that it might be confusing for some clients, but the added information can be so helpful. With this assessment, in particular, it might be helpful to know just how frequently a thought comes to mind but if it is very frequent and a highly believable thought, it is just that more important to go over it with the client. Finally, I also agree with what you have said about the OQ-45. Overall, I thought you brought up a lot of other important background information about the assessments I had not thought of to be a strength. Some things like these assessments being in a different language are not something I think about often. As counselors, we are sure to come in contact with clients from different backgrounds, yet we expect that they must know the English language well enough to answer these tests accurately and without confusion.

      Reply

    • Trey Powers
      Jul 01, 2020 @ 17:12:16

      Hi Althea!

      You make some good points in your dislike/weakness section for the BDI-II. I had said that I found nothing I disliked about the instrument, but your thoughts have given me some insight into a few of the flaws. It is important to first rule out medical conditions, as these may be easily fixed with medication, and would prevent the client from engaging with unnecessary therapy with potentially no results. It is also an important point that this instrument only considers symptoms from the past two weeks, and does not consider any past episodes of depression. Getting a full and detailed history is an important part of effectively diagnosing a client, and as a result, it seems as though this instrument would need to be supplemented with others in order to gain a complete picture of the client.

      Reply

    • Selene Anaya
      Jul 01, 2020 @ 17:34:40

      Hi Althea!
      I think you brought up a good strength about looking at the participant information and saw the large age range to be a strength. This goes to show that many symptoms can be the same in both children and adults. I also enjoyed that the BDI-II was clear about it being in Spanish. As clinicians, we will be interacting with people from many different backgrounds so having assessments that are in their first language can not only make it easier for them, but it can also comfort the individual. As for the Automatic thoughts questionnaire, I thought the degree of belief portion was also “genius” because it can help us prioritize certain thoughts the client is having without us needing to go through it all together and make a list after the client already completed the assessment. Finally for the OQ-45.2, I also really liked the subscales and the fact that the assessment is offered in multiple languages. Scoring the critical items was noted in the scoring instructions and I like that they included that because those are questions that we need to pay extra attention to. I am excited to learn more about the outcome questionnaires because although they contain more information than the assessments we are used to seeing, I can see how they can be super helpful.

      Reply

  6. Haley Scola
    Jun 27, 2020 @ 19:03:56

    (1) Beck Depression Inventory – II (BDI-II)
    The strengths of this assessment was its clearness. This assessment was very straightforward with its questioning and instructions for the clinician. It was easy to follow which I think is very beneficial in an assessments effectiveness. Something that I thought may be a weakness was the questions were clearly labeled for what each question was assessing. This prevents the client from answering each question unbiased. If a client doesn’t want to be seen as pessimistic then maybe, they’ll answer “I am not discouraged about my future” instead of just seeing the question referring to their future and answering honestly. The clinical utility of this test is very high due to it is relatively easy to follow because of its nice organization and was pretty short so it’s fast to take. This states that the reliability and validity are both high which is another reason for its clinical utility.
    (2) Automatic Thoughts Questionnaire
    I really enjoyed this assessment. I thought its biggest strength was how it measured 4 different aspects (personal maladjustment and desire for change, negative self-concepts and negative expectations, low self-esteem, and helplessness). I think the fact that it measures all 4 of these aspects makes it a vital tool in the therapeutic process and allows for beneficial insight into the client. A weakness about this assessment is the way in which the statements were worded. Some clients may not want to admit, even to themselves, that they think some of these thoughts (example: “I’m so weak” or “I’m a loser”). I do agree that knowing the frequency of these thought would be very helpful but from the client’s perspective I think the questions may be detrimental to the helpfulness of this assessment. In terms of clinical utility, I think that this test can be helpful to the clinician’s insights on the client since the assessment is short and straight to the point.
    (3) Outcome Questionnaire (OQ-45.2)
    One strength I noticed was the variety of questions asked. I thought that all of the questions allowed significant insight that would be very helpful to the clinician. The set up allowed for subscales to be easily measured as well as an overall scoring which I thought was very useful for the clinician. Two weaknesses about this assessment is its length and its scoring system. When trying to fill this out I found myself confused and that it was hard to follow. Although the subscales can be very useful, I also think it added to the confusion in the scoring process. The clinical utility of this assessment is high if the clinician effectively understands beforehand how to score and interpret this assessment.

    Reply

    • Dawn Seiple
      Jun 28, 2020 @ 13:58:37

      Hi Haley,

      Though I didn’t make this observation myself about the BDI-II, I agree that categorizing each set of scores under a sub-heading like Pessimism or Self-Dislike, may be more detrimental to positioning the questions than it is helpful. It does seem like the questions could be asked without those headings and the patient might answer them in a more honest way. For the ATQ, I also mentioned how difficult and painful it could be to acknowledge so many negative thoughts. If a patient is feeling this badly about themselves, this questionnaire could certainly heighten their feelings of helplessness and sadness. As for the OQ-45.2, I liked the variety of questions as well and definitely could imagine it being helpful when first meeting a patient and then over time using it to gauge their progress.

      Reply

    • Selene Anaya
      Jul 01, 2020 @ 17:44:08

      Hi Haley!
      I agree with you about the reservations you have about the BDI-II labeling each question. Not only does it run the risk of the clients answering dishonestly, but I can also see how the label itself can sound a lot more intense which can influence their response. For the automatic thoughts questionnaire, I like how you mentioned how the 4 different aspects that are being assessed can help us gain more insight into the client’s situation. I thought it was very interesting how you mentioned the helpfulness of this assessment and how the degree of that helpfulness is different for the clinician and the client. Finally, for the OQ-45.2, I also found the scoring to be a bit confusing. I found myself losing track and I actually made some mistakes (one for one of the critical questions) which could have led to some significant changes to the insight my clinician would gain and lead to a possible overestimation of diagnosis (in my case). It could also lead to an underestimation of diagnosis if the clinician mixes up the score for a critical question and it is not addressed. The organization could be done differently, but overall I think it gives clinicians some great, helpful information about their clients.

      Reply

  7. Dawn Seiple
    Jun 28, 2020 @ 13:40:46

    Beck Depression Inventory – II (BDI-II)
    Likes/Strengths – Where this test is the most widely used for depression screening, it is clearly a helpful tool. It has both good reliability and construct validity. My first impression is that it would quickly identify people who were not depressed and those who were. While it is pretty direct, I don’t think this would cause patients to be dishonest.

    Dislikes/Weaknesses – I wonder if this questionnaire is as helpful when a patient is suffering from persistent depressive disorder or when the patient has been suffering from a major depressive disorder for months. Many questions ask the patient to rate how they are feeling over the last two weeks as compared to how they “used to” feel. If they have been depressed for years, they may not have had interest in people or things for a long time. They may have been irritable for a while and not detect any change in irritability.

    Clinical Utility – This test is easy to score and quick to administer which makes it ideal for a lot of different settings. Even inexperienced clinicians can interpret and utilize the results.

    Automatic Thoughts Questionnaire (ATQ-B)
    Likes/Strengths – The strength of this questionnaire definitely seems to be the more unique scoring options related to both frequency and degree of belief. The statements are pretty strong and do seem to warrant a scale. I like that the clinician can use this to understand how significant and frequent the patient’s automatic thoughts are. As noted, it has both strong reliability and validity.

    Dislikes/Weaknesses – The questions were very sad and were hard to answer even when I wasn’t experiencing any of these dark thoughts. Answering 30 questions all with a similar negative tone could be painful and could make the patient embarrassed and uncomfortable. It seemed like fewer questions could suffice.

    Clinical Utility – The scoring isn’t difficult but does get a little more complicated when the items need to be sorted into the four different categories of automatic thought. It seems that identifying a patient’s automatic negative thoughts would be especially helpful in designing a CBT treatment plan.

    Outcome Questionnaire (OQ-45.2)
    Likes/Strengths – I like that this questionnaire assesses multiple facets of the patient’s life and can be used as frequently as weekly. It seems like it would serve as a good formative check-in that could tell the clinician how the patient is progressing in treatment. Though the questionnaire incorporates 3 subscales, it is easy to score each of those. I especially like that it has a few questions that address any potential areas of immediate concern such as violence, suicide or substance abuse.

    Dislikes/Weaknesses – There wasn’t much I didn’t like about this questionnaire. Though it is a little long, it seems worth it to cover so many potential areas of concern.

    Clinical Utility – Once a clinician is familiar with this test, it seems it would be easy and worthwhile to administer. It can help a clinician target some specific areas of functioning difficulty for the patient and monitor how those improve (or don’t) over time.

    Reply

    • Yen Pham
      Jun 29, 2020 @ 23:24:50

      Hi Dawn,
      I totally agree with you on the strengths of the OQ-45.2 scale. It is sensitive to short‐term changes, making it a good instrument for evaluating client progress at any point during treatment. In other words, this scale provides the clinician with a “snapshot” of the client’s current functioning across a wide variety of disorders (the last week, including today). The various items and some critical items I also agree with you that it is the strength of this scale. For example, the item 8: suicide, items 11, 26, and 32: Substance Abuse., item 44: violence. However, I think that these questions are very straight so they often are hidden if the client does not really trust the counselors.

      Reply

    • Trey Powers
      Jul 01, 2020 @ 17:05:29

      Hi Dawn!

      I also liked the Outcome Questionnaire. I agree that it seems as though it would take some getting used to before a clinician is comfortable and confident with this instrument, though. Although it us a bit long, I think that actually may help with its effectiveness, as like you mentioned, it covers a wide variety of topics. I wonder when you think it would be most beneficial to administer this to a client. I had said that it seems like a good instrument for initial intake, but I can also easily see it being used as a form of formative assessment throughout therapy, particularly given its wide variety.

      Reply

    • Brigitte Manseau
      Jul 01, 2020 @ 21:10:25

      Hi Dawn,

      I was intrigued reading your dislikes regarding the BDI-II. I had only thought of one weakness for the assessment which was different than yours. You brought up a good point about how clients may choose their answers differently if they’ve been depressed for years. In terms of the OC 45.2, I had similar points to yours. I, too, liked how the assessment included items related to suicide, substance abuse, and violence. Also, I like how you mentioned how frequent the assessment could be used. I feel like the OC 45.2 would be beneficial to use throughout the therapy process. Even if a client does not initially indicate any red flags, the client may mark critical items in future assessments which could bring the “new” critical issues to the clinician’s attention.

      Reply

  8. Trey Powers
    Jun 29, 2020 @ 18:49:43

    1. BDI-II
    Likes/Dislikes
    This instrument is simple and not very long, but also gives insight into a variety of feelings that are associated with depression. The statements are easy to understand, and I like how they offer a scale of 0-3 in terms of the intensity of the feelings being asked about, while also offering the option to say that they are not feeling that particular emotion/symptom. I also like how the statements are divided into categories, making it easier to know what is being asked about. The instructions were specific, and cleared up any confusion that could come from feeling as though multiple statements fit. The instructions for the clinician also offer a great deal of specific information about the instrument, even regarding things such as background information. I don’t find myself having any dislikes.
    Clinical Utility
    This appears to be a very useful instrument for assessing depression. While short, it covers a good deal of the symptoms commonly associated with depression, and offers a range of possible statements for a client to chose from rather than simple yes or no or agree or disagree statements. The scoring is also easy, with the instructions giving clear explanation for the process. The instructions also include a great deal of supplemental and background information for the clinician to understand exactly when and why to use the instrument. This appears to be a useful tool for assessing depression.

    2. ATQ-B
    Likes/Dislikes
    This is another simple, relatively short instrument that does not take too much time to complete, while also offering valuable information about the client’s present state of mind. The fact that the instrument collects information on both the frequency that a person experiences these thoughts as well as the degree to which they believe the thoughts also seems to be a strength, as it allows for the collection of two types of information in one. It was also useful that the instructions provided meaning behind each of the numbers rather than letting each person formulate their own understanding of the numbers. It was also convenient that the second page also provided the scales, which prevents a person from having to turn back and forth from the first page to see the scales.
    I found that all the questions were very negative. While this is an assessment of depression, it seems as though the authors of the instrument could have included some positive questions that then could be reversed. While this would make scoring slightly more involved, it may break up the negativity of the majority of the questions.
    Clinical Utility
    This seems like a useful tool for assessing an element of depression. Automatic thoughts are something that can be very troubling for people, as they cannot help but experience them. Being able to identify whether the person is experiencing these types of thoughts, as well as how often, is a good way of initially establishing whether a person may be experiencing symptoms of depression. I feel as though this would be good to distribute to a client first, and then move on to the BDI-II if the results indicate that the person is experiencing significant negative automatic thoughts.

    3. OQ-45.2
    Likes/Dislikes
    I like the range of possible responses in terms of frequency. It seems as though this allows for the client to give a more accurate description of how frequently they are experiencing any of the feelings portrayed in the statements. There are also a wide variety of thoughts and feelings that are able to be assessed through this instrument, which is useful as this almost appears that it could be a catch-all instrument in some ways. I like how unlike the ATQ-B, this instrument does include positive statements as well as negative statements.
    Some of the statements come across as somewhat vague and open to interpretation. Additionally, this instrument is a bit long, and may lead to burnout in some clients.
    Clinical Utility
    I was at first intimidated by the instructions for scoring, but further examination revealed that the way the scoring works actually offers a great deal of insight for the clinician. The separation of statements into three categories I felt was especially useful, as it helps to understand the specific areas in which a person may be suffering in. This seems as though it would be a useful instrument to use for initial intake, perhaps, as it covers a variety of possible symptoms, both physiological and psychological, that can inform the clinician of several possible problems that the client has.

    Reply

    • Yen Pham
      Jun 29, 2020 @ 22:39:15

      Hi Trey,
      I enjoyed your very detailed and insightful discussion on the BDI-II scale. Just like you, I like this scale, and it is also a strong point when it is clearly classified in groups and has many choices for each group.Your discussion have added some other strengths that I haven’t mentioned in my posting, like clear instructions. For clinical utility I also agree with you that BDI-II is very useful instrument for assessing depression because this scale is widely known. Hoover, on my own opinion, I think this scale still has a weak when it requests a specific details of clients’ background: name, marital status, age, sex, occupation, and education, so some clients want to hide themselves when they are not really trust the counselors.

      Reply

    • Francesca DePergola
      Jun 29, 2020 @ 23:11:24

      Hey Trey!

      I also thought it was helpful that the BDI-II had categories because I feel like that makes it much easier for the counselor to know what needs to be focused on. I thought that the questions in the ATQ were very negative as well, and you bring up an important point that there could have been room for some positive ones or at least some reversed. I think that going from this assessment to the BDI-II is a good point because although this assessment identifies negative thoughts, and depending how the client scores, the next step might be to identify whether depression is present. I thought the same thing with the OQ-45 that it looked hard to score at first and that it would be a great intake assessment as it is very broad in what it is testing. I think this was one of the more interesting assessments we have looked at because of its length and variety of questions. Great points, thank you!

      Reply

    • Brigitte Manseau
      Jul 01, 2020 @ 20:35:03

      Hi Trey,
      I agree a downfall of the ATQ is that it is extremely negative. I like how you proposed a solution to that issue in which the creators could have included positive items that would be reversed. Prior to your post I hadn’t thought of what changes could make the assessment more likable in my eyes. Like yourself, I found the OQ-45.2 to be especially helpful for clinicians since it gives the clinician insight into various areas of a client’s life. I like how the questionnaire goes beyond just physical symptoms. The assessment helps track how the client’s depression is impacting his or her relationships and social life. I agree this questionnaire would be great for the initial intake since it gives a detailed glimpse into the client’s life.

      Reply

  9. Michelle McClure
    Jun 29, 2020 @ 21:17:11

    1. Beck Depression Inventory II (BDI-II)
    Strengths- The BDI-II is a relatively short assessment that is easy to complete, 21 questions that are scored on a zero to 3 scale and are asked about thoughts and feelings over the last 2 week period with overall high reliability and validity scores. The assessment takes about 5 minutes to complete and is also easy to score which is another strength and adds to the “user friendly” feel of the assessment.
    Weaknesses- I really liked this assessment and the set up and overall “feel” of this assessment so I find it difficult to say I feel there is a real weakness to it but possibly some people may not like the way the questions are set up and the answers that are available because they are too straight forward or hit “too close to home”.
    Clinical Utility- The BDI-II is so easy to take and easy to score with such high reliability and validity scores that it would be a useful tool for clinicians in most if not all mental health settings. It is a good instrument to give to a client whenever a clinician is concerned about possible depression.
    2. Automatic Thoughts Questionnaire
    Strengths- I personally thought this assessment was interesting. I think that a strength of this assessment is that it helps the client as well as the clinician discover the negative self-talk and the core beliefs of the client. It is extremely helpful to identify these negative beliefs to help in treatment planning and to focus session interventions on what will be most helpful to the client. The assessment is also easy to take for all the different areas it measures which besides negative self-concepts also includes low self-esteem, helplessness, and personal maladjustment and desire for change. The reliability and the validity of the assessment are also very high which adds to the strengths of the assessment.
    Weaknesses- I also really liked this assessment and felt it had many strengths that make it valuable to clinicians and clients so the only weakness I can think of is that it was more difficult and took more time to score.
    Clinical utility– This assessment is also easy to administer and the client can complete it quickly which as well as being another strength also makes the assessment valuable in many clinical settings including inpatient and outpatient treatment centers.
    3. Outcome Questionnaire (OQ-45.2)
    Strengths- This was a longer assessment with more questions then previous assessments and the questions covered a wide variety of topics which I believe is both a strength and a weakness of the assessment. The assessment is not as obvious as previous assessments to what it is trying to measure which I would consider another strength. This assessment measures a variety of mental, social, and safety issues and can give clinicians a good understanding of a clients problems and how those issues are affecting the clients functioning which would be beneficial in treatment planning, interventions and before discharging a client to ensure that the clinician was successful in improving the clients functioning and if there are still issues that the clinician should address before discharge.
    Dislikes-As mentioned above I feel that the length of the assessment was partially a weakness for this assessment. I feel like some clients would not like this assessment as much because of the length they would start to lose focus and/or interest. I also found the scoring on this assessment to be confusing at first and more time consuming then previous assessments. I would hope that after becoming more comfortable with the scoring that would become less of an issue and take less time.
    Clinical Utility- I feel that this would still be a valuable assessment in many mental health settings including inpatient and outpatient settings. I could see this assessment being used at an intake, before revising a treatment plan or when the clinician is considering discharge.

    Reply

  10. Yen Pham
    Jun 29, 2020 @ 21:52:32

    Beck Depression Inventory – II (BDI-II)

    1. Likes (or Strengths)

    This scale is easy to use because it consists of 21 groups of statements are so clear and organized. Each group has at least 4 options which will help the participants more consideration to pick out the one statement that best describes the way they have been feeling during the past two weeks, including today.

    2. Dislikes (or Weaknesses)

    The length of this scale is one limitation because it is not convince for someone is busy as well as the age range from 13 to older means this scale has no impacted on the age lesser than 13. Also, this scale provides so specific details of clients’ background: name, marital status, age, sex, occupation, and education, so some clients want to hide themselves when they are not really trust the counselors.

    3.Clinical Utility

    This scale is widely known, results easy to interpret. In addition, this scale helps counselors diagnose clients’ depression more accurately when they know the background of clients.

    Automatic Thoughts Questionnaire

    1. Likes (or Strengths)

    I like the ATQ because this scale measures both depressogenic thought frequency and the degree of belief. Each item has 10 options, 1- 5 (not at all- all the time) for thought frequency as well as 1-5 (not at all- totally) for the degree of belief. Although this scale has 30 items but each of them very short and clear. This scale does not mention the personal information of clients such as name, gender and education so that is strength because clients can be assured of picking out options honestly without fear of being exposed personality. Finally, this scale does not limit the range of ages. It can measure for everyone.

    2. Dislikes (or Weaknesses)

    Without asking clients’ background is the strength of this scale but it is also a weak because it is only provides counselors an unknown client with general information. It is hard to find the specific data of each client to diagnosis and plan a therapy. Also with abundant options on each item and measurement in two variables, they will probably annoy clients who do not have much time and patience.

    3. Clinical Utility (e.g., scoring, interpretation, population, assessment and treatment)

    Basis on the content of this scale, individuals say that these negative thoughts come to mind before they feel emotion. In other words, it can be said that things which cause happiness, sadness, anger and anxiety are automatic thoughts. Automatic thoughts are often tied to a specific situational trigger, intermediate. Therefore, automatic thoughts’ positions are crucial both in therapy and etiology. Specifically, in CBT, recognizing automatic thoughts and how they make patients feel and behave is sufficient.

    Outcome Questionnaire (OQ-45.2)

    1. Likes (or Strengths)

    The OQ-45.2 may be best conceptualized as a measure of depression for an adult (19 years and older). It is sensitive to short‐term changes, making it a good instrument for evaluating client progress at any point during treatment. In addition, this scale assesses personal and socially relevant characteristics that contribute to one’s quality of life as well as it contains risk assessment items for potential suicide, substance abuse and workplace violence. Specifically, item 8 is a screening item for potential suicide (I have thoughts of ending my life). Items 11, 26 and 32 refer to substance abuse items (After heavy drinking, I need a drink the next morning to get going, I feel annoyed by people who criticize my drinking, I have trouble at work/school because of drinking or drug use). Item 44 screens for violence at work (I feel angry enough at work/school to do something I might regret). Finally, like the BDI-II, this scale provides details of clients’ background, I like the adding in this scale such as session number, ID number and the date which helps counselors finding client’s data is easier.

    2. Dislikes (or Weaknesses)

    With un-trusted clients on counselors, clients seem to avoid telling the truth about their feeling if they were asked to provide their background. Also, this scale has some sensitive questions such as I listed above.

    3. Clinical Utility

    This scale provides the clinician with a “snapshot” of the client’s current functioning across a wide variety of disorders (the last week, including today).

    Reply

  11. Brigitte Manseau
    Jun 29, 2020 @ 23:46:25

    1. Beck Depression Inventory-II (BDI-II)
    A strength of the BDI-II is that each item has 4 statements to choose from. It allows more wiggle room for clients to choose the most accurate answer compared to scales that only have two options. I like that the that the assessment included both affective and somatic items. Also, I like how the instructions clarify how a client should pick his or her answer if the client is stuck between a few statements. The client knowing to pick the highest statement number that is applicable will help the clinician accurately score and interpret the assessment. It’s short so the assessment is quick for the client to fill out. With minimal training needed to administer the test, it is quick for the clinician to score and easy to interpret results. The BDI-II would be great to use in both in-patient and out-patient settings. The one downfall of this assessment is that clients who have other medical conditions may score higher on physical symptoms due to their medical condition. Therefore, the clients’ responses to the somatic items could be unrelated to depression.

    2. Automatic Thoughts Questionnaire
    At first glance I was intrigued by the way the scale was set up. I like how the questionnaire measures both frequency and degree of belief. A strength of the questionnaire is that it assesses four areas of automatic thoughts. Therefore, it allows clinicians to identify exactly which aspects of automatic negative thoughts the client has. I like that it uses a Likert scale so there are options if the client does not feel strongly for or against an item. Another strength of this assessment is that each item is straightforward and short. The client can fill out the assessment within a few minutes which is convenient. Scoring was easy since there were only thirty items.

    3. Outcome Questionnaire (OQ-45.2)
    A strength of the OQ-45.2 is that it assesses symptoms of distress, interpersonal relations, and social role all in one questionnaire. The clinician gains a deeper understanding of the client’s functioning through the three subscales. Also, if a client scores low on one subscale and high on the other two subscales, it will help the clinician focus on the two “problem” areas. Another strength is that it includes important items that can be flagged for suicide, substance abuse, and violence. If indicated, the clinician will follow up with the client. A minor detail that I liked was that there was a place to mark what therapy session the assessment was administered. A weakness is that the scoring may seem confusing at first if the clinician is unfamiliar with the assessment and the scoring. This questionnaire would work well for adults in outpatient settings.

    Reply

    • Dawn Seiple
      Jul 01, 2020 @ 09:24:46

      Hi Brigette,

      While I initially wasn’t sure about some of the incongruity of the 4 statements offered in each question on the BDI-II, I think you make a great point about that feature allowing for the patient to choose the statement that is most accurate and true to how they are feeling. They don’t have to be expressions of degree for the exact same sentiment to help the clinician gain insight. I also thought you made an important point about including both affective and somatic symptoms in the questionnaire and noting that somatic symptoms always come with the additional complication that they could be due to a medical condition. However, by identifying any potential medical issues, the clinician might be able to uncover important underlying conditions contributing to the patient’s mental health. By looking at the somatic answers in the context of the patient’s other responses, the clinician can get a more accurate understanding of the patient’s current condition and determine the likelihood that an underlying medical condition is involved.

      On the OQ-45.2, I had missed the feature that asks for what session the test was conducted in but agree that this is good to have. In fact, I am surprised that this is not a standard entry for assessments. Perhaps that is a reflection of the fact that the use of formative testing is less common than it should be.

      Reply

  12. Casey Cosky
    Jun 30, 2020 @ 00:05:04

    Beck Depression Inventory-II (BDI-II)

    I like that this scale was easy to score and to read. There wasn’t any confusing jargon what a client would not understand and it can be completed and scored relatively quickly. I also like that the options weren’t too black and white. They were not just “yes or no” questions. Being able to report answers in different levels can provide a more accurate response. It’s good that it was able to account for so many different symptoms of depression. I dislike how some of the symptoms could be due to external factors not realted to therapy. For example, someone may answer that they have trouble sleeping but don’t realize that they consumed way too much caffeine that day. Someone could also answer that they have difficulty concentrating but they don’t know they have ADHD. Someone could answer that they feel sad all the time but it’s because they’re going through a hard time in that moment. Because it is so easy to answer, someone could go through it very quickly without thinking. The questions are also very obvious and a client could easily lie about them. Overall, it’s still a useful assessment.

    Automatic Thoughts Questionnaire

    I love the varying degrees given as an option for this questionnaire. It gives the client more room to accurately express themselves, which leads to more accurate results. The questions are also very simple. Just like how I enjoyed the lack of difficult jargon in the BDI-II, I also appreciated that here. It’s easier for a client to give an honest answer when their primary focus isn’t on what the question is trying to ask them in the first place.
    I was not a fan of how vague the questions were. They were also very similar, which made me second guess my answers often. While I do love the different degrees given for responses because it does give the client room to be more accurate, it can also backfire when the client overthinks it. What also frustrated me about this questionnaire is that it was only supposed to be filled out in regards to the last week. I know I have had weeks when I would have scored really low on this but then the next week I would have scored really high. Overall, this assessment does do a good job of covering many different thoughts the client could be experiencing. The reliability and validity also show that it’s a helpful, useful tool. Taking this questionnaire and scoring it would not take up much time.

    Outcome Questionnaire (OQ-45.2)

    This was probably my favorite questionnaire out of the three. While it is long and most likely more time consuming than the others, it is clear and covers a lot of different aspects of the client’s thoughts, experiences, and behaviors. Physical symptoms, emotions, and external factors such as relationships are all taken into consideration in this questionnaire.
    Because it is so in depth, however, I do understand why scoring it would be a dislike. It seems confusing at first because there are different elements to consider and subscales to analyze, but I’m sure it becomes easier to score and interpret with experience. Plus, the more time and effort put into producing a score, the more accurate and useful that score probably is. Instead of a broad generalization of the topic, the clinician can actually get a good idea of what is happening in different aspects of a person’s life. This insight will be very beneficial for treatment.

    Reply

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Adam M. Volungis, PhD, LMHC

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