Assessment
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Psychological Assessment
Michael Berger
Department of Psychology, Royal Holloway, University of London, Egham, UK
Psychological problems in children and young
people commonly result from the interplay of a
complex of factors over time. The same problem
shown by different individuals can arise for any of a
variety of reasons, and the same instigator can lead
to individuals showing different problems. Aggres-
sion at home may occur because one individual is
socially isolated, another is not coping with the
learning demands of school, or in a third, because
of family tensions. One child bullied at school may
become withdrawn and uncommunicative whereas
another may be aggressive at home and disruptive
in school. Complexity is increased because the fac-
tors that give rise to difficulties may not always
be the same as those maintaining them. Rejection
by peers can lead to a loss of self-esteem, and
even if subsequently reaccepted, the individual
may remain hypersensitive to signs of rejection.
Assessment (or ‘evaluation’, ‘diagnosis’, or
‘case conceptualization’) is the
proces
s whereby
clinicians gather and interpret information from a
variety of sources to help understand and manage
such problems. The information is elicited and
collected using formal (structured) or informal
observations and interviews, and special tests.
An ‘assessment’, ‘evaluation’ or similar refers
to a set of statements conveying the clinician’s
understanding of the nature of the problems and
the actions needed to manage them. This
product
of the assessment process, referred to here as
a ‘formulation’, is essentially an explanation or
hypothesis about the nature of the problems and
what is required to manage or resolve them.
Assessment requires specialist knowledge and
skills and is arguably the most critical part of
Child Psychology and Psychiatry: Frameworks for practice
, Second Edition. Edited by David Skuse, Helen Bruce,
Linda Dowdney and David Mrazek.
2011 John Wiley & Sons, Ltd. Published 2011 by John Wiley & Sons, Ltd.
clinical practice: what the clinician learns through
their investigations profoundly influences what
happens by way of further action. Where the pri-
mary focus is on psychological functioning, a major
feature differentiating forms of clinical practice is
the clinician’s theoretical orientation or ‘model’.
Models influence how the practitioner approaches
assessment, how the problems are understood, the
nature of the eventual formulations they offer, the
interventions undertaken and even the structure
of services [1]. This chapter describes an approach
to the psychological assessment of children, young
people (hereafter children), their families and
others involved in their care based on a model
derived from several sources.
MODELS
Models in health care commonly reflect the char-
acteristics of medical diagnostic systems for iden-
tifying disorders. In simplified form, these view
a psychiatric disorder as something in the person
caused by a (usually) diagnosable disease or injury,
requiring individual treatment by professionals to
restore a healthy state. The appropriateness of
such models for understanding psychological prob-
lems is questioned, reflecting disagreements with
both the specifics of diagnostic systems – such as
categorical conceptualizations [2] – and the associ-
ated approaches to psychological problems [1]. A
‘social’ model, also simplified, views dysfunction
and disability as social constructs, not individ-
ual attributes, requiring social change to remove
the disabling consequences, ignoring the contribu-
tion of biological and psychological factors. From
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