2.2.5 Description of the assessment question and of the method used for assessment
Before starting the assessment of the client, the psychologist formulates one or more assessment questions, which are included in the report. The psychologist is accountable for translating the assessment questions into the method used for the assessment. The methodological competence of the psychologist should be reflected in the choice of method to be used for the assessment. That way, theory and practice are bound up with each other.
The assessment questions serve to provide insights to the client, any referrer, a principal, including an external principal, and the psychologist themselves into the assessment procedure that is followed. That way, the psychologist is accountable for their professional behaviour (see Article 35, “Rendering of account”). The assessment question can be highly standardised (such as in the selection of human resources, when an instrument is used to make a first selection from the initial list of candidates), but it can also be strictly individual, for example in psychodiagnostic research. An assessment question should in any case be seen as a translation of the assignment into the assessment procedure that is followed. It should be possible to tell from the assessment question why and to what end the psychologist uses certain research methods, including psychodiagnostic instruments.
An assessment question contains at least the following:
- the reason for the assessment,
- the client’s assessment question(s),
- the assignment for the psychologist, as agreed – perhaps with a principal, including an external principal,
- the choice of method and of instruments for answering the assessment question(s) (see 2.2.7, “Principles in the choice of psychodiagnostic instruments”)
The terms “cause”, “question”, “client”, “principal”, “assignment”, and “assessment question” point to different phases in the creation of an agreement to carry out an assessment. The reason could be “poor results at school”, for instance. The assessment questions from the principal or external principal, such as a parent or a teacher, could thus be, “Is this pupil doing well enough, or do they have insufficient cognitive abilities?” The assignment agreed could be “An assessment of intelligence, motivation and interest on the part of the pupil”. The assessment question or questions then indicate, for example, that in addition to a performance and motivation test, an individual intelligence test will be administered to take into account the pupil’s way of working. Furthermore, it can indicate that a questionnaire will also be used to chart how the student handles problems or stressful events, if, for instance, it has appeared during the intake session that the pupil responds rather stoically when things go badly.
An assessment question can contain one or more hypotheses on the basis of which the psychologist starts with the assessment. An assessment designed to test hypotheses indicates which method the psychologist uses to test the hypothesis or hypotheses, and which instruments are chosen for this – see BOX 3. The psychologist formulates criteria on the basis of which the hypothesis or hypotheses are rejected or accepted. These criteria may refer, for instance, to the limit values of test results.
BOX 3: Models for testing hypotheses
The literature describes various models on the basis of which psychodiagnostic decisions are, or can be, taken. There are many parallels between these models. For illustrative purposes, one of them, the diagnostic decision process formulated by De Bruyn, Ruijssenaars, Van Pameijer and Van Aarle (2003 to the authors, four phases can be distinguished within psychodiagnostics in healthcare: the analysis of complaints, of the problem, of explanations, and of indications.
In the first phase, the analysis of complaints, the psychologist collects information on the complaints of the client and/or their surroundings, and discusses these details with the client. If the description of the complaints by the person or persons concerned brings up questions or ambiguities, the psychologist should try to get clarity about the complaints in a conversation with them. This analysis should result in the formulation of helping questions. De Bruyn et al. call this clarifying diagnostics.
In the second phase, problem analysis, the psychologist should draw a link between the complaints reported by the client and/or his surroundings and problems, and assess the severity of these problems. De Bruyn et al call this comprehensive diagnostics.
In the third, explanatory, phase, the psychologist should draw up and test hypotheses on the basis of predefined test criteria. In this phase, the psychodiagnostic instruments are administered. Based on the description by the client and those involved, and on observations and test results, the psychologist forms a picture that, with a certain degree of probability, can serve as a statement of the problems that were defined in the second phase. This, according to De Bruyn et al, is the explanatory diagnosis.
In the fourth phase, analysis and indications, the psychologist formulates one or more recommendations for treatment or guidance: indications. These recommendations are based on data that is collected in the earlier stages, and need to be discussed with the client. De Bruyn et al call this the indicative diagnosis.
The psychologist should test their hypotheses (or assumptions) and theories at the end of each phase, on the basis of the data obtained.
It is advisable to include aspects of the methodological choices in the reporting, insofar as they have direct consequences for the understanding and interpretation of the research results. Examples include describing the theoretical framework the work has been based on, and the consequences of choosing a particular instrument for substantive interpretation. On request, the psychologist can always justify the choices of method and instruments (see 2.2.7, “Principles of choosing psychodiagnostic instruments”).
A psychologist should always clarify, or be able to, what the relationship is between the psychodiagnostic instrument that is used and the phrasing of a given question. They should also clarify, or be able to, what the relationship is between the test results and the findings that they come to on the basis of them. In addition, these results should always apply to the person (the client within the meaning of the Code). Scientifically trained psychologists who use psychodiagnostic instruments should be aware, in testing, of both their advantages and their limitations.
A psychodiagnostic instrument can be seen as a tool through which the person being examined (the client) has the opportunity to express themselves in a standardised way. One condition for this is that a psychodiagnostic instrument is used properly. Improper use of a psychodiagnostic instrument can have harmful consequences for a client and a principal, external or otherwise, because if it is used incorrectly, the results will be wrong.
Psychodiagnostics – and, more specifically, testing – is therefore a professional application of psychology that can have far-reaching consequences for people’s lives. That is why psychologists should receive enough theoretical and practical training to be able to practice psychodiagnostics responsibly. It is not possible within this standard to give an exhaustive listing of all possible qualifications in the field of psychodiagnostics in the Netherlands – but two examples are given of arrangements that seek to promote appropriate testing.
The first concerns a directive drawn up by the European Federation of Psychologists’ Associations (EFPA), namely the EFPA Standards for Test Use (EFPA, 2012), which describe competencies and qualifications for testing more generally. The directive distinguishes among three categories of test users – with an increasing level of knowledge and skill across the categories: the assistant user, the user, and the specialist in tests and testing. For illustrative purposes, BOX 4 contains the description of these levels of competency that appears in the EFPA Standards for Test Use (with a few minor changes in wording). Many test publishers use such a system to determine who is authorised to purchase a particular instrument, and some may also require that such a purchase be followed by training in the use of the instrument.
BOX 4: Three competence levels for test use in the EFPA Standards for Test Use
Assistant Test User (EFPA Level 1)
An individual who uses specific tests in well-defined and constrained contexts, under the supervision of a more experienced test user, such as an individual who has had training as a psychological testing assistant. One who operates within organisational policies and directives on testing and test use. Choice of tests and details of how they are to be used and applied are outside the person’s competence. Briefly:
- Is able to administer and use specific tests under the supervision of a person qualified at a higher level in clearly constrained settings.
- Is not able to make choices about which tests should be used or provide interpretations of test scores beyond those provided in standard reports.
- Has awareness of broader issues related to testing and test use, of limitations and value of using tests, and knows when to seek more expert help.
Test user (EFPA Level 2)
An individual who uses specific tests in well-defined and clearly constrained settings. For qualifications in the work area, this would typically be someone working in an HR department, employment agency or within a consulting firm offering testing services. They may be involved in testing for personnel selection, development or career guidance and advice. For the educational area, this might be a teacher with responsibility for special educational needs assessment. In health-related areas such as clinical and health psychology, this covers a wide range of roles where testing forms a limited but important part of the role, such as routine assessments by psychiatric nurses, psychodiagnostic instruments used by speech therapists and so on, as well as routine assessment procedures carried out by clinical or health psychologists. Briefly:
- Has an understanding of the technical psychometric qualities of tests that is enough to allow them to use tests but not to construct them.
- Can work independently as a test user in a specified and limited range of settings.
- Has the necessary knowledge and skills to interpret the scores on a limited range of specific tests.
- Is not able to make choices about which tests should be used (beyond choices between those tests on which they are qualified) nor able to provide interpretations of test scores beyond those based on the documentation provided for test users or provided in standard reports.
Specialist in Tests and Testing (EFPA Level 3)
This person will typically be an experienced psychologist who has, within their main area of practice, specialised in testing and test use and who uses tests as a core part of their practice. They may have specialised in relatively specific areas of testing or contexts of application (e.g. assessment of children, assessment for leadership development etc.) but will be expected to have built this on a broad base of knowledge and skills. Specialists in testing, as the term implies, may be particularly qualified to offer one or more of the following services:
- The provision of advice and consultancy on testing.
- Training others in test use.
- Test construction.
- The provision of expert evidence relating to test use in court cases.
Level 3 does not require sufficient expertise in methodology to construct and develop tests, but people with such expertise would be covered by this level.
Note that the examples are intended to illustrate the kinds of role that can occur at any level. The intention is not to give an exhaustive listing.
One example of a quality seal indicating that the professional has basic knowledge and skills in the field of psychodiagnostics is the Basic Certificate in Psychodiagnostics (Dutch initials: BAPD), a mark of quality of the NIP. This certificate guarantees that psychology graduates possess a basic level of theoretical knowledge and skills in psychodiagnostics, including in the selection, administration, and interpretation of psychodiagnostic instruments. To earn the BAPD, a psychologist must meet a number of criteria, including at least 200 hours of work experience in psychodiagnostics, under the supervision of an authorised BAPD supervisor, the writing of three case studies in the BAPD format, and adherence to theoretical requirements regarding psychodiagnostics, psychometrics and decision-making, psychodiagnostic instruments and procedures, practical skills in psychodiagnostic instruments, interviewing, observation and decision-making, and communication skills. For more information, please see Requirements for the Basic Certificate in Psychodiagnostics on the Dutch Open University website.
In addition, of course, specific additional qualifications and registrations obtain in all kinds of fields, for example with regard to assistance for youth in confinement (NVO-NIP, 2016) or forensic diagnostics within the youth sector. This includes the National Framework for Forensic Diagnostics for Youth, with which a number of organisations are affiliated, such as the Dutch Institute for Forensic Psychiatry and Psychology (Dutch initials: NIFP), the Council for Child Protection (RvdK), and the magistracy (Ministry of Security and Justice, 2014).