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PERSONALITY ASSESSMENT WITH ADOLESCENTS:
CHALLENGES AND GUIDELINES Tony D. Crespi and Natalie N. Politikos ABSTRACT Approximately 4.5 to 6.3 müÚon youth experience serious emotional distur- bances. Unfortunately, many ¡of them have unmet mental health needs. Tools used in personality assessment can offer unparalleled assistance in diagnosis, and assist in designing appropriate interventions. Unfortunately, not all psy- chologfists embrace personality assessment as a key component in conducting a comprehensive psychological evaluation. In this article the effective use of personality assessment tools is described, with particular attention to issues of comorbidity. Guidelines for effective practice are also offered.
Adolescents are facing a growing array of socioemotional and mental health issues.
Marsh (2004) notes, for instance, that approximately 4.5 to 6.3 million children £ind adolescents in the United States have a serious emotional disturbance that undermines functioning and pres- ents risk for their ftiture. Elsewhere, Crespi and Giuliano (2001) noted that juvenile delinquency and childhood violence is escalating. Without qualification, youth are at risk for mental health issues. In fact, Rob- erts et al. (1998) noted that children and adolescents represent a large segment ofthe population with unmet mental health needs.
Ysseldyke, Dawson, Lehr, Reschly, Reynolds, and Telzrow (1997) noted that the "student population enterinig the American classroom is more challeng- ing than at any time in our recent history" (p.
1).
Fortunately, there is cause for optimism. Ringeisen and Hoagwood (2002) note advances in identification and diagnosis of serious emo- tional disturbances in children and adolescents. At the same time, large numbers have comorbid disorders, with more than 40% pos- sessing co-occurring substance abuse disorders alone (Substance Abuse and Mental Health Services Administration, 2002).
Clearly, there is a pressing need for mental health interventions for youth with emotional disturbances (APA Subcommittee on Children Natalie N. Politikos, Ph.D., N.C.S.P., School Psychology Program, Depart- ment of Psychology, The University of Hartford, West Hartford, CT 06117.
Reprint requests to Dr. Tony D. Crespi, Department of Psychology, The University of Hartford, 200 Bloomfleld Avenue, West Hartford, CT. 06117.
ADOLESCENCE, Vol. 43, No. 171, Fall 2008 Libra Publishers, Inc., 3089C Clairemont Dr., PMB 383, San Diego, CA 92117 and Family, 2003). At the same time, the complexity of issues is sig- nificant.
As an example, co-occurring disorders are prominent in youth.
Bukestein (1994) observed that many psychiatric disorders occur in adolescence, and this is not unlikely to escalate to substance abuse disorders. Marsh (2004) observed that students with emotional distur- bance often have multiple problems, observing, as one example, that only 42% graduate from high school.
Hodges (2004) noted that psychological evaluations can be critical in accessing services, describing current functioning, serving as a base- line, and generally maximizing treatment utility. Most clearly, psycho- logical assessment, remains a cornerstone of professional practice for school psychologists who specialize in this age group. In fact. Fagan (2002) observed that school psychologists spend approximately half of their time in assessment, with Hosp and Reschly (2002) noting, by region, a range of 19 to 26 hours weekly devoted to assessment!
In a basic way, personality assessment is not new. Childs and Eyde (2002) observed that the Boulder Conference in 1948 identified person- ality appraisal as one of the core areas of professional practice. More recently Stedman, Hatch, and Schoenfeld (2000, 2001) reported that internship directors viewed training in ohjective personality testing and projective personality testing as important, in addition to training in cognitive assessment.
In short, personality assessment as one component of a comprehen- sive psychological evaluation is not new and has been historically im- portant in the assessment domain. In fact, tools used in personality assessment can offer unparalleled assistance in diagnosis, and assist in designing appropriate interventions. Unfortunately, not all school psychologists embrace personality assessment as a key component in conducting a comprehensive psychological evaluation, nor do all pro- grams offer extensive training in this aspect of psychological assess- ment. Furthermore, the more subjective nature of certain personality assessment techniques and the concem of the validity of findings as they pertain to litigation have further curbed this domain. This article examines the effective use of personality assessment tools, with partic- ular attention to issues of co-morbidity. Guidelines for effective prac- tice are also offered.
MENTAL HEALTH ISSUES In a fundamental way children's and adolescents' mental health needs remain underserved. The U.S. Public Health Service (2000) ob- 594 served that children, overall, do not have the necessary access to men- tal health services. Moreover, epidemiological studies indicate that approximately 20% experience a DSM-IV disorder (Costello et al., 1996).
I As mentioned. Marsh (2004) notes that approximately 4.5 to 6.3 million children and adolescents in the United States have a serious emotional disturbance. Equally worrisome, mental health issues are often interrelated, with children displaying multiple comorbid The research on emotional disorders in children clearly indicates a wide array of diagnoses, comorbid conditions, and weaknesses (Angold, Costello, & Erkanh, 1999)1 Fieldman and Crespi (2002) note, for in- stance, that child sexual abuse is an example of a highly complex prob- lem manifesting a host of S5miptoms which can include anger, sleep disorders, school difficulties, denial, memory lapses, as well as interfer- ing defense mechanisms. Finkelhor, Asdigian, and Dziuba-Leath- erman (1995) found, though, that children can use the skills taught in school-based programs when confronted with potentially dangerous situations. In point of fact, it was noted that schools are in a pivotal position from which to create a positive impact for victims of child sexual abuse, while acknowledging that it is not uncommon to observe such related issues in school as post-traumatic stress disorder (Mor- rissette, 1999), dissociative states (Hall & Powell, 2000), as well as academic disorders (Calam, Home, Glasgow, & Cox, 1998).
In a broad way, such issues as teenage pregnancy, adolescent vio- lence, substance abuse, depression, as well as academic disorders are facing school children (Crespi, Nissen, & Lopez, 2000). In fact, Tolan and Dodge (2005) note that mental health represents a serious crisis for children, continuing as an area of neglect despite evidence of the large need.
Unfortunately, while approximately 20% of children experience a DSM IV disorder (Costello et al., 1996), while there is rising evidence that disorders in children typically exist concurrently with other disor- ders (Mrazek, Biglan, & Hawkins, 2004), and while 1 in 10 children possess a serious emotional disorder causing impairment in school or home (Friedman, Katz-Leayy, Manderscheid, & Sondheimer, 1996), there remains evidence of significant unmet needs. Ringel and Sturm (2001) suggested that at least 75% ofthe children with emotional disor- ders do not receive services.
Schools and school psychologists are in an unprecedented position from which to provide immediate relief.
Hoagwood and Erwin (1997) suggested, for instance, that children already receive more services 595 through schools than other public systems. Huang et al. (2005), note however, a need for a greater continuum of services within schools, including early identification and treatment, with greater efforts at more refined assessments and services for children with emotional and behavioral disorders. One aspect of that challenge involves greater knowledge of personality assessment in order to assist in identifying those children in need of services and to design appropriate interven- tions.
PERSONALITY ASSESSMENT Assessment of emotional disorders in adolescents is complex. After all, as noted, many youth meet diagnostic criteria for multiple disor- ders (Angold, Costello, & Erkanli, 1999). Looking at attention deficit hyperactivity disorder, for example, Szatmari, Offord, and Boyle (1989) found that 44% of children with ADHD also met diagnostic criteria for a second disorder, and 33% met criteria for two or three additional disorders. Elsewhere, it is common to find depression in children co- existing with anxiety, ADHD, ODD, and OCD (Kessler, Avenevoli, & Merikangas, 2001; Meiler & Borchardt). Those engaged in assessment and diagnosis, then, find it challenging to comprehensively assess the issues.
Given this complexity of mental health problems and the extensive nature of comorbidity, both initial and réévaluations should use multi- dimensional and comprehensive assessment approaches. Wingenfeld (2002, notes for instance, in a critical examination of comorbidity that unidimensional measures may reflect only one disorder while missing coexisting disorders.
Assessment remains, actually, a large component of professional practice with school psychologists typically spending approximately half their time conducting psychological evaluations (Fagan, 2002). In fact, school psychologists, by region, spend from 19 to 26 hours weekly conducting evaluations (Hosp & Reschly, 2002), typically devoting 22 hours weekly to assessment tasks (Reschly & Wilson, 1995).
Looking at personality assessment more globally, Childs and Eyde (2002) observed that within professional psychology (i.e., clinical psy- chology), personality appraisal is one of the core areas of professional practice, looking at APA Approved Internship sites, Stedman, Hatch, and Schoenfeld (2000, 2001) reported that internship directors viewed training in intelligence testing, objective personality testing, and pro- jective personality testing as important. Of course, Clémence and Han- 596 training in assessment to dler (2001) actually found that more than half the sites provide enhance requisite skills.
Within school psychologjy, personality tests and projective tests have been noted to be "extreme!/' helpful in identifying emotional disorders (Knauss, 2001). Unfortunately, the author notes that despite their value, many school psychology training programs do not include coursework in these areas and many school psychologists do not use projective assessment measures. With APA-approved sites providing assessment training, partially because Ph.D. and Psy. D. programs do not always provide sufficient education in this area (Clémence & Handler, 2001), it would appear logical that school psychology training sites might face similar situations.
In a basic way, personality testing can be useful for school psycholo- gists.
Garb, Wood, Lilienfeld, and Nezworski (2002) indicate, in a criti- cal review of projective testing, that the Rorschach can be helpful in detecting a thought disorder, the TAT can be useful in detecting bor- derline personality disorder, and projective drawings have been useful in screening mental disorders.
Childs and Eyde (2002), indicate that looking at instruments com- nionly taught in courses on assessment in doctoral programs in clinical psychology there is a wide variation in instruments taught. Culling personality measures, it was noted that 86% teach the MMPI-2, 81% Rorschach, 71% TAT, 38% Millón Chnical Multiaxial Inventory III, 30% MMPI-A, 29% Sentence Completions, and 24% Projective Draw- ings.
The authors note that in 1999 the five most commonly cited as- sessment instruments reported in the literature included the Wechsler Adult Intelligence Scale, 'Wechsler Intelligence Scale for Children, Minnesota Multiphasic Personality Inventory II, Rorschach Inkblot Test, and the Thematic Apperception Test.
A converging body of evidence, then, suggests that while emotional disturbance is high in children and adolescents, and while personality assessment is deemed valuable, not all school psychology interns nor all graduates enter the field prepared to conduct this component of psychological testing. Certainly this seems troubling. Evans and Rey (2001) indicate that the recent rash of school shootings alone has thrust psychologists into a key role for assisting in the prevention of extremes of juvenile violence, with greater requests to become more involved in assessment and treatment; of youth deemed at risk for violence. The majority of children referred in their investigation were noted to ex- hibit behavioral problems consistent with diagnoses of oppositional defiant disorder and attention deficit hjT)eractivity disorder, both pre- dictors of later serious and violent juvenile offending.
597 Looking at the available research on personality assessment, it is clear that the bulk is confined to data indicating whether single instru- ments are successfiilin identifying (and sometimes predicting) specific behavioral problems.
The use of data constructed in this fashion would, ideally, provide a single way of systematically determining risk for emotional and behavioral disorders, and determining relative psycho- pathology in students. With adolescents, who are not always forthcom- ing, this research has tended to be quite focused. At the same time, this type of research is lacking in two notable regards: (1) Several personality measures, such as the Thematic Apperception Test, might be better conceptualized as observational tools than objective tests, (2) Issues of validity and reliability often are applied without a thoughtful understanding of the way these measures are constructed and yield meaningful data, and (3) Practitioners typically utilize multiple per- sonality measures in an attempt to gauge overlapping signs and diag- nostic symptoms rather than rel5dng on single measures. Practitioners and supervisors should consider each component in turn.
Looking at the first two aspects, the Thematic Apperception Test is an ideal tool to illustrate these points. To start, in a critical discussion on the use ofthe Thematic Apperception Test, Cramer (1999) noted that different cards "pull" for different themes—^indicating that scores for one picture for one person may be quite different for another picture with another person with very different conflicts. Looking consistently across cards, then, is not expected and the use of reliability measures, such as coefficient alpha would be an inappropriate approach to this tjrpe of assessment. Similarly, test-retest measures are not appropriate because initial exposure may modify responses as individuals have lost the elements of "surprise" and novelty. In addition, developmental changes as well as intemal and external factors can change responses.
Hence, it is inappropriate to apply the same psychometric properties and psychometric standards to this assessment method as to, for exam- ple, a measure of intelligence. The TAT is, then, an observational method, more than a test, and can and possibly should be examined within this framework.
The author notes that the TAT can produce meaningful, clinically relevant findings, separating normal adolescents from those with bor- derline personality disorders for example. The TAT can be used reli- ably and with validity, but it must be used and understood within the context of an observational method bioilt within a storytelling narrative framework. Just as observational methods have been used to study celestial movement in natural science, so too can the TAT be used to observe human behavior in a reliable and valid fashion (Cramer, 1996, 1999).
598 Rossini and Moretti (1997) note that the TAT remains a standard component of personality assessment for school-age children, as well as with adults, yet also remains controversial. Used as described by Cramer (1996, 1999), and within the idiographic framework from which it was intended, it can reveal attitudes, psychopathological pro- cesses, as well as motivations. Yet, the authors (i.e., Rossini & Moretti, 1997) note that much of the enormous literature on the TAT is not discussed in classes which teach the technique, suggesting that prepa- ration is superficial. These authors suggest the following: (1) The TAT should not be called a test unless a scoring system is used, but consid- ered a projective interviewing tool, (2) Clinicians using the TAT should read from the extensive literature on the TAT to deepen interpretation skill. It is noted that a small series of readings is not adequate for interpretation, and (3) Profession-wide there is a need for a contempo- rary TAT Manual, as well In contrast to research success or lack of success as consensus-approved readings and syllabi, on specific personality measures and their in identifying specific emotional disorders.
there is a lack of data on the use of multiple measures to assess emo- tional disturbance. The fact that responsible clinicians would not deter- mine and diagnose serious emotional disturbance based solely on any single instrument suggests, by itself, a glaring omission in the applied literature. In fact, the use psychometric models is a of multiple measures derived from different hallmark of forensic practice. Further, as Wingenfeld (2002) observes, comorbidity has clear implications for as- sessment, whereby assessment actually should be considering multiple diagnoses rather than a single diagnosis, using multidimensional mea- sures to explore all possible areas rather than a single unidimen- sional area.
For school psychologists assessing emotional disorders, then, multi- ple sources and multiple methods should be standard practice if the practitioner is to obtain a meaningful profile of emotional issues. Cer- tainly different personality measures make different contributions and reflect different weaknesses. Such can be said, though, of any assess- ment measure. In the nature, research combining behavior-rating scales, projective measures, and objective personality measures, com- bined with a range of cognitive and processing assessment tools, may be viewed as most useful and productive in assessing complex psycho- logical disorders in children.
599 GUIDELINES FOR PERSONALITY ASSESSMENT WITH ADOLESCENTS Guideline 1:
School psychologists should conduct comprehensive psy- chological assessments exploring all components of cognitive, socioemo- tional, personality, and intellectual processing because this models a best practice approach to thoughtfully considering contemporary per- sonality difficulties such as emotional disturbance.
While professional practice standards support the use of comprehen- sive evaluations, many practitioners, teachers, and administrators do not fully understand that while a learning disability, as an example, might be present in elementary school, subsequent evaluations must continue to use a comprehensive model hecause a range of further leaming, emotional, and behavioral disorders might arise in later years.
Through much research and continued development of assessment tools, we have been able to move to comprehensive assessments where intellectual and cognitive skills are concerned, with more and more practitioners willing to further investigate unanswered questions with additional measures. As we discuss the remaining guidelines, it is our hope that they will help move along the comprehensive aspect of per- sonality assessment while elaborating on the necessity for a broad scope and intensity.
Guideline 2:
School psychologists should consider issues of comorbid- ity in examining possible emotional disorders.
Contemporary research has provided suhstantial documentation that emotional disorders in children often do not occur in isolation.
Rather, multiple emotional disorders often can emerge over the trajec- tory of children's development. Assessment and diagnosis must attend to this information.
Furthermore, much as training programs emphasize intellectual and cognitive assessment skills in their students, as a profession we are dependent on trainers to instill not only the necessity for investigation of various comorbid diagnoses but also the "how" aspect of identifi- cation.
Guide line 3:
School psychologists should include multiple personal- ity measures in conducting a psychological evaluation which might assess personality issues.
To properly take into account psychometric strengths and weak- nesses, measures should be selected from different theoretical models and designs. An instrument such as the Thematic Apperception Test, for example, should be complemented by personality measures using different models.
A TAT might be balanced, for example, by an MMPI- 600 A, Sentence Completions, and a Behavioral Rating Scale. This ts^pe of approach would include al nice balance of, what we would consider, objective and subjective measures.
Guideline 4: School psychologists should read extensively from the literature on personality assessment in order to minimize error and maximize precision and caution.
Different components of personality tests can "pull" for different is- sues—indicating that scores for one TAT picture, for example, for one person, may be different for another picture with another person with different confiicts. Consistency across results, then, is not expected. In addition, developmental changes as well as intemal and external fac- tors c£in change responses across the lifespan. Practitioners need to understand these points and read across developmental ages to compe- tently conduct evaluations.
The field of assessment is constantly changing and developing as we acquire more information about human behavior. While as students we acquire a fair amount of information, the vast majority of complex skills, knowledge, and experience develop post graduation. Stressing the need for continuous professional development throughout one's professional career is imperative in maintaining and continuing to de- velop skill and expertise in all areas, but especially in assessment.
Guideline 5: School psychologists must read extensively from person- ality theories and the literature on diagnosis in order to completely assess and diagnose children and adolescents.
Assessment with linkages to diagnosis and intervention is incom- plete. With growing numbers of court cases finding fault with school psychologists who do not address diagnosis issues, it is critical that practitioners carefully read the literature and become comfortable with the use of such manuals as the DSM-IV.
Very often, the identity of a school psychologist is closely linked to the IDEA diagnostic categories while the DSM-IV is viewed as in- compatible with "school-based" diagnoses. As mentioned, the growing issues surrounding litigation as well as hest practice dictates the need for utilization of the DSM-IV as a diagnostic tool.
Guideline 6: School psychologists should select from a variety of drawing techniques and be familiar with the particular characteristics, strengths, and weaknesses,^ of the techniques used.
Oft«n we hear of colleagues utilizing figure drawings as "ice-break- ers" in their assessment routine without interpreting or using any of the information garnered to assist in diagnosis. Part of the fear may be that scoring figure drawings can be challenging since there are different scoring systems to use, some objective (i.e.. Draw A Person:
601 Screening Procedure for Emotional Disturbance) and some more sub- jective (i.e.. House Tree Person).
As with much of our discussion thus far, most drawing techniques can provide the clinician with useful information. The most important aspect of utilizing a drawing technique is being familiar with the re- search surrounding the technique and making appropriate interpre- tive inferences based on that research.
Guideline 7:
School psychologists should select from a variety of the- matic apperception techniques and be familiar with the particular char- acteristics, strengths, and weaknesses, of" techniques utilized.
There are a few different apperception techniques to select from, such as the Thematic Apperception Test, the Children's Apperception Test, and the Roberts Apperception Test for Children. While it is a luxury to have multiple methods to choose from, this variety poses a need for famiUarity in selection and interpretation.
Guideline 8:
School psychologists wishing to utilize the Rorschach need to have obtained training in the interpretive aspects of the tech- nique and be well versed in the strengths and weaknesses.
While the Rorschach Technique remains highly popular, not all stu- dents nor all practitioners approach this method with maximal educa- tion, training, and psychometric sophistication.
Practitioners should understand that just as no practitioner would use an older version of the Wechsler Intelligence Scale for Children, so too, users of the Rorschach need to understand that not all the various scoring methods remain equally viable and valuable. In fact, the use ofthe Rorschach without any scoring system is inappropriate.
Contemporary Practitioners should study the Comprehensive Scoring System and the various psychometric limitations ofthe techniç[ue.
Guideline 9:
School psychologists need to demonstrate versatility in integrating personality information from a variety of sources in de- termining strengths and weaknesses and making diagnoses.
Unlike the medical profession that includes a fair amount of objec- tive and qualifiable data, and where diagnoses can be reached based on the results of a single test or procedure, human behavior requires close examination of many layers and levels. In order to achieve a diagnosis of, for example, attention deficit disorder, the school psychol- ogist must rely not only on behavior-rating scales but on other methods (i.e., drawings, sentence completions) to determine that depression or anxiety are not responsible for the inattentive behaviors. It is impera- tive that as professionals we are able to integrate findings from multi- ple sources in order to "tease out" the complexities associated with such diagnoses.
602 Guideline 10:
School psychologists need to be prepared to update their skills and knowledge of personality assessment frequently and regu- larly.
As mentioned, the need for continuous development of skills is im- perative. It is not uncomnion for students in training programs to find that upon graduation their knowledge and skills regarding certain assessment instruments are already outdated due to the publication of a new version ofthe test. This phenomenon is more prevalent within the intellectual and cognitive assessment domain; however it also holds true for hehavior-rating scales, adaptive-behavior scales, and other "more objective" personality measures.
That having been said, it is not only important to stay current with updated versions of measures, but to maintain one's knowledge of the research pertaining to techniques that might not have historically changed much over the years. For example, human figure drawing techniques have retained certain elements throughout a number of decades; however, current research is suggesting that such techniques should be used cautiously cross-culturally as the interpretive guide- lines are largely based on U.S. populations that do not necessarily generalize as well as we once thought.
SUMMARY AND CONCLUSIONS Children's mental health problems represent a critical challenge for society. With 4.5 to 6.3 million children and adolescents demonstrating a serious emotional disturbance that undermines functioning (Marsh, 2004), with juvenile delinquency and childhood violence escalating (Crespi & Giuliano, 2001), school-age children are at high risk for men- tal health issues.
Looking directly within the schools, Ysseldyke, Daw- son, Lehr, Reschly, Reynolds, and Telzrow (1997) noted that the "student population entering the American classroom is more challeng- ing than at any time in our recent history" (p. 1).
Clearly, there is a pressing need for school-based mental health in- terventions for children with emotional disturbances (APA Subcom- mittee on Children and Family, 2003). Unfortunately, a large number of children actually possess multiple mental health problems.
Within this context, school psychologists are in an unprecedented position from which to offer assistance. Hodges (2004) noted that psy- chological evaluations can be critical in accessing services, describing current functioning, servin.g as a baseline, and generally maximizing treatment. Given that psychological assessment remains a cornerstone of professional practice for school psychologists, with practitioners spending approximately half their time in assessment, with Hosp and 603 Reschly (2002) noting, by region, a range of 19 to 26 hoiors weekly devoted to assessment, personality assessment is a critical issue for practitioners.
In a basic way, personality assessment is not new. Childs and Eyde (2002) observed that personality appraisal has been a core area of practice since the 1940s. Stedman, Hatch, and Schoenfled (2001, 2000) reported that internship directors viewed training in objective person- ality testing and projective personality testing as important.
In short, personality assessment as one component of a comprehen- sive psychological evaluation is an important skill. Unfortunately, not all school psychologists embrace personality assessment as a key com- ponent in conducting a comprehensive psychological valuation, nor do all programs offer extensive training in this aspect of psychological testing. Given so many children with emotional issues, though, prac- titioners need to consider further training and greater understanding ofthe role personality assessment can play in helping children. Devel- oping professional guidelines for personality assessment is one vehicle for providing this help.
Continuing education workshops on personality assessment is another important tool. In combination, this can yield positive results for children, schools, and society.
REFERENCES American Psychological Association Subcommittee on Children and Family.
(2003).
Policy options: Promoting, preserving, and restoring children's mental health. Washington, DC: Author.
Angold, A., Costello, E. J., & Erkanli, A. (1999). Comorbidity: Journal of Child Psychology and Psychiatry and Allied Disciplines, 40, 57-87.
Bukstein, O. G., (1994). Treatment of adolescent alcohol abuse and depen- dence. Alcohol Health and Research World, 18, 296-301.
Calam, R., Home, L., Glasgow, D., & Cox, A. (1998). Psychological disturbance and child sexual abuse: A follow-up study. Child Abuse and Neglect, 22, 901-913.
Childs, R. A., & Eyde, L. D. (2002). Assessment training in clinical psychology doctoral programs: What should we teach? What do we teach? Journal of Personality Assessment, 78, 130-144.
Clémence, A. J.., Handler, L. (2001). Psychological assessment on internship:
A survey of training directors and their expectations for students. Jour- nal of Personality Assessment, 76, 18^7.
Costello, E. J., Angold, A., Bums, B. J., Erkanli, A., Strangl, D. K., & Tweed, D.
L. (1996). The Great Smoky Mountains study of youth: Functional impairment and serious emotional disturbance. Archives of General Psy- chiatry, 53, 1137-1143.
Cramer, P. (1999). Future direction for the Thematic Apperception Test. Jour- nal of Personality Assessment, 72, 74-92.
604 Crespi, T. D., & Giuliano, A.
Cramer, P. (1996). Story-telling, narrative and the Thematic Apperception Test.
New York: Guilford.
J. (2001). Juvenile delinquency and adolescent violence: Focus for family therapy and consultation in independent prac- tice.
Journal of Psychotherapy in Independent Practice, 2, 83-95.
Crespi, T. D., Nissen, K. S., & Lopez, P. G. (2000). Managed health care and school-based services: Present status and contemporary case delibera- tions—^Applications for school practice. Special Services in the Schools, 16, 95-109.
Evans, G. D., & Rey, J. (2001). In the echoes of gunfire: Practicing psycholo- gists' responses to school violence. Professional Psychology:
Research and Practice, 32, 157-164. | Fagan, T. K. (2002). School psychology: Recent descriptions, continued expan- sion, and an ongoing paradox. School Psychology Review, 31, 5-10.
Fagan, T. K, & Wise, P. S. School psychology: Past, present, and future (2nd ed).
Bethesda, MD: National Association of School Psychologists.
Fieldman, J. P., & Crespi, T. D. (2002). Child sexual abuse: Offenders, disclo- sure, and school-based initiatives. Adolescence, 37, 151-160.
Finkelhor, D., Asdigian, N., &¡Dziuba-Leatherman, J. (1995). The effectiveness of victimization prevention instruction: An evaluation of children's re- sponses to actual threats and assaults. Child Abuse and Neglect, 19, 141-153.
I Friedman, R., Katz-Leavy, j!, Manderscheid, R., & Sondheimer, D. (1996).
Prevalence of serious eniotional disturbance in children and adolescents.
In R. W. Manderscheid & M. A. Sonnenschein (Eds.), Mental health.
United States, 1996 (pp. 71-88). Rockville, MD: Center for Mental Health Services. !
Garb, H. N.., Wood, J. M., Lilienfeld, S. O., & Nezworski, M. T. (2002). Effective use of projective techniques in clinical practice: Let the data help with selection and interpretation. Professional Psychology: Research and Practice, 33, 454-463. ] HaU, J. M., & Powell, J. (2000). Dissociative experiences described by women survivors of childhood abuse. Journal of Interpersonal Violence, 15, 184-188.
I Hoagwood, K., & Erwin, H. (1997). Effectiveness of school-based mental health services for children: A |10-year research review. Journal of Child and Family Studies, 6, 436-451.
Hodges, K. (2004). Using assessment in everyday practice for the benefit of families and practitioners. Professional Psychology: Research and Prac- tice, 35, 449-456. \ Hosp, J. L., & Reschly, D. J. (2002). Regional differences in school psychology practice. School Psychology Review, 31, 11-29.
Huang, L., Stroul, B., Friedmain, R., Mrazek, P., Friesen, B., Pires, S., & May- berg, S. (2005). Transforming mental health care for children and their families. American Psychologist, 60, 615-627.
Kessler, R. C, AveneVoli, S., & Merikangas, K. R. (2001). Mood disorders in children and adolescents: An epidemiological perspective. Biological Psychiatry, 49, 1002-1014.
Knauss, L. K. (2001). Ethical! issues in psychological assessment in school settings. Journal of Personality Assessment, 77, 231-244.
605 Marsh, D. T. (2004). Serious emotional disturbance in children and adoles- cents:
Opportunities and challenges for psychologists. Professional Psy- chology:
Research and Practice, 35, 443^448.
Meiler, W. H., & Borchardt, C. M. (;i996). Comorbidity of major depression and conduct disorder. Journal of Affective Disorders, 39, 123-126.
Mrazek, P. J., Biglan, A., & Hawkins, J. D. (2004). Community monitoring systems: Tracking and improving the well-being of America's children and adolescents. Falls Church, VA: Society for Prevention Research.
Morrissette, P. J. (1999). Post-traumatic stress disorder in childhood sexual abuse: A synthesis and analysis of theoretical models. Child and Adoles- cent Social Work Journal, 16, 77-97.
Reschly, D. J., & Wilson, M. S. (1995). School psychology practitioners and faculty: 1986 to 1991-92 trends in demographics, roles, satisfaction, and system reform. School Psychology Review, 24, 2-80.
Ringeisen, H., & Hoagwood, K. (2002). Clinical and research directions for the treatment and delivery of children's mental health services. In D. T.
Marsh & M.
A.
Fristad (Eds.), Handbook of serious emotional disturbance in children and adolescents (pp. 33-55). NY: John Wiley.
Ringel, J., & Sturm, R. (2001). National estimates of mental health utilization and expenditure for children in 1998. Journal of Behavioral Health Ser- vices & Research, 28, 319-332.
Roberts, M. C, Carlson, C. I., Erickson, M. T., Friedman, R. M. S., Vargas, L.
A., & Wohlford, P. F.
(1998).
A model for training psychologists to provide services for children and adolescents. Professional Psychology: Research and Practice, 29, 293-299.
Rossini, E. D., & Moretti, R. J. (1997). Thematic Apperception Test (TAT) interpretation: Practice recommendations from a survey of clinical psy- chology doctoral programs accredited by the American Psychological As- sociation. Professional Psychology: Research and Practice, 28, 393-398.
Stedman, J. M., Hatch, J. P., & Schoenfeld, L. S. (2001). Internship directors' VEduation of pre-intemship preparation in test-based assessment and psychotherapy. Professional Psychology: Research and practice, 32, 421-424.
Stedman, J. M., Hatch, J. P., & Schoenfeld, L. S. (2000). Preintemship prepa- ration psychological testing and psychotherapy: What internship direc- tors say they expect. Professional Psychology: Research and practice, 31, 321-326.
Substance abuse and Mental Health Services Administration. (2002). Report to Congress on the prevention and treatment of co-occurring substance abuse disorders and mental disorders. Washington, DC: Author.
Szatmari, P., Offord, D. R., & Boyle, M. H. (1989). Ontario child health study:
Prevalence of attention deficit disorder with hjrperactivity. Journal of Child Psychology and Psychiatry, 30, 219-230.
Tolan, P. H., & Dodge, K. A. (2005).Children's mental health as a primary care and concern. American Psychologist, 60, 61-614.
U.S.
Public Health Service. (2000). Report ofthe Surgeon General's Conference on Children's Mental Health; A national action agenda. Washington, DC:
U. S. Department of Health and Human Services.
Wingenfeld, S. A. (2002). Assessment of behavioral and emotional difficulties in children and adolescents. Peabody Journal of Education, 77, 85-105.
Ysseldyke, J., Dawson, P., Lehr, C, Reschly, D. Reynolds, M., & Telzrow, C. (1997). School psychology: A blueprint for training and practice II.
Bethesda, MD: National Association of School Psychologists.
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