Assessment in Forensic Psych

Introduction to the Special Series

on Psychological Reports

Gary Groth-Marnat

Private Practice and the Pacifica Graduate Institute

Psychological assessment is one of the core activities of professional psychologists. The

endproduct of assessment is usually a psychological report. Whereas there is extensive

research guiding most aspects of psychological assessment, there is an overall paucity of

research on the psychological report itself. As a result, clinicians usually rely on prec-

edent, sample reports, folklore, habit, and intuition. This series has been organized to

present a summary of what is known regarding research and issues related to psycholog-

ical reports. The intended result is that clinicians will have more solid, empirically based

guidance on how best to write their reports. It is also hoped that an agenda for research

will be clearly articulated.

Approaching this topic has been difficult. Decades ago, it was possible to discuss

what “a” psychological report should look like. The modal report in the 1950s and into

the 1960s was a personality evaluation requested by a psychiatrist to assist with diagnosis

and treatment planning. The early surveys by Tallent and Reiss (1959) provided some

help in this process. Currently, however, there is far more diversity. Clinical psycholo-

gists are called on to write reports in medical, forensic, psychiatric, organizational, or

educational settings. Within these settings, there is considerable diversity due to the many

questions that might be asked as well as the numerous specific instruments available to

help answer these questions. For example, within forensic settings there are guidelines on

how to proceed with and write up child custody evaluations (American Psychological

Association [APA], 1994, 1999). There are quite different procedures and new instru-

ments that have been designed to address comprehension of Miranda rights, competency

to stand trail, capacity to make legal decisions, and techniques to detect exaggeration of

psychiatric symptoms. These referral questions and new technologies raise technical,

ethical, and procedural issues that all need integration into a report. There is also consid-

erable diversity in length of reports, how they are organized, inclusion of raw data, use of

everyday (vs. technical) language, and the degree of organization.

Another difficulty in approaching this topic has been minimal research. Many of the

types of surveys done by Tallent and Reiss several decades ago need to be repeated but

Correspondence concerning this article should be addressed to: Gary Groth-Marnat, Hollister Ranch, Parcel 98,

Gaviota, CA 93117; e-mail: [email protected]

Published online in Wiley InterScience (www.interscience.wiley.com). DOI: 10.1002/jclp.20195 using new designs related to current issues (i.e., use of computer-based technology) and

for various settings. Whereas some surveys have been done for child custody reports (i.e.,

Ackerman & Ackerman, 1997) and neuropsychological contexts (i.e., Donders, 2001),

there is still a need for far more research. For example, nothing has been done to ask

clients themselves what they think about reports done on them. This is despite the fact

that they are now quite likely to be reading these reports. The result of this paucity of

research has been that authors are often tempted to give recommendations for report

writing based on their own biases or experiences rather than based on empirical grounds.

The following special series is an effort to extract core and central issues that relate

to most reports. Whenever possible, authors have been encouraged to rely on available

research or to conduct their own research. At the same time, they have been encouraged

to take into account the tremendous diversity inherent in current report writing. The range

of topics includes the clarity of reports, the optimal use of computer-assisted assessment,

balancing pathological with positive aspects of the person, ethical issues in report writ-

ing, guidelines on writing forensic reports, and a summary of current controversies.

The first article in this series addresses the issue of clarity in report writing. Presum-

ably, psychologists all believe the reports they write are clear. In contrast, Harvey (this

issue, 2006, pp. 5–18) points out that this is seldom the case. She not only provides

evidence to support this, but also investigates the reasons for the lack of clarity and

includes recommendations on how this can be corrected. The major reason for why reports

lack clarity is that their reading level is too advanced for the “typical” reader. If the reader

is a psychologist or another health care professional, then the report might indeed be

understandable. However, the report’s readership has now extended to a much larger

audience. As a result, psychologists must now challenge themselves to try to reach this

larger audience. Hopefully, the recommendations given by Harvey will translate into

techniques for increasing the clarity of their reports.

Over the past two decades, the use of computer-assisted assessment has increased.

This trend is almost certain to continue in the future. Professional psychologists as well

as software developers are thus confronted with learning how the cognitive processes of

the clinician can optimally interact with information derived from computers. The result

of this interface must then be incorporated into the psychological report. In the second

article in the series, Lichtenberger (this issue, 2006, pp. 19–32) first clarifies the appro-

priate uses of computers and then provides a comparison of computer-based versus

clinician-based predictions. She then considers common errors that clinicians make and

challenges them to develop strategies on how to counteract these errors. She then dis-

cusses methods for training and recommends strategies that software developers might

incorporate into future programs. We hope that psychologists reading this article will take

a more active approach toward working with computers, more accurately integrate the

results of computer-assisted assessment, and clarify their expectations for future software.

The increasing prominence of positive psychology over the past decade has had an

impact on conceptualizations of the person, strategies for promoting happiness, design-

ing assessment instruments, and altering what the public expects from psychologists.

Much of this contrasts with the frequent accusation that psychological assessment pri-

marily focuses on client pathology rather than client strengths. Snyder, Ritschel, Rand,

and Berg (this issue, 2006, pp. 33– 46) argue for the inclusion of both strengths and

weaknesses in the psychological report. Part of their rationale is that including strengths

promotes hope. Assessing client strengths also highlights qualities that can be used to

facilitate change and clarify what the client and therapist are striving towards (rather than

what they are working against). Including strengths in reports also means that the impact

on the client who is reading reports about himself or herself is likely to be more positive

2 Journal of Clinical Psychology, January 2006

Journal of Clinical PsychologyDOI 10.1002/jclp thereby promoting greater rapport with the psychologist and support for the assessment

process. The authors not only provide a rationale for such an approach, but also include

a structure for integrating results based on internal (client) versus external (environmen-

tal) assets and internal (client) versus external (environmental) weaknesses. This struc-

ture will prove useful when organizing psychological reports.

A number of ethical issues relate primarily to writing psychological reports. It is

essential to be aware of these given not only the importance of providing high-quality

care, but also due to the relatively recent update in the APA code (APA, 2002), legal

guidelines, and the fact that we live in a litigious society. Michaels (this issue, 2006,

pp. 47–58) outlines considerations related to confidentiality, clinical judgment, harm,

labeling, release of test data, and use of computer-assisted assessment. Clinicians writing

reports should both be aware of these issues as well as know how to reason through them.

Thus, Michaels provides information on how to resolve ethical issues when they arise.

Clinical psychologists have become increasingly involved in legal issues. This can

vary from reluctant encounters in which the professional psychologist receives a sub-

poena, to practices that rely mainly on legal referrals. Given that nearly every practicing

psychologist at some time will need to work with the legal system, it is crucial to have

information on how best to present forensic psychological reports. In the fifth article in

the series, Ackerman (this issue, 2006, pp. 59–72) provides information on report struc-

ture, length, audience, diagnostic considerations, ethics, record keeping, release of test

data, test security, computer generated reports, and report content. He also highlights

special considerations related to civil reports, custody cases, personal injury, civil com-

mitment, and criminal cases. Although this covers an extremely broad range, it should

nonetheless provide numerous guidelines and suggestions on how to develop a forensic

report. It also covers a number of ethical issues; hence, it also provides a nice comple-

ment to Michael’s article on ethics.

The topics approached in these five articles raise a wide range of issues and contro-

versies. In the last article, which I co-authored with Leah Horvath, we summarize and

expand on the most important of these controversies. We also introduce some additional

controversies and issues. Included are discussions of length, readability, acknowledge-

ment of the limited validity of some assessment devices, use of computer-based narra-

tives, inclusion of test scores, degree to which reports are integrated, inclusion of client

strengths, and developing feedback reports. It was felt that it was important to provide an

integration of previous work, expand on this material, and set an agenda for future research.

Over the past decade, there have been internal and external challenges to clinical

assessment (Groth-Marnat, 1999). The psychological report is often at the “frontline” of

these challenges because the psychological report communicates the results of assess-

ment. It is where the outcome of assessment interfaces with the client and often where

major decisions regarding a person’s psychological status are made. In many instances,

the content, tone, and recommendations of a psychological report will affect the client for

many years to come. Thus, we have a significant responsibility to present a report that

exemplifies the best of what we as practitioners can provide. My hope is that this series

will help fellow practitioners to meet these challenges as well as to highlight strategies

for providing optimal services to our clients.

References

Ackerman, M.J., & Ackerman, M.C. (1996). Child custody evaluation practices: A 1996 survey of

experienced professionals. Family Law Quarterly, 30, 565–586.

Ackerman, M.J. (2006). Forensic report writing. Journal of Clinical Psychology, 62 (1), 59–72.

Introduction to Psychological Reports 3

Journal of Clinical PsychologyDOI 10.1002/jclp American Psychological Association. (1994). Guidelines for child custody evaluations in divorce

proceedings. American Psychologist, 49, 677– 680.

American Psychological Association, Board of Professional Affairs. (1999). Guidelines for psy-

chological evaluations in child protection matters. American Psychologist, 54, 586–593.

Donders, J. (2001). A survey of report writing by neuropsychologists. II: Test data, report format,

and document length. The Clinical Neuropsychologist, 15, 150 –161.

Groth-Marnat, G. (1999). Current status and future directions of psychological assessment: Intro-

duction. Journal of Clinical Psychology, 55, 781–785.

Groth-Marnat, G., & Horvath, L.S. (2006). The psychological report: A review of current contro-

versies. Journal of Clinical Psychology, 62 (1), 73–81.

Harvey, V.S. (2006). Variables affecting the clarity of psychological reports. Journal of Clinical

Psychology, 62 (1), 5–18.

Lichtenberger, E.O. (2006). Computer utilization and clinical judgment in psychological assess-

ment reports. Journal of Clinical Psychology, 62 (1), 19–32.

Michaels, M.H. (2006). Ethical considerations in writing psychological assessment reports. Journal

of Clinical Psychology, 62 (1), 47–58.

Snyder, C.R., Ritschel, L.A., Rand, K.L., & Berg, C.J. (2006). Balancing psychological assess-

ments: Including strengths and hope in client reports. Journal of Clinical Psychology, 62 (1),

33– 46.

Tallent, N., & Reiss, R.J. (1959). Multidisciplinary views on the preparation of written psycholog-

ical reports: III. The trouble with psychological reports. Journal of Clinical Psychology, 15,

444 – 446. 4

Journal of Clinical Psychology, January 2006

Journal of Clinical PsychologyDOI 10.1002/jclp