Well, IME the ROR can be unsettling to someone who is actively psychotic because the images are inkblots (and references to the objectives must be created in one's own psyche), but TAT has some cards that 'pull' for the person's interpretation of the relationships or determination of the images' characters in an obvious way. Therefore, if the person says (of the card that shows the image of the young man and old man together) "The old man wants to stab the younger man" (using erg's 'stabbing' reference): And you probed further by asking what are the characters thinking? And you are met with "The old man is thinking about how he's going to stab the young man, and the young man is thinking the old man is going to stab me because I'm dumb." Then clinically (because in this card, there are no weapons, aggressive facial expressions, etc), you begin to see themes of aggression, persecution, derogatory thoughts INVOLVED IN THE STORY-TELLING TASK when asked about characters/images presented. You would NOT infer that these emotional constructs are evident in the person's life, until it is validated by a more predictive instrument with more reliability. Hence, the projective data would corroborate themes that are apparent in the patient's clinical picture.
And WisNeuro, the person may be defensive of all methods, but again, you are initially asking him/her to focus on external stimuli (the cards & subsequent interpretation of those cards), rather than internal stimuli (their own thoughts, actions, behaviors), which can be less threatening. Plus TAT does not have to be a lengthy administration (maybe 30-45 min - really depending on the complexity of the responses) but facilitates engagement before you tackle 400-some questions of another measure that will explicitly ask "Do you hear voices?"
Heck, I was going to suggest House-Tree-Person-Kinetic Family (just need 4-5 unlined sheets of paper & pencil w/o an eraser)...when erg 923 said he did not have TAT materials. Children & adolescents love it/Adults are sometimes apprehensive because it is a drawing task but it also introduces themes that can be used clinically if you are clear in your report to say where the data came from once the other measures show these themes in significant ways. Therefore if there is a line in the clinical findings section of your report that says "The abovementioned clinical findings were also demonstrated by the patient in the drawing task administered when asked 'what is the family drawn doing?' The patient replied "the Dad is getting ready to stab the family." Oh, a lot can be left up to interpretation, but you don't report your interpretation of the projective material, only the data from salient themes and let the (report) reader make the interpretation. Plus they will only read the summary section anyway.
I cannot wait until I begin at my Northeastern VA because I'm curious about their protocol for use of projectives....but again, I am suggesting non-threatening ways to initially engage a person in a clinical personality assessment that he may be otherwise resistant to, and therefore digging in my toolbox for suggestions.
But again, erg made an extremely valid point that it is your licenses/reputation on the line...don't use these techniques for engagement if not fully trained in administration and interpretation, it would be a waste of everyone's time.
