Rorschach Discussion

[aequitasveritas]

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So far nobody has posted their curriculumas as I have.

It is interesting how the only thing that seems to come out of these threads is APA internship scrutiny. Although APA int. is important it is not the only variant of a successful or robust program.

Yes we are what we make of ourselves in an extra curricular sense...but didactics also matter a great deal. Advanced psychotherapy, advanced analytic therapy, advanced cbt techniques....I hope none of you are goign to say you can simply read a text for the nuances of therapeutic technique and (especially analytic) conceptualization.

Another one of the greatest strenghts of Alliant PhD of the assessment training. We are versed in so many methods including: intellectual/cognitive/autistic/, objective-self report, performance(projective) based. How many of you can claim to have been trained by a co-author of the Rorschach Performance Assessment System (Don Viglione....who also was Exners' understudy and now hold the crown)?

Would anyone mind posting their assessment training with a verification to the link? You can claim that your program is so ecclectic and incredible that you simply get it outside of the classroom...but I guess that's just your word isnt it?

 

[erg923]

Yes, I was trained in the Rorschach (and have given 2 or 3), but I can't say Im too proud of that. I have no delusions that being trained by a coauthor of any test somehow makes me better at that instrument, or a better psychologist....

 

[aequitasveritas]

Yes, I was trained in the Rorschach (and have given 2 or 3), but I can't say Im too proud of that.

I cant say that i have the delusion that being trained by a coauthor of any test somehow makes me better at that instrument or a better psychologist....

Wow..2 or 3 admns....ur practically an expert (I've given over 50 in practice, dissertation, and training)

Per your delusion comment, aside from the lack of class and taste you expose (not to mention your obvious ignorance of the Rorschach), I am making a point about the quality of the program and the accomplishment of the faculty.
Yes, learning the Rorschach is incredibly delicate and learning from the best makes a huge difference. So, yes to that extent it does and has made me a better psych assessor, which is part of a "better" psychologist.

 

[erg923]

Wow..2 or 3 admns....ur practically an expert (I've given over 50 in practice, dissertation, and training)

Per your delusion comment, aside from the lack of class and taste you expose (not to mention your obvious ignorance of the Rorschach), I am making a point about the quality of the program and the accomplishment of the faculty.
Yes, learning the Rorschach is incredibly delicate and learning from the best makes a huge difference. So, yes to that extent it does and has made me a better psych assessor, which is part of a "better" psychologist.

The tendency to defer to the authority of "experts" who have made their career on the instrument appears to be even more prominent in the Rorschach world, IMHO, than in the rest of clinical psychology. Wood has written about the "great man" Ror culture that elevates its own above the status of ordinary scientists. This is in itself dangerous, and ironic since studies of such experts often find them no more accurate than other interpreters, and sometimes notably worse.

 

[erg923]

I think Jim Wood has taken a very sensible approach to the Ror CS, focusing on the empirical support for individual variables and indices rather than trying to generalize to a test with over 150 such scores. To briefly summarize, there is good evidence that the CS is sensitive to perceptual distortion and abnormal verbalization found in the psychoses and sever personality disorder, 2) there is some evidence that there is a modest relationship with IQ, and 3) non CS variables have shown decent ability to predict therapy outcome. There is an ongoing debate about whether the CS norms seriously overpathologize. Wood has invited CS enthusiasts to add to his list of well-validated variables. So far, no response that I know of.

I would agree that, for something which started out as a 19th century parlor game, the Rorschach has certainly endured. I hope that Scrabble has a similar lifespan...

 

[erg923]

Wow..2 or 3 admns....ur practically an expert (I've given over 50 in practice, dissertation, and training)
Per your delusion comment, aside from the lack of class and taste you expose (not to mention your obvious ignorance of the Rorschach), I am making a point about the quality of the program and the accomplishment of the faculty.
Yes, learning the Rorschach is incredibly delicate and learning from the best makes a huge difference. So, yes to that extent it does and has made me a better psych assessor, which is part of a "better" psychologist.

Again, Ill come back to the trade school thing. Yes, I' m sure your class taught it better and more comprehensive, blah blah, blah, but i don't really care about that. My class was pretty hard on the Ror, and we were encouraged to think about it critically. I dont go to a trade school. The science and theory behind it was the focus of the class. Coding and admin was taught, but was of secondary focus behind understanding the underlying theory, science, controversy and usefulness of the instrument.... and I'm thankful for that.

 

[aequitasveritas]

Again, Ill come back to the trade school thing. Yes, I' m sure your class taught it better and more comprehensive, blah blah, blah, but i don't really care about that. My class was pretty hard on the on Ror, and we were encouraged to think about it critically. I dont go to a trade school. The science and theory behind it was the focus of the class. Coding and admin was secondary, and I'm thankful for that.

I will refrain from flagging your post but you are displaying low-class at the moment.

I not only adm and coded but interpreted and integrated into full psych batteries.
R u honestly proposing that the co-author of the Comprehensive System taught from anything other than critical thinking and research base? Wow.

And per your Wood article...perhaps you should read the White article released by the APA that aggregated the psychometrics on the Ror and concluded that it was highly valid and reliable ...even when given by...experts

 

[erg923]

We are having a dialog about a sensitive an controversial topic, don't let it hurt your feelings...

Otherwise, no argument there about the Ror; the same could be said of astrology, homeopathy, kirlian photography, etc. When I find a scientific reason why perceptual features of an inkblot (over and beyond content) should give any clue to personality, I'll let you know....

 

[erg923]

Ok, ok, I have calmed down and realized that i was being a lil hard on the Ror. Even I can admit its valid for some things.

However, my question remains: What is the incremental validity of this instrument within a comprehensive evaluation? Does not the law of diminishing returns make the arduous conduction and scoring of it prohibitive in most cases....from both a clinical and financial standpoint? Moreover, is the time involved justified from an economic perspective (both for the patient and the organization) for what you get back??

Personally, I take the stance (which i have adopted from multiple supervisors) of not using instruments that i could not explain/justify should the case get dragged into court. Since I have no neuropsychological or even psychological phenomenological basis regarding how or why it does/might/should work, and because the existing "science" on it is so controversial, I stay away from it, and avoid the possibility of a potentially very tough and nasty cross examination on the topic.

 

[Ollie123]

I'll post my course listings over the weekend. Though again, I'm not sure what the point is given they aren't an accurate representation of what we are trained to do, and APA was the one who encouraged the school to cut many of the clinical courses. You can choose not to believe it if you want - I'm okay with disagreement on this issue.

I will add that if you want to prove to everyone what great assessment training you get, you have probably already figured out that telling us how many Rorschachs you have done is probably not the best way to do it🙂

I've read a number of pro-Rorschach papers during my time in grad school. If you can provide a link or more specific citation to the White report I'd appreciate it. I've also read a number of Lilienfeld, Garb and co. I'm honestly curious...does Viglione have people read Lilienfeld's articles in the class? Is there discussion of the controversey and whether the Rorschach is a valid assessment tool? If so, how is the information from the controversey integrated into a decision that it should still be done with any regularity in practice? I've always wondered how the training looked in programs that Rorschach proponents on the faculty.

 

[Therapist4Chnge]

MOD NOTE: I moved the Rorschach part of the discussion from THIS thread to its own thread, as I think the Rorschach is worth discussing in more detail. -t4c

 

[erg923]

I will add that if you want to prove to everyone what great assessment training you get, you have probably already figured out that telling us how many Rorschachs you have done is probably not the best way to do it🙂.

Just to expand on this, I think Ollie is correct. This conversation (this one and the previous one debating training hours) is occuring largely with people from clinical science or hardcore scientist-practioner training programs. Preaching about your fantabulous Rorschach training is probably more likely to fall on deaf ears with this group than it would your other students, and may be a reason for some of the heated debate.

 

[aequitasveritas]

Ok, ok, I have calmed down and realized that i was being a lil hard on the Ror. Even I can admit its valid for some things.

However, my question remains: What is the incremental validity of this instrument within a comprehensive evaluation? Does not the law of diminishing returns make the arduous conduction and scoring of it prohibitive in most cases....from both a clinical and financial standpoint? Moreover, is the time involved justified from an economic perspective (both for the patient and the organization) for what you get back??.

The Rorschach: Facts, fictions, and future. Viglione, Donald J.; Hilsenroth, Mark J.; Psychological Assessment, Vol 13(4), Dec, 2001. pp. 452-471.

A review of recent research addressing the utility of the Rorschach.Full Text Available Viglione, Donald J.; Psychological Assessment, Vol 11(3), Sep, 1999. pp. 251-265.

As far as the arduous conduction I completely agree....for the CS. Yet the new RPAS system is much more streamlined.

Just for a basic (introduction?) refresher, it is not meaningful to speak of the "great Ror man" or argue about "Rorschach validity" without identifying the coding system first. If you're using Piotrowski, Beck, or Klopfer (and for legal purposes u better not!) then validity is a huge issue. If you're using the CS or the RPAS then ur using a highly valid and reliable test. Again though, valid and reliable for what? Are you looking at the MOA for object relaitons, the DEPI for convergent validity, the WSUM6 for cog/thought, the Complexity Index as a first factor? This isnt like a BDI...it's a much more complex process, which can be a problem obviously. Yet the facts stand. Check out work by Meyer and Viglione about foresnic validity and the list goes on.

Personally, I take the stance (which i have adopted from multiple supervisors) of not using instruments that i could not explain/justify should the case get dragged into court. Since I have no neuropsychological or even psychological phenomenological basis regarding how or why it does/might/should work, and because the existing "science" on it is so controversial, I stay away from it, and avoid the possibility of a potentially very tough and nasty cross examination on the topic.

Perhaps you will read some more and change your tune..perhaps not. The question is not can it be used as a forensic tool but for what specifically can you asses with it in a valid and reliable way? You're statement is far too simplistic.

 

[erg923]

[Perhaps you will read some more and change your tune..perhaps not. The question is not can it be used as a forensic tool but for what specifically can you asses with it in a valid and reliable way? You're statement is far too simplistic.

First, I dont think it too simplistic, Second, I thought you had forensic experience? You known darn well the courts have little tolerance for ambiguity or controversial psych methods/instruments. The simplier you can make it for them, the better. One way is too minimize opening yourself up to easy objections and diffcult questions from opposing counsel. Anything I can do to appear as scientific as possible and not make myself look like a fool (thereby making my expert opinion status less credible with a jury) is a a good thing in a forensic context.

so....How would you explain why the Rorschach works in if you were on the stand?

Lastly, if your so experienced in it, why can't you just briefly explain 1.) how this instrument increases incremental validity 2.) speak to its economic justifiablity within an exam. Why would I (or an insurance company) pay for this exam/why should my employee spend time doing this exam? However, i suppose this is all tied back to incremenal validity. If it doesnt have much, then the answer to the last part of my question is an obvious "it's not worth it".... would you agree?

 

[aequitasveritas]

I'll post my course listings over the weekend. Though again, I'm not sure what the point is given they aren't an accurate representation of what we are trained to do, and APA was the one who encouraged the school to cut many of the clinical courses. You can choose not to believe it if you want - I'm okay with disagreement on this issue..

I will add that if you want to prove to everyone what great assessment training you get, you have probably already figured out that telling us how many Rorschachs you have done is probably not the best way to do it🙂.

I put the total hours as a rejoinder to erg923 who seemed to state that (s)he was versed in the test with a few admns. I work in the Rorschach lab where we're creating the new RPAS system in conjuction with Greg Meyer, Joni Mihura, and others from University programs. I'm currently working on reponse styles as represented by the first factor on the Ror and the PAI as well as impression management as moderstors of the Ror with the PAI sysnthetic variable that we just created. So yes, I am versed in the psychometrics of the test, the scientific critiques and more.
I will say though...unlike volume on other tests, the quantity of rors one admns, scores, and intertprets is hugely important as it is difficult to master.

I've read a number of pro-Rorschach papers during my time in grad school. If you can provide a link or more specific citation to the White report I'd appreciate it. I've also read a number of Lilienfeld, Garb and co. I'm honestly curious...does Viglione have people read Lilienfeld's articles in the class? Is there discussion of the controversey and whether the Rorschach is a valid assessment tool? If so, how is the information from the controversey integrated into a decision that it should still be done with any regularity in practice? I've always wondered how the training looked in programs that Rorschach proponents on the faculty.

I will post the White article soon. I only have a hard copy and it's not in my data base currently.

I can't remember whether we read Lilienfield specifically...I remember reading Garb. Yes, critical thought is the aim and he actually leads more scientifically with an application edge to the class. The idea is to produce a clinician or researcher to can defend the test in legitimate ways. It doesn't serve any proponent of the the CS or RPAS to avoid addressing compelling arguments...or they would sound silly on SDN!😀
I must redirect the discussion a little though. It seems like there is a tone of Ror researchers being out to support the test no matter what. Actually the most ardent critics of supportive articles are other prominant authors. For instance, Archer and Krishnamurthy critique of Meyer 1997 & 1999. There are much more.

 

[aequitasveritas]

First, I dont think it too simplistic, Second, I thought you had forensic experience? You known darn well the courts have little tolerance for ambiguity or controversial psych methods/instruments. The simplier you can make it for them, the better. One way is too minimize opening yourself up to easy objections and diffcult questions from opposing counsel. Anything I can do to appear as scientific as possible and not make myself look like a fool (thereby making my expert opinion status less credible with a jury) is a a good thing in a forensic context.

so....How would you explain why the Rorschach works in if you were on the stand??

Essential issues in the forensic use of the Rorschach. Gacono, Carl B.; Evans, F. Barton; Viglione, Donald J.; In: The handbook of forensic Rorschach assessment. Gacono, Carl B. (Ed.); Evans, F. Barton (Ed.); Kaser-Boyd, Nancy (Col); Gacono, Lynne A. (Col); New York, NY, US: Routledge/Taylor & Francis Group, 2008. pp. 3-20.

Lastly, if your so experienced in it, why can't you just briefly explain 1.) how this instrument increases incremental validity 2.) speak to its economic justifiablity within an exam. Why would I (or an insurance company) pay for this exam/why should my employee spend time doing this exam? However, i suppose this is all tied back to incremenal validity. If it doesnt have much, then the answer to the last part of my question is an obvious "it's not worth it".... would you agree?

...perhaps you did not read my last response or the articles that I provided you.

 

[aequitasveritas]

An overview of Rorschach psychometrics for forensic practice.Citation Only Available Viglione, Donald J.; Meyer, Greg J.; In: The handbook of forensic Rorschach assessment. Gacono, Carl B. (Ed.); Evans, F. Barton (Ed.); Kaser-Boyd, Nancy (Col); Gacono, Lynne A. (Col); New York, NY, US: Routledge/Taylor & Francis Group, 2008. pp. 21-53. [Chapter]

This chapter deals with the validity and reliability for forensics in particular. erg932. enjoy

 

[Evidence Based]

Forgive me for the ignorance, but I wonder about the usefulness of such projective tests when we have thoroughly reliable and valid assessments like the MMPI that tackle many of the same phenomena. I will freely admit to never have administered or scored any of these tests, but exactly is the point of tacking on a few extra hours to an assessment that adds very little to the clinical picture that one didn't already know?
Erg, for instance, mentioned that the Rorshach had predictive validity for psychosis and severe personality pathology. While I'm sure this is the case, I feel like psychosis is not exactly difficult to pick up on in a good clinical interview. To be fair, I'm sure the Rorshach does sometimes pick up things that a clinician might miss on the first go around. But does this happen often enough to justify its use on a regular basis?

 

[Neuropsych2be]

Forgive me for the ignorance, but I wonder about the usefulness of such projective tests when we have thoroughly reliable and valid assessments like the MMPI that tackle many of the same phenomena. I will freely admit to never have administered or scored any of these tests, but exactly is the point of tacking on a few extra hours to an assessment that adds very little to the clinical picture that one didn't already know?
Erg, for instance, mentioned that the Rorschach had predictive validity for psychosis and severe personality pathology. While I'm sure this is the case, I feel like psychosis is not exactly difficult to pick up on in a good clinical interview. To be fair, I'm sure the Rorschach does sometimes pick up things that a clinician might miss on the first go around. But does this happen often enough to justify its use on a regular basis?

All testing is a sampling of behavior and has the potentiial to be useful. As a cognitive perceptual task, the Rorschach is a very useful source of hypotheses about the client's psychological processes. I have had cases where the client was not overtly psychotic in which the MMPI-2 was "flatlined" and yet on the Rorschach and the TAT, all sorts of psychosis and disturbed object relations emerged. What is useful about these techniques is that they allow one to peer into a client's psychological processes in a way that an MMPI-2 or PAI just does not. I feel I truly know the person after administering these kinds of instruments.

 

[aequitasveritas]

Forgive me for the ignorance, but I wonder about the usefulness of such projective tests when we have thoroughly reliable and valid assessments like the MMPI that tackle many of the same phenomena. I will freely admit to never have administered or scored any of these tests, but exactly is the point of tacking on a few extra hours to an assessment that adds very little to the clinical picture that one didn't already know?
Erg, for instance, mentioned that the Rorshach had predictive validity for psychosis and severe personality pathology. While I'm sure this is the case, I feel like psychosis is not exactly difficult to pick up on in a good clinical interview. To be fair, I'm sure the Rorshach does sometimes pick up things that a clinician might miss on the first go around. But does this happen often enough to justify its use on a regular basis?

Just a short note right now because I don't have time to respond in depth.

Projective (actually "performance based" is the most up to date term) access traits and constructs of personality in fundamentally different manners. For instance, the BDI really only measures "anaclitic" depression and does not detect introjective depression which often tend to constrict on self report tests, such as the MMPI-2 and would only elevate defensiveness but wouldnt give you a codetype. Moreover, perfomance based tests largely preclude low task engagement due to the ambiguity of the stimulus.
One of the reasons the Rorschach i so useful with offenders is that it doesnt allow them to manipulate the various scales. On the MMPI, although fairly robust for actual management of impression, it is easy to directionally constrict.

Of course there are graduates like myself who are attempting to display that various subscales between self report and performance based assessments converge when you hold the first factors on each test constant as well as/or impression management scales.

On the mot basic level of expl. the Ror is an opportunity to actually display the WAY they DO a perceptive task whereas the MMPI-2 and the like require the subject to cognitively appraise the content and formulate a response.

 

[ClinPsycMasters]

Ror is not as bad as they made it sound in undergrad courses. My prof said it's as useless as "Freud's penis envy thing" in response to a question after the class ended.

Regardless, imho, it's a decent test but we have better ones these days, so it's not sin to administer, but why would you nowadays?

 

[Neuropsych2be]

The distinction between objective and projective testing is somewhat artificial. In both cases clients are presented with stimuli and their responses are recorded and analysed. In the case of the Rorschach it is ambiguous stimuli and in the case of the MMPI-2 it is questions. In both cases clients must engage in some form of internal psychological processing to arrive at a response. The power of the MMPI-2 or the PAI or the Millon is that the responses are limited to true and false and the data derived can be analyzed statistically in terms of normative data and scales can be derived. The power of tests such as the TAT and Rorschach is precisely the unstructured nature of the response which has the potential to reveal a great deal about the client's life experience beyond the limitations of the other method. Just examine Drew Westin's work on the TAT for an example. The distinction mirrors the difference between quantitative and qualitative data in research methodology. It would be a mistake to set up a false dichotomy between these two methodologies or approaches to assessment becuase both approaches give valuable information about the client's phenomenological world. In my view, both methodologies are useful because they share an underlying process of examining client response to stimuli. However, I I should note that I am quite comfortable regarding qualitative research as being fully scientific and fully valid, so the use of the Rorschach and the TAT presents me with little problem. I'd imagine someone propagandized to believe that only quantitative methods are "science" would have a real difficult time with the Rorschach. Personally, I would love to know what faculty interactions and meetings are like between Drew Westen (a man I deeply admire) and Scott Lillenfeld at Emory 🙂

Implicit in this discussion seems to be the belief psychological assessment is a matter of developing and using the right scales or tests and all we need is a battery that will give us the right data. However, data does not speak for itself. Data does not sit there, glittering with reliability and validity. Data only have meaning if they are understood and interpreted within an appropriate clinical context. One of the worst mistakes a novice clinician can make is to become too "test bound" in one's approach. All aspects of psychological practice represent humanistic and compassionate applications of science in which our respect for methodology is balanced by an understanding of the experience of our client. Psychological testing is an imperfect window into the inner lives of our clients. The data we glean must be interpreted and integrated with a whole plethora of other data from the clinical interview and background of the client etc...with an understanding that even in assessment the forces of transference counter-transference are at play! (I suppose the CBT crowd would refer to this as implicit interpersonal schema's) Is an elevation on scale 4 of the MMPI-2 a pathological trait indicative of a personality disorder or does it represent an adaptive trait?? Well, it depends!! There is no clear cut answer to that question unless many many other factors are considered. Data from the MMPI or any "objective" scale is also quite ambiguous. Clinicians may interpret test data itself according to their own preconceptions 🙂 This is particularly likely if data are interpreted in a mechanical manner or the clinician is too "test bound" in their approach.

 

[erg923]

Good points.....I suppose if all the blots are said to resemble Dancing with the Stars, that's as valid an insight into the person's psyche as anything.

 

[aequitasveritas]

Here is the White Paper. It's from the SPA (not APA...my memory was a bit hazy as I read it so long ago).

This is an article that every psychologist who engages in the dicussion of Ror should read. I hope it is of some help.

I have it in PDF as a published article but the bit size overloaded the thread so there is a link below to the same document in unpublished form.

Erg923...Wood is referenced🙂

AV

www.rorschach.nu/artiklar/SPA_Rorschach_White_Paper.pdf

 

[erg923]

Thanks, ill read it when i can.

One last thing I would like to say befoere I exit this debate:
Yes, I know the rorschach is complex, blah, blah.....but I get frustrated when we tend to use this as afront to our arguments of "Oh, you just dont understand cause you're not experienced enough at it" (AKA not very "good" at it). I think we tend to equate "the experience of the clinician" with scientific validity here. Again going back to Woods articuluation of the "great man" culture. Experienced clinicians are not necessarily more accurate clinicians, and are subject to biasing effects of expectations. I recall a study where clinicians were given Rorschach protocols with the implication of a certain diagnosis - and their interpretations of the results reflected aspects of what might be expected from that diagnosis. My personal view is that continued use of the Rorschach (especially in a forensic case) is an embarrassment to scientifically-based clinical psychology and neuropsychology.

Lastly, perhaps most of this comes down to personal preferences and comfortabliness with ambiguity. I'm sure the Rorschach can give clinically-meaningful information. I really do not dount this. However, so can having lunch with the patient, or watching home videos of their wedding. However, I'm not sure one would consider these procedures to have significant validity or reliability in terms of quantifiable data (we know the CS has some problems, the extent of the problem is the only debate). And none of these are the kind of thing I feel comfortable writing a report and basing conclusions upon....

 

[aequitasveritas]

Thanks, ill read it when i can.

One last thing I would like to say befoere I exit this debate:
Yes, I know the rorschach is complex, blah, blah.....but I get frustrated when we tend to use this as afront to our arguments of "Oh, you just dont understand cause you're not experienced enough at it" (AKA not very "good" at it). I think we tend to equate "the experience of the clinician" with scientific validity here. Again going back to Woods articuluation of the "great man" culture. Experienced clinicians are not necessarily more accurate clinicians, and are subject to biasing effects of expectations. I recall a study where clinicians were given Rorschach protocols with the implication of a certain diagnosis - and their interpretations of the results reflected aspects of what might be expected from that diagnosis. My personal view is that continued use of the Rorschach (especially in a forensic case) is an embarrassment to scientifically-based clinical psychology and neuropsychology.

Lastly, perhaps most of this comes down to personal preferences and comfortabliness with ambiguity. I'm sure the Rorschach can give clinically-meaningful information. I really do not dount this. However, so can having lunch with the patient, or home watching videos of their wedding. However, I'm not sure one would consider these procedures to have significant validity or reliability in terms of quantifiable data (we know the CS has some problems, the extent of the problem is the only debate). And none of these are the kind of thing I feel comfortable writing a report and basing conclusions upon....

I appreciate your concerns and your frustration with aspects of the test. Ths Ror is never a stand alone for me but is a useful facet of a full battery.
...I think this thread could do without the "blah blah" stuff though😉

 

[erg923]

Data only have meaning if they are understood and interpreted within an appropriate clinical context. One of the worst mistakes a novice clinician can make is to become too "test bound" in one's approach. All aspects of psychological practice represent humanistic and compassionate applications of science in which our respect for methodology is balanced by an understanding of the experience of our client. Psychological testing is an imperfect window into the inner lives of our clients.

Whoops, ok, Im not done yet.

This is a GREAT POINT and Its very true. However, there is a flip side to this that is my pet peeve. I think it often gets ignored, bc peple are trying be careful not to be too test bound. The flip side is people throwing psychometric principles and rigor into the wind. As much as a flexible battery approach to neuropsych assessment is nearly a necessity these days, as a trainee, I have been absolutely floored by the casualness with which interpretations are made based on 20 different test with 20 different normative groups. I also had a supervisor who was very big on discussing strengths and weakness. However, I always wondered since we are giving 20 test with 15-20 different normative groups, how could that NOT produce scores that were all over the map. Just based on statistical probability, that's kind of what i would expect to see happen!! Yet these scores were interpreted as reflective of impairment or retained abilities...frustrating!

Really wish people were not test bound, BUT also wish people would start thinking more about the underlying psychometrics of their decision making...Obviously this has implications for the Ror as well.

 

[erg923]

As a cognitive perceptual task, the Rorschach is a very useful source of hypotheses about the client's psychological processes. I have had cases where the client was not overtly psychotic in which the MMPI-2 was "flatlined" and yet on the Rorschach and the TAT, all sorts of psychosis and disturbed object relations emerged. What is useful about these techniques is that they allow one to peer into a client's psychological processes in a way that an MMPI-2 or PAI just does not. I feel I truly know the person after administering these kinds of instruments.

This is all your subjective interpretation/impressions based on case study- like data.

What is useful about these techniques is that they allow one to peer into a client's psychological processes in a way that an MMPI-2 or PAI just does not.

Yes, yes, thats nice and all, but what do you do with these impressions...these peeks into the soul, so to speak?

How does it really add or help the patient? How confident are you really in that interpreation. Could you defend this in court? I would suggest that if you are giving preferential intepretations to "poor object relations" on a Ror vs whatever the MMPI is telling you, you are committing a serious fallacey in scientific judgment. Again, psychometric basis for your decision making here?

I feel I truly know the person after administering these kinds of instruments.

"Feel" whatever you want, it doesnt make it true...

 

[aequitasveritas]

Erg,

This really is a meaningless debate unless we're talking about specific Ror variables on specific systems for specific purposes. It is utterly useless to speak of the validity of "the Rorschach".

What you "do" with "these peaks into the soul" (what I would call data based on variables, but ok) is integrate them into an assessment in order to address the questions of personality and functional capacity, obviously.

Furthermore, you clearly havnt had time to get to the articles I've posted about the Rorschachs use and psychometric validity in forensics. Perhaps you should take a look before posting essentially the same simplistic objection again and again. If you have a more refined question there may be a useful dialogue here.

 

[Ollie123]

Thanks for the links, I'm swamped at the moment but will try to get to them soon (though I'm pretty sure at least one of them I have read previously). I will say that its nice to see someone who actually knows the science well enough to debate it. I've had a handful of discussions with Rorschach proponents on this board, but they have generally not been with people who were....aware of the scientific method, shall we say? and generally relied on anecdotes and/or "You can't tell me what to do! 'I' think it works!" approaches to debate.

I will say I do think the Rorschach has gotten more scrutiny than other tests, which is not terribly surprising given its origins. However, I do think there are plenty of other assessments with just as many problems that haven't been given the public thrashing the Rorschach has, and probably should be.

In all honesty, even as someone who believes its use in the vast majority of clinical practice settings is rarely justifiable, I am glad to see research still being done on it. I haven't seen any science that convinced me it is worth learning yet (particularly given it is quite distal from my area of study), but I try to keep to the evidence and I don't like the religion-like faith many people have in particular assessments or modalities (or the converse, for that matter).

I'll post again once I have a chance to read through the articles.

 

[aequitasveritas]

I will say that its nice to see someone who actually knows the science well enough to debate it.

...even if that person hails from Alliant/CSPP PhD?!😀

 

[Ollie123]

An oft held fallacy on these boards is that myself (and many others) deny that it is POSSIBLE to be well-educated when attending a professional school. I'm not sure anyone has ever said that, but that hasn't stopped people from believing it.

My (I don't think I'm alone, but don't want to speak for others) complaint is just that it doesn't provide the same quality assurance that most programs do. That is, the bar seems to be set lower. ...At some schools.....way lower. That is bad for the field and profession in the long term. I'm guessing you did pretty well at Alliant. My concern is with those who didn't, but still graduated.

 

[aequitasveritas]

I was just being a little jocular😉

Those criticisms are very well founded and as an insider, so to speak, I can tell you they are undoubtedly true, unfortunetly.

Just fyi,I'm not a doc yet-still in the program.


Moreover, I don't want to detract from the Rorschach/scientific nature of the thread.

 

[kedmonkey]

-

 

[PsychGraduate]

So far nobody has posted their curriculumas as I have.

It is interesting how the only thing that seems to come out of these threads is APA internship scrutiny. Although APA int. is important it is not the only variant of a successful or robust program.

Yes we are what we make of ourselves in an extra curricular sense...but didactics also matter a great deal. Advanced psychotherapy, advanced analytic therapy, advanced cbt techniques....I hope none of you are goign to say you can simply read a text for the nuances of therapeutic technique and (especially analytic) conceptualization.

Another one of the greatest strenghts of Alliant PhD of the assessment training. We are versed in so many methods including: intellectual/cognitive/autistic/, objective-self report, performance(projective) based. How many of you can claim to have been trained by a co-author of the Rorschach Performance Assessment System (Don Viglione....who also was Exners' understudy and now hold the crown)?

Would anyone mind posting their assessment training with a verification to the link? You can claim that your program is so ecclectic and incredible that you simply get it outside of the classroom...but I guess that's just your word isnt it?

I know a few graduates from Alliant and I have looked into what they offer. Alliant is a good school. Not all of the graduates I know are skilled enough in their field,but most are. I see no problem with their training and education.

 

[poch]

As a side note, it's funny to me that these projective tests came out of psychoanalysis but aren't actually in keeping with psychoanalytic principles, in the sense that they rely on universal definitions for each possible projection rather than focusing on the psychic context these projections come out of. It's sort of like how Freud tacked on a dream symbolism guide to the end of The Interpretation of Dreams later just so that it would sell better, even though he thought that dreams could only be analyzed within the context of the individual.

In the end I don't really understand the usefulness of most empirically valid projective tests -- most researchers don't really want to use them and they aren't actually theoretically sound from a psychodynamic point of view.

 

[aequitasveritas]

As a side note, it's funny to me that these projective tests came out of psychoanalysis but aren't actually in keeping with psychoanalytic principles, in the sense that they rely on universal definitions for each possible projection rather than focusing on the psychic context these projections come out of. It's sort of like how Freud tacked on a dream symbolism guide to the end of The Interpretation of Dreams later just so that it would sell better, even though he thought that dreams could only be analyzed within the context of the individual.

In the end I don't really understand the usefulness of most empirically valid projective tests -- most researchers don't really want to use them and they aren't actually theoretically sound from a psychodynamic point of view.

(Lets keep this thread Rorschach driven. There's an Alliant PhD post somewhere else.)

Interesting point. Like you I've always been interested in the qualitative/quantitative vortex the Rorschach seems to create.

I really am vexed by the psychodynamic anomaly of the test also. However, as dreams and unconscious fantasies are infinite to someones psyche, the interpretive yield from the Rorschach is finite; limited to the uniform stimuli of the blots. So the stimulus conformity requires and also allows for empirically driven popular responses, form quality, content responses, and special scores.

It's most useful to think of it this way. The CS and RPAS are meant to give you empirical evidence on someones perceptual proclivities relative to others...the CS and RPAS are not purely psychodynamic coding systems like the earlier ones. So if someone gives you a percept on a particular feature of a blot you code the percept for the way they describe it verbatim. You code the object and thing they say it is, the causality (the reasons they say it looks that way to them) and you code the content of the descriptions against huge (new) international norms in order to tell: based on said comparison does what is generally true for someone who sees the world like this? It is the constellation of this coding across the entire test that is specific to the individual although the inferences and summaries are standardized. Yet, the behavioral observations during the test and the full psychological assessment are not limited to any one test.

Per you objection to empirically valid projective tests (performance based is actually the most accurate term nowadays)
If we are to exist as a science in addition to an art we must somehow display how phenomena exist across the population. In order to do that we must quantify constructs in some way. Can that be flawed, yes. Yet it is necessary.
I argue that the performance based test is necessary because it tells much that self-report does not and cannot. And, it is necessary to standardize the both tests for universal inferences in court, forensics, etc etc.

 

[Therapist4Chnge]

I argue that the performance based test is necessary because it tells much that self-report does not and cannot. And, it is necessary to standardize the both tests for universal inferences in court, forensics, etc etc.

I'd like to dive more into this, as one of my struggles with assessment is the increased reliance on self-report measures. I'm curious as to how we can incorporate projective measures (once validated) to better address assessment needs.

 

[Neuropsych2be]

(Lets keep this thread Rorschach driven. There's an Alliant PhD post somewhere else.)

Interesting point. Like you I've always been interested in the qualitative/quantitative vortex the Rorschach seems to create.

I really am vexed by the psychodynamic anomaly of the test also. However, as dreams and unconscious fantasies are infinite to someones psyche, the interpretive yield from the Rorschach is finite; limited to the uniform stimuli of the blots. So the stimulus conformity requires and also allows for empirically driven popular responses, form quality, content responses, and special scores.

It's most useful to think of it this way. The CS and RPAS are meant to give you empirical evidence on someones perceptual proclivities relative to others...the CS and RPAS are not purely psychodynamic coding systems like the earlier ones. So if someone gives you a percept on a particular feature of a blot you code the percept for the way they describe it verbatim. You code the object and thing they say it is, the causality (the reasons they say it looks that way to them) and you code the content of the descriptions against huge (new) international norms in order to tell: based on said comparison does what is generally true for someone who sees the world like this? It is the constellation of this coding across the entire test that is specific to the individual although the inferences and summaries are standardized. Yet, the behavioral observations during the test and the full psychological assessment are not limited to any one test.

Per you objection to empirically valid projective tests (performance based is actually the most accurate term nowadays)
If we are to exist as a science in addition to an art we must somehow display how phenomena exist across the population. In order to do that we must quantify constructs in some way. Can that be flawed, yes. Yet it is necessary.
I argue that the performance based test is necessary because it tells much that self-report does not and cannot. And, it is necessary to standardize the both tests for universal inferences in court, forensics, etc etc.

I think this is one of the reasons that Exner chose to describe this as a cognitive/perceptual task rather than a test of projective processes. This need for reliability was also the driving force behind the development of the Holtzman which seems to have never caught on despite is superior psychometric properties.

 

[aequitasveritas]

Indeed.

"superior" psychometrics of Holtzman? We're gonna need to talk about that😉

I think it's important to understand that someones psychodynamics drive their cognitive and perceptual performances. Thus, to speak of the Ror as one or the other is not specific enough. It is a test born out of psychodynamic principles, it is not necessarily psychodynamic, and it primarily measures these tendencies as well as thought/personality etc in cognitive manners...much like therapy itself😉

 

[aequitasveritas]

I'd like to dive more into this, as one of my struggles with assessment is the increased reliance on self-report measures. I'm curious as to how we can incorporate projective measures (once validated) to better address assessment needs.

Do you or have you ever incorporated performance based measures like the CS or RPAS into a psych assessment? What is the difficulty you are running into or where do you think the incorporation is lacking?

Sugarman or Archer have great articles on how to do this. I can post if needed.

 

[Therapist4Chnge]

Do you or have you ever incorporated performance based measures like the CS or RPAS into a psych assessment? What is the difficulty you are running into or where do you think the incorporation is lacking?

Sugarman or Archer have great articles on how to do this. I can post if needed.

It isn't so much about difficulty as it is about a hesitancy to rely on projective measures for diagnostic use. I think they can compliment the objective measures and provide some good "grist" for therapy, but that is the extent I trust them. For example, I can look at an MMPI-2 and see that the patient feels persecuted, but I don't know much about the context. I can then administer a TAT and see if anything comes up. Obviously I could just inquire about persecutory feelings during the clinical interview, though that can be hit and miss if they are too defensive. I'll still dig around, but that is less reliable.

It may sound like I'm splitting hairs, but the supporting research for something like the TAT isn't great. I'm even less of a fan of the Ror. (Extner), though I admit I went into my projectives training quite skeptical. I haven't given one in a few years, so I won't be much use talking about the particulars. To be fair, the MMPI-2, MCMI-III, and the PAI research is far from bulletproof, but I feel more comfortable with it. The irony is that I prefer to avoid personality assessment all together and stick with my neuro work. 😀 Give me hard data, let me see the imaging, and then I'll observe them in action.

 

[Neuropsych2be]

Indeed.

"superior" psychometrics of Holtzman? We're gonna need to talk about that😉

I think it's important to understand that someones psychodynamics drive their cognitive and perceptual performances. Thus, to speak of the Ror as one or the other is not specific enough. It is a test born out of psychodynamic principles, it is not necessarily psychodynamic, and it primarily measures these tendencies as well as thought/personality etc in cognitive manners...much like therapy itself😉

Aequitasveritas

As I was typing that I put in the word "allegedly" with regard to the psychometric properties of the Holtzman but then I erased it. I am not a huge expert on the Holtzman. Hell the last time I saw it was maybe 15 years ago. My recollection is that it supposedly has superior reliabiity but I am really not that much of an expert on it. As an instrument it seems to have flopped, perhaps for good reason! 😛

 

[DrGero]

To be fair, the MMPI-2, MCMI-III, and the PAI research is far from bulletproof, but I feel more comfortable with it. The irony is that I prefer to avoid personality assessment all together and stick with my neuro work. 😀 Give me hard data, let me see the imaging, and then I'll observe them in action.

Snort. That seems to imply neuropsych. assessment and/or imaging is "bulletproof."

For my part, I haven't given a Rorschach in about eight years, and I had the same skepticism about it when I was trained in the Exner system. I have supervised a student in it's used (a neuropsych. student) who used it as part of a much larger battery which included the WAIS and WMS IV, the MMPI-2, the MCMI, and several other measures - we were trying to rule in / rule out the presence of a schizophrenia spectrum disorder (among other things) and I thought my student made a good case that the Ror added a reasonable degree of incremental validity towards answering this question.

But by itself, I tend to agree with all the points raised that the Ror is much too unweildy for use in regular clinical practice, and that there is still too much that's murky about the validity of it's use given the lingering controversy (apparent here) about the various competing "systems" used for interpreting it.

But I take issue with the idea of dispensing with quality personality assessment measures simply because they aren't "hard" enough. Moreover, I learn so much more about patients with a comprehensive integrated battery rather than just a neuropsych test and some neuroimaging. I'm here to learn about the whole *person*, no just their brains, if you know what I'm saying - I think that's why I'm a psychologist and not a neurologist.

 

[aequitasveritas]

Just a clarifier

There really aren't competing systems for the Rorschach from a validity and reliability perspective. The Comprehensive System from Exner has been the gold standard and the Rorschach Performance Assessment System is the newest and most streamlined version of the CS by Viglione, Meyer, Mihura, and a few others.

The RPAS coding book will be out by late september. So for now use the CS when in forensic cases or when there will be 3rd party review. When the RPAS is published it will be the new standard of care.

If you use any other system there is no question that you're opening up a pandora's box of liability.

Regarding "merky" there's a need to discuss specifics. I agree the the CS has been unwieldy though....the RPAS is a much more simplified version, which also cuts out the variables that had less then credible v & r and makes it more practitioner friendly.