Date of this Version
Published in The Future of Testing, edited by Barbara S. Plake & Joseph C. Witt (Hillsdale, NJ: Lawrence Erlbaum Associates, 1986).
At the outset, this writer's frame of reference should be made clear. It is the perspective of the author of a book that contains more than five hundred references from the scientific and professional literature which raise doubts about the expertise of clinicians in their role as diagnosticians in general, and also, specifically, within the forensic arena. The perspective further is that of one who provides a consultation service to lawyers pointing out to them the weakness and shortcomings of psychiatric and psychological reports and testimony both in terms of the inherent problems and of any specific deficiencies of omission or commission in the particular case. Thus, clinical assessments are often seen in their most public form and under conditions in which weaknesses and deficiencies are most vulnerable to exposure.
Clinical assessment has been defined as “the process by which clinicians gain understanding of the patient necessary for making informed decisions" (Korchin , 1976, p. 124). Korchin and Schuldberg (1981) elaborate,
Clinical diagnosis, in the restricted sense, may be included, but more usually the intent is description and prediction towards the ends of planning, executing, and evaluating therapeutic interventions and predicting future behavior. Any of numerous techniques can be used, singularly or in combination, depending on the orientation of the clinician and the specific questions for which answers are sought. Thus, interviews with the client or with others; observation in natural or contrived situations; or the use of tests of different functions, varying in breath, objectivity, psychometric refinement, and inference might all be included. The immediate goal may be the relatively precise measurement of a particular psychological function or the construction of a 'working image or model of the person' (Sundberg & Tyler, 1962), (p. 1147) .
Generally, clinical assessment is distinguished from other types of psychological assessment such as educational assessment or personnel assessment by its focus on determination of the presence or absence of psychopathology or deviance- that is, problems or discomforts the individual is having with himself/ herself or problems or discomforts the individual is causing to society or other people. Clinical assessment concerns itself not only with the nature of the psychopathology but also with its extent, the implications of its nature and extent for the individual's prospective functioning, the potential for altering such functioning and the means to accomplish such alteration.