Some folks swear by ’em! Others swear at ’em!
These statements summarize the range of attitudes of many psychologists, counselors, and teachers toward psychological and educational testing. It’s no wonder many professionals who have only passing exposure to psychological testing are often confused about the usefulness and scientific worth of these commonly used tests.

Although addiction counselors are usually not directly responsible for conducting psychological testing with clients, they sometimes have access to or can learn about their clients’ test results. Some of this information, which may be housed in the client’s case file or case record, can provide beneficial insights to addiction counselors seeking to improve the effectiveness of treatment interventions. This column is designed to provide addiction professionals with an overview of some important issues associated with testing, including how test results are commonly used by mental health professionals.

How is information gathered about your clients?
Two ways that addiction professionals learn about their clients is from conducting personal interviews and making clinical observations. These observations may occur in inpatient settings where the counselor can readily observe the client. However, observations also can be made in every encounter with the client, both professionally and personally. These opportunities often provide compelling and useful information for use in devising therapeutic interventions.

A third source of client information stems from access to the client’s case record or cumulative file. Often, the cumulative file contains much vital information that provides tremendous insight into the client’s inner workings, socialization patterns, and patterns
of substance use, to name a few. Some of the content housed within the cumulative file
is likely to include psychological and educational test results and interpretations. A
full-fledged psychological evaluation may be available as well, that could include educational, intelligence, and personality test results and subsequent interpretations and recommendations.

What is testing anyway?
A test, in the psychological and educational usage of the term, is simply a standardized interview, which can be administered on either a group or individual basis. This definition implies that tests uncover information that could be obtained by simply interviewing a person. In spite of some misunderstandings regarding tests and their use, there is nothing magical or mysterious about tests.
Although it would be possible to just interview clients, we know some good reasons to use tests. Tests are much faster to administer than interviews, can cover a wider range of psychological issues, and always cover the same range of concerns. They are also less expensive to complete than interviews, which makes them a cost-effective device to learn about clients. The development of a test, its standardization, and development of norms is a difficult and time-consuming process, but this yields far greater confidence in the results than would otherwise be possible. Table 1 on page 64 provides an overview of common areas in which tests are administered, and which addiction counselors are likely to encounter when working with clients.

Test properties
In this section, it will be useful for us to delineate some of important properties of tests, including norms and standardization, reliability, and validity. Before that, however, it is important to note that a fundamental issue associated with test design is the test purpose.
The test purpose governs every aspect of the test’s conception, development, validation, and usage. The purpose may include specification of the test’s target population, as well as intended uses.

Standardization and norms. Tests are standardized, which means that the questions, administration, and scoring are always done in the same way, allowing for a greater degree of accuracy of results. Standardized tests have “norms,” an important test property that serves as the basis of comparison of the individual’s test answers to those of other test-takers (Sundberg, 1977; Aiken, 1997). The client’s answers are summarized using different types of scores, which enable the client’s test scores to be compared with those of similar test-takers. Norms are established by administering a test repeatedly to large samples of populations that include representation from relevant demographic groups. Typically these demographic groups are identified through variables such as gender, race/ethnicity, native language, educational level, and geographic region.

The issue in standardization is determining which subpopulations data should be collected for — that is, which variables should be used to stratify the greater population into appropriate subpopulations to ensure that these sub-populations are represented within the norms. In assessing the accuracy of collected norms, it is important to evaluate how well the tested sample serving as the norm group matches the intended test population and relevant demographic subpopulations.

An individual’s test scores are only interpreted accurately within the context of the appropriate norm group for that client. Some typical demographic criteria identified by test developers for which subpopulation test norms are frequently collected include race, educational level, social class, linguistic grouping, and geographic location. It is essential that data be collected on appropriate sub-populations, so that test interpretations made about a given client’s score are appropriate within the context of that client’s demographic composition. Tests that do not provide norms accounting for important attributes (e.g., demographic, educational, etc.) associated with the client, may not be appropriate choices for assessing the client, and the test results are likely to have little interpretive value (Hood & Johnson, 1993). Addiction professionals should note whether their client’s test results are interpreted within the context of that client’s demographic placement on important and relevant variables.

Reliability. Reliability assesses the consistency or “repeatability” of test scores generated by a given test. Although slight changes in scores are acceptable, great changes would cause one to question any particular score. A test must be reliable in order for it to be valid (see below) — if scores generated by a test are unpredictable, it is difficult to have confidence in whether those scores are appropriate for drawing inferences about your client (Aiken, 2003).

Validity. Validity refers to the correctness of the test and its score. If a test claims to measure a psychological characteristic of a person, then it should fulfill this objective and not measure another characteristic instead (Sundberg, 1977; Aiken, 1997). Validity addresses the issue of interpretations and potential uses of test results generated by the test. In addition, test validity covers whether the test has sufficient evidence to support decisions stemming from the test results, including the classification of individuals and/or predictions about the client’s future behavior.

As with other issues about testing, it is mperative that valid interpretations of test results be made about clients of different gender, racial, ethnic, and culture groups. An important, but somewhat difficult point to be made about test validity is that validity evaluates how acceptable and appropriate test information is in supporting the interpretation and use of test results. That is, validity is not a property of the test itself, but rather, how well test results meet the intended purposes of the test (Aiken, 2003).

How should test scores be used?
Interpreting a case history documenting the results of extensive testing can be done in many ways. The key to successful test use lies in learning about an individual in a way that facilitates understanding, provides insight into behavior, personality, and attitudes, but does NOT encourage labeling or rigid interpretation of limited amounts of information. Test information can be viewed positively as a way to collect important bits of information about your client.

A key to test interpretation is to always look for any other pieces of test-related or other (perhaps anecdotal) information that may be available to either confirm or disconfirm the test results. At a minimum, such information will help you to shed light on what test results may mean about an individual or help explain unanticipated results. Remember, though, test results are no better than the interpreter of the findings. A test may be well developed and scientifically defensible, but inappropriate interpretation of findings from that test can invalidate many of the results or inferences drawn from those results (Hood & Johnson, 1993).

In general, it is not usually advisable to simply dismiss unexpected test findings, but they should not be thoughtlessly accepted either. Remember, years of research have gone into the development of many of these tests, and new norms are continuously being collected to reflect variations in populations and subpopulations. Assuming that the tests were administered fairly, honestly, and without statistical or other bias, it is probable that the scores generated from these standardized tests will contribute to your understanding of the client.

At the same time, it is important to emphasize that an appropriate approach to interpreting test findings is necessary to ensure that a client’s test history or case record generates useful and important information that can provide a positive, holistic view of the individual. When evaluating a client’s history or case record, remember to evaluate the results using the knowledge and insights that you already possess about the client. Take the time to recall your client’s personal life, reactions, patterns of behavior, and social interaction, as well as educational and career experiences. Sometimes, the client’s family and/or friends can provide useful feedback or insights that flesh out a more complete profile/picture of the client.

These seemingly disparate items of information can serve as additional insights into your client. Indeed, a composite picture can emerge of your client, one that is open enough to incorporate new clinical and other insights, but which provides you with a roadmap to understanding your client. This positive approach to using tests is likely to enhance your clinical experiences and treatment interventions with clients, which is a significant reward.

Sylvia Kay Fisher, PhD, is a research psychologist at the Bureau of Labor Statistics. She was formerly a therapist and psychological evaluator.

Ronnie H. Fisher, EdS, now retired, was a social worker, counselor, and professor of psychology at Miami-Dade Community College.

References
Aiken, L.R. (1997). Assessment of adult personality. New York City: Springer Publishing Company.
Aiken, L.R. (2003). Psychological testing and assessment (11th edition). Boston, MA: Allyn and Bacon.
Hood, A.B., & Johnson, R.W. (1993). Assessment in counseling: A guide to the use of psychological assessment procedures. Alexandria, VA: American Counseling Association.
Sundberg, N.D. (1977). Assessment of persons. Englewood Cliffs, NJ: Prentice-Hall.

This article is published in Counselor,The Magazine for Addiction Professionals, December 2004, v.5, n.6, pp. 63-66

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