SOME PROBLEMS WITH PSYCHOLOGICAL EVALUATIONS
SOME PROBLEMS WITH PSYCHOLOGICAL EVALUATIONS
A clinical psychologist may be appointed by the court to perform psychological evaluations. Although the psychologist is an expert, he or she can still be cross-examined. For example, we have caught the following:
1. Diagnosing a client with a condition (“sadistic personality disorder”) that is no longer recognized. The diagnosis was allowed by DSM-III (Diagnostic and Statistical Manual of Mental Disorders, Third Edition), but was discontinued in the current DSM-IV. The psychologist had apparently hoped that the Judge would be impressed, and that the lawyers would not catch the anomaly of diagnosing an unrecognized disorder.
2. Diagnosing a client on the basis of the MCMI (Millon Clinical Mulitaxial Inventory-III), an objective personality test, while failing to note that the MCMI was normed on clinical populations, not on the general population, as is the far superior MMPI-2 (Minnesota Multiphasic Personality Inventory). MCMI is more popular than it should be, because it is shorter than the MMPI, thus easier to administer; and has conveniently implemented computer scoring and analysis which greatly simplifies the labor that the psychologist has to perform to earn his or her fee. Psychologists seldom disclose these limits of the MCMI to the Court.
3. Stating that a client has elevated histrionic, narcissistic, or compulsive scales, on the basis of the MCMI, while failing to note that Dr. Millon himself stated that such elevated scales may reflect personality strengths as well as weaknesses; despite the fact that no Judge would recognize this caveat unless he or she were personally familiar with a restricted book.
4. Diagnosing a client based on projective or subjective personality tests, such as the Rohrschach (ink blot), while failing to note the limitations of these tests in areas such as inter-rater reliability, validity, and scoring standardization.
5. Using CAPI (Child Abuse Potential Inventory) for diagnostic purposes, while failing to note that the test manufacturer itself warned that CAPI is more of a preliminary screening tool than a full psychometric assessment instrument.
6. Not calling the Court Services Officer to ask for more information, when they had been given documentary material from DCF only, and not from the client. In such cases, it should have been obvious to even a beginning psychologist that getting one-sided information was unsatisfactory for a thorough diagnosis.
7. Stating hypotheses based on the evidence, but failing to state other possible hypotheses and why they were ruled out. Ruling out hypotheses is standard practice in medicine and psychology, and is known as “differential diagnosis”. But differential diagnosis is time-consuming, and sometimes it is easier to go simply with what one is expected to find. Fortunately, this situation is changing, but vigilance is needed.
8. Overstating the accuracy of psychological diagnoses, and failing to note that such diagnoses are often not replicable from one doctor to another; which is a standard criterion of the scientific method. Fortunately, due in part to our writings, some psychologists now properly qualify their findings as expert guidance, but only guidance, for the Court.
9. Making outrageous statements in college textbooks. In particular, “Introduction to Clinical Psychology”, 6th edition, edited by Prof. Michael T. Nietzel, is a textbook used to train beginning psychologists. Prof. Nietzel is currently the President of Missouri State University. His textbook contained two totally false assertions in the chapter on Forensic Psychology, which begins at page 443:
a. Text Statement: Clear and convincing evidence, needed to remove a child, is quantified as a 75% chance. This high standard, along with unrealistic social worker caseloads, results in unnecessary child abuse or even death to children.
The 75% statement is clearly false as a matter of law. Absolutely no such percentage exists. It was probably a graduate assistant, helping the professor “write” his text, who made this up to impress the professor. The good-natured professor, already having tenure, never bothered to question it.
In addition, the editorial remark that this “quantification” results in increased child abuse or death has, of course, no basis in fact. Nevertheless, it is listed as a solemn scientific conclusion for the benefit of psychologists-in-training. (There is no doubt whatsoever that this statement was encouraged by a member of the School of Social Work faculty).
b. Text Statement: The psychological evaluator determines if custody is to be terminated.
This is simply untrue in every legal jurisdiction in America. The Judge makes the determination. This assertion would also surprise many social workers, who think that they make the determination.
While anyone, of course, can make a mistake, one wonders at the level of care exercised by professors of clinical psychology, who cannot even send legal statements to a professor at the local law school for evaluation.
In addition to the two above-listed false statements, the textbook was also deficient in the chapter on Assessment in Clinical Psychology. It correctly pointed out that sources of assessment data are: interviews, observations, tests, and life records; but failed to note that collateral contacts (i.e., talking to clinicians who have actually treated the patient for months, or who have observed the parent actually visiting with his or her own children) are equally important.
Atty. Agranoff wrote to Prof. Nietzel. After some prodding, he agreed that the errors would be corrected in the 7th edition of the textbook. He kindly referred us to the professor doing that edition.
That professor, however, told me that unfortunately the 7th edition had already gone to press. However, he would contact me for comment for the 8th edition.
That never happened.
10. Displaying the sort of bias that one would expect at a Klan meeting. Here is a direct quote from a court-ordered psychological evaluation dated April 2, 2009:
“Many, if not most individuals seen in a child protection context are predisposed to highlight their virtues and minimize their flaws.”
At least this doctor was honest, almost antisocially so. The truth, of course, is that due to normal human nature, most individuals in any context highlight their virtues and minimize their flaws. This is not necessarily due to overt dishonesty; as the poet Robert Burns reminded us, we seldom see ourselves as others see us.
The point is that when you start with a biased evaluator, you have to work twice as hard to get an equitable result. All the more reason for clients to be prepared by a qualified lawyer.
In fairness, many of the above-listed problems have been corrected. But they were not self-corrected.
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