Unease in Progress

As many know, I'm currently on a psychological diagnostic rotation for a full year at a local hospital. I've learned how to administer several psych assessments over the past three years in school, and this is my year to put the knowledge into practice.

A summary of my feelings as I learned these tests: cool! ick. ehh. okay. well maybe. not bad. pretty cool. cool!

I started learning how to give cognitive assessments a.k.a. intelligence assessments a.k.a. IQ exams. I hated them. That was two years ago, and the class (and assessment) felt like psychology for accountants. All standards and norms and standard deviations and categories, etc. I soon came to understand the value of the assessments, because they can really identify how one can best help a patient. So, if used right, I decided I was okay with that test.

Along the way I learned objective measures as well as projective measures like the Rorschach. Both types are fascinating. I have problems with both, but as long as one is careful to use the tests appropriately, they really can help people tremendously. I'm a fan of these.

Since July, when I started this rotation, I've given lots of assessments and gotten better at giving and interpreting them. But until yesterday I had not given a full IQ test. It was painful to administer, and hard to watch the client struggle with some of the subtests.

With objective measures, there is no right or wrong answer. Just lots and lots of true/false questions. Or maybe multiple choice. And the results are objectively quantified into codetypes which can be interpreted pretty accurately. With projective measures, there are also no right or wrong answers, and the responses are analyzed for content and themes and patterns. Patients need only to endure the length of objective tests and the weirdness of projective tests. Sometimes these case vague discomfort for the client, but generally the cost is far outweighed by the benefit towards treatment.

But the cognitive test? Ehch. The tests are designed to asses the full spectrum of many (though not all) types of intelligence. Thus, by it's nature, the questions start ridiculously easy and work up towards impossible. Therefore, everyone (except, you know, someone supremely gifted) will struggle with every part of this assessment. It's suppossed to do that.

So this process is not finished. Interpretation and treatment are still to come, so maybe I will see the benefit that will outweigh the cost. But watching that in action, with someone who just wants help and likely has some cognitive impairment, just flat out sucked.