Critical Moments - Capitalizing on Therapeutic Opportunities during Collaborative Assessment

BACKGROUND & PURPOSE: The effort to bring about meaningful positive change is one of the more
complex, and at times elusive goals of collaborative assessment. Planned Assessment Interventions
serve this purpose in a more structured Therapeutic Assessment. However, we have found that such
material can also be explored in an unplanned way during collaborative assessments when important
affect, thoughts, or behaviors emerge spontaneously. Often these opportunities allow the evaluator to
address core problems and questions with the client that are at the heart of an assessment and to
experience the problem “in vivo” in a way that deepens understanding. However, capitalizing on these
moments sometimes results in detouring or even derailing the test plans and procedures, and we have
begun to think more systematically about when it is appropriate to diverge from the formal line of
inquiry. It is our intent in these papers to delineate some of the indicators for therapeutic detours and
derailments from testing procedures, and to provide examples of how this has been effective in our
own practices of collaborative assessment. For example, important considerations in deciding to take a
detour include when to do it, under what conditions, with what test material, and when is it most likely
to work. CASE DESCRIPTIONS & EVALUATION OUTCOMES: Dr. Santas will present case material related
to relatively brief therapeutic interventions during different phases of collaborative assessments with
an adult and a teenager. These interventions happened when testing the limits, during the extended
inquiry, addressing an interaction within the relationship, or in response to questions. In both cases, the
interventions were critical in deepening understanding for the client (and assessor), clarifying diagnostic
questions, and impacting the client’s story about themselves. In contrast, the conditions under
which one might leave a projective test incompletely administered in order to explore a therapeutic
opportunity seem to us much more constrained, and thus much more rare, than when choosing to
take a detour. To illustrate the decision to depart from the planned procedure, Dr. Witkin will present a
case of a 17 year old girl whose assessment was derailed when the evaluator decided to challenge and
explore her behavior mid-test, rather than continue to document what the therapist already knew. The
conversation that ensued was enough to complete the collaborative assessment, answer all questions,
make family recommendations, and ultimately set the client and her parents onto a more productive
therapeutic path. CONCLUSIONS: These case studies attempt to make more explicit something that
we already do as assessors who are also therapists, most likely along with others in the CTA community.
We hope to stimulate further discussion as we try to elucidate the conditions and boundaries for such
spontaneous therapeutic interventions and how they fit into the more formal Therapeutic Assessment
model (such as when this type of intervention makes a planned Assessment Intervention redundant,
and when a more planned intervention is still needed). The conditions for spontaneous interventions
and for disrupting a test include but are not limited to the purpose of the evaluation, the nature of the
test and its importance in a battery, the relationship of the intervention to the central question for the
assessment, the trust in the relationship, and the therapeutic experience of the assessor.