Clinical assessment of child and adolescent personality and behaviour by Frick, Barry, & Kamphaus (fourth edition) – Chapter 4 summary

Informed consent should be provided before any clinical service to a child or adolescent. The informed consent must be obtained from at least one of the parents if the child is below the age of consent. Without exception, it should be the first thing that is done in clinical assessment. There are several basic elements of informed consent:

• A description of the facility and the qualifications of the person(s) providing the evaluation.
• A description of the purpose of the evaluation.
• A summary of the planned procedures, including how the results will be provided.
• A summary of the potential benefits of the procedures.
• A summary of the potential risks and discomforts associated with the procedures.
• A statement of the right to refuse and description of alternative services.
• A description of the fee for the services.
• A description of protections for confidentiality, including how information will be stored (1), who is legally authorized to obtain the results (2) and when confidentiality needs to be broken (3).

Children under the age of consent do not have the right to refuse participation. However, the clinician needs to seek the individual’s agreement (1), consider preferences and best interests (2) and provide an appropriate explanation (3) to people who cannot give informed consent. The child has the right to have the policies and procedures explained to them in a language that is appropriate to their developmental level.

Clinicians should only administer tests for which one is competent. They should carefully follow the standardized procedures for administration and scoring specified by the test developer. Administration procedures that introduce construct-irrelevant variance (e.g. distractions) should be avoided.

Only interpretations that have been supported by research should be made from test scores (i.e. evidence-based clinical practice). The results should be explained to the individual being tested in developmentally appropriate language.

Clinicians need to protect the integrity of testing materials. If it is not protected, users who are not qualified to interpret the results may use it or future test-takers will get acquainted with the materials, making them invalid for testing.

Fairness refers to responsiveness to individual characteristics and testing contexts to ensure that test scores will yield valid interpretations for intended uses (e.g. make adjustments to the test for people who are visually impaired). Test bias (i.e. measurement bias) refers to the validity of interpretations not being equally valid across groups. Differential item functioning (DIF) occurs when equally able test takers differ in their probabilities of answering a test item correctly as a function of group membership. This is evidence of test bias.

There are several guidelines for working with a multicultural population:

1. Recognize and understand that identity and self-definition are fluid and complex and that the interaction is dynamic.
2. Understand that cultural attitudes and beliefs can influence perceptions of and interactions with others.
3. Recognize and understand the role of language and communication through engagement that is sensitive to the lived experience of the individual.
4. Be aware of the role of the social and physical environment in the lives of people.
5. Recognize and understand historical and contemporary experiences with power, privilege and oppression.
6. Promote culturally adaptive interventions and advocacy within and across systems, including prevention, early intervention and recovery.
7. Examine the profession’s assumptions and practices within an international context and how this influences self-definition, purpose, role, and function.
8. Seek awareness and understanding of how developmental stages and life transitions intersect with the larger bio-sociocultural context and how identity evolved as a function of such intersections.
9. Conduct culturally appropriate and informed practice.
10. Take a strength-based approach when working with others that seeks to build resilience and decrease trauma within the sociocultural context.