ON INDIVIDUALIZING THE PSYCHOLOGIST’S CLINICAL EVALUATION

NORMAN TALLENT

Veterans Administration Center, Kecoughtan, Virginia and

The George Washington University

Increasingly, systematic attention is being directed to the manner in which the psychologist communicates his clinical findings(6, 14, 16, 1 6 , 1 7 ) . The concern of this paper centers about an aspect of this problem-the failure of some psychologists to individualize the client in their clinical reports, that is, to describe the client so that the reader knows how he differs from other people and in what important ways he is similar to others. Davenport ( l ) , for example, found that psychologists had difficulty in selecting TAT interpretive statements, taken from case reports on a sample of men, which could be used to discriminate among patients. Many of the statements could be applied to any adult male.

This peculiarity of interpretive-type comments may readily be put to nefarious use as noted by Paterson@# p *‘) who presented a “Character Reading a t Sight of Mr. X. According to the System of Mr. P. T. Barnurn.” The essence of the Barnum method is to descrihe a personality by using a few mildly negative generalities which are quickly neutralized in a matrix of acceptable, even flattering remarks, both types of comments being apparently applicable to almost everybody. This sort of report is thus likely to be readily “validated” by the subject about whom the gener- alized description allegedly is written. People are gullible this way(4* l a ) , hence Meehl has referred to such description as the “Barnum Effect.” The phenomenon is also demonstrated by the other arts in the same category, such as palmistry, graph- ology, tea leaf reading, and astrologyc2); and the revelations in the thirty-five cent horoscope stemming from the latter discipline have been compared with certain classes of interpretive remarks which may be derived from the Rorschach‘’). Not to be outdone by some of the serious students of projective tests who use their tech- niques to gain Barnum-type material, Holt (I2) has published a valid-sounding TAT interpretation of a patient prior to seeing patient or protocol. Similarly, Dr. Norman Sundberg prepared an unpublished clinical report) which he labeled “Completely Blind Analysis of the Case of a Schizophrenic Veteran.” It was “written before knowing anything about the patient except that he was a new admission to the Rose- burg V(eterans) A(dministration) H(ospita1) and was to be worked up” for a sched- uled staff meeting.

Quite similar to the Barnum phenomenon is what might be called the Aunt F a n n y description in clinical reports. Superfluous statements, such as, “This client has difficulty in performing at optimal capacity when under stress,” or “The client has unresolved dependency feelings,” or “The client has unconscious hostile urges” might readily prompt the report reader to think “So has my Aunt Fanny!” The nondifferentidting Aunt Fanny description may be complimentary to the client, un- complimentary, or neither, and it also differs from the Barnum method in that it is not used with the intention of satisfying a client.

Another commonly noticed offense against individualized reporting is seen in the trade-marked report. This name is proposed for reports which may communicate the psychologist’s personal concerns, interests, conflicts’, shortcomings, or dynamics rather than those of the client. Where the psychologist reports in this manner his clients tend to appear to have gross similarities of personality make-up. The exist- ence of this phenomenon has been shown by several workers. ( 3 9 6 , 8 , lo- 11)

Still another type of nonindividualized report is the prosecuting-attorney brief- virtually the reverse side of Barnum’s coin. After listening to such a report at a staff meeting, the listener might be tempted to call out “NOW will the attorney for the defense please come forward!’’ Such reports are saturated with the negative dyn- amics the psychologist reads about while in graduate school, but give little or no attention to positive features, t o commendable conscious strivings, socially valuable compensations, and other well-wed defenses. These reports consistently reflect the

244 NORMAN TALLENT

motto “Always interpret a t the lowest possible level of psychosexual fixation or re- gression.” They are prepared by psychological simians who hear no good, see no good, and report no good.

Honesty and sober reflection certainly are necessary if Barnum’s method is to be eliminated from psychology. Such an attitude should also tend to keep descrip- tions of Aunt Fanny to a minimum. A little more insight into the self, and perhaps greater interpretive acumen, would be the prescription for the psychologist who trade-marks his reports or writes prosecuting-attorney briefs.

There are several considerations which apply to individualizing a client in a psychological report. These may be used as guides for the psychologist to the extent his data permit. 1. Consider how important it is to mention a finding which is true of many persons. About one-half of the population is of average int’elligence, yet it may be important to mention in a report that “average intelligence” is descriptive of the client under consideration. 2. Show the unique aspects of a trait. It is mean- ingless to just indicate, for example, a trait of dependency. We all have it. What is important is how the trait is manifested. 3. The significance of a trait in an individual depends partly on its strength. Adjectives indicating strength should be used liber- ally. 4. The level(s) at which behavior occurs should be made explicit. “Hostile” is a word which has different meanings as the Significant dynamic in a social reformer, the smarting innuendo of the society matron, and the outbursts of the explosive psychopath. 5. The circumstances under which behavior becomes overt, or in some way significant, should be clear t o the reader. Divorcing a report from the life situa- tion is an effective way of keeping it general. 6. The manner in which traits interre- late should be specified. Relating hostility to unresolved dependency may be more meaningful than to simply indicate hostility and dependency in various parts of the report. 7. Avoid a ‘%hotgun effect”, i.e., including every possible finding and thus precluding the possibility of having omitted somet.hing. Always ask “Will this state- ment help my reader to understand the client as an individual?”

SUMMARY The need for clinical psychological reports t o more effectively portray the in-

dividual characteristics of the client was examined. Four types of report writing which defeat this purpose were discussed and remedial measures were suggested.

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