Standard 9: Assessment
9.01 Bases for Assessments
(a) Psychologists base the opinions contained in their recommendations, reports and diagnostic or
evaluative statements, including forensic testimony, on information and techniques sufficient to substantiate
their findings. (See also Standard 2.04, Bases for Scientific and Professional Judgments.)
(b) Except as noted in 9.01c, psychologists provide opinions of the psychological characteristics of
individuals only after they have conducted an examination of the individuals adequate to support their
statements or conclusions. When, despite reasonable efforts, such an examination is not practical,
psychologists document the efforts they made and the result of those efforts, clarify the probable impact of
their limited information on the reliability and validity of their opinions and appropriately limit the nature
and extent of their conclusions or recommendations. (See also Standards 2.01, Boundaries of Competence,
and 9.06, Interpreting Assessment Results.)
(c) When psychologists conduct a record review or provide consultation or supervision and an individual
examination is not warranted or necessary for the opinion, psychologists explain this and the sources of
information on which they based their conclusions and recommendations.
9.02 Use of Assessments
(a) Psychologists administer, adapt, score, interpret or use assessment techniques, interviews, tests or
instruments in a manner and for purposes that are appropriate in light of the research on or evidence of the
usefulness and proper application of the techniques.
(b) Psychologists use assessment instruments whose validity and reliability have been established for use
with members of the population tested. When such validity or reliability has not been established,
psychologists describe the strengths and limitations of test results and interpretation.
(c) Psychologists use assessment methods that are appropriate to an individual'
s language preference and
competence, unless the use of an alternative language is relevant to the assessment issues.
9.03 Informed Consent in Assessments
(a) Psychologists obtain informed consent for assessments, evaluations or diagnostic services, as described
in Standard 3.10, Informed Consent, except when (1) testing is mandated by law or governmental
regulations; (2) informed consent is implied because testing is conducted as a routine educational,
institutional or organizational activity (e.g., when participants voluntarily agree to assessment when
applying for a job); or (3) one purpose of the testing is to evaluate decisional capacity. Informed consent
includes an explanation of the nature and purpose of the assessment, fees, involvement of third parties and
limits of confidentiality and sufficient opportunity for the client/patient to ask questions and receive
answers.
(b) Psychologists inform persons with questionable capacity to consent or for whom testing is mandated by
law or governmental regulations about the nature and purpose of the proposed assessment services, using
language that is reasonably understandable to the person being assessed.
(c) Psychologists using the services of an interpreter obtain informed consent from the client/patient to use
that interpreter, ensure that confidentiality of test results and test security are maintained, and include in
their recommendations, reports and diagnostic or evaluative statements, including forensic testimony,
discussion of any limitations on the data obtained. (See also Standards 2.05, Delegation of Work to Others;
4.01, Maintaining Confidentiality; 9.01, Bases for Assessments; 9.06, Interpreting Assessment Results; and
9.07, Assessment by Unqualified Persons.)
9.04 Release of Test Data
(a) The term test data refers to raw and scaled scores, client/patient responses to test questions or stimuli
and psychologists'
notes and recordings concerning client/patient statements and behavior during an
examination. Those portions of test materials that include client/patient responses are included in the
definition of test data. Pursuant to a client/patient release, psychologists provide test data to the
client/patient or other persons identified in the release. Psychologists may refrain from releasing test data to
protect a client/patient or others from substantial harm or misuse or misrepresentation of the data or the
test, recognizing that in many instances release of confidential information under these circumstances is
regulated by law. (See also Standard 9.11, Maintaining Test Security.)
(b) In the absence of a client/patient release, psychologists provide test data only as required by law or
court order.
9.05 Test Construction
Psychologists who develop tests and other assessment techniques use appropriate psychometric procedures
and current scientific or professional knowledge for test design, standardization, validation, reduction or
elimination of bias and recommendations for use.
9.06 Interpreting Assessment Results
When interpreting assessment results, including automated interpretations, psychologists take into account
the purpose of the assessment as well as the various test factors, test-taking abilities and other
characteristics of the person being assessed, such as situational, personal, linguistic and cultural differences,
that might affect psychologists'
judgments or reduce the accuracy of their interpretations. They indicate any
significant limitations of their interpretations. (See also Standards 2.01b and c, Boundaries of Competence,
and 3.01, Unfair Discrimination.)
9.07 Assessment by Unqualified Persons
Psychologists do not promote the use of psychological assessment techniques by unqualified persons,
except when such use is conducted for training purposes with appropriate supervision. (See also Standard
2.05, Delegation of Work to Others.)
9.08 Obsolete Tests and Outdated Test Results
(a) Psychologists do not base their assessment or intervention decisions or recommendations on data or test
results that are outdated for the current purpose.
(b) Psychologists do not base such decisions or recommendations on tests and measures that are obsolete
and not useful for the current purpose.
9.09 Test Scoring and Interpretation Services
(a) Psychologists who offer assessment or scoring services to other professionals accurately describe the
purpose, norms, validity, reliability and applications of the procedures and any special qualifications
applicable to their use.
(b) Psychologists select scoring and interpretation services (including automated services) on the basis of
evidence of the validity of the program and procedures as well as on other appropriate considerations. (See
also Standard 2.01b and c, Boundaries of Competence.)
(c) Psychologists retain responsibility for the appropriate application, interpretation and use of assessment
instruments, whether they score and interpret such tests themselves or use automated or other services.
9.10 Explaining Assessment Results
Regardless of whether the scoring and interpretation are done by psychologists, by employees or assistants
or by automated or other outside services, psychologists take reasonable steps to ensure that explanations of
results are given to the individual or designated representative unless the nature of the relationship
precludes provision of an explanation of results (such as in some organizational consulting, preemployment
or security screenings, and forensic evaluations), and this fact has been clearly explained to the person
being assessed in advance.
9.11 Maintaining Test Security
The term test materials refers to manuals, instruments, protocols and test questions or stimuli and does not
include test data as defined in Standard 9.04, Release of Test Data. Psychologists make reasonable efforts to
maintain the integrity and security of test materials and other assessment techniques consistent with law
and contractual obligations, and in a manner that permits adherence to this Ethics Code.
COMMENTARY
Standard 9: Assessment
9.01 Bases for Assessments: Very few standardized assessment instruments have been
normed or validated with specific Indigenous peoples. Hence their validity is not
established within the confines of the specific nations. Psychologists often do not
acknowledge this in their written or oral reports of assessment findings with American
Indian subjects. Cultural competence in the client’s specific Tribal background is of
paramount concern in guiding the choice of assessment instruments and the interpretation
of the results.
9.01: Most commonly used psychology assessments and measures do not have Native
norms. But even when they do, the measure’s original development was not usually done
in consultation with a Native population using Native constructs (refer to Values
Statement). So the validity of using Westernized measures with Native people is further
reduced if not completely absent.
9.02 Use of Assessments: It is almost impossible to find instruments whose validity and
reliability have been established with Native people. That being said, when assessments
are necessary, interpretations should be highly qualified. The robustness of the results
cannot be assumed.
9.02 (a): The assessment interview is generally taught as a series of questions that build
upon one another in a linear way to generate a diagnosis and guide the development of a
treatment plan. For Native clients, circular story telling must be understood and
incorporated, since linear story telling may not be as familiar.
9.02 (a): The context of the client in their community must be understood in order to
gather appropriate information during an assessment. The assessor should understand the
presence and salience of intergenerational trauma and grief in the client’s individual
background and in the specific community.
9.02 (c): Many Native people do not speak English and if they do, they may not speak the
type of English used in the assessments. I have never heard of a measure having
Cherokee, Blackfeet, Navajo, etc. norms.
Story
I was conducting psychological assessments for Child Protection Services on the Navajo
reservation. I was using a battery of tests that included the Rorschach, Thematic
Apperception Test, Incomplete Sentence Blank, and the WAIS III. When I first began to
do the testing, I used the standard TAT test, where the respondent was to make up a story
related to the picture I presented. I noticed right away that the respondents were pausing
before giving a response to the pictures. For example, Card 1 has a white boy in a white
starched shirt looking at a violin. My sense was that the Navajo children I was testing did
not have a lot of exposure, if any, to a violin. Secondly, they were trying to think about
what a white boy would be doing with this violin, therefore were not putting themselves
into the story.
I created a set of cards that had Navajo children and adults, as well as Navajo scenery. I
noticed that the children responded right away to the pictures, as they were more able to
identify with the figures and the scenery in the pictures. Interestingly, years later, I
thought I could use these same cards with children at the Taos Pueblo, but found them to
respond, “This looks like a Navajo… etc., etc.”! Thus, I changed the pictures to include
Pueblos and Pueblo scenery. I did the same with Lakota respondents, selecting pictures of
Lakotas in various situations.
9.03 Informed Consent in Assessments: Informed consent is not necessarily accurate
with American Indian people because they are more likely to respond more to the social
skill repertoire of the psychologist than to the content of the proposed assessment. “If I
trust you, sure, I’ll do what you want me to do.” If the client distrusts the psychologist,
they are more likely to be passive and quiet; giving half-hearted cooperation and reducing
the accuracy of the outcome measures.
9.03 (b) This can be very complicated when there is a language barrier.
9.03 (c): The use of an interpreter is likely to generate a situation of multiple
relationships. It is highly likely that the interpreter will know the client or perhaps even
be a family member. This would potentially limit confidentiality and also create a higher
level of discomfort for the client because a friend, family member, or community
member is in their session.
9.03 (c): Conducting an assessment through interpreters creates a set of problems
stemming from the difficulty of accurately translating items from English to Native
tongue, and responses from Native tongue to English. Ideally, the responses would be
checked with translation-back translation methods to determine the variance of items
across the languages before being used to formulate the interpretation.
9.05 Test Construction: Test construction methods currently in use do not create tests
valid for use across different Native groups. Researchers rarely work with Native people
to develop accurate measures. It is the responsibility of psychologists to create
assessments for Native people that have strong psychometric qualities.
9.05: Appropriate assessments for Native clients include information about the client’s
collective family and community rather than merely just individual measures. These
assessments may include a home visit or community cultural visit to look at the in-vivo
factors of resiliency. (See Value Statement, especially #7.)
Story
Our Tribe believes in the “Spirit” and our relationship to the sacred in all things. It is
important to utilize this concept while conducting assessments with our people. Native
psychologists utilize this concept in designing how we move through the process of
assessment with our clients. It influences relationship building and subsequent
interpretation. Non-verbal and spirit-moved exchanges are included in the assessment
process. An assessment might need to be prolonged so a client can utilize the established
and growing rapport to cry and share her or his narrative before the information gathering
of assessment can continue. The character of the assessor is very important, making a
difference in the effort put forth by the client.
It is our responsibility as Native psychologists to master this approach in addition to the
objective, linear approach we learned in graduate school. Our professionalism is not
reduced or compromised by pursuing this approach to assessment.
9.06 Interpreting Assessment Results: The context of the client in their specific
community must be understood in order to appropriately interpret the information
gathered during an assessment. Too frequently, the interpretation of results may be
incorrect due to lack of cultural competence in the assessor, a lack of cultural
understanding, and of course, the lack of norms. The literature is replete with
interpretation problems when it comes to indigenous communities and individuals.
Interpretations have failed to understand the spiritual belief system; failed to take into
account the community versus individualistic views; and failed to see the client within
their cultural norms. Those incorrect interpretations tend to be based upon the dominant
culture’s norms, individualistic perspectives and spiritual systems.
9.06: The level of acculturation of the client and the level of cultural competence of the
administrator could influence the validity as well as the interpretation of the results of an
assessment.
Story
In conducting an ADHD assessment with a 5 year-old boy, I realized that the way of
interpreting the results of an assessment could narrow our view of the client’s needs and
the subsequent treatment planning. Collateral data for this child suggested that his ADHD
symptoms might be the consequence of trauma often experienced in low-income,
marginalized populations. Standard practice in the clinic supported psychotropic
treatment for ADHD, based on the presence of symptoms in the assessment for ADHD.
The problem for me was that the information related to trauma and environmental issues
were ignored by the senior clinician. The narrow focus on the results from the ADHD
assessment put a 5 year-old on Ritalin and his parents in parenting classes that ignored
environmental variables.
From an Indigenous perspective healing starts with the family and community. The
assessment available did not support a holistic perspective on wellbeing that could
generate answers and solutions for healing from the Indigenous perspective. A systems
perspective in assessment is needed to examine the dynamic that otherwise could
pathologize a child’s natural response to their stressful environment.
9.07 Assessment by Unqualified Persons: Many who do assessments in Indian country
are not qualified but do it because they lack cultural competence. When there is no one
else to do the assessment, it is incumbent upon the psychologist to obtain culturally
competent supervision.
9.09 Test Scoring and Interpretation Services: It is the observation of many SIP
members that the use of extreme caution when scoring and interpreting assessment results
for Native clients is not used enough. It is also rare to find non-culturally competent
psychologists seeking supervision about test scoring and interpretation (refer to the
Principle of Humility in the Values Statement).
9.09 (b): There are no automated interpretation services that use norms for Native
populations.
9.10 Explaining Assessment Results: It is rare to find a culturally competent
psychologist who can explain assessment results regarding American Indian clients. It is
equally rare to find non-culturally competent psychologists who seek supervision about
this (refer to the Principle of Humility in the Values Statement).
