Assessments vs. Clinical Judgment: Use of the MMPI-2

One of the major trends at present is an effort to relate and incorporate assessment information with clinical interventions (Mark & Daniel, 2003). Testing and clinical treatment have been separated for many years and assessments are now being used as part of the general clinical process itself. Paradoxically, many of the prior opponents of such a combination are leading the way regarding this trend. For example, humanistic psychologists are using some assessments in an informal joint fashion with their clients. That is to say that the assessment results are used not as a perfect answer or label with the therapist having the final judgment with respect to the design of the treatment plan, but as part of the self-exploration of the client.

Assessments precise to this process are being developed at the moment. Fascinatingly, many practitioner-oriented therapists, regardless of their initial mental discomfort with “personality assessment” in the traditional sense (since assessment of personality structures involves underlying unobservable traits and personality structures), have led this movement to combine assessment and treatment (McAdams, 2009).

In effect, with respect to behavioral-cognitive approaches, assessment and treatment are observed as indivisible (Mark & Daniel, 2003). A person is tested, type of treatment is determined by observations, treatment is then applied, and finally testing is done again to see if the treatment has been successful. Aptitude-treatment interaction (ATI) research findings seem to be particularly important in this regard.

The importance in ATI research as it relates to the area of personality assessment is on the treatment results and their relationship to certain stable cognitive aptitudes. Social psychological aptitude variables such as the cognitive styles of the internal and external locus of control, field dependence and independence, type of classifications, and expectancies have been continually studied to determine their differential effects on treatment outcome measures. Thus, the assessment process appears to be becoming more integrated within the psychotherapeutic process.

Assessment helps the therapist choose a particular approach to treatment with the client. That is, with the combined behavioral-cognitive assessment intervention focus, the atheoretical-empirical strengths of the DSM III-IV systems of classification, and the ATI research being done showing that certain therapies are better with certain types of clients and/or problems, pre therapy assessment becomes crucial.

Today assessment information is viewed as important during therapy in that it helps the therapist see if there is progress or if he or she is perhaps missing something with respect to the functioning of the client. After therapy, assessment is used to analytically evaluate if and how the client was helped.

A continuing conflict persists with regards to the differential utilities of clinical versus actuarial approaches to assessment (McAdams, 2009). In the clinical approach, the clinician is viewed as the central part of the process in that clinical judgment rules the predictions and judgments of the overall assessment process. In the actuarial approach, the tests stand on their own based on past empirically set up contact between the test and selected standard group. The overall trend at present seems to be on the actuarial side.

Findings from numerous studies (Lanyon & Goodstein, 1992) have shown that the assessment approach is equal to or better than the clinical judgment approach. The assessment approach has been found to be better both in the predictive aspect of the assessment process as well as in the clinical description of the assessed person.

Despite the claims of many practitioners that the clinician is central and better, the assessment approach continues to be reported as being equal to or better than the clinical approach. In fact, a linear rather than configural or weighted combination of test results is producing a very good description of personality (Greene, 1991; Weiner, & Greene, 2008), as a result countering the claim that clinical diagnosticians have unique configural processing abilities when engaged in the assessment process.

Clinical judgment remains a very important part of the overall assessment process. In fact, Lanyon and Goodstein (1992) report that the clinical judgment is very helpful in perfectly describing individuals and that not much incremental validity is gained by adding other tests to the judgment.

The use of computers is part of this actuarial trend. Automated administration, scoring, and even computer-generated narrative descriptions and interpretations of projective personality tests are now being used a great deal. Examples include the MMPI-2 reports (Greene, 1991) and the Exner Rorschach reports (Exner, 1993). There are, however, some problems associated with this trend in that it is being used and perhaps relied on more than may be warranted. Given the generally positive, but rather limited empirical base, many more reliability and validity studies with varied populations are needed to document and improve the automated approach to assessing personality.

Given the positive reviews of the actuarial approaches, the trend with respect to objective personality tests such as the MMPI-2 and the Million tests is toward increased use of automated assessment. Here the cookbook actuarial data set is fed into a computer that then produces a comprehensive descriptive narrative interpretation with a great deal of statistical, predictive power.


Exner, J.E. (1993). A Rorschach workbook for the comprehensive system. Bayville: Rorschach Workshop.

Greene, R.L. (1991). The MMPI-2: An interpretive manual. New York: Allyn and Bacon.

Lanyon, R.I., & Goodstein, L.D. (1992). Personality assessment. New York, NY: University Press of America.

Mark, J. H., & Daniel, L. S. (2003). Comprehensive Handbook of Psychological Assessment, Personality Assessment. Hoboken, New Jersey: John Wiley & Sons.

McAdams, D. P. (2009). The person: An introduction to the science of personality psychology. Hoboken, NJ: John Wiley & Sons, Inc.

Weiner, R. L. & Greene, I. B. (2008). Handbook of personality assessment. Hoboken, NJ: John Wiley & Sons, Inc.

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