There has been insufficient effort in most areas of applied psychology to evaluate incremental validity. To further this kind of validity research, the authors examined applicable research designs, including those to assess the incremental validity of test instruments, of test-informed clinical inferences, and of newly developed measures. The authors also considered key statistical and measurement issues that can influence incremental validity findings, including the entry order of predictor variables, how to interpret the size of a validity increment, and possible artifactual effects in the criteria selected for incremental validity research. The authors concluded by suggesting steps for building a cumulative research base concerning incremental validity and by describing challenges associated with applying nomothetic research findings to individual clinical cases.
Evidence-based assessment (EBA) emphasizes the use of research and theory to inform the selection of assessment targets, the methods and measures used in the assessment, and the assessment process itself. Our review focuses on efforts to develop and promote EBA within clinical psychology. We begin by highlighting some weaknesses in current assessment practices and then present recent efforts to develop EBA guidelines for commonly encountered clinical conditions. Next, we address the need to attend to several critical factors in developing such guidelines, including defining psychometric adequacy, ensuring appropriate attention is paid to the influence of comorbidity and diversity, and disseminating accurate and up-to-date information on EBAs. Examples are provided of how data on incremental validity and clinical utility can inform EBA. Given the central role that assessment should play in evidence-based practice, there is a pressing need for clinically relevant research that can inform EBAs.
The main purpose of this article and this special section is to encourage greater attention to evidence-based assessment (EBA) in the development of a scientifically supported clinical child and adolescent psychology. This increased attention is especially important in light of (a) the omission of assessment considerations in recent efforts to promote evidence-based treatments for children and (b) ongoing changes in the nature of clinical child assessment. We discuss several key considerations in the development of guidelines for EBA, including the purposes of assessment, the role of disorder or problem specificity, the scope of assessment, assessment process parameters, possible "cross-cutting" assessment issues, psychometric considerations, and issues related to the clinician's integration of assessment data. We conclude the article with suggestions for how current, summary information on EBA can be developed, maintained, and disseminated.
This article presents the basis for, and the research on, emotionally focused couples therapy (EFT), now recognized as one of the most researched and most effective approaches to changing distressed marital relationships. Drawing on attachment theory and the research on interactional patterns in distressed relationships, we describe the theoretical context of EFT. We then outline the nature of the clinical interventions used in EFT and the steps hypothesized to be crucial to couple change. The central role of accessing and working with emotional issues in the relationship context is highlighted. Following this presentation, we review both the outcome and process research on EFT and present meta‐anarytic data from randomized clinical trials to substantiate the clinical impact of EFT on couple adjustment. Finally, the empirical and clinical challenges facing EFT are summarized.
Despite the availability of effective treatments for late life depression, data indicate that only a small minority of adults over the age of 65 years with depression access any kind of care for emotional or mental health problems. Using data from the Canadian Community Health Survey (Cycle 1.1), we compared patterns of mental health service utilization among middle-aged (45-64 years), younger old (65-74 years), and older old (75 years and older) adults with and without depression and identified predictors associated with accessing different services (n=59,302). Compared to middle-aged adults with depression, individuals aged 65 and older with depression were less likely to report any mental health consultation in the past year and especially unlikely to report consulting with professionals other than a family physician. Age remained a significant predictor of mental health service utilization even after accounting for other relevant variables such as gender, marital status, years of education, depression caseness, and number of chronic medical conditions. Although the prevalence of depression is lower in older age groups, the present study provides compelling evidence that mental health services are particularly underutilized by depressed older adults.
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