Clinical Reasoning: A Missing Piece for Improving Evidence-Based Assessment in Psychology

Abstract

Clinical reasoning is a foundational component of conducting evidence-based psychological assessments. In spite of its importance, limited attention has been paid to the teaching or measurement of clinical reasoning skills relative to psychological assessment, as well as how clinical reasoning develops or how its efficacy can be measured. Improving clinical reasoning throughout the assessment process, from initial case conceptualization to hypotheses testing, to recommendation writing, has the potential to address commonly noted concerns regarding diagnostic accuracy, as well as the accessibility and utility of psychological reports and recommendations, and will, ultimately, lead to improved outcomes for clients. Consequently, we provide a definition of clinical reasoning in relation to psychological assessment, followed by a critique of graduate training assessment and the current challenges of measuring clinical reasoning in psychology. Lastly, this paper provides suggestions for how to incorporate clinical reasoning throughout the assessment process as a way to answer client questions more effectively and provide meaningful recommendations to improve outcomes.

Staff supported community outings among forensic mental health patients: patient characteristics, rehabilitative goals, and (the absence of) adverse outcomes

“…There was just one instance of a patient absconding during the outing; furthermore, there was no evidence suggesting the individual engaged in any aggression or substance use during their unauthorized leave. The low base rate of adverse events is an important finding that can impact not only policy but also inform clinicians about the frequency of adverse events during outings, which in turn, can support clinicians to make more informed decisions ( 34 ). It is crucial that these decisions are carefully balanced to prevent decisions that inappropriate restrict a patient’s rights (e.g., preventing a patient from participating in community-based outings for fear of violence despite a low base rate) or place the public at risk.…”

Pense como um neuropsicólogo: método PCN

“…Seu desafio não está na escrita em si, mas nos processos do raciocínio e, ainda, nas lacunas do conhecimento por parte do profissional. Wilcox, Schroeder & Drefs (2023) concluem que trabalhos são necessários para compreender melhor o processo de raciocínio clínico na avaliação, a fim de determinar as melhores formas de ensinar, monitorar e melhorar o raciocínio clínico dos psicólogos durante o processo de avaliação.…”