Effective use of projective techniques in clinical practice: Let the data help with selection and interpretation.

Abstract

By learning about the validity of individual test scores, psychologists can avoid using scores that are invalid and making judgments that are potentially harmful to their clients. This is important not only for improving clinical and forensic practice but also for avoiding lawsuits. In this article, the effective use of projective techniques is described, with attention to the overperception of psychopathology, diagnosis and the description of symptoms, and the detection of child abuse. Guidelines are offered for using the Rorschach, Thematic Apperception Test, human figure drawings, and the Washington University Sentence Completion Test.

Rorschach Comprehensive Variables and Assessment for Psychodynamic Psychotherapy

“…In a study of nonpatient adults, Shaffer and Erdberg (1999) obtained results for many CS variables that differed from the data in Exner's Comprehensive System Workbook (1995). These findings have resulted in a series of articles debating the CS norms and the risk of false positive identifications of psychopathology in clinical and forensic settings (Aronow, 2001;Garb, 2003;Garb, et al, 2002;Hibbard, 2003;Hunsley & Di Giulio, 2001;Lilienfeld et al, 2000;Meyer, 2001;Wood, Nezworski, Garb, & Lilienfeld, 2001a, 2001b. However, Exner has reported that he is now working on calculating CS norms for a new non-patient sample, using essentially the same design and exclusion criteria as in the original project.…”

“…The Rorschach Workshops, which constitute the main empirical foundation for the CS, have been criticised for relying too heavily on unpublished studies of questionable value (Garb, Wood, Lilienfeld, & Nezworski, 2002;Garb, Wood, Nezworski, Grove, & Stejskal, 2001;Hunsley & Bailey, 2001;Wood, Nezworski, & Stejskal, 1996a, 1996b.…”

“…The Rorschach is a multidimensional method, and as Weiner (1996Weiner ( , 2001) contended, individual scores should have their own validity for different purposes. As mentioned earlier, Garb et al (2002) recommended that only CS variables that have been researched and found valid for a specific question should be used in the applied fields of psychology. Moreover, the questions motivating the use of the Rorschach as a complement to the clinical interview in decisions concerning dynamic psychotherapy, should be clearly formulated in each case.…”

“…The CS has been criticised for deficiencies in psychiatric diagnostic validity (Carlsson, Kula, & Laurent, 1997;Garb et al, 2001;Garb et al, 2002;Garfield, 2000;Lilienfeld, Wood, & Garb, 2000;Wood, Lilienfeld, Garb, & Nezworski, 2000a, 2000b.…”

“…The research in the present thesis concerns selected CS variables and assessment for psychodynamic psychotherapy, and the focus is not on psychiatric pathology but on assets and liabilities of relevance for the possibility to engage in psychodynamic psychotherapy. Garb et al (2002) recommended that psychologists working in the fields of applied psychological investigation should only use CS scores that have been researched and found valid and reliable for the question under investigation. This is a recommendation in line with the reasoning by Weiner (1996Weiner ( , 2001 concerning the multidimensionality of the Rorschach and the need to calculate the validity of different parts of the method for various purposes.…”