"Why am I so stuck?": A Collaborative/Therapeutic Assessment Case Discussion

Collaborative assessment as an intervention in the treatment of mental Illness: a systematic review

BACKGROUND

Three meta-analyses suggested that the psychological assessment as a therapeutic intervention approach might have therapeutic effects but had unspecific inclusion criteria.

METHODS

We searched four databases for RCTs that reported on the use of psychological assessment as an intervention. Two reviewers independently selected papers, extracted data, and assessed study quality.We conducted and reported the systematic review following the PRISMA statement. We assessed the Risk of bias in included studies using the Risk of Bias tool and graded the strength of the evidence with GRADE.

RESULTS

We included two RCTs: The first study investigated Therapeutic Assessment (TA) combined with Manual-Assisted Cognitive Behavior Therapy (MACT) compared with MACT only in 16 outpatients with personality disorders. The trial found among completers (n = 7) no difference in borderline symptomatology but a possible difference regarding suicidality favoring MACT + TA. The trial did not provide any outcomes relating to readiness for treatment. The other trial investigated TA compared with a Goal-focused Pretreatment Intervention in a sample of 74 outpatients with personality disorders. The results found no intervention effects on symptomatology but suggested that TA might improve patient expectancy for future treatment among completers of the intervention. Both trials were judged at a high risk of bias and with very low certainty of evidence.

DISCUSSION

We found no support for the clinical effect of psychological assessment as a therapeutic intervention due to the high risk of bias and low certainty of the evidence.

Self-guided online therapeutic assessment in substance abuse care: A Conflict Analysis implementation and feasibility case study

"Michael" is a 60-year-old Black male receiving substance abuse treatment at a Veterans Affairs hospital. As part of Michael's care, he participated in an implementation and feasibility trial evaluating Conflict Analysis (CA), a self-guided online therapeutic assessment. CA leverages innovative diagnostic and therapeutic resources to improve client engagement and therapeutic achievement. CA employs narrative formats, encouraging patients to frame experiences within personal vocabulary, and provides personalized feedback automatically extracted from patient responses. CA is self-guided, widely accessible, and has few costs. Paper presents Michael's protocol, associated therapeutic outcome measures, and psychologist's evaluation of CA benefits. Michael completed brief online CA deployment containing a wellness-based personality inventory, four narrative tasks, and an interactive feedback template. Michael completed insight, stress, depression, wellbeing, and perceived diagnostic and therapeutic benefit measures at baseline, post, and three-week follow-up. Interventions took 2.5 h. Attending psychologist reviewed CA protocols and completed diagnostic and therapeutic questionnaires. Michael's record identifies elevated dominance. Protocol highlights Michael's drinking as mechanism to lessen social anxieties, anger, and competitiveness. Results suggest CA encouraged increased motivation to change, treatment engagement, and reduced depression. Psychologist rated benefit at maximum threshold. Implications include improving assessment efficacy, increasing online care opportunities, and expanding CA research.