similar constructs. Evidence of discriminant validity comes from nonsignificant relationships between test scores and theoretically dissimilar constructs. For example, the convergent validity of the CDI-2 is supported by high correlations with other measures of childhood depression, whereas the discriminant validity of the CDI-2 is supported by lower correlations with measures of other childhood problems such as anxiety and aggression.
Finally, psychologists examine the test’s criterion-related validity. Criterion-related validity refers to the degree to which test scores can be used to infer a probable standing on some external benchmark, or criterion. One measure of criterion-related validity is called concurrent validity, the degree to which test scores are related to some criterion at the same point in time. For example, children with depression should score significantly higher on the CDI-2 than children without depression. Another aspect of criterion-related validity is called predictive validity. Predictive validity refers to the ability of test scores to predict theoretically expected outcomes. For example, children who earn high CDI-2 scores may be at risk for suicidal thoughts and actions in the future (Geisinger, 2018).
Review
Standardized tests are administered, scored, and interpreted in the same way to all children. Most standardized tests are norm-referenced. They yield scores that quantify the degree to which the child’s performance is similar to that of his or her peers.
Reliability refers to a test’s consistency. Examples include test–retest reliability, inter-rater reliability, and internal consistency.
Validity refers to a test’s ability to accurately reflect a desired construct. Examples include content validity, construct validity, and criterion-related validity.
4.2 Systems of Psychotherapy
Mental health professionals hold positions of authority and trust. People usually come to therapists when they are experiencing emotional distress and problems with daily life. Clients are often vulnerable, and they seek care that is sensitive and responsive to their needs. The provision of evidence-based and ethically mindful treatment is especially important when clients are juveniles. Parents and other caregivers place their most valuable assets—their children—in the care of therapists, with the expectation that clinicians will help their children overcome problems and achieve the highest level of functioning possible. To illustrate various approaches to treatment, consider Anna, a girl who needs help from a skilled and caring professional.
Case Study: Psychotherapy
Anna’s Secret
Sixteen-year-old Anna first disclosed her habit of bingeing and purging in the most unlikely of places: the dentist’s office. During a routine cleaning, the hygienist noticed a marked deterioration of her dental enamel and an overall yellowish-gray hue of her back teeth. These signs, combined with slight inflammation of her salivary glands, suggested repeated vomiting.
“When the hygienist asked if I made myself vomit on purpose, I felt really strange: a mix of terror and relief,” Anna later explained to her therapist. “I was so embarrassed, but it also made me feel a little better that I could now talk about it.”
With the help of the hygienist, Anna agreed to tell her mother about her pattern of bingeing and purging. Her behavior began 18 months ago and had waxed and waned depending on Anna’s stress level. She was most likely to binge when upset about her family, friends, or school and when she was feeling lonely or left out. She tended to binge on snack foods, especially chips, cereal, and ramen noodles. On average, Anna would binge 4 to 5 times per week.
“I wasn’t really surprised when Anna told me,” her mom added. “She’s tried to hide it from us by running the water in the bathroom sink, taking a lot of showers, and using air fresheners and mints. It was like the elephant in the living room that we all saw but no one talked about.”
“Well, it’s out in the open now,” Anna’s therapist replied. “Let’s see if we can find a way to make things better.”
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What Is Psychotherapy?
Definition and Common Factors of Therapy
Most mental health professionals spend the majority of their time practicing psychotherapy. Unfortunately, no one has provided a definition of psychotherapy that satisfies all practitioners. One influential definition of psychotherapy has been offered by Raymond Corsini (2005), an expert in helping others:
Psychotherapy is a formal process of interaction between two parties … for the purpose of amelioration of distress in one of the two parties relative to any or all of the following areas: cognitive functions (disorders of thinking), affective functions (suffering or emotional discomforts), or behavioral functions (inadequacy of behavior)…. The therapist [has] some theory of personality’s origins, development, maintenance and change along with some method of treatment logically related to that theory and professional and legal approval to act as a therapist.
According to this definition, psychotherapy is an interpersonal process. Therapy must involve interactions between at least two individuals: a therapist and a client. The therapist can be any professional who has specialized training in the delivery of mental health services. Therapists can include psychologists, psychiatrists, counselors, and social workers; however, therapists can also include paraprofessionals who have received training and supervision in the use of psychosocial interventions (Hill, 2020).
The therapist uses a theory about human development and the causes of psychopathology to develop a means of alleviating the client’s psychological distress. The client is an individual experiencing some degree of distress or impairment who agrees to participate in the therapeutic interaction to bring about change.
The purpose of psychotherapy is to alter the thoughts, feelings, or overt actions of the client to alleviate symptoms and improve well-being. Change occurs primarily through interactions with the therapist. Specifically, the therapist provides conditions, consistent with his or her theory of psychopathology, to improve the functioning of the client.
Jerome Frank (1973) has suggested that certain factors are common to all forms of psychotherapy. These common factors include the presence of a trusting relationship between the client and therapist, a specific setting in which change is supposed to take place, a theory or explanation for the client’s suffering, and a therapeutic ritual in which the client and therapist engage to alleviate the client’s distress or impairment. Frank argues that these common factors of psychotherapy have been primary components of psychological and spiritual healing since ancient times (Frank & Frank, 2004).
The famous psychologist Carl Rogers (1957) argued that there are three necessary and sufficient conditions for therapeutic change. Rogers developed person-centered psychotherapy as an approach to treatment that focused chiefly on these three factors.
First, the therapist must show empathy toward the client. Specifically, the therapist must strive to understand the world from the client’s perspective and take a profound interest in the client’s thoughts, feelings, and actions.
The therapist must also respond to the client with congruence—that is, the therapist must show his or her genuine feelings toward the client and avoid remaining emotionally detached, distant, or disengaged. Rogers described the ideal therapeutic relationship as “transparent”—that is, the client should easily witness the clinician’s genuine feelings during the therapy session. The therapist does not try to hide her feelings or put on airs.
Finally, the therapist must provide the client with unconditional positive regard—that is, the therapist must be supportive and nonjudgmental of the client’s behavior and characteristics in order to