Clinical assessment of child and adolescent personality and behaviour by Frick, Barry, & Kamphaus (fourth edition) – Chapter 16 summary

It is essential to consider the different people who will read a report to avoid improper interpretation of the results when writing a report. The clinician should aim to make reports accessible and useful to all involved people. The report refers to the means by which a client’s history and difficulties are described, results are obtained and interpreted, and suggestions for future approaches to the difficulties are discussed.

A psychometric property refers to a portion of the report that presents only test scores and is usually given at the beginning of a report. This is often not of use for parents.

There are several pitfalls of report writing:

1. Vocabulary
   Clinicians should avoid using jargon, complex sentence structure and too many acronyms.
   1. Complex words to add length to the report.
   2. Esoteric language only understood by the clinician.
   3. Not written in lay language (e.g. excessive focus on scores).
   4. Vague and unclear language that cannot be falsified.
   5. Vague or imprecise language (i.e. psychobabble).
2. Faulty interpretation
   This can be the result of personal ideas (1), biases (2) and idiosyncrasies (3). It can be most readily seen when the psychologist is using the same theories or drawing the same conclusions in every report.
3. Report length
   The report should not be unnecessarily long.
4. Number obsession
   The report should not focus unnecessarily on numbers and only emphasize numbers when they contribute to the understanding of the child being evaluated. Invalid test scores should not be incorporated and test results should not be reported just because it was administered.
5. Failure to address referral questions
   The report should clarify and address the true referral question, although this may not always be the same as the one presented by the client.

There are several good practices for report writing:

1. Report only pertinent information
   Only relevant information to the referral question should be included.
2. Define abbreviations and acronyms
   It is important to use non-technical language and acronyms should be defined when they are used.
3. Emphasize words rather than numbers
   There should be an emphasis on words rather than numbers.
4. Reduce difficult words
   The text should be readable and use the child’s name rather than ‘the child’.
5. Briefly describe the instruments used
   The instruments that are used should be briefly described.
6. Edit the report
   The report should be edited to ensure the most accurate communication in the least amount of space.
7. Use headings and lists freely
   This can enhance the readability of the report.
8. Use examples of behaviour to clarify meaning
   This makes sure that there is no discussion about a topic (e.g. anxiety).
9. Check scores
   Only correct scores should be reported.
10. Check grammar and spelling
    The grammar and spelling should always be checked.
11. Reduce report length
    A report may be too long when:
    
    1. The time it took to write is too long.
    2. The psychologist has difficulty organizing all of the details for presentation.
    3. Some f the content is not clear or useful.
    4. The detail is much greater than can be put to good use.
    5. Speculations are presented without a good rationale.
    6. The writing is unnecessarily repetitious.
    7. The organization is not tight.
    8. The reader is irritated by the length of reads only a few sections.

There are several guidelines for communicating test results to parents:

1. Avoid deceit and do report bad news.
2. Use percentile ranks when describing norm-referenced test results.
3. Allow parents opportunities to participate by asking about topics.
4. Anticipate questions prior to the interview and prepare answers.
5. Schedule adequate time for the interview.
6. Practice communicating with parents from a variety of backgrounds.
7. Avoid questionable or overly explicit predictions.
8. Be careful about terms that may be interpreted badly by parents (e.g. average range).
9. Do not engage in counselling beyond one’s level of expertise.
10. Be aware that some parents are not ready to accept test results.
11. Maintain a positive tone throughout the session and discuss the child’s strengths and competencies.
12. Use good, basic counselling skills by allowing the parent to talk about successes of raising a child.
13. Provide some discussion of the strengths of the child and parents early in the feedback session.

When giving feedback to the child, the clinician’s feedback may have negative consequences (e.g. telling a child that he has difficulty in social interaction may make the child less likely to interact with others). A person with a positive relationship with the child should deliver the news or the primary clinician should share the results in a counselling session when this is the case.