Personality Assessment with Adolescents: Challenges and Guidelines
Crespi, Tony D., Politikos, Natalie N., Adolescence
Adolescents are facing a growing array of socioemotional and mental health issues. Marsh (2004) notes, for instance, that approximately 4.5 to 6.3 million children and adolescents in the United States have a serious emotional disturbance that undermines functioning and presents risk for their future. Elsewhere, Crespi and Giuliano (2001) noted that juvenile delinquency and childhood violence is escalating. Without qualification, youth are at risk for mental health issues. In fact, Roberts et al. (1998) noted that children and adolescents represent a large segment of the population with unmet mental health needs. Ysseldyke, Dawson, Lehr, Reschly, Reynolds, and Telzrow (1997) noted that the "student population entering the American classroom is more challenging than at any time in our recent history" (p. 1).
Fortunately, there is cause for optimism. Ringeisen and Hoagwood (2002) note advances in identification and diagnosis of serious emotional disturbances in children and adolescents. At the same time, large numbers have comorbid disorders, with more than 40% possessing co-occurring substance abuse disorders alone (Substance Abuse and Mental Health Services Administration, 2002).
Clearly, there is a pressing need for mental health interventions for youth with emotional disturbances (APA Subcommittee on Children and Family, 2003). At the same time, the complexity of issues is significant. As an example, co-occurring disorders are prominent in youth. Bukestein (1994) observed that many psychiatric disorders occur in adolescence, and this is not unlikely to escalate to substance abuse disorders. Marsh (2004) observed that students with emotional disturbance often have multiple problems, observing, as one example, that only 42% graduate from high school.
Hodges (2004) noted that psychological evaluations can be critical in accessing services, describing current functioning, serving as a baseline, and generally maximizing treatment utility. Most clearly, psychological assessment, remains a cornerstone of professional practice for school psychologists who specialize in this age group. In fact, Fagan (2002) observed that school psychologists spend approximately half of their time in assessment, with Hosp and Reschly (2002) noting, by region, a range of 19 to 26 hours weekly devoted to assessment! In a basic way, personality assessment is not new. Childs and Eyde (2002) observed that the Boulder Conference in 1948 identified personality appraisal as one of the core areas of professional practice. More recently Stedman, Hatch, and Schoenfeld (2000, 2001) reported that internship directors viewed training in objective personality testing and projective personality testing as important, in addition to training in cognitive assessment.
In short, personality assessment as one component of a comprehensive psychological evaluation is not new and has been historically important in the assessment domain. In fact, tools used in personality assessment can offer unparalleled assistance in diagnosis, and assist in designing appropriate interventions. Unfortunately, not all school psychologists embrace personality assessment as a key component in conducting a comprehensive psychological evaluation, nor do all programs offer extensive training in this aspect of psychological assessment. Furthermore, the more subjective nature of certain personality assessment techniques and the concern of the validity of findings as they pertain to litigation have further curbed this domain. This article examines the effective use of personality assessment tools, with particular attention to issues of co-morbidity. Guidelines for effective practice are also offered.
MENTAL HEALTH ISSUES
In a fundamental way children's and adolescents' mental health needs remain underserved. The U.S. Public Health Service (2000) ob served that children, overall, do not have the necessary access to mental health services. Moreover, epidemiological studies indicate that approximately 20% experience a DSM-IV disorder (Costello et al. …