Multimethod approaches to assessment are typically more useful for accurate diagnosis and treatment planning due to the case formulation process. These approaches recognize the complexity of an individual and take their history, self-perception, social perception, and the underlying dynamics that influence their behaviour into account using data obtained from diverse modalities. As such, clinicians are better able to engage in interpretative reasoning that is more nuanced, triangulating evidence from multiple sources to make a more complete picture across contexts. Additional benefits include more active and reflective participation from both client and clinician, thereby mitigating self-report bias by including clinician-rated observations (especially important in ego-syntonic symptoms re: personality disorders). Therapeutic Assessment (Finn, 2007) is a patient-centered semi-structured approach to psychological assessment, where clients and clinicians generate questions, choose assessment methods, and use test data to inform interventions in order to build therapeutic alliance and deepen patient self-understanding. This kind of approach has been found to improve motivation for further treatment (leads to a strengths-based therapeutic method and better therapeutic alliance before treatment even begins). Despite its empirical backing, there is a gap in the literature on the efficacy of TA when embedded into the structure of doctoral training - a concerning finding given the reduced emphasis on integrative and formulation-driven assessment practices over building test administration and procedural competencies.
The Therapeutic Model of Assessment is a simplified adaptation of TA, allowing it to be more feasible in a trainee setting. Using a retrospective comparison group, the current study found that implementing TMA overall resulted in improved therapeutic alliance, as well as a reduction in symptoms and dropout rates. Additionally, in the case of personality disorders, TMA was found to especially reduce the rate of dropout compared to the no-TMA group. Finally, this finding remained true even for clients with more complex personality pathology (i.e. comorbidity).
First episode psychosis (FEP) is associated with differences across multiple Five Factor Model personality dimensions, not just neuroticism. Specifically, three main personality profiles were found to be associated with FEP, and one of these profiles was associated with psychotic symptoms. These profiles were stable over time.
This study examines the predictive value of personality traits on therapeutic outcomes for FEP engaging in group treatment, specifically either CBT or skills training for symptom management. This RCT randomly assigned participants to one of the two group treatments or to a wait-list (control group). Personality inventory (NEI-FFI), symptomology outcomes (BPRS-E), and coping strategies (CCS) were all measured. The researchers found an overall link between personality traits, symptoms, and treatment outcomes in each group intervention. Personality traits were especially associated with changes in active coping strategies. Conscientiousness accounted for 14% of the variance in the CBT group, Extraversion accounted for 41% of the variance in the SM group, and Openness to experience accounted for 22% of the variance in the control group.
This study examines the predictive value of personality traits on therapeutic outcomes for recent onset psychosis (early psychosis but not necessarily first episode) engaging in group treatment, specifically either CBT or skills training for symptom management. This RCT randomly assigned participants to one of the two group treatments or to a wait-list (control group). Personality inventory (NEI-FFI), symptomology outcomes (BPRS-E), and coping strategies (CCS) were all measured. Cluster analysis found three personality profiles, but none were linked with psychotic symptoms. Personality traits were also not linked to symptomatic treatment outcomes, but were linked to behavioural changes (i.e. active coping strategies) where extraversion accounted for 17% of the variance. Active coping strategies were also predicted by profile 1 (highest openness) (26% of the variance) and profile 3 (highest extraversion)(14% of the variance). Greater use of passive coping strategies were associated with neuroticism.