Rorschach

[PsychologistinTraining]

Hello! I am a PsyD student in my post-doc year. I recently completed a 5-day training on the R-Pas and working with my supervisor to incorporate it into the Assessment Center where I work (for appropriate cases). We used to use the Comprehensive System. One hurdle I've come across... the findings report delivered by the R-Pas system has a great deal of information, but it's challenging for me to translate into a reader-friendly report. Does anyone have any recommendations on how to relay the information in an efficient way?

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[WisNeuro]

The most efficient and empirically driven way to communicate Rorschach findings? Do you have a shredder in the office?

 

[Sanman]

Sorry, I was trained on Exner's system. Once gave a 3+ hour long Rorschach to a rather psychotic seeming 9 year old and then never touched it again. I still shudder thinking about it when I move the Exner book on my shelf.

 

[PsyDr]

I actually trained with Exner. Not the dumbest two weeks of my life, but not the smartest. Totally useless as a diagnostic tool, or a tool in forensics. Maybe useful in long term depth psychoanalysis.

Plus we all know that the best way of dealing with feelings is to suppress them, or make jokes. And that comes from someone who touched JFKs testicles!

 

[WisNeuro]

I actually trained with Exner. Not the dumbest two weeks of my life, but not the smartest. Totally useless as a diagnostic tool, or a tool in forensics. Maybe useful in long term depth psychoanalysis.

Plus we all know that the best way of dealing with feelings is to suppress them, or make jokes. And that comes from someone who touched JFKs testicles!

I mean, who hasn't touched those testicles?

 

[psych.meout]

I mean, who hasn't touched those testicles?

 

[PsyDr]

I mean, who hasn't touched those testicles?

Read the Grant study by Valliant. They used to take nudes of everyone entering Haaaavard.

 

[WisNeuro]

Read the Grant study by Valliant. They used to take nudes of everyone entering Haaaavard.

You mean that's not a standard part of freshman move in at any university?

 

[quickpsych]

We were taught the Rorshach in grad school and also I know some psychologists who utilize it in their private practice. For the computer printouts, you should be able to do a interpretative report that describes more "robustly" the findings including interpersonal tendencies, stress management, locus of control, etc etc. I know some psychologists who have found some of these tie in nicely alongside MCMI and MMPI. The TAT and Sentence Completion comes up too with these integrations.

That said I'm not a huge fan of the Rorshach, I find it interesting but clunky and some of the "findings" can sometimes feel like reading a horoscope and not an assessment report.The interpretative report seems to take a lot of liberty in telling you what someone long ago would have thought of the results; if that makes sense. As you said it can be hard to find the useful information in the report, which I think can lead to cherry picking tendencies (rightly or wrongly) where you can find a result that lines up with what one might think "fits" that particular person. So in that way , find it pretty dated.

 

[psycho1391]

Hello! I am a PsyD student in my post-doc year. I recently completed a 5-day training on the R-Pas and working with my supervisor to incorporate it into the Assessment Center where I work (for appropriate cases). We used to use the Comprehensive System. One hurdle I've come across... the findings report delivered by the R-Pas system has a great deal of information, but it's challenging for me to translate into a reader-friendly report. Does anyone have any recommendations on how to relay the information in an efficient way?

Hi! Happy to send you a few of my redacted reports from grad school. I trained in both systems and am happy to help! Just PM me to remind me. I leave for a conference in a few days and may be busy, so you may have to keep bugging me.

Also happy to talk about integrating the report if you want a zoom meeting.

 

[texanpsychdoc]

Hello! I am a PsyD student in my post-doc year. I recently completed a 5-day training on the R-Pas and working with my supervisor to incorporate it into the Assessment Center where I work (for appropriate cases). We used to use the Comprehensive System. One hurdle I've come across... the findings report delivered by the R-Pas system has a great deal of information, but it's challenging for me to translate into a reader-friendly report. Does anyone have any recommendations on how to relay the information in an efficient way?

My program required us to take a the full 15-week semester course on the Rorschach in addition to a stand-alone projective class that overviewed other projective tests. I was also a TA for the Rorschach a year later and have saved some mock reports. Shoot me a private message and I am glad to share with you.

 

[Justanothergrad]

Hello! I am a PsyD student in my post-doc year. I recently completed a 5-day training on the R-Pas and working with my supervisor to incorporate it into the Assessment Center where I work (for appropriate cases). We used to use the Comprehensive System. One hurdle I've come across... the findings report delivered by the R-Pas system has a great deal of information, but it's challenging for me to translate into a reader-friendly report. Does anyone have any recommendations on how to relay the information in an efficient way?

I know Greg and Joni, years ago interviewing in their lab. I also was trained in the Rorschach (non-Rpas) by various folks, although not with Exner specifically (folks trained by Whitehead, Menninger's, etc). That said, I tend to agree that the predictive utility is lost relative to other measures and I dont use it / favor it despite my main area of work falling within personality assessment. Despite the issue being the instrument in the thread, the broader issue here is how you identify and describe clinical content in a concise manner. The same issue occurs on other measures, including broadband measures with countless scales (e.g., MMPI family/PAI, etc). I suggest you back up from thinking about a specific instrument and think about the content being evaluated and conceptualize that way.

A second, larger, issue is that you are asking here rather than guidance coming from your supervisor. Ask them what they want. They should give you examples, templates, or detail how it should be written.

 

[smalltownpsych]

Hello! I am a PsyD student in my post-doc year. I recently completed a 5-day training on the R-Pas and working with my supervisor to incorporate it into the Assessment Center where I work (for appropriate cases). We used to use the Comprehensive System. One hurdle I've come across... the findings report delivered by the R-Pas system has a great deal of information, but it's challenging for me to translate into a reader-friendly report. Does anyone have any recommendations on how to relay the information in an efficient way?

I don’t know anything about the system, but concise report writing has always been my forte. It sounds like you might be must overwhelmed with data. Hit the main points first, then break it down into domains of relevance. Usually start with validity and assessment observations. Outlines can really help with the structure. Create the outline and then just fill in the blanks. Also, when overwhelmed just start putting stuff down and organize and edit it later on. Move on to sections you feel more confident with. Kind of like test taking strategy, don’t spend too much time stuck on something because the answer might come easier when you come back to it later.

 

[cara susanna]

I also was trained on Exner (for one of my practica).

 

[Pragma]

I also was trained on Exner (for one of my practica).

Me too. Felt like a waste of time looking back?

 

[medium rare]

Me too. Felt like a waste of time looking back?

Ditto. Trained in Exner in grad school. I’ve done a whopping 2 Rorschachs in 18 years. Highly doubt I’ll ever administer one again.

 

[WisNeuro]

Me too. Felt like a waste of time looking back?

Yeah, we were fully trained, did a few in our training cases. Then they went over all of the research about how useless the Rorschach was. It was actually a pretty good lesson in knowing the research behind the instruments that you use, something that has been falling by the wayside in graduate programs.

 

[ClinicalABA]

Me too. Felt like a waste of time looking back?

Way back when I was in Grad school, we were expected to take the Rorschach class in our third years to complete our assessment course requirement. A classmate and I were the first in the known history of the program to basically say "no thanks." My only other realistic option was to wait until 4th year and take what, at the time , I thought was a useless class in child assessment (I was focusing on gerontology at the time). Classmate designed a neuropsych training practicum with didactics to meet her requirement. I now do exclusively child assessment and she's a very productive AD researcher at an AMC. I guess in part we each have old Hermann and his inkblots to thank for our careers!

As an aside, Brad Pitt could play Rorschach in a movie (it really should be a comedy)- there is quite a resemblance.

 

[PsychologistinTraining]

Hi! Happy to send you a few of my redacted reports from grad school. I trained in both systems and am happy to help! Just PM me to remind me. I leave for a conference in a few days and may be busy, so you may have to keep bugging me.

Also happy to talk about integrating the report if you want a zoom meeting.

Thank you so much! I just sent a direct message via "conversations."

 

[erg923]

Hello! I am a PsyD student in my post-doc year. I recently completed a 5-day training on the R-Pas and working with my supervisor to incorporate it into the Assessment Center where I work (for appropriate cases). We used to use the Comprehensive System. One hurdle I've come across... the findings report delivered by the R-Pas system has a great deal of information, but it's challenging for me to translate into a reader-friendly report. Does anyone have any recommendations on how to relay the information in an efficient way?

The information you get from all this administration and interpretation work is suspect in terms of validity, and even more so into translating it into a functional psychiatric treatment plan that adds value or differentiates it from ones where this was never done. I know many psychologists like to think it does, but it simply does NOT in the vast majority of cases. I work for a large company that has records on literally thousands and thousands of patients/members whom have had this done (at least based on records submitted). Thus, I can assure you what I am saying here is true.

I agree that this can all be very facinatin.... and yield some interesting "hypotheses." I just don't know why a skilled therapist cannot discover most of this during the first few counseling sessions with patient/family (which is exactly what is suppose to be happening as part of the initial therapy process). Maybe if there is some significant obstinance or selective mutism going on in a child/adolescent? Maybe.

 

[Therapist4Chnge]

Ditto. Trained in Exner in grad school. I’ve done a whopping 2 Rorschachs in 18 years. Highly doubt I’ll ever administer one again.

Same. It was a required class, which was stupid. I basically just argued with the professor about the actual utility of it in clinical practice. He was fond of saying that after the first couple/few hundred, it is easier to incorporate into clinical work. I thought it was mostly voodoo that can be bested by a solid clinical interview and record review. I thought Psychodynamic stuff was interesting in theory, but not practical.

 

[psych.meout]

The information you get from all this administration and interpretation work is suspect in terms of validity, and even more so into translating it into a functional psychiatric treatment plan that adds value or differentiates it from ones where this was never done. I know many psychologists like to think it does, but it simply does NOT in the vast majority of cases. I work for a large company that has records on literally thousands and thousands of patients/members whom have had this done (at least based on records submitted). Thus, I can assure you what I am saying here is true.

I agree that this can all be very facinatin.... and yield some interesting "hypotheses." I just don't know why a skilled therapist cannot discover most of this during the first few counseling sessions with patient/family (which is exactly what is suppose to be happening as part of the initial therapy process). Maybe if there is some significant obstinance or selective mutism going on in a child/adolescent? Maybe.

And that's the crux of the issue. Even if the Rorschach and projective testing in general produced insights for the issues and populations for which their scores/data have been validated, the incremental validity is very low compared to other assessment methods that are significantly cheaper, shorter, and easier.

 

[medium rare]

I thought it was mostly voodoo that can be bested by a solid clinical interview and record review. I thought Psychodynamic stuff was interesting in theory, but not practical.

Or by the Magic 8 Ball or reading the Tarot…

 

[smalltownpsych]

Agreed with above posters. Little to no clinical utility and I can get the information from interacting with the client. They will lay out their projections aka manifestations of core beliefs or schemas when they describe their interactions with others and as I experience the way they interpret or react to my responses. I guess people just want to complicate things that are pretty simple. Got to be a psychological principle there, just can’t think pf what applies.

 

[WisNeuro]

Agreed with above posters. Little to no clinical utility and I can get the information from interacting with the client. They will lay out their projections aka manifestations of core beliefs or schemas when they describe their interactions with others and as I experience the way they interpret or react to my responses. I guess people just want to complicate things that are pretty simple. Got to be a psychological principle there, just can’t think pf what applies.

But how else will I know that the patient is depressed if I don't give them the Rorschach? Oh, you mean I can give a 2 minute questionnaire, or simply talk to them for a few minutes? But then, how do I bill an inordinate amount of time for the assessment?

 

[ClinicalABA]

The information you get from all this administration and interpretation work is suspect in terms of validity, and even more so into translating it into a functional psychiatric treatment plan that adds value or differentiates it from ones where this was never done. I know many psychologists like to think it does, but it simply does NOT in the vast majority of cases. I work for a large company that has records on literally thousands and thousands of patients/members whom have had this done (at least based on records submitted). Thus, I can assure you what I am saying here is true.

I agree that this can all be very facinatin.... and yield some interesting "hypotheses." I just don't know why a skilled therapist cannot discover most of this during the first few counseling sessions with patient/family (which is exactly what is suppose to be happening as part of the initial therapy process). Maybe if there is some significant obstinance or selective mutism going on in a child/adolescent? Maybe.

You still seeing the TAT or House-Tree-Person?

 

[AcronymAllergy]

You still seeing the TAT or House-Tree-Person?

I can't speak for Erg, but I've seen both in reports from providers in the local-ish community. Not often, but it's happened.

 

[WisNeuro]

I can't speak for Erg, but I've seen both in reports from providers in the local-ish community. Not often, but it's happened.

I'll see them once or twice a year.

 

[PsyDr]

Agreed with above posters. Little to no clinical utility and I can get the information from interacting with the client. ...

It's a great test of how much BS a patient is willing to put up with.

So is the TPT.

 

[smalltownpsych]

You still seeing the TAT or House-Tree-Person?

Speaking of house tree person, I remember an online degree fake psychologist telling all the counselors at a CMH that a knot meant sexual trauma and how far up the tree meant how they were when it happened. Pretty sure that there is absolutely no evidence to support the validity of that. I had heard it once before from another source so I guess it’s a belief that is out there, but I never had the energy to even look into it to see how bogus the claim was. In my mind, the burden of proof for that kind of crap needs to be on the one promoting it. Although maybe the APA could come out with a useful list of all the things that are demonstrably not true and post it online. That could actually be something helpful.

 

[ClinicalABA]

Speaking of house tree person, I remember an online degree fake psychologist telling all the counselors at a CMH that a knot meant sexual trauma and how far up the tree meant how they were when it happened. Pretty sure that there is absolutely no evidence to support the validity of that. I had heard it once before from another source so I guess it’s a belief that is out there, but I never had the energy to even look into it to see how bogus the claim was. In my mind, the burden of proof for that kind of crap needs to be on the one promoting it. Although maybe the APA could come out with a useful list of all the things that are demonstrably not true and post it online. That could actually be something helpful.

I was trained in some similar nonsense. Also remember something about the size of the person's hands also signifying abuse of some sort. I also remember a professor encouraging us to present a blank piece of paper after the standard TAT cartoons (or whatever you call them), as that can be "a rich source of information about the psyche" (I think he meant the client's psyche, but it told me more about his). Haven't touched that stuff since.

 

[Sanman]

I personally could never get past the interpretation of food responses in the Exner system. I figured if it was 2pm and we hadn't eaten lunch yet, I'd be seeing burgers and pizza everywhere.

 

[calimich]

Speaking of house tree person...

During grad school I completed a 600-hour school-based assessment practicum which was based out of the county's department of education. It was good training and I got to attend IEP meetings, talk with teachers, and observe and test children and adolescents at "regular" schools, continuation schools, and programs located within juvenile detention facilities. I was introduced to many reputable instruments -- WISC, WIAT, WRAT, PIC, CDI, PPVT, EVT, Kaufman, Vineland, BASC, Conners, Brown, Gilliam, CARS -- and the Thematic Apperception Test (TAT) and House-Tree-Person (HTP). I never saw the TAT administered or read any reports that used it, but the HTP was part of the standard battery. It occupied a very small part of the final report and the supervising psychologist was appropriately skeptical and didn't give it a lot of attention, but I learned to administer it and basics of interpretation. I did think it was interesting to observe how kids responded differently to the same prompt.

The college has lots of assessments, including the TAT. When covering assessment in class I always bring examples of several instruments and we have some fun with the TAT. I show a few images on the big screen and invite students to mentally project their stories before sharing in small groups whatever they are comfortable. Lively discussions always follow and the image interpretations span the morbid to the hopeful. As a parent, I can't help myself from noticing the kids' drawings when I volunteer in my 6-year old's class. Whose house has a broken window? Does the tree have fruit? What's up with the size of those hands?

Interesting and useful to spring conversation, perhaps reflection, however I don't use them in my own clinical practice and don't recommend them to students.

 

[smalltownpsych]

I’ve worked with lots of kids and agree that pictures and ways they play can provide insights. I’ll never forget the girl that took the mommy and the daddy doll from the little dollhouse and threw the dad on the ground and the mommy in the trash. Apparently being abandoned and neglected because of substance abuse caused this young lady to have a little bit of anger.
I just think it’s a problem when we overvalue or over interpret one source of info that has extremely low validity.

 

[AcronymAllergy]

It's a great test of how much BS a patient is willing to put up with.

So is the TPT.

I'm convinced the TPT was primarily developed as a covert form of punishment for patients and graduate students who irritate you.

 

[PsyDr]

If

I'm convinced the TPT was primarily developed as a covert form of punishment for patients and graduate students who irritate you.

Years ago, I did a deep dive into the entire brain tumor HRB stuff. Spent tons of money tracking down very old handout materials from Reitan's workshops. "How the hell did he know it was a glioma, stage 2?", I'd ask myself.

This sick bastard was sitting fully hemiparetic patients down in front of the TPT, letting them max out on time on the paralyzed side, and then reporting the data. That was one of the days I started questioning the purely psychometric approach.

 

[AcronymAllergy]

If

Years ago, I did a deep dive into the entire brain tumor HRB stuff. Spent tons of money tracking down very old handout materials from Reitan's workshops. "How the hell did he know it was a glioma, stage 2?", I'd ask myself.

This sick bastard was sitting fully hemiparetic patients down in front of the TPT, letting them max out on time on the paralyzed side, and then reporting the data. That was one of the days I started questioning the purely psychometric approach.

Wow. I mean, I guess that's one way of ensuring there's a significant difference in scores between hands that coincides with pathology.

Reitan seemed like an...interesting guy.

I gave the HRB in its near-entirety dozens and dozens and dozens of times in grad school. Never made someone with hemiparesis go through the TPT. Probably why I don't have a test battery named after me.