Improving Judgment and Interpretation
In this chapter, and in preceding chapters on inter-
viewing and assessment, we have discussed a variety of
factors that can reduce the efficiency and validity of
clinical predictions and interpretation. One cannot
presume to lay down a series of prescriptions that
will lead inevitably to perfect performance. Let us,
however, call attention to several factors that are
importanttokeepinmindasonemovesfromdata
to interpretation to prediction. Although the perfor-
mance of clinicians has not been good, there are ways
of making improvements (Faust, 1986; Garb, 1998).
Information Processing
As clinicians process assessment information, they
are often bombarded with tremendous amounts of
data. In many instances, this information can be
difficult to integrate because of its volume and
complexity. Clinicians must guard against the ten-
dency to oversimplify. It is easy for them to over-
react to a few“eye-catching”bits of information
and to ignore other data that do not fit into the
picture they are trying to paint. Whether the pres-
sure comes from an overload of information or
from a need to be consistent in inferences about
the patient, clinicians must be able to tolerate the
ambiguity and complexity that arise from patients
who are inherently complex.
The Reading-in Syndrome
We commented in an earlier chapter that clinicians
sometimes tend to overinterpret. They often inject
meaning into remarks and actions that are best
regarded as less than deeply meaningful. Because
clinicians are set to make such observations, they
can easily react to minimal cues as evidence of psy-
chopathology. What is really amazing is that the
world gets along with so many“sick”people out
there. It is so easy to emphasize the negative rather
than the positive that clinicians can readily make
dire predictions or interpretations that fail to take
the person’s assets into account. Garb (1998) points
out that clinicians who do evaluate clients’strengths
and assets in addition to assessing pathology and
dysfunction are less likely to pronounce clients as
maladjusted or impaired.Validation and Records
Too often, clinicians make interpretations or pre-
dictions without following them up. If clinicians fail
to record their interpretations and predictions, it
becomes too easy to remember only the correct
ones. Taking pains to compare the clinician’s view
with that of professional colleagues, relatives, or
others who know the patient can also help to refine
interpretive skills.Vague Reports, Concepts, and Criteria
One of the most pervasive obstacles to valid clinical
judgment is the tendency to use vague concepts and
poorly defined criteria. This process, of course, cul-
minates in psychological reports that are equally
vague. Under these conditions, it can be very diffi-
cult to determine whether clinicians’ predictions
and judgments were correct (which may be why
some of them use such shadowy terminology!).
To combat this problem, Garb (1998) recommends
that clinicians use structured interviews, structured
rating scales, objective personality tests, and behav-
ioral assessment methods to inform their clinical
judgment and predictions.The Effects of Predictions
Sometimes predictions turn out to be in error not
because they were based on faulty inferences, but
because the predictions themselves influenced the
behavioral situation. For example, a prediction
that a patient would have difficulty adjusting at
home after release from the hospital may have
been correct. However, the patient’s relatives may
have accepted the prediction as a challenge and
therefore provided an environment that was more
conducive to the patient’s adjustment than it would
have been in the absence of the prediction. Thus,
the very act of having made a judgment may serve298 CHAPTER 10