When the Assessor's Limits Are Tested: Enactments and the Assessment Frame in Psychological Testing.

Limit testing in psychological assessment is understood typically as a unidirectional technique in which the assessor intentionally introduces a parameter(s) in the service of data gathering by modifying standard procedures. Other parameters are introduced as conflict-based enactments tied to projective identification processes, and represent modifications in the assessment framework. Such modifications, abstracted from the psychotherapy literature, include atypical shifts in the assessor's usual practices concerning fees, scheduling, confidentiality, privacy, anonymity, administrative and technical procedure, and intervention style. In this article, I suggest that most framework modifications, if analyzed, hold the promise of an incremental data yield. These points are illustrated through discussion of (a) the assessment frame, enactments, and projective identification; (b) transference-countertransference interplay in response to frame issues; (c) 2 Rorschach responses that symbolically reflect enactments and projective identification; (d) interaction with coding consultants; (e) configurational analyses of the Rorschach responses; (f) patient-assessor and assessor-consultant parallel processes; and (g) test feedback.

Discussion of difficult assessment cases: psychodynamic perspectives.

I discuss the papers of Kleiger (this issue), Husain (this issue), and Bram (this issue), each of whom described their personality assessment of a very challenging case. Each case illustrates the way in which experienced personality assessors integrate psychoanalytic theory with clinical reasoning, multi-method assessment, and an understanding of the patient-examiner relationship when evaluating patients with serious psychiatric needs. The discussion elaborates particular aspects of each case and integrates the different estuaries through which personality assessors use psychoanalytic theory to develop diagnostic and treatment inferences.

Psychoanalytic interpretation of superego functioning following CS readministration procedures: case illustration.

The Comprehensive System (CS; Exner, 2003) has specific procedures to address brief Rorschach protocols when the first administration yields fewer than 14 responses. These procedures involve the assessor's asking the client to retake the test by providing more responses on the second administration than the first administration. The request carries with it an implicit criticism of the client's initial effort and a mandate to improve performance on retake. The retake request, with its ambiguously worded demand for improved performance, engages the client's superego (i.e., the client feels judged) and makes it possible to study superego manifestations (e.g., guilt, shame) on the Rorschach test, using a model of (a) brief first record, (b) retake directive, and (c) second administration. We present a case that illustrates a clinical strategy, modeled on a psychoanalytic understanding of the CS retake procedure, for studying the client's superego functioning under retest conditions.

An integrative approach to assessment supervision.

Psychological assessment supervision requires the application of technical, conceptual, and interpersonal interventions that address the supervisee's skills, knowledge, and ethical competencies. This article discusses assessment domains that are fundamental to helping trainees refine technical and reasoning skills, and utilizes Jacob, David, and Meyer's (1995) application of Johnson-Laird's (1988) typology of thought as a supervisory technique that encourages the supervisee's inductive, associative, creative, and self-reflective thinking in response to clinical situations. A clinical illustration is presented.

Case illustration of a boy with nonverbal learning disorder and Asperger's features: neuropsychological and personality assessment.

I present a case study of a latency-age boy referred for assessment of a nonverbal learning disability/disorder (NLD) who also had features of Asperger's syndrome (AS). I review NLD terminology, presumed brain-behavior relationship, neuropsychological profile, and diagnosis/classification issues. I discuss the challenge of differentiating NLD from AS in relation to the client's pattern of visual-spatial, communication, social-emotional, and behavioral NLD correlates. I integrate neuropsychological and personality assessment data with interviews, observations, prior testing, and input from teacher and therapist in formulating a diagnostic impression. I discuss Rorschach (Exner, 2003) and neuropsychological consultations in relation to subtle language and interpersonal features of the client's communication style. I provide parent feedback at 18 and 24 months posttesting. I discuss implications relative to a model of school neuropsychological assessment that includes the Rorschach test.