The Integration of Traditional and Collaborative Approaches to Psychological Assessment: Recommendations for Graduate Training

Psychological Assessment in Clinical Psychology

Psychological assessment has long been one of the foundational responsibilities of clinical psychologists. Reviewing the history of psychological assessment, Weiner (2013) noted that it always has and always will have a place in the field of clinical psychology. As such, it stands as a pillar of clinical training.

Looking ahead, this responsibility is unlikely to diminish. According to projections by Norcross et al. (2021), psychological assessment will be one of the competencies that distinguishes psychologists from master’s-level clinicians over the next decade. Given its enduring role in defining psychologists’ scope of practice, training student clinicians to conduct high-quality psychological assessments remains essential. In response to this need, this paper introduces an integrated model designed to combine collaborative psychological assessment principles with traditional assessment training.

Collaborative and Traditional Approaches to Psychological Assessment

In collaborative assessment, the examiner works interactively with the examinee to elicit the examinee’s voice throughout the assessment process, including their perspective on the selection of test measures and how the report is written (Finn et al., 2012; Finn & Tonsager, 1997; Fischer, 2000). Beyond its role in the assessment process, collaborative assessment may also function as a prelude to treatment, serving as an initial therapeutic experience that promotes engagement in psychotherapy. Research by Aschieri et al. (2023) suggested that using a collaborative assessment method increased client engagement in therapy, symptom relief, and self-growth.

By comparison, traditional assessment is defined as the standard and more objective approach to psychological assessment. It includes a structured clinical interview and administration of a series of cognitive, emotional, and personality measures selected by the examiner without feedback from the examinee. The focus of traditional assessment is primarily on the “data,” rather than fostering psychotherapeutic engagement with the examinee. If psychotherapy is suggested, it is typically recommended as a separate service provided by a psychotherapist in the community.

An Integrated Model for Graduate Training

Although these approaches differ in emphasis, they need not be mutually exclusive. The integrated model proposed in this paper is not meant to replace how people are assessed via a traditional assessment, but rather to enhance graduate training and, ultimately, the quality of psychological assessments. An integrated model places greater emphasis on the examinee’s subjective experience, including the emotional, interpersonal, and cognitive factors throughout the assessment process. For the student clinician, the goal is to develop the skills necessary to gather and synthesize clinically relevant information, strengthen interpersonal and critical thinking abilities, attend to multicultural considerations, and produce integrated reports with meaningful, individualized treatment recommendations. For examinees, the goal is to create an assessment experience that fosters a sense of being understood, respected, and meaningfully involved in the diagnostic process.

While traditional forms of assessment remain the gold standard in the field, there has long been a split between traditional and collaborative schools of thought. Among the earliest critics of traditional testing, Dana and Leech (1974) commented on the “omnipotent” role of the examiner, whose position of authority over the examinee created the potential for exploitation. Proponents of collaborative assessment have generally questioned the quality, relevance, and generalizability of traditional assessment results when insufficient attention is given to the examinee’s subjective experience within the context of the assessment (Fischer, 2000). They believe that traditional forms of assessment may lead the client to feel objectified by a process that places emphasis on the data over the person and may over-pathologize the client (Finn & Tonsager, 1997).

Incorporating an integrated approach into graduate training may address some of the shortcomings associated with the more formal, stand-alone, traditional assessment graduate training and result in a more interpersonally attuned, conceptually minded diagnostician. In turn, student clinicians may become more equipped to synthesize data within the broader context of the individual being tested and produce more highly integrated and individualized reports, fostering stronger buy-in of the diagnosis and engagement in treatment.

Graduate Training in Psychological Assessment: A Brief Literature Review

Research on graduate training in psychological assessment has shown a consistent set of trends over the last decade. Graduate programs continue to emphasize intellectual, achievement, and objective personality measures, while training in projective assessment has declined (Ingram et al., 2019; Piotrowski, 2015; Ready & Veague, 2014). This has left student clinicians with a narrower training experience that has perhaps led them to feel inadequately prepared prior to practicum and internship (Ingram et al., 2019; Yarrington et al. 2023).

Mihura et al. (2017) pointed to a lack of uniformity in graduate training based on whether a program operates from a practitioner-science or science-practitioner model. Practitioner-science models place greater emphasis on practical training of student clinicians grounded in empirical science, with graduates most often pursuing a career in applied clinical settings. In contrast, science-practitioner models emphasize the primacy of scientific training in clinical psychology, with graduates more often pursuing careers in research and academics. Correspondingly, science-practitioner programs have seen the largest decrease in the training and use of projective measures (Mihura et al., 2017). These trends highlight broader differences in how psychological assessment is conceptualized and taught across graduate programs, raising questions not only about which assessment methods student clinicians learn, but also about how they are trained to approach the assessment process itself.

A Synthesis of Traditional and Collaborative Assessment Models

This paper proposes a synthesis of selected collaborative concepts within the traditional framework to maximize the diagnostic training of student clinicians. The integrated model encourages the development of student clinicians who become confident, observant, relationally fluid, and perceptively attuned. Reports are written that speak not only to the data, but to how the examinee emotionally responds to instructional sets, imposed structure, time limits, ambiguity, and cognitive and emotional vulnerabilities. Stated differently, this student clinician considers a wide range of “results” that are integrated within the experiential world of the person on the other end of the assessment.

Examples of these wide ranging results might include observational interactions with examinees who become overly concerned with being liked by the examiner, ask excessive questions that go beyond the basic instructional set, become easily overwhelmed by timed tasks, feel the need to overly explain why they got an answer wrong, seek excessive reassurance, or demean the task of telling stories to cards or describing what ink blots look like. Such behaviors may clarify the examinee’s overall self-awareness, interpersonal style, frustration tolerance, obsessiveness, and/or provide glimpses into how they handle ambiguity. This information may offer alternative perspectives for interpreting the broader dataset or reinforce clinical impressions supported by the assessment data.

More so than the stand-alone traditional assessment, the integrated model allows for a clearer understanding of the person within the assessment process. Opportunities arise that allow the student clinician to get to “know” the person sitting across from them. Personally relevant and realistic recommendations become easier to generate from this more intimate way of relating to and understanding the examinee.  

Recommendations for Graduate Training in Psychological Assessment

The following collaborative suggestions might be considered to maximize the traditional approach to graduate training in psychological assessment.

Recall and Query of Behavioral Observations

While behavioral observations are described in the psychological report, they may not be relevant to the context of the administration and interpretation of the test results. The author refers to these as generic observations, meaning they are made without much thought beyond noting an observed behavior. Examples of generic observations include the following: the client was cooperative, the client looked to the floor, or the client fidgeted during the administration of card one of the Thematic Apperception Test (TAT). The important question, however, is how these observations are relevant to the rest of the clinical data.

Particularly for student clinicians, there can be a need to observeto record rather than observe to understand what the behavioral observations say about the examinee in the context of the assessment. Observations may be noted to box-check and complete the report. While student clinicians may identify important behaviors, they may not move beyond describing them in the behavioral observations section to consider their broader relevance to the examinee’s functioning. For instance, might the fidgeting to card 1 of the TAT reflect a genuine discomfort with ambiguity or a connection with the boy that was described as feeling alone? Without follow-up or integration with other assessment findings, the clinical significance of such observations may remain unclear. Student clinicians should be encouraged to explore these behaviors within the collaborative relationship between examiner and examinee and consider how they may contribute to the broader case conceptualization.

The Recall/Query section begins after the formal test administration is completed. This is the time for the student clinician to review all noted behavioral observations in order to determine their meaning and relevance. The student clinician begins by reading through each behavior observation starting with the first observation. Consider the following example.

Student Clinician: I noticed that you laughed a few times when I asked about your current relationship with your mother. Can you tell me more about that?

Examinee: It’s just I feel like I can’t ever live up to her standards.

Student Clinician: Standards?

Examinee: She’s just so controlling, like she doesn’t want me to grow up.

Student Clinician: She doesn’t want you to grow up?

Examinee: She makes me anxious. I’ve always been so anxious around her so I just shut down and do what she tells me.

The query should be focused and brief given that a clinical interview has already been conducted. Unless significantly relevant clinical information is uncovered (as in the case that follows), the student clinician should limit the query to a simple reflective question or a restatement of the client’s words.

The following example illustrates how Recall/Query can generate diagnostically meaningful information that might otherwise remain undiscovered. The observed behaviors are from a young adult examinee during administration of the TAT.

One of her queried responses (shaking leg rapidly) was in relation to card 6GF, which depicts a woman opening a door with her arm over her head. The examinee noted that the card evoked the childhood trauma of seeing her mother leave her brother’s room on Christmas Eve morning. Her brother died of a drug overdose. The trauma was never discussed among the family. Her mother succumbed to a prolonged depression in which she became emotionally unavailable. The father began drinking heavily. The event led to the client having to navigate through her high school years without much support or direction. She felt abandoned in her grief, which led to low self-esteem. None of this was generated from the original clinical interview beyond the examinee mentioning that her brother died of a drug overdose.  

The examinee added that the card caused her to shut down and speed through the rest of the TAT and subsequent tests that followed. The examiner thought she was resistant when, in reality, the card elicited a trauma response that caused her to emotionally disconnect. She felt “on edge” for the duration of the assessment, which interfered with her ability to focus and effectively participate.

When asked about looking out the window, she noted that the topic of college made her feel like she was not living up to expectations. This led to a discussion about how she often felt like she was floating in space, anxious, distracted, and unfocused.

These observations raise important questions about the nature of the attentional difficulties for which the examinee initially sought testing. Do they reflect an underlying attention-deficit disorder, or might they be better understood as trauma-related symptoms, contextual and relational factors, or personality dynamics, particularly given the reported absence of childhood symptoms? Whatever the case, none of this relevant information could have been generated without the collaborative recall.

The Question-and-Answer Phase

Time should be set aside for the examinee to ask questions about their experience of the assessment. While questions related to test integrity cannot be addressed, time can be spent discussing thoughts and feelings evoked during the assessment. This might provide relevant information based on the questions asked by the examinee, including feelings related to multicultural factors and aspects of the assessment perceived as more or less difficult. Examinees might discuss how they performed, seek reassurance, or voice relief that the process is over. Some may not wish to engage and show little interest in the outcome; all of which may say something about the individual’s cognitive and emotional process, relational style, associated personality features, avoidance, and/or ways of relating to an authority figure.

Personalized and Practical Treatment Recommendations

Student clinicians may suggest treatment recommendations that read as generic or less than practical. In defense of the student clinician, recommendations may be difficult to develop, particularly if they have limited familiarity with the resources, services, and referral options available within the communities in which they are training. This could be addressed early in the training year by making them responsible for identifying available community resources (i.e., psychiatrists, community mental health, domestic abuse agencies, yoga studios, art classes, etc.).

Even with this in mind, recommendations may fail to resonate with examinees, who may perceive them as unrealistic or impractical. For example, a recommendation to join a yoga studio may be unrealistic due to limited financial resources. These generic or impractical recommendations run the risk of being ignored and negatively impacting treatment follow-through.  

Not every suggestion will resonate as personally crafted. However, providing the most relevant recommendations has the best chance to engage examinees who may walk away feeling understood. The establishment of an interactive connection may increase the likelihood of the examinee investing in a treatment that now feels relatable and achievable. Having an experience with a professional that took the time to understand them might be all they needed to actively pursue treatment. Perhaps, there is a psychotherapist that will engage and understand them just as well as the examiner did.

The Collaborative Read-Through

The student clinician is encouraged to collaboratively read through the pre-final draft of the report with the examinee. They should pause after each section and ask for the examinee’s thoughts. Side notes can be taken, which may be included in the final report. The implicit message to the examinee is that their voice matters. The collaborative interaction might foster an insight and awareness that primes an active readiness for treatment. For the student clinician, it allows a further opportunity to develop their interpersonal, writing, and conceptualization skills.

The Value of Integrating Collaborative Concepts with Traditional Assessment

Psychological assessment has long been one of the primary duties performed by clinical psychologists and will likely remain a defining component of the profession. This paper presented an approach to diagnostic training that integrates components of collaborative assessment with traditional graduate training. The author posits that the use of collaborative concepts can complement and enhance traditional training models by emphasizing the person within the context of the data. By collaboratively interacting with the examinee, the student clinician is able to work toward becoming a more interpersonally attuned and conceptually minded thinker. Overall, the integrated model allows for a more complete and generalizable graduate training experience.

An integrated approach may also provide opportunities to more meaningfully attend to multicultural factors that influence the assessment process. By individualizing and humanizing the assessment, collaborative practices may help student clinicians better understand how an examinee’s cultural background, identity, and experiences shape symptom presentation and engagement with the assessment. This may be particularly valuable for training purposes, given research by Adams et al. (2023) who found that student clinicians desired more time devoted to discussions about their clients’ cultural backgrounds as it relates to symptom presentations. Additionally, Maroney et al. (2025) highlighted the importance of attending to power differentials experienced by transgender student clinicians, which may also be relevant when working with transgender examinees during the assessment process. Thus, the integration of a collaborative approach might be the preferred approach for highlighting important considerations related to multicultural diversity.

In closing, by placing emphasis on the unique person being assessed, the collaborative approach brings the data to life. In so doing, it speaks to the life of that particular individual. The take home message to student clinicians, who may obsess about test administration and scoring, is to always remember there is a person behind the data. Respecting that person within the context of the assessment will result in the most clinically formulated, comprehensively written reports that speak to the individual needs of the client and increases the much-needed buy-in for the recommended course of treatment.