Assessment in psychotherapy and its impacts

This article discusses the assessment of behavior in psychotherapy and its impacts on children. It explores the factors that affect children's behavior and the importance of cultural inclusivity in psychotherapy. The article also touches on the role of brain imaging in psychopathology.

Running head: PSYCHOLOGY
PSYCHOLOGY
Name of the Student
Name of the University
Author note

1PSYCHOLOGY
Reflection 1
Title: Assessment in psychotherapy and its impacts
The first chapter in the Clinician’s Handbook of Child Behavior Assessment provides
some significant insight into the assessment of the behavior of children in various contexts.
Not only does it provide a background on behavior assessment but also asks two very
significant questions – ‘Whose’ behavior is being assessed and ‘what’ behavior is being
assessed. I think among all the questions asked in the first chapter, these two hold paramount
significance as it not only answers the questions regarding behavior assessment but also
provides a foreshadowing on the readers on behavior assessment of children. A key inclusion
in the first part of the chapter was the assessment that the behavior of a child is not
independent but rather a byproduct of parent and teacher behavior with the children. I have
experienced as well as read about instances of family violence where an indirect
psychological impact on children has reaped a variety of behavioral traits like increased
aggression, resilience, apathy (Margolin & Gordis, 2004) as well as in some cases, premature
depression and anxiety followed by substance abuse in adolescents (Hughes, 1988). This
comes as a shocking revelation at the outset, however it would not be unjustified as the
critical period for learning in case of children is also very important for their behavioral
development. I also find the aspect of behavioral disorder as a correlated disorder with other
mental health disorders a perfectly justified assertion. I have personally experienced instances
from my childhood where one of my friends had delusional disorder under DSM – V
category of Grandiose (APA, 2013) and he used to behave extremely rudely with almost
everyone except his father.
Regarding external factors affecting children’s behavior, it has been extensively
covered in chapter 4 of ‘Abnormal Child Psychology’ where the authors have rightfully
highlighted all the possible factors that can affect child behavioral development. I personally

2PSYCHOLOGY
think that the systematic order in which the procedure for assessment and evaluation has been
addressed in the book(s) are well suited especially when we are concerning with children.
The most interesting aspect that I have found in these two books along with the book on
psychometrics is that all these texts are focused on the aspect of assessment. This indicates
that irrespective of the factors underpinning a mental condition, assessment plays the most
significant role when it comes to understanding the condition of the child behavior. On the
other hand, a faulty assessment can lead to faulty assumptions and formulations which would
be detrimental to the child.
Reflection 2
Title: Understanding children behavior – individualism vs culturalism.
1. Given that most children engage in activities or behaviors that are deemed wrong or
inappropriate by their parents, it becomes a difficult task to address their behavior while
facing the dilemma between confiding with the child or the parent. In this regard, I would like
to refer to another TED video where Sir Ken Robinson (TED, 2007, Jan 6) talk about his
interaction with choreographer Gillian Lynne. In the video, Sir Robinson mentions that when
Lynne was a young child, she never paid attention to schoolwork but would rather spend her
time dancing. It was in the 1930s, when ADHD was not identified as a disorder, she was
taken to a practitioner by her mother where the practitioner talked only with her mother about
her issues. Initially it would describe the discrepancy that lies between the patient – parent
and the professional. However, as the video progresses we get to know that Lynne was left
alone with music turned on in the chamber and as her mother and the practitioner observed
from outside, Lynne started dancing, to which, the practitioner explained her mother that she
does not have any disease, she was rather a dancer. In my opinion, as a practitioner, it is as
important to identify the children’s behavioral issues as it is to make sure that the parents are

3PSYCHOLOGY
well aware of why a child behaves in a way that they do. The blame for a particular behavior
should not be placed on the child, but rather the factors that affect the child’s behavior need
to be thoroughly and critically analyzed.
7. Culture play a significant role when it comes to assessing children’s behavior. It is
an identified notion and concept that children, as well as adults are driven by their culture on
significant terms. Sometimes, in some cultures, children are provided independence and
responsibility at an earlier age than in most other places. On the other hand, there are also
cultures that highlight how children are cared and nurtured for a longer period. Most urban
cultures nowadays follow the latter pattern. Coming to the aspect of cultural inclusivity in
psychotherapy, generalizing the culture for a therapeutic practice can help in assessing a
commonality across the individual cases which can further provide a ground for identifying
factors that are idiosyncratic to the culture (Helms & Cook, 1999). Oppositely, generalizing a
cultural implication may prove to be harmful as it may exclude the personal aspects and
nuances that the individual might face, resulting in a misjudgment of the entire procedure.
Therefore, the whole process from formulating the case to evaluating the outcome, which
otherwise would have been very systematic, would in this case fall apart.
Reflection 3
Title: The BAD (Brain, Assessment and Disorder) in children.
The 3d scan replication of the nerves in brain was a very interesting video. It showed
not only how far technology has come but also provided a background of how interesting the
field of biological neural network mapping was (National Geographic, 2014, Jan 30). This
reminds me of a video that I watched on how the neural network in an animal brain functions
when it is shown a movie. The video (published by Harvard medical school on March 2011)
depicted a similar 3d imagery of the animal’s neurons in the brain when they are firing while
it is watching the movie. The video did not explain the differences between the animal brain

4PSYCHOLOGY
and the human brain but I believe a more complicated structure would be revealed in a human
brain (Harvard Medical School, 2011, Mar 2).
Psychological assessment of a human being, or assessment in general has been a
significant topic for discussion for a prolonged period of time. The video titled ‘intelligence2
brief history of psychological testing’ provides a detailed explanation of the history of
assessment over the period of human history (Psy1113, 2011, Feb 9). This was also an
impactful video as human capability assessment, in my opinion, is a gray area that has been
given an inappropriate justification. Children, for instance, are often marginalized in terms of
their ability to perform in a classroom or a test resulting in a lot of significant mental and
emotional stress, often resulting in serious mental complications like anxiety and depression
and sometimes may even lead to death through suicide. This is a common scenario and I have
personally experienced quite a number of my friends who underwent severe cases of
depression and lack of self-worth after scoring bad grades in a test.
Personally, John Ronson’s talk about psychopathy on the video published by TED
was the one which impacted me the most, not only cognitively and emotionally, but also from
an introspective point of view. The video challenged my pre-existing notions about mental
health assessment and the parameters that are used to identify a certain disorder. I was able to
draw a reference to the 2007 movie ‘Lars and the Real Girl’ where the lead character Lars
would seem to suffer from Delusional Disorder, pertaining to DSM-V criteria of Erotomania.
However his case was complicated as the exact parameters seemed unmatched. He was in
love with a blow-up doll and believed that the doll, named Bianca, was real (Aubrey,
Cameron & Kimmel (Producers) & Gillespie (Director), 2007). In the case of the video, the
character Tony who faked mental illness, was diagnosed with psychopathy (TED, 2012, Aug
15), which made me understand why it is so difficult to exit from the sphere of mental health
and assessment once it is entered. It also made me realize that the preexisting notions

5PSYCHOLOGY
regarding particular traits of mental illness are not critically demarcated, but rather juxtapose
to form a complicated connection where every bit of behavior can be justified under a
specific case of mental illness. For instance, if a person who displays frequent instances of
anger followed by a regular polite sense of communication, he can be classified under DSM-
V criteria 309.4 (Mixed Disturbance of emotions and conduct) (APA, 2013), whereas in
reality he is probably just having difficulty coping with stress and he realizes that his angry
outbursts are not logical. One more thing that the video made me realize was that the DSM-V
serves as a handbook for identifying mental disorders without providing adequate reasoning
as to whether or not the reasoning is justified from a personal point of view.
The experiment with marshmallow was significant in the sense that it displayed the
ways children differ from each other. The video connects Skinner’s theory of operant
conditioning (Skinner, 1971) where either a punishment or a reward is given for a particular
behaviour, with the concept of patience in children. Young children have very low attention
span which also means that they are not patient enough to sit through a particular task in
order to get a reward. The video specifically identifies several instances of restlessness where
the children are either nibbling at the marshmallow or licking it (FloodSanDiego, 2010, Apr
29), while someone else is having a difficult time sitting patient while waiting for the second
marshmallow. However as they were instructed that waiting would result in two
marshmallows, some of them did wait. This indicated towards the extant differences in child
behavior, and also subtly enhanced the fact that a unified testing measurement is not the most
feasible way to test a child.
All of these videos had one commonality in their themes – assessment. All of them
collectively highlighted different aspects of behavioral assessment, some emphasized on a
biological and neurological approach while some indicated towards a more socially inclusive
approach.

6PSYCHOLOGY
Reflection 4
While both the mentioned sites primarily focus on psychological testing and
assessment, I personally do not know anyone who meets the criteria. I have however read
about instances in context of Bilan Psychologique where the study focused on the various
barriers parents and families faced during the assessment of their children (Kazdin et al.,
1997).
I have two instances from school, where two of my acquaintances suffered from
pyromania and kleptomania respectively. While the one suffering from kleptomania later
agreed to the fact that thieving enhances his sense of self worth, something he had always had
issues with, the latter almost had a serious case of injury when he tried to burn a puppet he
made out of crumpled newspaper in the reading room of his house. These instances indicate
how different conditions can develop irrespective of sharing similar environment for growth
and development.
What the pictures of brain scan tells me is that brain imaging can impact
psychopathology by providing significant information regarding the way different neural
structures in the brain function. As identified in one of the previously mentioned videos from
YouTube, the neurons in the brain fire differently in different case scenarios. Brain imaging
tells me that they can be used (and are being used) in psychopathology to identify the
differences in patients in how their brain function. They can also be helpful in determining
future research prospect on brain damage and disorders.

7PSYCHOLOGY
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental
disorders (DSM-5®). American Psychiatric Pub
Aubrey, S., Cameron, J., Kimmel, S. (Producers), & Gillespie, C. (Director). (2007). Lars and
the Real Girl [Motion picture]. United States: MGM Distribution Co.
FloodSanDiego. (2010, Apr 29). The Marshmallow Experiment - Instant Gratification [Video
file]. Retrieved from https://www.youtube.com/watch?v=Yo4WF3cSd9Q
Harvard Medical School. (2011, Mar 2). Brain Circuits: Harvard Medical School
Researchers Crawl a Neural Network [Video file]. Retrieved from
https://www.youtube.com/watch?v=bZtXgZjbshs
Helms, J. E., & Cook, D. A. (1999). Using race and culture in counseling and
psychotherapy: Theory and process. Allyn & Bacon.
Hughes, H. M. (1988). Psychological and behavioral correlates of family violence in child
witnesses and victims. American Journal of Orthopsychiatry, 58(1), 77-90.
Kazdin, A. E., Holland, L., Crowley, M., & Breton, S. (1997). Barriers to treatment
participation scale: Evaluation and validation in the context of child outpatient
treatment. Journal of Child Psychology and Psychiatry, 38(8), 1051-1062.
Margolin, G., & Gordis, E. B. (2004). Children's exposure to violence in the family and
community. Current Directions in Psychological Science, 13(4), 152-155.
National Geographic. (2014, Jan 30). Beautiful 3-D Brain Scans Show Every Synapse |
National Geographic [Video file]. Retrieved from https://www.youtube.com/watch?
v=nvXuq9jRWKE
Psy1113. (2011, Feb 9). intelligence2 brief history of psychological testing [Video file].
Retrieved from https://www.youtube.com/watch?v=pmg2NEL7390
Skinner, B. F. (1971). Operant conditioning. The encyclopedia of education, 7, 29-33.

8PSYCHOLOGY
TED. (2007, Jan 6). Do schools kill creativity? | Sir Ken Robinson [Video file]. Retrieved
from https://www.youtube.com/watch?v=iG9CE55wbtY
TED. (2012, Aug 15). Strange answers to the psychopath test | Jon Ronson [Video file].
Retrieved from https://www.youtube.com/watch?v=xYemnKEKx0c