Standardized Evaluation in Clinical Practice

In clinical settings clinicians continue to underutilize
interviews and rating scales because their benefits are underappreciated and
their use is perceived as too costly and time consuming. Augmenting the
broad information contained in the APA's Handbook of Psychiatric
Measures, this in-depth guide examines the real-world issues
involved in implementing measures in actual clinical settings. This book


* Asserts that the use of structured diagnostic interviews in clinical
settings is justified, suggesting that it would be most cost-effective to
target research assessment toward those groups most difficult to evaluate
and most likely to be misdiagnosed, especially those whose misdiagnosis
leads to consumption of a greater-than-expected amount of treatment
resources
* Focuses on the underrecognition and underreporting of
diagnostic comorbidity, discussing the daunting practical issues of using
comprehensive structured interviews and suggesting instead that a
self-administered questionnaire be used to screen for the most common DSM-IV
Axis I disorders
* Considers the use of structured
interviews-administered by either lay interviewers or by computer-in the
diagnostic assessment of children and adolescents, making a case that using
the research model (i.e., reliable measures that can be given to large
numbers of subjects) in clinical settings meets the cost-efficiency
requirements of understaffed clinical providers
* Discusses the utility
and limitations of research instruments for crucially important clinical
purposes-determining suicide risk-and presents the inherent difficulties in
predicting risk and explore the underlying clinical risk factors based on
their proposed stress-diathesis model
* Presents the issues and
challenges involved in the U.S. Department of Veteran's Affairs (VA) attempt
to implement a national program requiring the routine use of the GAF scale.
The authors conclude with a discussion of the reasons why the Global
Assessment of Functioning (GAF) scale was chosen, software and procedures,
methods to ensure system compliance, and the specific measures taken by two
VA networks that helped improve its implementation

It is a
groundbreaking guide that details the pros and cons of using structured
interviews and rating scales in clinical settings to ensure reliable and
valid assessment of diagnoses, symptoms, and outcomes.