Tag

rorschach inkblot test

What Is Projective Testing and Why Might My Child Need It?

By | NESCA Notes 2022

By: Moira Creedon, Ph.D. 
Pediatric Neuropsychologist, NESCA

There can be a great deal of confusion about what kind of testing you want for your child. No wonder when we have so many options – neuropsychological testing, psychoeducational testing, speech and language testing, occupational therapy testing, personality testing, and psychological testing. The part that can be incredibly challenging is that these labels often involve overlapping test measures, meaning that the assessor may choose the same specific tasks that might fall into most or all of these categories. Take cognitive assessment using IQ tests which can be used by a psychologist conducting psychological, neuropsychological, or psychoeducational testing. Another layer of confusion is added for parents when one considers that many professionals in schools or medical practices are also confused and interchangeably use these labels. In an effort to demystify the process, I want to tackle a common question: what is projective testing and why might my child need it?

Projective testing provides psychologists with very specific and unique insight about a person’s thinking habits and processing. Unlike cognitive or academic tests, projective tests do not have a “right answer.” So, projective testing is not going to ask a child to solve a math problem or define a word. It is not going to test how quickly they can name vegetables or see how skilled they are at shifting between sets of the rules. The overall goal of projective testing is to figure out how a child, teen, or adult responds to an ambiguous situation. This means, we ask people to project their brain habits (thinking style, way of interpreting the world, way of processing emotions, way of viewing self and others) onto a situation when it is not clear that there is a “right” or “wrong” answer. A person must use their problem-solving and emotion regulation skills in action. Examples of projective tests include the Rorschach inkblot test, story-telling tasks (e.g., the Thematic Apperception Test or the Roberts Apperception Test), drawings, and incomplete sentences. Projective tests take additional time to administer and usually longer to score, so they are scheduled as separate visits at NESCA.

Why might you use a projective test? There are some situations where projective testing is incredibly useful, such as when a diagnosis of a thought disorder (e.g., psychosis) is in question. It is also very useful for questions of trauma, attachment, anxiety, or mood disorder. Projective testing is also incredibly useful when psychiatric symptoms are confusing. Take the example of someone who is a perfectionistic or very guarded about their symptoms. A person with this profile is very likely to read a question that says, “I am very anxious,” and answer no. However, projective testing can see if there are themes of anxiety by considering how a person responds to an ambiguous situation. Take another example of someone who leans in the other direction and reports many symptoms that overlap with many diagnoses. In this case, many symptoms are endorsed as “yes.” Projective testing can help to provide clarity to narrow down the list, especially without an obvious answer. In both of these cases, it is helpful to access a person’s unconscious brain habits as a key to understanding a person’s functioning.

When would you not use projective testing? I do not use projective testing when my referral question does not need it. For example, a question of a learning disability or ADHD does not require projective testing. Using projective measures would be inappropriate, time consuming, and potentially stressful for a person when it is not needed. Similarly, projective testing is not often used in individuals with Autism Spectrum Disorder as there is little research about how neurodivergent populations respond to the ambiguous stimuli. I also do not use projective testing if neuropsychological testing suggests that a person has an intellectual disability or struggles in their visual processing skills (e.g., NVLD) since many of the projective measures (e.g., Rorschach, story-telling, drawings) use a visual stimulus card. In those cases, it would be inappropriate to assume that a response reflects a person’s emotional processing when it would really be about their visual processing.

Projective testing is incredibly informative and, like other neuropsychological tools, should only be utilized by professionals who are trained to administer and interpret these tests. Since it is not as simple as a correct single answer on an answer key, it is critical that these procedures are administered by psychologists with the advanced training to use and interpret the information. And, like all of our measures, the results gathered using projective measures are data points that are combined with other data points. The performance on one test or demand does not dictate the entire conclusion. A strong and comprehensive assessment will use projective test data as part of a larger understanding of your child. Information gathered in projective testing can highlight important strengths for your child and contribute helpful information to drive treatment.

NESCA has several clinicians who are highly trained and skilled at administering projective testing. If you have questions about projective testing and whether your child needs it, let us know by filling out our online Intake Form.

 

About the Author

Dr. Creedon has expertise in evaluating children and teens with a variety of presenting issues. She is interested in uncovering an individual’s unique pattern of strengths and weaknesses to best formulate a plan for intervention and success. With experiences providing therapy and assessments, Dr. Creedon bridges the gap between testing data and therapeutic services to develop a clear roadmap for change and deeper of understanding of individual needs.

 

If you are interested in booking an evaluation with Dr. Creedon or another NESCA neuropsychologist, please fill out and submit our online intake form

 

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton and Plainville, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

10 Facts about the Rorschach Inkblot Test

By | NESCA Notes 2022

By Renée Marchant, Psy.D.
Pediatric Neuropsychologist

As an evaluator, I receive a number of questions about the usefulness of the Rorschach Inkblot Test. The following “10 facts” are designed to answer some common questions and also incorporate some new and fresh scientific research findings related to the Rorschach.

The Rorschach Inkblot Test is a diagnostic tool that should always be incorporated within a comprehensive evaluation which includes projective or “performance-based” testing. If you are considering if your child or teen would benefit from projective testing, please refer to one of my earlier NESCA blog posts: More Than An Inkblot: Measuring Problem-Solving and Critical Thinking Skills with Projective Tests.”

  1. The Rorschach Inkblot Test is a test that provides data and information about how a child or teen problem-solves situations “in the moment.”
  2. Research indicates that the Rorschach is a valid assessment tool (with validity akin to other personality measures, as well as measures of IQ).
  3. Recent fMRI studies show high levels of brain activation in brain regions associated with emotion, emotion memories, perception, attention and visual processing.
  4. After the Rorschach Inkblot Test is administered, an experienced evaluator uses an evidence-based scoring system to compare a child’s responses to a normative sample to evaluate their performance. RPAS (Rorschach Performance Assessment System) is the most evidence-based scoring system to date and has strong empirical evidence.
  5. The Rorschach evaluates and detects psychotic symptoms.
  6. The Rorschach is helpful for evaluating trauma, including dissociation and intrusive symptoms.
  7. The Rorschach assesses both trait (stable characteristics or patterns) and state (a temporary way of being) variables. For example, the Rorschach tells us about how a person is coping with everyday stressors (e.g. from bullying to family loss to lack of sleep). The Rorschach also tells us if a person has a more pervasive habit of “bottling up” emotions or behaving rashly or impulsively when overwhelmed.
  8. The Rorschach quantifies a child or teen’s strengths, such as capacity for insight and adaptability, or resiliency to stress.
  9. The Rorschach Inkblot Test is not for everyone. More research is needed about the utility of the Rorschach for individuals with expressive language communication impairments or visual-spatial processing deficits.
  10. Not every evaluator is equipped to administer and interpret the Rorschach Inkblot Test. The Rorschach is a powerful diagnostic tool when interpreted in conjunction with observation and other test results by a skilled, experienced practitioner with extensive training in Rorschach administration and interpretation.

 

About the Author:

Dr. Renée Marchant provides neuropsychological and psychological (projective) assessments for youth who present with a variety of complex, inter-related needs, with a particular emphasis on identifying co-occurring neurodevelopmental and psychiatric challenges. She specializes in the evaluation of developmental disabilities including autism spectrum disorder and social-emotional difficulties stemming from mood, anxiety, attachment and trauma-related diagnoses. She often assesses children who have “unique learning styles” that can underlie deficits in problem-solving, emotion regulation, social skills and self-esteem.

Dr. Marchant’s assessments prioritize the “whole picture,” particularly how systemic factors, such as culture, family life, school climate and broader systems impact diagnoses and treatment needs. She frequently observes children at school and participates in IEP meetings.

Dr. Marchant brings a wealth of clinical experience to her evaluations. In addition to her expertise in assessment, she has extensive experience providing evidence-based therapy to children in individual (TF-CBT, insight-oriented), group (DBT) and family (solution-focused, structural) modalities. Her school, home and treatment recommendations integrate practice-informed interventions that are tailored to the child’s unique needs.

Dr. Marchant received her B.A. from Boston College with a major in Clinical Psychology and her Psy.D. from William James College in Massachusetts. She completed her internship at the University of Utah’s Neuropsychiatric Institute and her postdoctoral fellowship at Cambridge Health Alliance, a Harvard Medical School teaching hospital, where she deepened her expertise in providing therapy and conducting assessments for children with neurodevelopmental disorders as well as youth who present with high-risk behaviors (e.g. psychosis, self-injury, aggression, suicidal ideation).

Dr. Marchant provides workshops and consultations to parents, school personnel and treatment professionals on ways to cultivate resilience and self-efficacy in the face of adversity, trauma, interpersonal violence and bullying. She is an expert on the interpretation of the Rorschach Inkblot Test and provides teaching and supervision on the usefulness of projective/performance-based measures in assessment. Dr. Marchant is also a member of the American Family Therapy Academy (AFTA) and continues to conduct research on the effectiveness of family therapy for high-risk, hospitalized patients.

 

To book an evaluation with Dr. Marchant or one of our many other expert neuropsychologists, complete NESCA’s online intake form.

 

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton and Plainville, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

 

10 Facts about the Rorschach Inkblot Test

By | NESCA Notes 2020

By Renée Marchant, Psy.D.
Pediatric Neuropsychologist

As an evaluator, I receive a number of questions about the usefulness of the Rorschach Inkblot Test. The following “10 facts” are designed to answer some common questions and also incorporate some new and fresh scientific research findings related to the Rorschach.

The Rorschach Inkblot Test is a diagnostic tool that should always be incorporated within a comprehensive evaluation which includes projective or “performance-based” testing. If you are considering if your child or teen would benefit from projective testing, please refer to one of my earlier NESCA blog posts: More Than An Inkblot: Measuring Problem-Solving and Critical Thinking Skills with Projective Tests.”

  1. The Rorschach Inkblot Test is a test that provides data and information about how a child or teen problem-solves situations “in the moment.”
  2. Research indicates that the Rorschach is a valid assessment tool (with validity akin to other personality measures, as well as measures of IQ).
  3. Recent fMRI studies show high levels of brain activation in brain regions associated with emotion, emotion memories, perception, attention and visual processing.
  4. After the Rorschach Inkblot Test is administered, an experienced evaluator uses an evidence-based scoring system to compare a child’s responses to a normative sample to evaluate their performance. RPAS (Rorschach Performance Assessment System) is the most evidence-based scoring system to date and has strong empirical evidence.
  5. The Rorschach evaluates and detects psychotic symptoms.
  6. The Rorschach is helpful for evaluating trauma, including dissociation and intrusive symptoms.
  7. The Rorschach assesses both trait (stable characteristics or patterns) and state (a temporary way of being) variables. For example, the Rorschach tells us about how a person is coping with everyday stressors (e.g. from bullying to family loss to lack of sleep). The Rorschach also tells us if a person has a more pervasive habit of “bottling up” emotions or behaving rashly or impulsively when overwhelmed.
  8. The Rorschach quantifies a child or teen’s strengths, such as capacity for insight and adaptability, or resiliency to stress.
  9. The Rorschach Inkblot Test is not for everyone. More research is needed about the utility of the Rorschach for individuals with expressive language communication impairments or visual-spatial processing deficits.
  10. Not every evaluator is equipped to administer and interpret the Rorschach Inkblot Test. The Rorschach is a powerful diagnostic tool when interpreted in conjunction with observation and other test results by a skilled, experienced practitioner with extensive training in Rorschach administration and interpretation.

 

About the Author:

Dr. Renée Marchant provides neuropsychological and psychological (projective) assessments for youth who present with a variety of complex, inter-related needs, with a particular emphasis on identifying co-occurring neurodevelopmental and psychiatric challenges. She specializes in the evaluation of developmental disabilities including autism spectrum disorder and social-emotional difficulties stemming from mood, anxiety, attachment and trauma-related diagnoses. She often assesses children who have “unique learning styles” that can underlie deficits in problem-solving, emotion regulation, social skills and self-esteem.

Dr. Marchant’s assessments prioritize the “whole picture,” particularly how systemic factors, such as culture, family life, school climate and broader systems impact diagnoses and treatment needs. She frequently observes children at school and participates in IEP meetings.

Dr. Marchant brings a wealth of clinical experience to her evaluations. In addition to her expertise in assessment, she has extensive experience providing evidence-based therapy to children in individual (TF-CBT, insight-oriented), group (DBT) and family (solution-focused, structural) modalities. Her school, home and treatment recommendations integrate practice-informed interventions that are tailored to the child’s unique needs.

Dr. Marchant received her B.A. from Boston College with a major in Clinical Psychology and her Psy.D. from William James College in Massachusetts. She completed her internship at the University of Utah’s Neuropsychiatric Institute and her postdoctoral fellowship at Cambridge Health Alliance, a Harvard Medical School teaching hospital, where she deepened her expertise in providing therapy and conducting assessments for children with neurodevelopmental disorders as well as youth who present with high-risk behaviors (e.g. psychosis, self-injury, aggression, suicidal ideation).

Dr. Marchant provides workshops and consultations to parents, school personnel and treatment professionals on ways to cultivate resilience and self-efficacy in the face of adversity, trauma, interpersonal violence and bullying. She is an expert on the interpretation of the Rorschach Inkblot Test and provides teaching and supervision on the usefulness of projective/performance-based measures in assessment. Dr. Marchant is also a member of the American Family Therapy Academy (AFTA) and continues to conduct research on the effectiveness of family therapy for high-risk, hospitalized patients.

 

To book an evaluation with Dr. Marchant or one of our many other expert neuropsychologists, complete NESCA’s online intake form.

 

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton and Plainville, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.