Psychology
2011. Vol. 2, No. 1, 42-48
Copyright © 2011 SciRes. DOI:10.4236/psych.2011.21007
Co-Existence or Alliance? Psychological Assessment and Its
Effects on Therapeutic Process Using Systemic
Psychotherapy as an Example
Anna Pittermann1,2, Klaus D. Kubinger2
1Department of Surgery, Medical University of Vienna, Vienna, Austria;
2 Faculty of Psychology, University of Vienna, Vienna, Au s tria.
Email: anna.pittermann@akhwien.at
Received August 5th, 2010; revised December 22nd, 2010; accepte d December 27th, 2010.
Psychotherapists are still uncertain about what positive or negative effect psychological assessment might have
on the process of psychotherapy. The aim of this study was to sum up the effects of psychological assessment on
the therapeutic process in the systemic therapy of couples. The question of whether psychological assessment
techniques enhances therapeutic progress and helps to achieve therapeutic goals, from the point of view of the
clients, was investigated using randomized samples of clients in couples therapy. For this purpose, couples, who
had signed up for systemic psychotherapy, were randomly placed in either a group with psychological assess-
ment or one without. In addition to the continual monitoring of the subjective achievement of therapeutic goals,
the perceived benefits of the results of the psychological assessment by the clients and therapists were also in-
vestigated. The investigation of 42 couples showed that therapeutic success, from the client’s point of view, oc-
curred sooner and was more stable when a psychological assessment was done in advance. In general, psycho-
logical assessment was seen in a more positive light by the couples than by the therapists.
Keywords: Psychological Assessment, Systemic Psychotherapy, Therapeutic Progress
Psychotherapy and Psychological Assessment
Despite the extensive literature on psychological assessment
(Kubinger, 2003; Kubinger, 2006) and its application within
psychotherapy (Cierpka, 2000, 2003; Fiegl & Reznicek, 2000;
Kubinger, 2006; Laireiter, 2000a) there is still great un- cer-
tainty among practicing psychotherapists about the use of psy-
chological assessment within their work. In Austria clinical-
psychological assessment forms only a small part, if at all pre-
sent, of what is taught as part of psychotherapy education (e.g.
Training guidelines - Psychoanalysis; Austrian Psychotherapy
Act; Training guidelines - Systemic Therapy), resulting in little
engagement with this subject for those psychotherapists without
additional clinical psychological or psychological training.
Psychological assessment is, thematically and in terms of ap-
plication, closely linked to psychotherapy. Many questions
addressed by psychological assessment are also relevant to
psychotherapeutic practice and some questions can only be
answered with the aid of psychological assessment (Laireiter,
2005). Despite, or perhaps, because of this close and yet vague
connection, most therapists have a very clear attitude towards
psychological assessment. They have decided to either reject,
endorse or simply ignore the option of employing it, while the
need is not felt for either the gathering of findings about effi-
cacy based on psychological assessment or for existing findings
to be incorporated into therapy (Ludewig, 2005; Stieger, 1995).
This attitude is seldom supported by thoroughly researched
results or experience tested in practice. Most of these attitudes
either stem from personal opinion or life experience, and not
from the scrutiny of the particular theoretical concepts of as-
sessment, or are based on a profound lack of information about
how to employ psychological assessment. Control studies of the
effects of psychological assessment within psychotherapeutic
processes, whether fruitful or disruptive in nature, could not be
found even in extensive research of literature. Assessment, as
an information gathering process, and psychotherapy whether
seen as a fruitful partnership or an enforced and not very har-
monic relationship, are an “integral element of a circular proc-
ess” (Scheib & Wirsching, 1994, p. 169). In everyday practice
the therapist always encounters p sychological ass essment anew;
patients come to the therapist with diagnoses or results, the
therapist creates a hypothesis based on information, evaluates
their own work with the help of assessment techniques (Braun
& Regli, 2000; Laireiter, 2000b) and even sometimes employs
these for therapeutic purposes (especially projective techniques
such as the Enchanted Family (Kos & Biermann, 2002), repre-
sentational tests such as the Family System Test (Gehring,
1998), or circular questioning in the Subjective Family Image
(Mattejat, 1994)), for further information about assessment
tasks in psychotherapy, see (Laireiter, 2000c). Some assess-
ment techniques even come unmistakably from a therapeutic
background (such as Beckmann, Brähler and Richter’s Giessen
Test (Beckmann, Brähler, & Richter, 1983) psychoanalysis or
the Family Board (Ludewig, 2000) systemic family therapy).
There are, especially among the main systemic family therapy
clientele, namely couples and families (in the widest definition
of those words), a large number of techniques which concen-
trate on this target group and the most common problems that
they bring to psychotherapy. These techniques include Couples
Diagnosis with the Giessen test (Brähler & Brähler, 1997), the
Family Relations Indicator (Howells & Lickorish, 1989), the
A. PITTERMANN ET AL. 43
Family Assessment Measure (Cierpka & Frevert, 1994), the
Family System Test (Gehring, 1998) and the Family Identifica-
tion Test (Remschmidt & Mattejat, 1999) (see also Ludewig,
2000; Brähler & Brähler, 1997; Benninghoven, Cierpka and
Thomas, 2003; Thomas, 2003). Despite this wide range of test
instruments many therapists would rather rely on their own
diagnostic aptitude than an assessment procedure or gathering
more information. The aim of this study is to investigate whe-
ther the therapeutic process in systemic family therapy is posi-
tively or negatively influenced by psychological assessment. A
positive influence could be a focusing of the therapy process
based on the results of an assessment done prior to therapy.
Psychological assessment could in this way simplify thera-
peutic work for the therapist, accelerate the achievement of
therapeutic goals or lead to greater client satisfaction. However,
it is also conceivable that this type of assessment has no influ-
ence, or even has a disruptive influence on the therapeutic
process because it requires resources such as time and energy
without providing any advantage to the therapeutic process.
Furthermore, it might be subjectively experienced by the client
as unhelpful or labeling.
Trial Plan and Methods
The study of the effects of psychological assessment on sys-
temic couples therapy was carried out at the Institut für Ehe-
und Familientherapie (IEF; Family Therapy Institute), Vienna.
The IEF is a Vienna Social Services institute which currently
employs nine systemic psychotherapists. The Family Therapy
Institute provides systemic psychotherapy for couples, families
and individuals. Psychological assessment is not routinely car-
ried out there. The management team, therapeutic team and
administrative team have all already kindly agreed to take part
in the study, and to support the research project.
The plan for the study was to include couples who contacted
the institute with “partnership problems” (as opposed to dif-
ficulties relating to other members of the family group). The
randomization of couples was carried out by using the date that
they joined the study. The couples were alternately placed in
the “therapy without psychological assessment (PA)” (control
group, CG) and the “therapy with psychological assessment”
(trial group, TG). The trial group couples underwent psycho-
logical assessment lasting approximately one hour before the
first session with the therapist (see Figure 1). In accordance
with Orlinsky (2008) no attention was paid to the therapeutic
variables (gender, age, number of years at IEF etc.) as it is in
any case unclear as to how these effect the therapeutic proc-
ess.
During the first four sessions, the clients from both groups
were continually monitored by gathering information about
their experience of the therapeutic progress. The number of
sessions chosen for observation was based on the experience of
the Family Therapy Institute, which showed that most thera-
peutic change happened within the first four sessions and that it
was very possible to form an opinion on the success of the
therapy at this point. Moreover, due to the numerous short
courses of therapy that are carried out at the Family Therapy
Institute, and for comparison and cost reasons, it seemed most
logical to document the first four sessions. The documentation
carried out by the therapist at the end of each session included
the therapist’s subjective appraisal of the degree of achievement
of goals on a scale of 1 to 10 (1 = no achievement; 10 = maxi-
mum achievement of therapeutic goals), the documenting of the
therapeutic process (routine electronic documentation of con-
tent of the session) and, if necessary, the documenting of any
early termination or other therapeutic change. At the end of the
session the couples were asked to separately mark their evalua-
tion of the therapeutic progress on a scale of 1 to 10 (1 = no
progress; 10 = maximum progress). Additionally, after the
fourth session the clients of the “with psychological assess-
ment” group were asked for their feelings about psychological
assessment and whether they would judge the instruments used
to be helpful or interesting, or not. After the fourth session the
therapists with clients of the “with assessment” group also re-
ceived a questionnaire about how they, in retrospect, would
evaluate the information obtained by psychological assessment.
At the end of the four sessions of the study all the clients and
therapists completed a final questionnaire regarding the achieve-
ment of the therapeutic goals.
Test Condition “With Psychologic al A ss essment”
After initial contact with the Family Therapy Institute the
subjects under the test condition “with psychological assess-
ment” completed an assessment session lasting approximately
one hour, during which they were presented with two relation-
ship assessment questionnaires to work through. Every couple
was separated so that each partner worked alone on the couples
assessment with the Giessen Test (Brähler & Brähler, 1997)
and the questionnaire about supply and demand in partnerships
([Fragebogen zu Angebot und Nachfrage] FAN (Pfundner,
Test Group
“with assessment” Control Gro u p
“without assessment”
Telephone contact by the couple Telephone contact by the couple
Assessment Appointment
Couples diagnosis with the Gies-
sen test
Questionnaire about supply and
demand in partnershi ps
-
1st session
Discussion of results
Evaluation of therapeutic progress
M/W/T
1st session
Evaluation of therapeutic pro-
gress M/W/T
2nd session
Evaluation of therapeutic progress
M/W/T
2nd session
Evaluation of therapeutic pro-
gress M/W/T
3rd session
Evaluation of therapeutic progress
M/W/T
3rd session
Evaluation of therapeutic pro-
gress M/W/T
4th session
Evaluation of therapeutic progress
M/W/T
Therapeutic goals reached
questionnaire M /W/T
Questionnaire about psychological
assessment M /W/T
4th session
Evaluation of therapeutic pro-
gress M/W/T
Therapeutic goals reached ques-
tionnaire M/W /T
Figure 1.
Table representing the planned study (M/W/T = conducted by Man/
Woman /Therapist).
A. PITTERMANN ET AL.
44
1997; Simader-Hunek, 2004; Kubinger, 2007).
Couples Assessment with the Giessen Test
Couples assessment with the Giessen test comprises of two
questionnaires for each partner. Using the 40 items of the Gies-
sen test, each partner first evaluates himself (self evaluation)
and then his/her partner (external evaluation). The analysis is
carried out on the scales “social response”, “dominance”, “con-
trol”, “underlying mood” and “permeability”.
The method used adult, heterosexual couples as a standard
and enabled the description of individual characteristics, the
comparison of these descriptions for both partners, and the
comparison of interactions (degree of symmetry, degree of
complementarity, degree of validation, the contradictions un-
covered in the self and external evaluations, and the degree of
identification). Couple types have not been allocated due to
their controversial status (Kubinger et al., 2003).
The Partnership Supply and Demand Questionnaire
In the partnership supply and demand questionnaire each
partner is able to use the Q-sort method to state which aspects
of living together in the partnership, which they receive from
the other partner, are particularly important to them, and which
aspects they are willing to give. By using the Q-sort technique,
in which individual answers must be ordered in a graded series
of categories of subjective importance, the grading of every
answer as “very important” is avoided and an individual rank-
ing of priorities becomes necessary. The analysis is carried out
descriptively in an overview of the interindividual and intrain-
dividual differences between supply and demand.
In order to avoid gathering redundant information with the
psychological assessment and the first interview, special atten-
tion was paid to choosing instruments to use in the study which
provide information that went beyond a medical history. The
purpose of the methods used was to elicit more information
than the first and second interviews normally yielded, and to
deliver relevant results for the assessment of the relationship.
Projective methods were avoided because of the possible ob-
structive effects on a clear delineation between intervention and
assessment. The Giessen Test and The Partnership Supply and
Demand Questionnaire were chosen, on the one hand, because
they were specially designed for use with couples (as opposed
to many other methods which provide more insight into rela-
tionships between more than two people), and also because t h ey
offer many opportunities for couples therapy feedback. They
could positively influence the therapy process by providing
both more information to the therapist and more clarity to the
client, and they therefore have the potential to focus the thera-
peutic process and steer it onto the right tracks.
The results of the questionnaire were compiled by the person
in charge of the study and retained in one closed envelope for
the therapist and another for the client. During the first session
that the client and therapist had together the envelopes were
opened and the results were read. The other trial group sessions
of the study took place in a similar manner to those of the con-
trol group (again see Figure 1).
Gathering of Da ta
The gathering of data at the Institut für Ehe-und Familien-
therapie ran from April 2006 (first applications) to August 2007
(last results from the couples in the study).
The Participants
The couples who took part in the study consisted of 42 men
and 42 women. At the time of initial contact 23 couples (54.8%)
were married and 19 (45.2%) were living together. 73.8% of
the clients stated that they lived with their partner and one or
more children, 14.3% lived with their partner, 9.5% lived alone
and 2.4% lived alone with their child. It was not possible to
collect information about the current professions of 12 of the 84
people in the study. Of the remaining 72 people, 40 were em-
ployees (55.6%), 10 stayed at home (13.9%), 6 were unem-
ployed (8.3%), 5 were students, 4 (5.6%) were self employed
and 3 (4.2%) were skilled workers. 3 people were retired. The
couples who contacted the Institut für Ehe-und Familienthera-
pie for therapy all came from the greater Vienna area.
Application
25 couples (59.5%) made contact seeking therapy of their
own initiative, the other 17 couples (40.5%) were referred (for
example by counseling centres, psychiatric institutions, etc.). In
66.7% of cases, contact was made by the woman.
17 couples (40.5%) gave a possible separation as their reason
for the application, 23 couples (54.8%) indicated conflict within
the relationship, and for two couples (4.8%) violence was the
reason for starting therapy.
The Setting
13 couples had a male therapist, 21 couples a female thera-
pist, 2 couples had a male/female co-therapist team, and 2 cou-
ples a female/female co-therapist team. 4 couples, who had had
an assessment appointment, did not start therapy at the IEF.
Procedure
There was room in the study for 42 couples, i.e. 84 individu-
als. There were 26 couples (61.9%) in the trial group and 16
(38.1%) in the control group. The clients included in the study
contacted the IEF about couple therapy by phone and had a
50:50 chance of being assigned either to the trial or control
group. When the clients made contact by phone a list immedi-
ately identified if they were to be in groups with or without
Psychological Assessment. The clients with psychological as-
sessment were immediately invited to the first assessment ap-
pointment. Every client, regardless of whether they were as-
signed to the trial group or control group was informed that
there would be a waiting period before the first interview. The
waiting period at the Family Therapy Institute is, several weeks
to months due to the high demand, and this means that by the
time a first interview session becomes available the client may
possibly have lost interest in therapy or have solved their own
problems themselves.
It is notable that considerably more clients from the trial
group actually appeared for their first interview, although they
had exactly the same length of time to wait for the first inter-
view. This explains the difference in percentage of clients in the
trial group and control group after distribution.
A. PITTERMANN ET AL. 45
Results
Therapy Status
In August 2007, 21 couples (50.0%) were in ongoing therapy
according to study conditions, 17 (40.5%) had ended therapy, 3
were no longer interested and one couple remained on the
waiting list. 56.0% of the couples for whom therapy had al-
ready ended belonged to the group without assessment (control
group) and 44.0% to the group with assessment (trial group)
(see Table 1). As regards the completion or continuation of
therapy, there was no significant difference (chi-square test: p =
0.444) between the couples with and the couples without psy-
chological assessment.
Of the 17 couples who were no longer in therapy, 8 (41.1%)
had broken off the therapy, 9 (52.9%) had ended the therapy in
mutual agreement with the therapist or therapists. Also in this
case, there was no significant difference regarding the reasons
for ending therapy between the two groups (chi-square test: p =
0.819, see Table 2 ) .
Duration of the Therapy
The number of clients in therapy over the four observed ses-
sions can be found in Figure 2. Of 26 (100%) clients starting
therapy with psychological assessment, 22 (84.6%) appeared
for the first therapy session. The same number of clients with
psychological assessment came to the second session. 20
(76.9%) continued with the third session, and there was a total
of 19 present at the fourth session (73.1%). The distribution of
clients without psychological assessment looked a little different.
In this case, 16 couples appeared for the first session (the
100% mentioned in the table should not disguise the fact that
considerably more couples made contact and underwent a first
interview appointment. However, as they were part of the group
without assessment they were not considered to have not ap-
peared for their first session - a situation that will be explored at
more length in the discussion). 87.5% (14 couples) were at the
second session, 68.8% at the third and only 50.0% (8 couples)
remained for the fourth session. The difference in number of
sessions attended between the couples with and without psy-
chological assessment was not significant (chi-square test: p =
0.075).
Table 1.
Therapy status.
Ongoing Therapy Ended Therapy
With Psychological
Assessment 14 (56.0%) 11 (44.0%)
Without Psycholog i c al
Assessment 7 (43.8%) 9 (56.3%)
Table 2.
Reasons for ending therapy.
Couple Drop Out Mutually Agreed
Cessation
With Psychological
Assessment 4 (50.0%) 4 (50.0%)
Without Psycholog i c al
Assessment 4 (44.4%) 5 (55.6%)
The time between application and first session was different
between the two groups: 69 days (range: 21-138) versus 52
days (6-187), for the trial group and control group respectively.
Whereas the time period within the trial group between application
and testing was about 30 days (12-62). As regards the time
period between the individual sessions, there was no significant
difference between the control group and trial group couples
(GLM: p = 0.418).
Therapeutic Progress Made Over the Course of the
Sessions
Self Evaluation by the Clients
The self evaluation of therapeutic success of the clients with
and without psychological assessment is recorded in Table 3.
The evaluation of the therapeutic progress of clients in the
group with psychological assessment shows a significant dif-
ference between the different points in time in the therapy
(Friedman test, p = 0.002). The self evaluation increased con-
stantly over time. The group without psychological assessment
also displayed a significant difference between points in time
(Friedman test, p = 0.005). After an initial increase in self
evaluation, by the 3rd session this had fallen below the value
for the first session, only to increase significantly again in the
fourth session. For clients with psychological assessment sig-
nificantly better values, in comparison to the first session, were
already apparent by the third session, for clients without as-
sessment this improvement was not apparent until the fourth
session.
If the difference in self evaluation between the sessions in the
categories, improvement (“+”), no improvement (“0”) and de-
terioration (“–”) is considered, it becomes apparent that be-
tween the 2nd and 3rd sessions significant frequent improve-
ments appear in the group with psychological assessment, while
significant frequent improvements only become clearly appar-
ent in the group without psychological assessment between the
3rd and 4th sessions (Table 4). When observed in detail the im-
provements both at the time point of session 3 and 4 are sig-
nificantly higher for the group with psychological assessment.
A breakdown of the results according to gender shows that
there is no difference in self evaluation for men over time be-
tween the groups with and without psychological assessment
(Friedman test; p = 0.069). Only in the third session was a sig-
nificant difference to be seen (U test; p = 0.047), in that male
Figure 2.
Number of clients in therapy. (PA = Psychological Assessment)
A. PITTERMANN ET AL.
46
Table 3.
Evaluation of therapeutic goals with and without psychological as-
sessment.
With Psychological
Assessment Without Psycholog i c al
Assessment
Self Evalua ti on n Md (range) n Md (range)
1st session 40 4 (0-10) 30 5 (1-10)
2nd session 39 5 (0-10) 24 6.5 (2-10)
3rd session 36 6.5 (3-10) 17 5 (0-10)
4th session 28 6.5 (3-10) 11 8 (4-10)
Table 4.
Evaluation of therapeutic goals with and without psychological as-
sessment, including di fferences in self evaluati on between sessions.
With Psychological
Assessment Without Psychologi c al
Assessment
Self Evaluatio n n Md (range)/% n Md (range)/%
1st session 40 4 (0-10) 30 5 (1-10)
Difference
1st-2nd session
+
0
21 (56.8%)
6 (16.2%)
10 (27.0%)
+
0
12 (50.0%)
6 (25.0%)
6 (25.0%)
2nd session 39 5 (0-10) 24 6.5 (2-10)
Difference
2nd-3rd session
+
0
22 (66.7%)
4 (12.1%)
7 (21.2%)
+
0
4 (26.7%)
3 (20.0%)
8 (53.3%)
3rd session 36 6.5 (3-10) 17 5 0-10)
Difference
3rd-4th
session
+
0
10 (35.7%)
7 (25.0%)
11 (39.3%)
+
0
8 (88.9%)
1 (11.1%)
0 (0.0%)
4th session 28 6.5 (3-10) 11 8 (4-10)
(+. improvement, 0. no change, -. decrease)
clients with psychological assessment evaluated their therapeu-
tic progress as being better (Med = 6.5) than men without as-
sessment (Med = 4.5). In the case of the women a significant
difference over time (Friedman test: p = 0.039) was observed in
the group with assessment which was not present in the group
without psychological assessment (Friedman test, p = 0.115).
Women with assessment improved continually over time in
their self evaluations (Med. 1st session = 4.5; 2nd session = 5;
3rd session = 6.5; 4th session = 7). Women without assessment
displayed a non significant decline after the third session (Med.
for the 4th sessio n s : 5, 6, 5, 8).
External Evaluation by the Therapist
Clients from the group with psychological assessment always
gave themselves a higher value than the therapist did. By the
3rd session this difference had become significant (Wilcoxon
test, p < 0.001) (Table 5). The clients without psychological
assessment evaluate their therapeutic progress higher than their
therapists do. In this group the difference becomes significant
in the 1st session (Wilcoxon test, p = 0.003) and 2nd session
(Wilcoxon test, p = 0.002) (Table 5). There was no significant
difference in the therapist’s evaluations between clients wi-
th/without psychological assessment (U test, p > 0.05).
Subjective Evaluation of Psychologi ca l A ssessment
By the Clients: 66.7% of clients stated that the examination
prompted them to think things through and 33.3% felt the psy-
chological test helped them to deal with their difficulties. By
the Therapists: In only 10.8% of cases did the therapists experi-
ence psychological assessment as being supportive of the thera-
peutic process. In at least 24.3% of cases the results were con-
sidered a relevant source of additional information. In their
evaluation of the benefits of the assessment for the clients, the
therapists indicated that they believed psychological assessment
had prompted the client to think things through in only 25.7%
of cases, and it was accepted that assessment helped clients to
deal with their difficulties in only 8.6% of cases.
Discussion
The results of this study relating to the effects of psycho-
logical assessment on the therapeutic process show that psy-
chological assessment doesn’t have a negative effect on any of
the parameters investigated by us. The values of the self evalua-
tion of therapeutic success increase over time for clients with
and without assessment - a fact that indicates that therapy is
experienced by clients as helpful and relevant irrespective of
the provision of psychological assessment or its absence. It is
noticeable, however, that for clients with psychological as-
sessment the therapeutic benefits subjectively experienced seem
to occur sooner and may be more permanent. An earlier sig-
nificant improvement is experienced by the clients in this study,
i.e. after the completion of testing, and this improvement is
more stable. A clear difference between the genders regarding
benefit from psychological assessment could not be established.
It was notable that the therapeutic progress experienced by the
clients was always greater than that of their therapists’ evalua-
tions. The therapists did, however, see a continual improvement
in their clients, but indicated obvious therapeutic progress only
at a later stage than the clients did. The earlier and more stable
therapeutic success for clients with psychological assessment
was related, as also stated by the clients who were questioned
about the subjective evaluation of the assessment carried out, to
the examination with psychological testing of the couples being
useful in helping the couples to deal with the problems that had
led them to therapy in the first place. They could therefore
make earlier constructive use of the therapy. The initial conclu-
sion to be drawn is that, despite the clearly very limited context
Table 5.
Evaluation of therapeutic success by the therapist (treatment and con-
trol group).
With Psychological
Assessment Without Psychol og i c al
Assessment
Self Evalua ti on n Md (range) n Md (r ange)
1st session 41 4 (0-7) 28 3 (1-7)
2nd session 39 4 (0.8) 22 3 (1-6)
3rd session 36 4 (1- 9) 15 4 (0-7)
4th session 19 6 (2-9) 9 6 (4-8)
A. PITTERMANN ET AL. 47
of only two instruments being used in the psychological test
examination within the unique circumstance of couples therapy
within the framework of a systemic therapy institute, psycho-
logical assessment can indeed have a very positive influence on
the therapeutic process. A further positive aspect of psycho-
logical assessment is apparent in that an assessment done be-
fore the first session can lead to a couple appearing for therapy
despite a long waiting period. It must be noted that there is no
data about how many couples without assessment dropped out
during the waiting period, as it is exclusively the couples who
appeared for their first interview appointment in the group
without assessment who appear in the statistics. At this point
therefore it can only be observed, without being supported by
figures, that the number of couples that did not appear for their
first interview after assessment was carried out was an order of
magnitude smaller than that of the couples in the group without
an assessment appointment. It seems possible that either this
difference can be explained by the couples having already “in-
vested” in the assessment and wanting to justify having gone to
this trouble and they therefore appear for their first interview to
find out the results of the assessment, or it could be that the
assessment carried out during the waiting period conveyed the
impression to the couples that real interest was being shown in
their problems and in this way a stable commitment to the
therapy institute was established. The fact that there is no dif-
ference between the groups in the breaking off or ending of
therapy indicates that the couples who appeared for therapy,
irrespective of whether testing has previously been carried out
or not, were genuinely interested in undertaking therapy.
In order to answer the question of what use psychological as-
sessment has for clients and therapists at the end of the day, the
subjective evaluation of the relevance of psychological assess-
ment was investigated from a clients’ and therapists’ point of
view. The final evaluation questionnaire filled out by the trial
group included the opportunity to give an open answer to the
question, “I found the questionnaire examination to be help-
ful/not helpful, because:” While the clients were sparing with
their criticism, and only in one or two cases said that the test
results were not of enough significance or already known, the
therapists took issue with numerous difficulties with psycho-
logical assessment. The criticism included the statements that
psychological assessment was too superficial, irrelevant to the
therapeutic process, would cement hypotheses, and that the
results were in stark contrast to the problems claimed. Not one
therapist gave a positive evaluation of psychological assess-
ment. The clients, on the other hand, presented a great many
arguments in support of psychological testing. The clients indi-
cated that they found the questionnaire examination to be help-
ful since it gave them an overview of the necessity of formulat-
ing their difficulties and general problems, concretized the “ini-
tial conditions” of the problems, provoked contemplation of
and engagement with their image of themselves and how others
saw them, and in this way allowed the development of a new
understanding of the problem. The clients noted that in addition
to this they had gained new perspectives on their problems, but
also the things they had in common had become clearer and
avenues to discussion between the partners had opened up. It is
certainly necessary and desirable that further investigation,
using various different control studies and different test tech-
niques, is carried out in order to identify the optimal ways of
implementing psychological assessment within the therapeutic
process for the future. This first study regarding the possibility,
not simply of the coexistence, but the actual alliance of psy-
chological assessment and psychotherapy has clearly shown
that this course of action is worth pursuing.
Acknowledgements
The authors would like to thank the head of the Institute für
Ehe-und Familientherapie, Dr. Joachim Hinsch, and his team
who made this study possible.
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