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.