Further Evidence that Projective Techniques Continue as Popular Clinical Assessment Tools in Practice Settings

        Despite continuing criticism regarding the psychometric credibility of projective techniques, evident in the scholarly literature (e.g., Imuta et al., 2013; Lawrence et al., 2021; Ryan et al., 2019), mounting recent evidence indicates that projective tests are considered an integral part of acceptable methods used or applied in research studies (Eby, 2020; Piotrowski, 2022). In fact, a quick perusal of the recent literature shows the presence of projective measures are relied upon and embedded in research studies (e.g., Aoki & Kogayu, 2021; Bram et al. 2018; McGlone & Viglione, 2020; Schapers et al., 2021; Tafti et al., 2021; Toeplitz, 2013; Yuan et al., 2021). Moreover, I note several novel adaptations to drawing tests, which continue to attract research attention over the past decade: „Draw-a-Person-in-the- Rain‟ test (Willis et al., 2010), „Person Picking an Apple from a Tree‟ technique (Potchebutzky et al., 2020), and the newly developed „House Imagery Test‟ (Yuan et al., 2021). Perhaps reflecting the acceptability and relevance of projective assessment, chapter coverage in recent texts on psychological assessment clearly depicts the importance of projective techniques in clinical and child psychology applied to the mental health evaluation process (Saklofske et al., 2013; Sellbom & Suhr, 2020; Verdon & Azoulay, 2020; Weiner & Kleiger, 2021; Wright, 2020; Yalof & Bram, 2021).

         All this bodes-well for research, but what about the status of projective testing in practice/applied settings, particularly as a foundation for forming a conceptual therapeutic framework in mental health treatment? Hence, the purpose of this commentary is to address this specific issue by examining recent test usage findings, based on empirical data, as reported by practitioners.

        Of particular interest are the findings of 2 recent dissertations regarding the use of projective tests by practicing psychologists. The first study surveyed a sample of 510 members of APA Division 12 (both clinical child and pediatric psychologists) on the use of drawings (H-T-P, DAP, KFDs) in assessment (Longest, 2006). The most interesting observation is that 25% of the practitioners responded to the survey. Such attention to drawings in clinical practice shows a continued professional interest in projective assessment (see Piotrowski, 2016). More recent data on the use of a variety of projective techniques by psychologists were reported in a dissertation on current assessment practices in the context as an aid in therapy (Hanigan, 2021). This study surveyed licensed psychologists in practice across a myriad of applied settings in the USA. Of the 293 respondents, 29% were engaged in assessment for 20+ hours/per week (this is a slight increase from survey data reported over the past 2 decades). In addition, 55% of these practitioners use at least one projective technique (45% don‟t use any projective measures). Frequency of projective test usage is of particular interest, and I outline the findings below (% of respondents):

Table 1: Frequency of projective test usage

        What is particularly noteworthy regarding the findings reported in the Hanigan (2021) study is that use of projective measures was compatible to the extent of reliance on objective tests (e.g., the Millon Inventories, the NEO, and the 16PF) by this national sample of psychologists. Furthermore, this study found nearly equal usage of the Rorschach-Performance Assessment System versus Exner‟s Comprehensive System. This latter finding reflects the perennial scholarly debate regarding the relative status of these 2 Rorschach approaches in contemporary personality assessment (see Gacono & Smith, 2022 for a discussion).

        Overall, the continued presence of projective measures in the research literature, the introduction of a host of novel projective techniques in recent years, and contemporary survey data on test usage clearly confirm the fact that projective techniques remain a significant part of the assessment armamentarium of mental health professionals. Indeed, this corroborates the conclusions of earlier reviews on psychological testing practices (see Frauenhoffer et al., 1998; Hughes et al., 2007; Piotrowski, 2015).I note one caveat to these general conclusions: The current pandemic has had a very detrimental impact on the assessment enterprise (Gicas et al., 2021; Krach et al., 2020), particularly with regard to the use of the Rorschach. In fact, a recent survey of members of the Society for Personality Assessment (noted in Ales et al., 2022) found that 52% of SPA practitioners have ceased conducting clinical assessment due to the challenges of test administration via tele-health mediums in the context of COVID-19. This disengagement of personality assessment practice has been corroborated in an analysis of the recent mental health literature related to COVID-19 (Piotrowski & Watt, 2021).Hence, we must await the findings of future studies (post-COVID) before an accurate appraisal on the nature and extent of psychological testing (particularly projective techniques) can be determined (Krishnamurthy et al., 2022). But, for now, projective assessment appears alive and (somewhat well) in the field of mental health evaluation.

References:

Ales, F., et al. (2022). Can the Rorschach be administered remotely? Psychological Injury & Law, in press. Aoki, S., & Kogayu, N. (2021). Color projection in the Rorschach test. Rorschachiana, 42(1), 35-51.

Bram, A.D., et al. (2018). Psychological testing and psychoanalysis: Fixable gap or great divide? Journal of Projective Psychology & Mental Health, 25(2), 166-172.

Eby, M. (2020). Projective psychodiagnostics: Inkblots, stories, and drawings as clinical measures. In Oxford Research Encyclopedia of Psychology. Oxford, UK.

Frauenhoffer, D., et al. (1998). Psychological test usage among licensed mental health practitioners: A multidisciplinary survey. Journal of Psychological Practice, 4(1), 28-33.

Gacono, C.B., & Smith, J.M. (2022). Rorschach fact or fiction? A commentary on the R-PAS and CS/CS-R. Journal of Projective Psychology & Mental Health, in press.

Gicas, K.M., et al. (2021). Clinical psychological assessment training issues in the COVID-19 era: A survey of the state of the field and considerations moving forward. Canadian Psychology, 62(1), 44-55.

Hanigan, C.R. (2021). Understanding current practice and the role of therapeutic techniques in the provision of psychological assessment.

Unpublished doctoral dissertation, Regent University, Virginia Beach.

Hughes, T.L., et al. (2007). Current status of Rorschach assessment: Implications for the school psychologist. Psychology in the Schools, 44(3), 281-291.

Imuta, K., et al. (2013). Drawing a close to the use of human figure drawings as a projective measure of intelligence. PLOS ONE, 8(3), e58991.

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Krach, S.K., et al. (2020). Testing our children when the world shuts down: Analyzing recommendations for adapted tele-assessment during COVID-19. Journal of Psychoeducational Assessment, 38(8), 923-941.

Krishnamurthy, R., et al. (2022). Professional practice guidelines for personality assessment. Journal of Personality Assessment, 104(1), 1-16.

Lawrence, J., et al. (2021). Trends and characteristics of criminal responsibility evaluations in Missouri. Journal of Forensic Psychology Research and Practice, 21(3), 283-300.

Longest, K. (2006). Mental health professionals‟ use of drawings in the assessment of children. Unpublished doctoral dissertation, University of Oklahoma, Norman.

McGlone, G.J., & Viglione, D.J. (2020). Utility of the Rorschach in psychological assessments for diocesan and religious candidates.

Spirituality in Clinical Practice, 7(4), 278-301.

Piotrowski, C. (2022). Projective techniques in research: A brief history and current update. Journal of Projective Psychology & Mental Health, 29(1), 1-3.

Piotrowski, C. (2016).Drawing techniques in assessment: A summary review of 60 survey-based studies of training and professional studies. Journal of the Indian Academy of Applied Psychology, 42(2), 220-236.

Piotrowski, C. (2015). Projective techniques usage worldwide: A review of applied settings 1995-2015. Journal of the Indian Academy of Applied Psychology, 41(3), 9-19.

Piotrowski, C., & Watt, J. (2021). COVID-19 and psychological research: Neglected investigatory domains. North American Journal of Psychology, 23(4), 669-675.

Potchebutzky, H., et al. (2020). The subjective experience of children with disruptive behavior problems as reflected in “Person Picking an

Apple from a Tree” drawings. Journal of Creativity in Mental Health, 15(1), 2-16.

Ryan, T.A., et al. (2019). Use of projective techniques in emotional disturbance evaluations. Journal of the American Academy of Special Education Professionals, (Spring-Summer), 6-14.

Saklofske, D.H., et al. (Eds.). (2013). Oxford handbook of child psychological assessment. New York, NY: Oxford University Press. Schapers, P., et al. (2021). Arousing motives or eliciting stories? On the role of pictures in a picture-story exercise. Assessment, 1-14. Sellbom, M., & Suhr, J.A. (Eds.). (2020). Cambridge handbook of clinical assessment and diagnosis. UK: Cambridge University Press.

Tafti, M.A., et al. (2021). A comparison of the diagnostic power of FEATS and Bender-Gestalt test in identifying the problems of students with and without specific learning disorders. The Arts in Psychotherapy, 73, 101760.

Toeplitz, Z. (2013). Projective techniques in forensic practice: The Thematic Apperception Test (TAT). Problems of Forensic Sciences, 94, 535-549.

Verdon, B., & Azoulay, C. (Eds.). (2020). Psychoanalysis and projective methods in personality assessment. Boston, MA: Hogrefe. Weiner, I.B., & Kleiger, J.H. (Eds.). (2021). Psychological assessment of disordered thinking and perception. Washington, DC: APA.

Willis, L.R., et al. (2010). Draw-a-Person-in-the-Rain as an assessment of stress and coping resources. The Arts in Psychotherapy, 37, 233-239.

Wright, A.J. (2020). Conducting psychological assessment: A guide for practitioners (2nd ed.). New York, NY: Wiley.

Yalof, J. A., & Bram, A.D. (2021). Psychoanalytic assessment: Applications for different settings. New York: NY: Routledge/Taylor. Yuan, Y., et al. (2021). The House Imagery Test: A new measure of mental status. Psychology and Behavioral Sciences, 10(1), 49-55.

Chris Piotrowski, PhD

Senior Editor

University of West Florida

Email: piotrowskichris@hotmail.com