Case 55: Sentence Completion Methods: A Summary Review of 70 Survey-based Studies of Training and Professional Settings

Sentence Completion Methods: A Summary Review of 70 Survey-based Studies of Training and Professional Settings

Chris Piotrowski

           In a recent editorial, Piotrowski (2017) contends that the fate of projective techniques will be linked to the precarious status of personality assessment in clinical training settings. Moreover, since 1990, projective techniques, as a class, have been the target of extensive criticism in the scholarly literature (e.g., Lilienfeld et al. 2000). This prompts the question: Have Sentence completion methods and tests(SCTs) lost their luster as a major component of the assessment process? Since scholarly reviews of the extant literature on SCTs have rarely appeared in the recent literature (see Holaday et al., 2000; Sherry et al., 2004), an examination on the status of SCTs would be informative. Thus, the intent of the current study is to determine whether recent shifts in testing practices and research attention in the field of assessment have had a deleterious impact on the popularity of SCTs in graduate training programs and professional usage worldwide. To that end, the author identified, through an extensive literature review, published survey research with regard to SCTs that reported on assessment training and test usage patterns from 1989-2015. The 70 identified survey-based or records-based studies served as the data pool in the current review (Training=16; Practice=54). This analysis indicated that, from a historical perspective, sentence completion methods have been popular assessment tools, evident in that 35 of the70 studies (50%) reported that SCTs have been relied upon to at least a „moderate‟ degree. However, reliance on SCTs has been more prominent in academic assessment training (69% of studies) than in practice settings (44% of studies). Quite apparent in this review, was the obvious diminution of SCT usage since 2003 in both professional clinical academic programs and in applied settings. One noteworthy exception is that several very recent (since 2014) surveys of internship settings confirm continued emphasis on SCTs. Regardless, supplemental data point to the reality that coursework and training emphasis with SCTs have been rather cursory and unstructured. In addition, these vast survey-based findings suggest that SCTs are embraced more by child clinicians and school psychologists than in mental health assessment of adults. However, based on the evidence in this exhaustive review, it appears that current usage of SCTs is waning. Thus, the future status of SCTsin the assessment enterprise appears rather limited, but certainly not moribund.

          Over the past 75 years, Sentence Completion methods and tests (hereon, SCTs), largely within the context of projective methods, have been popular assessment tools in practice (Fisher,  1967;  Frank,  1948;  Keddy  & Piotrowski, 1992; Klopfer & Taulbee, 1976; McGrath & Carroll, 2012; Murstein, 1965; Piotrowski, 1985, 2015a; Piotrowski & Keller, 1992; Rabin, 1986; Reynolds & Kamphaus, 2003; Sherry et al., 2004; Wade & Baker, 1977).

          Moreover, scholarly research on various SCTs has been rather robust over the years (see Lah, 2001, 1989). In an analysis on the prevalence of projective techniques in published research reported in key journals from 1947-1965, Crenshaw et al. (1968) found the SCT to be ranked 4th in terms of investigatory interest over this time period. A

recent bibliometric search (terms in Title: “sentence completion” or “incomplete sentences”, conducted in May 2017) in the database PsycINFO identified 242 article references, 43 dissertations, and 23 book/chapters with a focus on SCTs. Indeed, a cursory examination of recent scholarship shows the research attention to traditional SCTs and newly developed SCTs remains active (e.g., Chan et al., 2012; Huang, 2016; McCloskey, 2014; Weis et al., 2008).

Findings from research studies have not only found support for the construct validity of SCTs but also highlight the empirical relevance of sentence completion data in clinical research (see Rusu et al., 2012; Torstrick et al., 2015). Proponents of projective assessment contend that SCTs provide rich idiographic material that reflects

Chris Piotrowski, Ph.D., University of West Florida (USA), Email: cpiotrowski@uwf.edu

Key Words: Sentence Completion Tests, Assessment practices, Assessment Training, Trends personality characteristics and provide indirect clues to underlying attitudes, affects, stressors, and coping mechanisms (Basu, 2014;Rapaport et al., 1968; Sherry et al., 2004; Weiner & Greene, 2008). Moreover, sentence completion approaches seem very conducive to the assessment process when evaluating children and as a prodigious precursory tool in screening for psychological disturbance or maladjustment (e.g., Kugler et al., 2013).

            One major drawback in the advancement (and professional acceptance)of this assessment technique has been the multitude of varied formats, sentence stems, and content spectrum of SCTs available to both clinicians and researchers (see Rogers et al., 2003). Another hindrance has been the labeling of SCTs as a strictly projective technique and the lack of formal scoring and interpretive systems. Based on these concerns, projective techniques, in general, have generated much scholarly criticism by clinicians and academicians over the years (Garb et al., 2002; Lilienfeld et al., 2000; Smith & Dumont, 1995), even during the zenith of their popularity (see Butcher, 2006;Harwood et al., 2011; Swensen, 1968; Vukovich, 1983). Critics, like Ziskin (1995, pp. 824-825), aptly stated “The most devastating criticism is that the examiner may engage in as much projection and subjectivity in the interpretation of responses as did the examinee in generating the responses - Not only are the test stimuli ambiguous, but so too is the meaning of the responses given by the examinee.”

Thus, based on the apparent acceptability of SCTs in practice venues and, conversely, disparagement of projective assessment in the scholarly literature, the aim of the current study is to review the extant literature on assessment usage of SCTs in both academic training and applied settings.

 

Historical Context:

Graduate-level Training Settings:

          Early surveys, such as McCully (1965), reported rather positive attitudes of internship directors regarding projective techniques, with 76% of respondents considering SCTs as somewhat or very important. In a survey of academic clinical psychologists in APA- approved clinical training programs, Thelen et al. (1968) found that 80% of respondents considered SCTs important to master, with 41% confirming that coverage of SCTs should be required coursework. About this time, Shemberg and Keeley (1970) detected a slight decrease in training in projective techniques in PhD clinical training programs. However, very positive attitudes, toward diagnostic testing, were reported by internship directors several years later (Garfield & Kurtz, 1973); in fact, 64% of internship centers emphasized SCTs. Moreover, clinical psychologists recommended that clinical students learn about SCTs (Wade & Baker, 1977).

          During the 1980s, where attitudes of academic faculty and internship directors toward projective tests were somewhat tempered, SCTs were still endorsed as important for practice by 62% and of academic clinical psychologists, with 34% stating that SCTs should be required coursework (Pruitt et al., 1985). In a survey of APA clinical psychology programs, Piotrowski and Keller (1984) found that a majority (53%) of directors recommended training in SCTs. Moreover, SCTs continued to be somewhat popular during internship training(see Durand et al., 1988), including extensive clinical experiences with SCTs by advanced clinical interns in child specialty programs (Elbert & Holden, 1987). Supporting this view, Knight and Godfrey (1984) reported that hospital psychologists (45%) in New Zealand recommended that clinical students gain competency in the Rotter ISB.

 

Mental Health Practice Settings:

Early on, national surveys on clinical test usage in outpatient and hospital settings found that SCTs ranked 4th and used in almost 50% of mental health agencies (Sundberg, 1961). However, SCTs did not rank  highly  in  a  survey  of  practicing psychologists (Hinkle et al., 1968). In a nationwide survey of clinical agencies, Lubin et al. (1971) reported that SCTs ranked 8th.Gendreau (1975), in a study on psychological test usage in corrections in Canada, reported that the Rotter ISB was ranked 13th. Other surveys of mental health practitioners in the 1970s found SCTs ranked amongst the „Top 10‟ tests in terms of usage (see Brown & McGuire, 1976; Piotrowski & Keller, 1978). Emphasis in practice with Sentence Completion approaches continued into the 1980s (Harrison et al., 1988; Haynes & Peltier, 1983; Lubin, Larsen, & Matarazzo, 1984; Sweeney, Clarkin, & Fitzgibbon, 1987; Watkins et al., 1988).In fact, one survey found that 47% of practitioners recommended professional competency with SCTs (Piotrowski, 1985).

In the area of child assessment, one study of practicing school psychologists reported that 87% of respondents used SCTs in the assessment of personality (Goh et al., 1988), although SCTs have not been found to be popular in the assessment of specific childhood disorders like ADHD (see Rosenberg & Beck, 1986).Interestingly, although child psychologists rely on projective techniques, few (17%) have been reported to use SCTs in clinical work (Tuma& Pratt, 1982).

Surprisingly, clinicians such as behavior therapists, with an anathema to projective techniques, have been reported to occasionally rely on SCTs (Piotrowski & Keller, 1984).Noteworthy, the popularity of SCTs has not been evident in practice settings overseas; e.g., based on test usage data from 383 Australian practicing psychologists, Sharpley and Pain (1988) found that SCTs were not highly recommended for inclusion in graduate-level training. Thus, prior to 1990, most surveys indicated reliance on SCTs by mental health practitioners.

 

Investigatory Design:

           In order to appreciate historical trends on the scope of emphasis and usage of Sentence Completion Tests (SCTs) in graduate-level training and practice/professional settings, the author utilized bibliometric analyses of the extant literature to identify survey-based studies. To that end, a systematic search of the database PsycINFO (published by the American Psychological Association) was conducted, as this research repository is considered the leading scholarly file of research in the social and behavioral sciences worldwide. Table 1 summarizes survey findings of both academic and applied settings on training emphasis and usage of SCTs since 1989. This timeline reflects the inception of the burgeoning critique of projective techniques in the scholarly literature. Thus, this review includes the 70 published studies that were identified in journal publications, based on academic/training and clinician/practitioner samples worldwide.

 

Findings:

           First, response-rates of the reviewed studies varied widely; thus, the conclusions of the current analysis findings must be tempered by the unknown views of a sizeable percentage of non-responders from the samples under study. Thus, with a cautionary stance, the current analysis showed that, overall, based on data from both academic and practice settings over the past 3 decades, SCTs have been emphasized or used to at least a

„moderate‟ degree in 35 of the 70 (50%) studies in this review. This popularity was apparent in doctoral training or internship settings, where SCTs received „moderate to high‟ coverage in 11 of the 16 studies (69%)

compared to only 24 of the 54 studies (44%) of practice settings. In fact, 30 of the 54surveys (56%) of applied settings indicated infrequent use of SCTs, although 22% found rather high usage levels in practice.

           Regarding usage over time, this review revealed that emphasis on the SCTs, overall, has diminished somewhat since the year 2000, both in training and practice. The only exception noted was continued popularity and reliance on SCTs by school psychologists (Hojnoski et al., 2006), child psychologists(Cashel,2002), and in vocational rehabilitation evaluations (Donoso et al., 2010).However, although substantial levels of training emphasis with SCTs in APA academic programs were reported by Childs and Eyde (2002) and Belter and Piotrowski (2001), coursework exposure to SCTs has been virtually nonexistent in graduate-level training in recent years (see Peterson et al., 2014; Ready &Veague, 2014). Interestingly, SCTs still enjoy moderate levels of emphasis in internship settings (Bates, 2016; Ready et al., 2016).Future studies should shed some light on how this diminution in instructional attention during graduate-level trainingwill impact the status of SCTs over the next decade.

           Several other trends in practice or applied settings were noted: a)SCTs have been rarely used and are largely neglected by neuropsychologists in assessment of personality (Rabin, 2005; Smith, 2010);b) historically, SCTs have had a central role in the evaluation practices of school psychologists (e.g., Hojnoski et al., 2006; Hughes et al., 2010; Hutton et al., 1992; Kennedy et al., 1994), but the focus on SCTs in academic school psychology programs has diminished over the past decade; and c) there is a dearth of data on the status of SCTs in graduate-level educational or training programs in countries outside the USA; hence, future research needs to examine pedagogic issues and identify trends regarding assessment training, over time, at universities in nations worldwide (see Piotrowski, 2015b for review).

 

Conclusion:

• In terms of graduate-level training, prior to 2003, SCTs were well integrated into the assessment curriculum in clinical psychology programs and internship settings. However, in recent years, SCTs have witnessed a sharp diminution in emphasis in professional clinical programs, but (surprisingly) continue to be somewhat valued in internship settings. Moreover, based on supplemental data, it appears that much of the didactic instruction on SCTs has been rather cursory and unstructured. In this regard, scholarly commentary, in recent years, has been devoted on concerns regarding achieving competency in testing during assessment training in professional psychology programs (see Flanagan & Esquivel, 2006; Lan& Chang, 2016; Krishnamurthy et al., 2004). Hence, interested students may need to pursue educational opportunities on SCTs via nontraditional venues such as workshops and individualized instruction in order to gain proficiency and mastery with sentence completion assessments.

• In terms of usage in practice, from an historical perspective prior to 2000, SCTs were quite popular in clinical, child, and school psychology settings. However, SCTs have been largely eschewed by neuropsychologists and forensic psychologists. Overall, based on recent surveys, the popularity of SCTs in practice settings has seriously waned in the past 10 years, with the exception of continued use by school psychologists and in specific areas of legal evaluations. This disuse of SCTs by the majority of mental health professionals is perhaps due to managed care constraints (Maruish, 2002; Piotrowski & Belter, 1999; Riaz, 2006), attention on empirically-based assessment (Lilienfeld et al., 2015), and the diminution in training emphasis with projective techniques in professional programs, quite evident in recent years (see Piotrowski, 2015c; Ready et al., 2014). Quite surprisingly, Delphi poll findings point to the general acceptance of SCTs in terms of clinical credibility(see Norcross et al., 2006).

• Regarding SCTs usage overseas, the data are rather spotty, with strong emphasis in some countries like Japan but largely neglected in European and South American nations. Moreover, more research on the status of SCTs in graduate-level education and training in nations outside the USA are needed, particularly due to recent research interest in SCTs in select countries (e.g., Bhattacharya et al., 2015).

• Based on the emerging literature, it is evident that SCTs are been applied in business research, such as in marketing and consumer psychology (e.g., Vidal et al., 2013).

• These findings, in aggregate, confirm that a minority of mental health practitioners have relied on SCTs and sentence completion methods over the past century, and have done so based largely on several key attributes of these techniques discussed in the assessment literature; notably, that SCTs can contribute to idiographic assessment and serve as an exploratory assessment tool in the mental health evaluation, particularly children and youth (Basu, 2014; Chandler, 2003). In addition, SCTs assist the clinician in understanding and addressing stressors, social-emotional  needs,  and  interpersonal challenges. However, due to the perennial introduction of „new‟ psychological scales and measures, reimbursement limitations, and the proliferation of „brief‟ and abbreviated testing instruments, the status of SCTs in academic training programs has clearly suffered in recent years. Hence, with obvious diminution in training emphasis, enthusiasm for SCTs in practice settings will surely be curtailed. Thus, based on the current systematic review, the future status of SCTs in the assessment enterprise appears rather limited, but not quite moribund.

 

Table-1: Emphasis or Use of Sentence Completion Tests in Training/Practice Settings across 70Studies (1989-2016)
Study	Country	Sample	Findings
Piotrowski & Keller (1989)	USA	Test usage in 413mental health facilities	356 of the 413 settings used SCTs, ranked 6th in overall usage.
Tsoi & Sundberg (1989)	Hong Kong	Division of Clinical Psychology of the Hong Kong Psychological Society	SCTs were not ranked amongst the top 10 tests.
Bubenzer et al. (1990)	USA	743 members of the American Association for Counseling & Development, primarily practitioners	SCTs were not ranked highly.
*Watkins et al. (1990)	USA	Data based on 56 directors of counseling psychology training programs	27% of these programs emphasized SCTs in coursework/training.
Archer et al. (1991)	USA	165 respondents who were either APA Division 12 members, Society for Personality Assessment members, and/or practitioners with a research interest in adolescent assessment	The SCTs ranked amongst the top tests for inclusion in a „Standard‟ test battery, endorsed by 46% of respondents.
Butler et al. (1991)	USA	280 members of the International Neuropsychological Society	36% of respondents in neuropsychology use SCTs for „personality‟ assessment.
Ogawa & Piotrowski (1992)	Japan	Japanese Clinical psychologists	SCTs ranked 2nd in terms of usage in Japan.
Hutton et al. (1992)	USA	389 school psychologists (members of NASP); update on the Goh et al. (1981) study	For the area of personality assessment, SCTs were used by 20% of sample (ranked 5th).
*Piotrowski & Zalewski (1993)	USA	A 1991 replication of the Piotrowski & Keller (1984) study; 80 Directors of both PhD and PsyD APA clinical psychology programs	35% of the programs suggested competency in SCTs; this reflected a slight decline in emphasis on SCTs compared with findings (53%) of the 1984 survey.
Kennedy et al. (1994)	USA	Practicing school psychologists	Overall, projective tests used frequently; SCTs ranked 4th.
Stinnett et al. (1994)	USA	Data analysis based on 123 members of the National Association	In social-emotional assessment, 60% use SCTs (ranked #1 in this area).

		of School Psychologists (NASP) in 1993
Chan & Lee (1995)	Hong Kong	50 practicing psychologists in 1993	Projective tests were quite popular; SCTs ranked 8th.
Watkins et al. (1995)	USA	412 APA members who were clinical psychologists	SCTs used by 84% of practicing psychologists & ranked 4th overall; 52% of psychologists felt that clinical students should gain competency in SCTs.
Borum & Grisso (1995)	USA	102 forensic psychologists/psychiatrists	For psychologists, SCTs were relied upon by only 6% of respondents; for psychiatrists, 3%.
*Wilson & Reschly (1996)	USA	Data, obtained in 1992, on assessment practices from 251 members of the National Association of School Psychologists (NASP); and faculty in school psychology programs	For the practitioner sample, SCTs were not amongst the top 10 instruments; for faculty, SCTs were not covered in coursework nor in supervised training.
Lees-Haley et al. (1996)	USA	Forensic evaluation reports by100 forensic neuropsychology experts	SCTs (ranked 10th) and were used by 28% of respondents in forensic cases.
Mardell- Czudnowski (1996)	USA	Special needs professionals (n=1059) testing practices with children	SCTs were rarely used.
*Culross& Nelson (1997)	USA	Surveyed 63 instructors listed in NASP-approved graduate programs in school psychology on tests emphasized in personality assessment coursework	SCTs were taught in 62% of personality assessment courses.
Patchett- Anderson (1997)	New Zealand	Test usage by clinical psychologists	SCTs were amongst many psychological tests that practitioners recommended clinical students to learn.
Ackerman & Ackerman (1997)	USA	Practitioners in court-related custody evaluations involving children and parents	SCTs ranked amongst the top tests (#8); In a re-analysis of the findings, Hagen &Castagna (2001) found that SCTs were used in 19% of assessment reports of parents and in 22% of evaluations of children.
Frauenhoffer et al. (1998)	USA	Surveyed 487 mental health practitioners (psychologists, counselors, social workers)	45% of psychologists rely onSCTs (ranked 5th); social workers (5th); professional counselors (6th).
Piotrowski et al. (1998)	USA	137 practitioners in National Register of Health Service providers in Psychology	Although several projective tests (Rorschach, TAT, HFDs) were considered important to assessment practice, SCTs were not noted.
Muniz et al. (1999)	Spain, Portugal, & Latin America	Test use by practicing psychologists	Overall, projective methods were quite popular, but SCTs were used infrequently.
Boccaccini & Brodsky (1999)	USA	Diagnostic test usage in personal injury cases by 80 practicing forensic psychologists	SCTs were not frequently used in the assessment of „emotional injury‟.
*Piotrowski &	USA	Extent of graduate-level assessment	32% of these internship sites provided

Belter (1999)		curriculum was reported by training directors from 84 APA-approved internship settings	training on SCTs; however, SCTs were notconsidered „essential‟ for practice.
Holaday et al. (2000)	USA	60 members of the Society for Personality Assessment on SCTs assessment usage	The Rotter ISB was the predominant SCT used with adults (47%), adolescents (32%), and children (18%); few assessors relied on formal scoring protocols.
Camara et al. (2000)	USA	179 practitioners, mostly clinical psychologists regarding test usage	Neuropsychologists shunned SCTs; but clinical psychologists valued SCTs(ranked 15th).
Archer & Newsom (2000)	USA	346 psychologists, working with adolescents	SCTs (ranked 3rd) were used by 65% of respondents.
*Stedman et al. (2000)	USA	324 internship directors across a variety of mental health settings	Directors did not mention SCTs to be included in „integrated‟ assessment.
Boothby & Clements (2000)	USA	Correctional (prison) psychologists	SCTs were not amongst the top 20 assessment instruments.
*Clemence & Handler (2001)	USA	Surveyed 382 internship settings on use and training of psychological tests	Internship directors supported graduate- level preparation in projective assessment;45% recommended competency and inclusion inSCTs in a „Testing battery‟.
Muniz et al. (2001)	European (Spain, UK, Holland, Slovenia, Croatia, Belgium)	3,455 professional psychologists use of psychological tests	In these 6 countries, projective tests were not used frequently; SCTs were not relied upon in assessment.
Luiselli et al. (2001)	USA	Assessment for autism reported by100 practitioners in national service centers for developmental disabilities in 30 states	Although about 25% of service centers use projective tests in the treatment of autism, SCTs were not noted.
Quinnell & Bow (2001)	USA	Testing practices in child custody evaluations by 198 practicing psychologists	30% of the sample use SCTs in assessment of children; 26% in testing adults.
*Belter & Piotrowski (2001)	USA	Survey data on 82 directors of APA- approved doctoral clinical/professional psychology training programs on assessment curriculum	Nearly 60% of the programs required a specific course on projective testing; SCTs were emphasized in 23 of the 82 programs (28%).
*Childs & Eyde (2002)	USA	Course syllabi data, from 84 APA clinical psychology programs, determined coverage of assessment techniques	29% of programs indicated that SCTs are covered in the assessment curriculum (12th ranked test).
Cashel (2002)	USA	162 child & adolescent practitioners in outpatient, hospital and school settings	SCTs were ranked 3rd amongst 30 tests in the assessment of youth; 75% of respondents use SCTs to some degree.
*Stedman et al. (2002)	USA	Based on survey data from 334 psychology interns, determined extent of pre-internship assessment	Results showed that clinical students met or exceeded most expectations of internship training directors by producing a

		report writing experiences	median of 18 integrated testing reports; however, reports including SCTs were few (M=2).
Bow et al. (2002)	USA	84 psychologists reported on assessment practices regarding sexual abuse in child custody cases	SCTs were used in 13% of assessments of accusing parents and alleged perpetrators.
Dugdale & Dunn (2002)	New Zealand	Practicing psychologists and counselors	SCTs were not ranked highly.
Demaray et al. (2003)	USA	Surveyed over 316 school psychologists on assessment practices in ADHD	Although 30% supported projective assessment, only 11% relied on SCTs in ADHD evaluations.
Lally (2003)	USA	64 Diplomate-status forensic psychologists, test use in court- related evaluations	SCTs were considered „unacceptable‟ from 69%-76% of sample across several forensic domains.
Ryba et al. (2003)	USA	Psychologists‟ test usage in juvenile competency to stand trial evaluations	Projective tests were infrequently employed; only 10% reported using SCTs.
Shapiro & Heick (2004)	USA	Determined assessment practices of 648 school psychologists (NASP members)	SCTs used infrequently across recent cases involving psychological assessment issues.
Echemendia & Harris (2004)	USA	Test use practices of 911 neuropsychologists	No projective techniques were amongst top tests used.
Elhai et al. (2005)	International sample	Test use in PTSD evaluations by 227 members of the International Society for Traumatic Stress Studies	SCTs not relied upon.
Rabin et al. (2005)	USA/Canad a	Assessment practices of 747 clinical neuropsychologists	Only the Rorschach was amongst the top 40 tests in neuropsychological assessment; SCTs not noted.
Hojnoski et al. (2006)	USA	170 school psychologists reported use of projective tests	SCTs were the most popular projective technique, used by 61% of respondents, mostly for diagnostic purposes &hypothesis development.
Archer et al. (2006)	USA	152 forensic psychologists‟ use of projective techniques in court-related assessments	15% of respondents (n=22) use SCTs at least „occasionally‟ in forensic evaluations of adults with regard to personality assessment.
Koonce (2007)	USA	246 NASP members were surveyed on selection of tests in ADHD assessment	For direction for selection of ADHD test battery, 30% of respondents relied on SCTs (ranked 9th).
Madaus et al. (2009)	USA	Assessment practices reported by 164 „special education‟ directors in school districts in 5 northeastern states	Apparently, projective techniques are not used in the assessment of social- emotional behavior in „special education‟ milieu.
Ogawa et al. (2010)	Japan	2010 assessment practices of 237 Japanese psychologists in practice; replication study of 2004 survey	SCTs used by 50% of respondents; a slight decline in popularity compared to 2004 survey (65% used SCTs); however, only 15% felt that students should pursue instruction on SCTs.
Smith et al. (2010)	USA	404 members of the International Neuropsychological Society or	SCTs were not relied upon in neuropsychological testing nor for

 

		National Academy of Neuropsychology surveyed on personality assessment practices	personality assessment.
Donoso et al. (2010)	USA	150 professionals who conduct vocational rehabilitation evaluations	SCTs ranked 9thand used by 40% of practitioners.
Raez (2011)	Peru	University psychologists in Lima, and members of the Peru Society of Rorschach & Projective Methods	92% of the sample use projective techniques; but SCTs were used infrequently.
Ackerman & Pritzl (2011)	USA	213 forensic psychologists surveyed on tests used with parents in child custody evaluations	41% of the sample use SCTs in assessment of parents.
Evers et al. (2012)	17 European countries	Study conducted in 2009; sample included 12,606 professional psychologists regarding testing practices; data analysis based on 400 respondents	Projective tests were not ranked highly across all countries; SCTs were rarely used.
*Neukrug et al. (2013)	USA	Based on survey data from 210 counselor educators across the U.S., this study examined graduate-level coverage of assessment instruments by instructors	70% of instructors reported teaching emphasis with the Rotter ISB (ranked 36th);the Forer SCT noted my 27%.
Peterson et al. (2014)	USA	926 counselors (clinical mental health, school, occupational) rated tests of all types regarding usage	Amongst a copious set of testing instruments, SCTs were used infrequently; the Rotter ISB (ranked #54) and the Forer SCT (#94).
Neal & Grisso (2014)	International sample: USA (45%), Canada (7%), Europe (3%), Australia- New Zealand (4%)	434 forensic examiners of professional organizations	Across a variety of forensic/legal domains, a myriad of testing instruments was used; however, the only projective test noted was the Rorschach.
*Ready & Veague (2014)	USA	Compared training in psychological assessment across 3 training models (Clinical-Science, Scientist- Practitioner, Practitioner-Scholar) in APA-Accredited programs	No projective tests ranked in the top 10; only practitioner-scholar programs offer limited coverage on projective techniques; SCTs not mentioned.
Wechsler et al. (2014)	Iberian/Latin -American countries	Test development & usage in Portugal, Spain, Argentina, Venezuela, and Brazil	Projective tests very popular in Venezuela; Rorschach somewhat popular in Brazil and Argentina; Spain and Portugal indicated low usage of projective tests.SCTs are not amongst the top tests used by practitioners in any of these countries.
Rotomskis et al. (2016)	Lithuania	Assessment practices of 113 psychologists who work in mental health care institutions	SCTs were not frequently used.
Rabin et al.	USA and	512 neuropsychologists (INS/NAN	In the area of personality/mood

(2016)	Canada	members) on test usage	assessment, SCTs were rarely used (by 2.6%) and ranked 15th in that domain.
*Ready et al. (2016)	USA& Canada	236internship directors‟ views on pre- doctoral academic training in testing and assessment	SCTs were endorsed by about 25% of these directors; somewhat more emphasized in child clinics (by 40%).
Wright et al. (2016)	USA	Views of 279 professional APA psychologists on assessment/testing practices	SCTs not ranked among top tests; in the projective test category, only the Rorschach ranked in „Top 10‟.
*Mihura et al. (2016)	USA	Assessment/testing training reported by 83 APA clinical psychology programs	SCTs were „covered‟, overall, in 47% of programs; more emphasized in practitioner-focused training.
*Kohns (2016)	USA	Experiences of 148 advanced clinical students from both APA & non-APA professional psychology programs regarding assessment training	Although exposure to projective assessment was rather high (30 coursework hours), specific data on SCTs were not reported.
*Bates (2016)	USA	182 APPIC internship directors‟ views on assessment/testing training practices	Compared to other tests, SCTs ranked 14th (endorsed by 23% of directors); SCTs are relied upon in assessment by 44% of interns; although emphasis in projective testing decreased substantially in recent years, directors prefer incoming interns to have academic exposure to projective assessment.
Egeland et al. (2017)	Scandinavia	702 Nordic neuropsychologists‟ use of personality/psychological tests (outside of neuropsychological measures)	No projective tests were mentioned.
Note. Studies (n=16) marked with asterisk(*) focused on graduate/internship training.

 

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