Selecting and interpreting culturally appropriate instruments

“Select, administer, and/or interpret appropriate instruments/assessments that align with contextual, cultural, and developmental considerations” (NBCC, 2027 task 2B.11)

Assessment instruments are only meaningful if they fit the client: their age, developmental level, language, culture and the question being asked. Counselors select, administer and interpret tools with those factors in mind and understand basic psychometrics. The exam tests reliability, validity, norms and fairness.

Key points

Reliability is consistency of measurement (for example test-retest, internal consistency, inter-rater); validity is whether the instrument measures what it claims to measure (content, criterion-related, construct).
A test can be reliable without being valid, but cannot be valid without being reliable.
Norms describe the group a client is compared with; check that the norm group is relevant to the client's age, culture and language.
Standard scores: z-scores have a mean of 0 and standard deviation of 1; T-scores a mean of 50 and standard deviation of 10; in a normal distribution about 68 percent of scores fall within one standard deviation of the mean and about 95 percent within two.
The standard error of measurement describes the range around an observed score in which the true score is likely to fall; report scores as ranges when it matters.
The ACA Code of Ethics asks counselors to use caution with instruments normed on populations other than the client's and to consider culture in interpretation.
Follow standardized administration; deviations, translations or accommodations should be noted when interpreting results.

In practice

A counselor needs a depression measure for an older Korean-speaking client. She chooses a version translated and validated for Korean-speaking adults rather than translating an English tool herself.

A teenager scores one point above a cutoff on an attention rating scale. The counselor considers the standard error of measurement, other data and school context before drawing conclusions.

Check yourself

What is the difference between reliability and validity?

Reliability is consistency of measurement, while validity is whether the instrument measures what it intends to measure.

A T-score of 70 is how many standard deviations above the mean?

Two, because T-scores have a mean of 50 and a standard deviation of 10.

Why does the norm group matter in interpreting a score?

Scores are compared with the norm group, so a group unlike the client can make results misleading.

NBCC's knowledge and skills for 2B. Assessment

Knowledge of: Foundational knowledge of statistics; Diagnostic criteria - DSM-5-TR; Diagnostic Criteria - ICD-11; Symptoms of trauma; Medical diagnoses and symptoms that can contribute to mental health symptoms; Differential diagnoses, co-occurring diagnoses, and comorbidities; Risk assessment and risk factors or symptoms; Cultural idioms of distress; Cultural implications of diagnosis.

Skill in: Conducting a diagnostic assessment and evaluation; Conducting and interpreting assessments; Conducting formal assessments; Conducting informal assessments; Conducting lethal means restriction.

A study guide written by ExamDragon from NBCC's published task; not NBCC material and not part of the exam.