Background to my interest in teaching children with autism

Chapter 13
Assessment Errors – Errors of Measurement
Introduction – Assessing Assessments
Psychotherapy is a responsible enterprise, and failures not processed through ‘post-mortem’ are just not acceptable. This Part is concerned with some of the sources of mistakes which all of us make. Since mistakes in psychotherapy would be expected to start with mistakes of understanding on the part of the therapist, it seems right to start this Part with an explanation of some of the more obvious complexities involved in assessment, thus in reaching an understanding of the person and thus, in turn, in selecting an appropriate means for treatment intervention.
A Tearful Scream
A recent immigrant by the name of Ursula, in her early thirties, was admitted to the old mental hospital. She was irritable and very complaintive, frequently screaming in apparent rage about how badly she was being tortured. She was manifestly hostile in an abrasive and contemptuous way about the mistreatment which she felt she was receiving from the various hospital staff. She was unwilling or unable to divulge much about her history and was extremely guarded about giving any personal information. She seemed unable to accept the logic of information given her, and it was felt by staff that she used an idiosyncratic logic in many of the things she did and said. She wore two pairs of slacks and two to four dresses at the same time, in a manner jarring to the eye. Ursula was interviewed by two extremely astute psychiatric diagnosticians, and both concluded beyond a doubt that she was suffering from a paranoid schizophrenic disorder. Since paranoid schizophrenia was one of the conditions being treated on the Behaviour Therapy Unit, she was transferred to that unit for treatment. Her behaviour on this unit gave every indication supporting the diagnosis, and so the behavioural treatment being used for paranoid schizophrenia was implemented with her. Only the gentlest of methods were employed. But for six long months of intensive treatment, Ursula continued to scream of the abuse and torture to which she was being subjected. At the end of six months there was no change in her clinical condition.

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