I've been doing some reassessment as part of my therapy, which basically involves taking all these standardized tests that I took when I first started going. And it's going well. Really well. Looking back at my previous scores, I'm frankly astounded, I don't know who the person talking was, as her experiences seem so far removed from mine. So it's going well for me personally, but these tests have got me thinking.
It seems to me that standardized assessment is something very easy to fake.
There's a lot of them, so I won't go into names and schools of psychology, but practically all of them ask you to report on and score certain difficulties, exaggerations, and things you're encountering in your day to day life. They rely on you to do it honestly, but... isn't honesty itself subjective?
What I say about my perceived experience will probably be in line with my expected result. If I'm in a place where I want to believe I've made significant progress and am "cured", it's very easy to lie. Not just to yourself, but to the test, as well. The questions are almost always transparent, and it's quite easy to figure out what to say to get a certain result.
Likewise, if I'm convinced I have a problem of any nature, I know exactly how to go about lying on these tests.
And obviously, tests aren't the only way in which therapists work. Ideally, a good therapist will also use their judgment and knowledge of you as a person to assess your progress. Which boils it down to their honesty, which is also subjective. It makes it all about the results they want, need or expect from a patient. And if you're unfortunate enough to fall in step with a biased therapist, it's presumably very easy for you both to permeate a lie about your supposed unwellness.
I'm lucky. It's not at all my case, and I'd say my therapist has a good understanding of me. But I'm just thinking... If I wanted to lie, it would be very easy. Be very easy for her to, as well, as we're quite beholden to our therapists. There is a skewed power dynamic there that would make it more likely to go along with a therapist's assessment than that of a friend or partner.
It worried me, when I was answering, how easily I could be unwell but pass with flying colors. It also worried me that my therapist's (and my own) assessment couldn't be enough to qualify me as "better". It's necessary to redo assessment to make sure.
Doesn't that seem wrong? Why would we need confirmation from an unreliable testing method of something we very plainly can see? Shouldn't a professional's in-person assessment be the main thing here, and not the other way around?
It's all murky because when we fall back on standardized testing, we leave a very large space for misinterpretation and misunderstanding. As with all tests, we invite the possibility of cheating and deception, which doesn't seem like something that should be in our mental health arsenal.
It feels to me that the healthier and more balanced we become, the more we should be able to rely on our instinct and judgment, not the other way around.
As I say, it's not my case, but the tests themselves are incredibly stark and reductive of the human condition. Are you a paranoid loony? Are you sticking fingers down your throat? Do you talk to people who aren't there? You're either sick or you're not, because this is a numbers' game. You either fall into a "healthy norm" margin, or you don't. Except, what if you fall into either without necessarily belonging there? It seems to me the psychological profession is attempting to use math to treat and diagnose something that's very unmathematical and incompatible with the strict rigor of grids and numbers.
I can't help but wonder what happens to the people who lose their bearing amidst all this incessant wellness questioning and fall through the cracks.
What do you think?
I wonder if someday soon AI will be so good that there will be an assessment that that participant can't lie/fake their way through? That's a crazy thing to think about. It could spark a huge change for the better or could take a dystopian turn depending who's in control of it. You're right, currently those tests are only as effective (or not) as the honesty of the person taking it.
We've had a lot of contact with the US healthcare system these past six months and with each visit they ask you standardized questions -- Are you feeling depressed? Have you wanted to harm yourself in the last 30 days? along with a lot of questions about Covid and travel. I often wondered how honest people are in that case. So many people are concerned with the cost of healthcare in America a bet a lot of people don't answer honestly because they don't want additional financial pressure.
I wonder the same thing! There's a chance people considering that would tell the truth, presumably, as a cry for help. Good chance they wouldn't though, which makes one wonder what the point is. I hope you're all well <3
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STOPDon’t you think the idea of using a therapist’s knowledge to access the patient is a test too?