A proposed model for the psychometric evaluation of clinical case formulations with quantified causal diagrams

Psychol Assess. 2020 Jun;32(6):541-552. doi: 10.1037/pas0000811. Epub 2020 Mar 2.

Abstract

Judgments about a client's behavior problems and treatment goals, and the factors that influence them, are elements of most clinical case formulations (CCFs). These judgments are designed to guide clinicians' selection of the most effective intervention foci. Despite their importance, CCFs have undergone infrequent psychometric evaluations. We describe a model to promote and facilitate the psychometric evaluation of CCFs with quantified causal diagrams. This article presents the conceptual foundations, path analyses, benefits, and limitations of quantified causal diagrams. We first present concepts of causality and causal diagrams that are applicable to CCF and psychopathology. We propose that clinical case formulations causal diagrams can strengthen a science-based approach to clinical assessment, facilitate the psychometric evaluation of CCFs, enhance the specificity, precision, and communicability of clinicians' judgments, help the clinician select the most effective intervention foci, predict the effects of changes in causal variables, and emphasize the importance of "uncertainty" in CCFs. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

MeSH terms

  • Causality
  • Clinical Decision-Making / methods*
  • Humans
  • Mental Disorders / diagnosis*
  • Mental Disorders / etiology
  • Mental Disorders / psychology
  • Mental Disorders / therapy*
  • Models, Psychological*
  • Psychometrics / methods*
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Uncertainty