ABSTRACT
Little is known about how child psychologists are formally prepared to perform one of their most challenging professional roles, the sharing of test data with their patients’ families. Although much time and energy is justifiably invested in mastering test procedures and using tests to describe personality characteristics and reach differential diagnoses, there is little formal training in how to convey this information to parents, and most psychologists learn these skills by observation or through trial and error. Although providing feedback to parents is often challenging for clinicians, providing feedback regarding personality assessment can be particularly difficult, as the results of personality assessments frequently involve judgments regarding children’s individual attributes, place in the family, the quality of their relationships with parents and siblings, and potential causes of behavior problems. Thus, the results of the evaluation frequently relate to the parents’ investment in their view of their child and their relationships, which may elicit intense personal feelings in the parents when they hear this information.Complicating this issue is the fact that results from personality assessments can be somewhat ambiguous, which can leave parents feeling as if they do not have succinct answers to their questions. In addition, the results may reveal personal, intimate details about the child and his or her parents that can make parents-and clinicians-feel uncomfortable. Thus, it is critical that this feedback be offered in a way that is informative, empathie, and supportive of parental emotional expression. Although there are no clear guidelines for this process, this chapter examines this issue by discussing possible techniques and means of explaining complicated and, at times, contradictory psychological test results to parents, so that parents are best able to plan for treatment and support strengths.
There are no published studies on how best to convey psychological test results to parents. However, there is a body of literature that has examined effective communication between 73
pediatric clinicians and parents, as well as research examining parent preferences for the communication of “bad” or sensitive news. Some of this research can be useful in the development of general guidelines for sharing psychological test results with parents.Hasnat and Graves (2000) investigated the level of satisfaction parents felt when first provided a diagnosis of developmental disability in their child. The authors found that parents were more likely to be satisfied if they received a large amount of information, and if the disclosing professional had an understanding of parental concerns, yet was direct in the manner in which the information is presented. Krahn, Hallum, and Kime (1993) interviewed mothers and fathers of infants with a recently diagnosed disability regarding their preferences for how they would prefer to hear the news of their child’s disability. Nine themes of parental preferences for how to communicate difficult information emerged, seven of which might be applicable to the sharing of personality measures, including: (1) communication of information, which indicated parents preferred direct and understandable language, including positive as well as negative characteristics; (2) diagnostician, where parents preferred hearing the information from a familiar person; (3) communication o f affect, whereby the parents preferred an empathic approach from a person who was comfortable with the expression of emotions; (4) pacing of process, where the information was presented gradually in a step-by-step fashion that left time for questions throughout the meeting; (5) when told, with parents preferring to be told as soon as problems are suspected; (6) where told, with parents expressing strong preferences for being told personally (as opposed to over the phone), in a private, uninterrupted setting; and (7) support persons present, with most parents preferring to be told together, or with a support person.In an outcome analysis that attempted to identify and categorize whether support for parents by clinicians led to positive changes in mothers (Wasserman, Inui, Barriatua, Carter, & Lippincott, 1984), the results indicated that mothers who received more clinician empathy were more satisfied with their care and had greater reductions in their level of concern. Some research has also found that parents value a sympathetic and caring approach (Girvin, 2002; Quine & Pahl, 1986; Sharp, Strauss, & Lorch, 1992), and other studies have suggested a desire for parents to know how well the child will function in the home and strategies for facilitating his or her growth (Lynch & Staloch, 1988). Cross-cultural studies on the sharing of bad news with parents (Krauss-Mars & Lachman, 1994) indicated that the use of a language other than the parents’ tends to have a negative influence on the communication between doctors and parents, and that an attempt should be made to understand the family’s own cultural views about diagnosis and treatment, because various cultures may have different ways of understanding or responding to certain disabilities or diagnoses (Ahmann, 1994).
