Testing via Therapy

The lack of test development in Freud’s free association techniques

In every psychology class, it is essential that we cover Freud’s work on the unconscious, as it lay the foundation for how we approach psychological disorders today. Much of Freud’s word has been discredited due to ethical issues. Large issues came about over therapists allegedly “causing” disorders in the patients by having them reinterpret thoughts that supposedly revealed unconscious, repressed memories. This was mainly done from the therapists extrapolating from free association sessions, during which the patient would spill out everything on their mind without barriers. Anything that may slip out unintentionally was interpreted as a peak into the unconscious, and therapists nitpicked every detail to come up with a convoluted diagnosis.

After reading Chapter 17 of our textbook, it is almost laughable at how free association violated every single guideline for developing assessments. Of course, free association was one of the first therapeutic practices and these guidelines were not even yet conceived of. But I thought I’d go over how each criteria was violated as therapists used this technique for diagnosing patients:

1. Have the test objectives been clearly specified and a table of specifications developed? Well, a TOS wasn’t even a thing, but I guess you could say the reason for the test is to find the patient’s unconscious processes??
2. Are the assessment procedures appropriate for measuring the specified construct? The assessment was done completely by the patient, really. They just spoke and occasionally the therapist would prompt them. Otherwise, no set questions would be asked and the therapist would essentially wing it.
3. Have explicit scoring criteria been developed? Nope, these were completely made up on the spot, no set criteria was established before the session. Individual therapists even took it upon themselves to interpret what each individual piece of information thought. One therapist may think that a sexual thought about a parent could be related to sexual assault experienced as a child, another as the patient being stuck in the “phallic stage” of development, from which they developed an Oedipus/Electra complex.
4. Was a sampling plan for standardization developed and were appropriate data collected? Ha.
5. Have clear guidelines for test administration been developed? In fact, many therapists just pulled out method this when either nothing else worked or if they felt like it; it was the trendy thing to do. Anyone could get it, and for any reason.
6. Have accommodations for test takers with disabilities and other special needs been planned? This just wouldn’t have been included at all.
7. Has the assessment been reviewed for technical accuracy and potentially insensitive or biased content? Possibly the most biased form of assessment ever created. It was completely up to the therapist to come to a conclusion from what they heard.
8. Have the technical properties of the assessment been evaluated? Experts eventually found out there was a total lack of validity and reliability in this form of testing. Probably why we abandoned this method.

There’s a reason these rules are in place — we have to make sure that tests have indeed been thoroughly evaluated and not used arbitrarily, like free association. Many adverse effects can come about, such as distress over the introduced thoughts, or misdiagnosis. Though we live in an era that now does have these practice guidelines in place, it is important that we take individual caution and approach tests with caution.