Journal of Projective Psychology and Mental Health: Volume 26, Number 1, Jan 2019 Editorial |
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| 1. Editorial: The Case for a Moratorium on Moratorium Articles regarding Individual Psychological Tests, pages 1-4. The status of tests and measures in assessment, in both mental health practice and training settings, has attracted extensive professional and academic attention over the past 70 years. Bennion et al. (2019, this issue) provide a rather detailed critique regarding the conclusions I offered regarding a literature review study on testing practices with the Bender-Gestalt Test (BGT; Piotrowski, 2016). Indeed, as Bennion et al. argue, my 2016 article does fall short with regard to a) not delineating among the various iterations and/or purposes of the BGT, and b) confabulating research emphasis on the BGT with usage in assessment by professionals overseas. The focus of the Bennion et al. critique, to the point (based on data analysis of usage trends), concludes that the BGT should not be taught in clinical psychology training programs. However, my analysis focused strictly on BGT practice usage patterns, based on reported findings across studies, over time. There is no mention in my analysis, conclusions, or text affirming that the BGT should be stressed in clinical training. My intent was to present a „Snapshot‟ on BGT usage, both in the USA and overseas, across recent decades. Based on all available survey data, no one can argue that some psychologists and a minority of other mental health professionals continue to use the BGT for a variety of assessment purposes. My rebuttal here does not contest Bennion et al.‟s data analyses, but rather focuses on their extrapolated conclusions and more specifically on their rather ardent position toward an individual mental health assessment technique. Interestingly, many years ago, I was severely criticized at a conference by a distinguished neuropsychologist for my „acceptance‟ of the BGT as a useful assessment tool. The striking aspect of the verbal barrage was the level of anger and disparagement expressed by this psychologist—my immediate thought was: How could these rather simple graphic designs (a.k.a., BGT) generate such dishevel in a rather distinguished, stoic academic? So here, many decades later, it is the BGT, once again, that has struck a nerve and garnered intense opposition. I find this rather intriguing than coincidental. In this commentary, I would like to respond to Bennion et al.‟s thoughtful critique along 3 distinct lines of discussion: a) the available extant data reported in prior studies, b) extrapolated implications, and c) motivation. Of these, I consider motivation the major issue which I intentionally want to stress here. Data: The reported data on the extent of professional test usage of the BGT is rather straightforward, both in my 2016 article and in Bennion et al.‟s (2019) detailed analysis. Over the last few decades, clinical reliance on the BGT, as an assessment tool, has clearly declined (dramatically in some clinical circles, such as neuropsychology). In this regard, I concur with Bennion et al.; thus, this trend line indicating diminutive status does not bode well regarding „future use‟ of the BGT. But, based on the data, the extent of this deemphasis does not necessarily apply to all professional specialty areas, i.e., the BGT is still part of the assessment armamentarium of a sizeable minority of school psychologists, professional counselors, and child clinicians (e.g., see Oakland et al., 2016; Peterson et al., 2014). Moreover, clinical evidence suggests that the BGT can still function as an „ice-breaker‟ to the assessment enterprise and/or a „screening‟ tool for both cognitive functioning and personality functioning. At the same time, with the vast proliferation of newly developed tests and measures (including abbreviated short-forms of cognitive tests), the role of the BGT, undoubtedly, will most probably diminish over time. Implications of aggregated survey findings: Bennion et al. make a vast leap in reasoning that based on trends affirming diminishing use, the BGT should therefore not be taught in the graduate-level assessment curriculum. Opinions regarding what tests should receive instruction in clinical programs has a long, contentious history that has not been adequately resolved and remains a strongly contested, perennial training issue in contemporary clinical psychology (see Kaslow & Egan, 2017; Mihura, 2018; Piotrowski, 2015). In my opinion, the topic regarding instruction and training emphasis in mental health assessment, while important, is a separate professional issue from testing practices and test usage patterns. In fact, there is copious literature on the disconnect between training and practice in clinical/professional psychology. An examination of the most recent data on this nexus regarding assessment indicates that only 7 of the top 10 tests taught in clinical programs (see Ready & Veague, 2014) rank among the top 13 tests used in psychological practice (see Wright et al., 2017). This disparity would be greater if compared to assessment practices of mental health counselors (e.g., Peterson et al., 2014). Put simply, emphasized tests in clinical training are not necessarily a direct function of popular tests used in professional practice. Motivation: Why the BGT? As a proponent of assessment psychology, I have always found it quite revealing that disparaging criticism of individual psychological tests/measures seems to always gravitate toward projective methods/tests. For example, Garb (1996) rendered an incisive „moratorium‟ on the Rorschach. Such derisive commentaries have found a receptive audience (Garb‟s condescending article has now garnered over 100 citations in Google Scholar & 80 in PsycINFO). Interestingly, the recent national survey of practicing psychologists reported the Rorschach listed among the top 10 tests in terms of usage (see Wright et al., 2017). Bennion et al. strongly urge deletion of the BGT from the clinical curriculum, largely based on the fact that there has been a diminution in clinical usage of this test. There is an extensive list of formerly popular mental health measures/tests that have lost their lofty status in assessment practice over the past 70 years (Frauenhoffer et al., 1998); for example, the 16PF, SCL-90, the StanfordBinet, several million inventories, some projective tests). Why target the BGT? In my view, we will never see an article titled: “There should be a moratorium on teaching the … 16PF… the MCMI…the SCL-90… the Clock drawing…the Stanford-Binet…the Hand Test†or some behavioral assessment technique. So why select-out the BGT? Why does this assessment tool cause clinicians such angst? Graduate faculty tend to emphasize assessment measures and techniques that they find useful and valid (but not necessarily popular) and, thus, to some extent tend to ignore APA review committee‟s recommendations on teaching areas of emphasis regarding assessment. Moreover, there is extensive variability on the spectrum of psychological tests that are „covered‟ in assessment coursework (see recent survey data reported by Mihura et al., 2017). Surely, younger faculty tend to shun some traditional tests and focus on newly published measures or scales. Thus, despite published standards and guidelines on the clinical assessment curriculum, there is little academic consensus regarding training in assessment in graduate clinical/professional programs. The outcome of this variability in doctoral program assessment training has been rather predictable. There is now an extensive body of research findings confirming the dismay of internship directors on the lack of prerequisite preparation of psychology interns regarding familiarity with specific mental health tests (see Ready et al. 2016, for the most recent review). Such findings reflect the reality of pre-internship graduate education: aspiring students learn but a small fraction of the knowledge and clinical experience needed for professional-level competency in psychological assessment (Evans & Finn, 2017; Kaslow & Egan, 2017; Krishnamurthy et al., 2004). Admittedly, this variability is not necessarily a bad thing: The Buros Mental Measurements Yearbook (along with other scholarly testing compendiums) list over 50,000 available assessment instruments/ tests—obviously, students can‟t master them all. So, allow professors to indulge students in some obscure or unpopular test. As novice, newly-minted practitioners, these former students will select for themselves the mental health measures and assessment techniques that they wish to master, probably via self learning, attendance at workshops, or study of emerging research in the assessment literature. Accordingly, scholars should not fret over what tests are emphasized or „covered‟ in some clinical training programs. Both the aspiring, novice student-clinician and the assessment field will survive, even though an individual test may gradually fall by the assessment wayside and be relegated as an historical artifact in clinical psychology. Final thoughts: To some degree, I do understand Bennion et al.‟s position—Over the decades, the BGT has been severely critiqued as a cognitive and/or projective measure (see Norcross et al., 2006). In fact, its most vehement detractors reside in the field of neuropsychology. While survey-based data show that the BGT has been occasionally used by clinical neuropsychologists, a recent update noted scant reliance on the BGT (see Rabin et al., 2016). However, the BGT has been popular with practicing school psychologists (Hojnoski et al., 2006). With regard to training, Bennion et al. need to note that a recent national survey found that the BGT is covered in instruction by 73% of counselor educators (Neukrug et al., 2013). Interestingly, the BGT is still covered in 43% of clinical psychology programs (see Table 3 in Mihura et al., 2017). Moreover, many current internship programs continue to emphasize projective methods (Stedman et al., 2018). Finally, Bennion et al. (along with other BGT critics) need to contemplate why the BGT continues to garner clinical research attention overseas; for example, with clinical psychologists in South Korea (Eom & Choi, 2018), neuropsychologists in Puerto Rico (Rodriguez-Irizarry et al., 2018), school psychologists (Oakland et al., 2016), and child clinicians. And not all this investigatory output is purely „basic research‟. Noteworthy, since my 2016 analysis, 10 articles on the BGT have been indexed in PsycINFO and 20 articles in the multidisciplinary database ProQuest. Thus, research on the test is clearly not moribund, and emergent research findings have both educational and clinical applications (e.g., Keppeke & Schoen, 2018). I rest my case: In this rebuttal, I strongly offer a clarion call for a moratorium on moratorium type articles in the assessment field, whether on the BGT or any other psychological test or measurement technique. In the context of scholarly discourse, there is a vast pedagogical difference between scholarly „critique‟ and recommendation for the banishment of individual evaluation methods from academic instruction and training. Put another way… If some professor in a clinical training program provides instruction on the Luscher Color Test (most discredited in the Norcross et al. 2006 study), let them— perhaps the instructor may be trying to convey to students the importance and implications of color in personality assessment (e.g., the Rorschach) and the human experience. Clinical faculty should aspire to provide a comprehensive overview regarding the wide breadth of coverage spanning evaluation methods, so as to foster an eclectic introduction to psychological testing and assessment—specialization will eventually follow as advanced students transit from internship settings to post-doctoral training and beyond. References: Bennion, L.D., Self, K.J., Kroke, P.C., & Crone, B.C. (2019). Should we teach Bender-Gestalt to clinical psychology students? An alternative view to Piotrowski‟s 2016 review. Journal of Projective Psychology & Mental Health, 25(3), this issue. Eom, J., & Choi, S. (2018). A study of clinical psychologists‟ opinion and practice of comprehensive psychological testing. Korean Journal of Clinical Psychology, 37(1), 1-17. Evans, F.B., & Finn, S.E. (2017). Training and consultation in psychological assessment with professional psychologists. Journal of Personality Assessment, 99(2), 175-185. Frauenhoffer, D., Ross, M.J., Gfeller, J., Searight, H.R., & Piotrowski C. (1998). Psychological test usage among licensed mental health practitioners: A multidisciplinary survey. Journal of Psychological Practice, 4(1), 28-33. Garb, H.N. (1999). Call for a moratorium on the use of the Rorschach Inkblot Test in clinical and forensic settings. Assessment, 6(4), 313-317. Hojnoski, R.L., et al. (2006). Projective test use among school psychologists: A survey and critique. Journal of Psychoeducational Assessment, 24, 145-159. Kaslow, N.J., & Egan, G.J. (2017). A competency focused commentary on the Special Section on teaching, training, and supervision in personality and psychological assessment. Journal of Personality Assessment, 99(2), 189-191. Keppeke, L., & Schoen, T.H. (2018). Perceptual-motor maturity in adolescence and the Tanner stages: A study with Bender-Gradual scoring system. Spanish Journal of Psychology, 21, E33. Krishnamurthy, R., et al. (2004). Achieving competency in psychological assessment: Directions for education and training. Journal of Clinical Psychology, 60(7), 725-739. Mihura, J.L., et al. (2018). Why we need a formal systematic approach to validating psychological tests. Journal of Personality Assessment, in press. Mihura J.L., Roy, M., & Graceffo, R.A. (2017). Psychological assessment training in clinical psychology doctoral programs. Journal of Personality Assessment, 99(2), 153-164. Neukrug, E. (2013). A national survey of assessment instruments taught by counselor educators. Counselor Education & Supervision, 52, 207-219. Norcross, J.C., et al. (2006). Discredited psychological treatments and tests: A Delphi Poll. Professional Psychology: Research and Practice, 37(5), 515-522. Oakland, T., et al. (2016). Top 10 standardized tests used internationally with children and youth by school psychologists in 64 countries. Journal of Psychoeducational Assessment, 34(2), 166-176. Peterson, C.H., et al. (2014). Assessment use by counselors in the United States. Journal of Counseling & Development, 92, 90-99. Piotrowski, C. (2017). Editorial: The linchpin on the future of projective techniques: The precarious status of personality assessment in the (overcrowded) professional psychology curriculum. Journal of Projective Psychology & Mental Health, 24(2), 71-73. Piotrowski, C. (2016). Bender-Gestalt test usage worldwide: A review of 30 practice-based studies. Journal of Projective Psychology & Mental Health, 23(2), 73-81. Piotrowski, C. (2016). Drawing techniques in assessment: A summary review of 60 survey-based studies of training and professional settings. Journal of the Indian Academy of Applied Psychology, 42(2), 220236. Piotrowski, C. (2015). Clinical instruction on projective techniques in the USA: A review of academic training settings 1995-2014. Journal of Projective Psychology & Mental Health, 22(2), 83-92. Rabin, L.A., et al. (2016). Stability in test usage practices of clinical neuropsychologists in the U.S. and Canada. Archives of Clinical Neuropsychology, 31, 206-230. Ready, R.E., et al. (2016). Psychology internship directors‟ perceptions of pre-internship training preparation in assessment. North American Journal of Psychology, 18(2), 317-334. Ready, R.E., & Veague, H.B. (2014). Training in psychological assessment: Current practices of clinical psychology programs. Professional Psychology: Research and Practice, 45, 278-282. Rodriguez-Irizarry, W., et al. (2018). The practice of neuropsychology in Puerto Rico: Implications for certification and specialization. Revista Iberoamericana de Neuropsicologia, 1, 45-62. Stedman, J.M., et al. (2018). Current patterns of training in personality assessment during internship. Journal of Clinical Psychology, 74(3), 398-406. Wright, C.V., et al. (2017). Assessment practices of professional psychologists: Results of a national survey. Professional Psychology: Research and Practice, 48(2), 73-78. Christopher Piotrowski, Ph.D. Research Consultant and Senior Editor, University of West Florida, 504 Concordia Blvd. Pensacola, FL 32505 (USA) Email: cpiotrowski@uwf.edu 2. Appraisal of Hurricane Harvey Versus Hurricane Irma: The Role of Empathy and Disengagement, Raymond Doe and Chris Piotrowski, pages 5-11. Due to their temporal proximity (2 weeks apart), Hurricanes Harvey (Texas) and Irma (Florida) in 2017 provided a unique opportunity to examine the potentially differential views of impacted populations toward both tropical events. From a theoretical perspective, the issues of empathy versus detachment were the central focus of the study. The design utilized the semantic differential (SD) to rate the 2 dimensions of Evaluation and Potency. Participants were 66 college students enrolled at (Lamar University, Texas) a mid-sized university on the southeast Texas coast, who experienced a direct-hit from the full devastation of Hurricane Harvey. The results indicated that these students evaluated Hurricane Harvey significantly more negative than Hurricane Irma;moreover, they viewed Hurricane Harvey as more potent than Hurricane Irma. These findings demonstrate that populations who experienced empathy to Hurricane Harvey showed detachment to Hurricane Irma in terms of their evaluation, t (63) = 3.4, p = .001, d = 0.42, and potency, t (63) = 5.6, p< .001, d = 0.70, even though both hurricanes were of similar magnitude and caused similar devastation. The findings were discussed in the context of a social-psychological perspective, with a focus on the issues of empathy and moral disengagement. 3. Fund Manager Performance in Bull and Bear Markets: A Financial Risk Attitude, Stress Tolerance and Complex Problem-Solving Perspective Joachim Birger Axel von Weissenber, pages 12-22. This study investigates how the personality factors of financial risk attitude, stress tolerance and complex problem solving predict investment performance in relation to rising versus descending market periods. The performance of 40 professional fund managers was measured over a total period of five years. In the rising market the three personality factors predicted 39% of the performance. In the descending market period, the risk attitude and stress tolerance factors predicted 46.4% of the performance. The conclusions of the present study are as follows: a) Small differences were found in prediction strength between the personality factors of rising and descending markets. b) The financial risk attitude was the most important factor in both bull and bear markets. c) Stress tolerance is important in both periods, but especially in descending markets. d) Motivation for complex problem solving is important in rising markets. e) The three personality factors seem to be robust predictors of fund manager performance in all market phases. 4. Fibromyalgia, Low Back Pain, Osteoarthritis, Myofascial Pain, and Complex Regional Pain Syndrome: Predominant Assessment Measures in Research Chris Piotrowski, pages 23-29. Comprehensive evaluation of pain, particularly the confounding influence of somatoform co-morbidity, is perhaps one of the most perplexing challenges faced by practicing clinicians (Bruns & Disorbio, 2015; Flor & Turk, 2011). Moreover, the assessment of pain populations is a highly prolific clinical area, characterized by a vast body of emerging research (Gatchel et al., 2017; Piotrowski, 2019).But where is the practicing mental health clinician to turn in identifying the major pain assessment instruments applied to presenting patients with an identifiable, specific pain condition? Thus, the aim of the current study was to identify the most prominent methods (i.e., measures, scales, inventories, tests) in the research literature, reported in studies with a focus on 5 specific pain complaints or pain states (fibromyalgia, low back pain, osteoarthritis, myofascial/myofascial conditions, and complex regional pain syndrome). In the current analysis, each of these 5 pain conditions/ailments was selected in a keyword search, limited to being mentioned in the Abstract of peer-reviewed articles. The PsycINFO search display offers a ‘drop-down menu’ that includes the category Tests & Measures which displays, in rank order, the most mentioned assessment instruments for the identified pool of articles. This procedure indicated that only 2 assessment methods (i.e., the Visual Analogue Scale and Hospital Anxiety & Depression Scale) ranked among the top 10 instruments across all 5 pain conditions. The Beck Depression Inventory (BDI) was among the top measures in 4 of 5 of these pain disorders which points to the central importance of assessing the state or prevalence of depression in pain patients. Perhaps reflecting the importance of the evaluation of general health status, the analysis confirmed the popularity of the SF-36 Health Survey across 4 of 5 of the pain conditions. Furthermore, general pain status as assessed by the McGill Pain Questionnaire (MPQ) was noteworthy in 3 of the 5 conditions (Low back pain, Complex regional pain syndrome, Myofascial/Myofascial pain). These results indicate that researchers consider screening scales and co-morbidity factors that reflect mental health (i.e., psychopathology) as critical factors to the assessment process in the overall evaluation of pain samples. The findings show that specifically designed measures, which are adapted for individual pain conditions, are a main component in the evaluation of pain (e.g., Fibromyalgia Impact Questionnaire, the Western Ontario & McMaster Universities Osteoarthritis Index, and the Arthritis Self-Efficacy Scale). Other measures such as the Oswestry Disability Index, the Roland-Morris Disability Questionnaire, and the Health Assessment Questionnaire are among the most relied upon and popular measures evident in pain research. Overall, researchers tend to focus more on the direct and immediate impact of pain on quality of life and overall health status than on mental health vulnerabilities of chronic pain per se. Future research would benefit from the further development of disorder specific assessment tools targeted for pain evaluation. 5. SIS-I Profile of PTSD Patients Rachana Kumari & Anjana Mukhopadhyay, pages 30-36. Somatic Inkblot Series (SIS) has emerged as a powerful procedure in projective psychology. It is based on the principles of projection and uses inkblots to interpret the responses given by an individual. The interpretation is further used to map personality and psychodynamics. The SIS has become an effective diagnostic projective tool for the assessment of patients suffering from various psychiatric problems. The present investigation selected 25 high and 25 low trauma affected adult (18 to 45 years) patients, both male and female cases, from various trauma centers of Varanasi. The level of trauma symptoms was assessed with the PTSD checklist civilian version (PCL-C). The present study aims at delineating the diagnostic power of the SIS in PTSD patients. The results indicated that several indices and pathological contents of SIS-I were able to discriminate the groups. 6. Distress in Diabetes and Incidence of Depression in the Middle Age, M. Mili and A.S. Raakhee, pages 37-40. Distress in Diabetes may affect the physical as well as emotional wellbeing of the patient. The current study is to examine the relationship of Distress in Diabetes and incidence of depression in middle age. A sample of 100 diagnosed Type 2 diabetes (Males= 50; Females =50) were administered Distress in Diabetes Self rating Scale and Patient Health Questionnaire-9. Regression analysis was carried out to find the relationship between the variables. Results showed that Age and Distress in diabetes are strong predictors of Depression in Type 2 diabetes patients belonging to middle age. 7. A Comparative Psychosocial Study of Aggression, Attachment Style and other Personality Correlates among Orphan, Destitute, Creche-attender and Normal Children Rajasree Chakraborty, Manisha Dasgupta and Nilanjana Sanyal, pages 41-50. Explorations into the personality correlates of children are frequent. The present research endeavor attempts a probing journey in terms of the variables of aggression (anger), attachment style, anxiety, and personality with 240 (60 in each of the four groups of orphans, destitute, crèche-attenders and normal control) children. The main objective was to locate differences, if any, between the sub-groups of children about the selected variables and their respective dimensions. Statistical analyses revealed significant profile differences between the samples. Orphan children have higher scores with respect to some dimensions of aggression, attachment, anxiety compared to normal controls. Personality indices in the form of significantly higher number of animal responses, movement responses, most typical responses, hostility and aggression and lesser number of atypical responses were found in orphan children. Higher scores were found for destitute children with respect to state anger/feelings, state anger/expression, trait anger/temperament, trait anger/reaction, anger expression out and anger control compared to normal children. Destitute children were also found to score higher in attachment and in all the dimensions of anxiety than normal controls. They had higher mean scores as compared to normal children in certain indices of personality. Creche-attender children had higher scores with respect to state anger/ feelings, trait anger/ temperament, trait anger/ reaction, and anger expression-in compared to normal controls, and had highest attachment. Higher scores almost in all dimensions of anxiety except for O.C.D. were found in creche-attending children as compared to normal children. Creche-attending children scored higher in animal responses, anatomical responses, most typical responses and rejection responses than normal children. The present research findings are of much significance in understanding the personality profiles of different groups of children differing in their place of stay in the canvas of healthy development of personality to help design psychotherapeutic programs. 8. Role of Materialism in Influencing Self-esteem Naveen Gupta and Riju A. Singh, pages 51-55. Self-esteem is “our feeling of self-worthâ€. It serves as both a protective and risk factor in the development of mental health problems. Mental disorders are among the leading causes of ill-health and disability worldwide. Depression and anxiety are the two most common forms of mental disorders. Studies provide support that low self-esteem contributes to depression (Orth, Robins, & Roberts, 2008). In this paper, we have explored the role of materialism in influencing self-esteem as materialism has become a prevailing phenomenon these days and is adversely affecting the quality of life. Materialism refers to “the importance a person gives to his possession and his/ her acquisitionâ€. Correlational design was used to study the association between self-esteem and materialism and simple Linear Regression analysis was done to understand whether materialism emerges as a significant predictor of self-esteem. The sample consisted of 600 participants in the age range of 18 to 65 years from Agra and Mathura districts of Uttar Pradesh, India. The results indicate that materialism is negatively associated with and influences self-esteem. The findings of the research have both individual and social implications and can serve as the basis for designing effective interventions aimed at preventing or reducing depression. 9. Understanding the Sensitivity of Coping Deficit Index of Comprehensive System of Rorschach in discriminating Schizophrenia and Anxiety Spectrum Disorder and Association with Self-Reported Measure Biswajit Dey and T.B. Singh, pages 56-62. The studies on various indices, including CDI have been conducted in many cultures but there is dearth of studies in India. To study the effectiveness of this index and its relationship with self-reported measures of coping, the patients of three groups of 15 subjects in each(N=45), namely schizophrenia, anxiety and normal controls, were selected through purposive sampling. Each patient was assessed with a socio-demographic data sheet, respective clinical ratings, Comprehensive System (CS) of Rorschach test and Coping Check-List (CCL-1). Statistical analysis revealed two CDI variables to be significantly different between psychiatric and normal groups whereas, six variables of CDI have shown significant association with self-reported measures of coping. 10. Should We Teach Bender-Gestalt to Clinical Psychology Students? An Alternative View to Piotrowski’s 2016 Review Layne D. Bennion, Kyle J. Self, Phillip C. Kroke & Baylee C. Crone, pages 63-72. Piotrowski (2016) reviewed 30 studies documenting psychologists‟ use of the Bender-Gestalt (B-G) from 1992 to 2014 across a variety of settings and samples. Based on his review, he offered the following conclusions: mental health practitioners, including psychologists, ignore “biased critiques†of the B-G, find the B-G useful in assessment of children, use the B-G to help generate working hypotheses, use the B-G as a rapid assessment tool, and use the B-G from an idiographic approach. Our analysis of these studies produced a different set of conclusions: (a) use of the B-G has declined over the past 20 years, (b) the B-G is being used even less by forensic psychologists and neuropsychologists (as compared to other practicing psychologists), (c) use of the B-G by international psychologists for clinical evaluations is quite rare, (d) the B-G does have usefulness, and continues to be used for, basic psychological science research such as visual-motor development and, (e) the BG is a very interesting example of historical changes related to the needs of clinicians at various times, but should not be taught as an instrument for psychological evaluations in clinical psychology programs. |
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