Clinical Reasoning: A Missing Piece for Improving Evidence-Based Assessment in Psychology

Abstract

Clinical reasoning is a foundational component of conducting evidence-based psychological assessments. In spite of its importance, limited attention has been paid to the teaching or measurement of clinical reasoning skills relative to psychological assessment, as well as how clinical reasoning develops or how its efficacy can be measured. Improving clinical reasoning throughout the assessment process, from initial case conceptualization to hypotheses testing, to recommendation writing, has the potential to address commonly noted concerns regarding diagnostic accuracy, as well as the accessibility and utility of psychological reports and recommendations, and will, ultimately, lead to improved outcomes for clients. Consequently, we provide a definition of clinical reasoning in relation to psychological assessment, followed by a critique of graduate training assessment and the current challenges of measuring clinical reasoning in psychology. Lastly, this paper provides suggestions for how to incorporate clinical reasoning throughout the assessment process as a way to answer client questions more effectively and provide meaningful recommendations to improve outcomes.