Corresponding Author Information: Katherine M. Thomas

Session Abstract: A growing body of research identifies how between-person and within-person approaches to assessment ask and answer different types of questions. Clinically, we are often interested in knowing both how clients compare to others, and also how clients compare to themselves over time and across contexts. Despite the rise of clinically relevant research on within-person processes, fairly few bridges have been built between this research and clinical practice. In this symposium we highlight how within-person therapeutic assessment can be used to better understand our clients and intervene on their problems in living.

Dr. Thomas will discuss a therapy patient, Amy, she saw for two and half years. Mid therapy they conducted a targeted assessment to better understand the interplay between some of her behaviors, urges, and emotions, with a particular focus on assessing emotions related to self-harm and thoughts of suicide. After completing a daily diary for over 100 days, they learned more about the emotional cues that corresponded to Amy's urges to self-harm, which helped them better intervene when these emotions arose.

Dr. Finn will discuss a client, Maria, aged 44, who suffered from chronic pelvic pain for 4 years, and had found no relief after many medical interventions. Maria angrily asserted that emotional and psychological factors played no role at all in her pain. However, during her Therapeutic Assessment she agreed to do daily ratings of her pain and other emotional variables she helped select. These ratings helped Maria and Dr. Finn understand her pain better, which led to eventual effective interventions.

Dr. Lewis will present on a young man, David, who enrolled in long-term residential treatment following years of chronic depression and multiple near-lethal suicide attempts. David observed in treatment that he most frequently felt suicidal on days that seemed totally ordinary, which often amplified persistent feelings of hopelessness and nihilism. In the context of a multimethod assessment that included daily experience sampling ratings of interpersonal perceptions and affect, situational features related to emotional intimacy and burdensomeness were found to relate to David's momentary suicidal thoughts, highlighting a specific risk dynamic that was otherwise difficult for him to articulate in treatment.

Our discussant, Dr. Hopwood, will talk about how repeated measurement is a natural fit for a technique designed to use psychological assessment to help people change relatively quickly. As the availability of clinically friendly approaches increases, incorporating them into Therapeutic Assessment is a natural and productive direction to take.

Chair Information: Katherine M. Thomas | Center for Therapeutic Assessment, Austin, TX

Discussant Information: Christopher J. Hopwood | University of California, Davis; Davis, CA

Presentation 1 Title: Assessing a Client's Urges to Self-Harm Using Repeated Daily Ratings


Katherine M. Thomas | Center for Therapeutic Assessment, Austin, TX

Presentation 2 Title: When Hurt Becomes Suffering: Using Repeated Measures to Understand Chronic Physical and Emotional Pain


Stephen E. Finn | Center for Therapeutic Assessment, Austin, TX

Presentation 3 Title: Dynamic Relational Factors Affecting Self-Destructive Impulses in Daily Life


Katie C. Lewis | Austen Riggs Center, Stockbridge, MA

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