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Clinical intuition is often little more than a coin flip when it comes to detecting suboptimal effort. We like to think we can spot a client who isn’t giving their best, but the data suggests otherwise. In this episode, I dive into the necessity of using objective performance validity indicators rather than relying on gut feelings. I discuss the prevalence of failure rates in adult ADHD evaluations, the difference between malingering and a cry for help profile, and the technical balance between sensitivity and specificity in the tools we choose. I also share a practical framework for addressing poor effort in the moment using a three stage feedback sandwich to preserve the clinical alliance while ensuring the integrity of your data.
Main Topics
- The limitations of clinical intuition in determining optimal effort
- Prevalence of validity failure rates in clinical ADHD evaluations
- Distinguishing between malingering and the cry for help profile
- Balancing sensitivity and specificity in validity measure selection
- The shift from legacy recognition tasks to multi stage symptom validity tests
- The two failure rule and the utility of the $0 embedded indicator
- Strategic scheduling and administration of PVIs throughout a battery
- The feedback sandwich: affirmation, calibration, and the reset
Cool Things Mentioned
- The Testing Psychologist mastermind groups and business consulting
- Reverb: the premier AI-powered report-writing platform for testing psychologists
Featured Resources
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The Testing Psychologist podcast is approved for CEU’s!
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About Dr. Jeremy Sharp
I’m a licensed psychologist and Clinical Director at the Colorado Center for Assessment & Counseling, a private practice that I founded in 2009 and have grown to over 20 clinicians. I earned my undergraduate degree in Experimental Psychology from the University of South Carolina before getting my Master’s and PhD in Counseling Psychology from Colorado State University. These days, I specialize in psychological and neuropsychological evaluation with kids and adolescents.
As the host of the Testing Psychologist Podcast, I provide private practice consulting for psychologists and other mental health professionals who want to start or grow psychological testing services in their practices. I live in Fort Collins, Colorado with my wife (also a therapist) and two young kids.
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