THE PRACTICAL RORSCHACH
James P. Choca, Edward D. Rossini, Dan Garside
There has been a significant decline in graduate training on projective techniques, a diminution due both to managed care and/or insurance reimbursement policies, and recent negative attitudes toward projective assessment instruments (Piotrowski, 2015). Of the projective tests, the Rorschach, with its intricate scoring, demands much time and effort to learn and use. Those of us who value this test have to find ways of adapting this instrument to the 21st Century. In our presentation at this year’s meeting of the Society for Personality Assessment (Choca, Rossini, & Garside, 2016) we proposed three complimentary ideas: (1) reducing the number of cards administered, (2) simplifying the routinely-used scoring system, and (3) obtaining more clinically relevant person-specific information when the test is administered.
Following the structure behind the Zulliger (2012), a test with only three inkblots, we developed Herm (short for Hermann). Herm consists of four Rorschach cards, two chromatic and two achromatic (cards I, III, VI, and X). Using archival data from 906 psychiatric patients, we compared 286 measures from the Comprehensive System Structural Summary of the four Herm cards to the same measures from the usual ten. The overall Pearson correlation was .94, the overall Spearman Rank Order correlation was .97, and all single correlations were significant to the .01 level or better. To put these correlations in perspective, the test-retest values for the full test administered twice does not approximate this level of equivalence (see table in Exner, 2003, page 179). In other words, for all practical purposes we obtained the same results as those of the full Rorschach by using only four cards. Our results were supported by similar conclusions reached by others (e.g., Carpenter et al., 1993, Grønnerød & Hartmann, 2010). Our discussant, Gregory J. Meyer, asserted that there was a loss of information when the Rorschach is shortened. He presented R-PAS data comparing results using the ten cards to those derived from only five cards. The correlation for the Perceptual & Thinking Composite he presented was .91, the validity of this composite decreased from .43 to .39; the correlation for M was .86 with the validity decreasing from .35 to .29; the test-retest correlation went from .59 to .53. The data obviously supported Meyer’s point: some information is indeed lost. And yet, we were thrilled with his data. If the “loss” we have to accept for doing something in half the time is in the realm of 0.06, clinicians should not give another thought to using a Rorschach short form. You can use Herm with any scoring system you desire and simply multiply your results by 2.5.
Secondly we proposed a simpler coding system that reduces the number of variables routinely scored. The proposal is to have an Essential Rorschach, containing a much smaller number variables to be scored for every client; this Essential Rorschach would then allow the addition of other variables, as appropriate for a specific examinee. We propose disregarding, as a matter of routine, variables that typically have a modal frequency of zero, and variables that lack interpretative distinctiveness. In this manner, the Essential Rorschach requires the scoring of only 33 variables: location codes W, D, d, S (with D and d distinguished only by the size of the area); determinant codes M (without active or passive indicators), FM (without active or passive indicators), FC, CF, C, C’ (for any achromatic association), Y (for any association involving shading), T (for any texture response), F; popular code P (nine possible, just based on content and location); Form Quality codes o, u, – (just based on the opinion of the examiner as to how easily the response can be seen); content codes H (to include Hd), (H), A (to include Ad), (A), An (to include Xy), Sx, Bl, Na (to include Bt), Cg, Fd, Cl, Ge (to include Ls), Fi (to include Ex), Ob (human-made object, to include Art, Ay, Sc, Hh); the code of SS (to include any Special Score); and a code NB (nota bene) to flag any unusual response that needs further attention.
Finally, we would like to step back from the antisceptic (empirical) obsessive-compulsive handling of the Rorschach to recover the more clinical approach that has been mostly disregarded in the United States during the last forty years. In our view, the over-emphasis on empiricism and actuarial interpretation is misdirected in the case of an instrument that, in actual practice, is never going to achieve a high level of scientific accuracy. This over-emphasis has the detrimental effect of precluding a more useful interactive administration. Frank J. Kobler, the professor who taught the Rorschach to the first two authors, asserted that the aim of the Rorschach was not to “measure” but to “understand” the individual (1983, pg. 136). Following that philosophy, we emphasize a highly idiosyncratic Follow-Up, a third step to be taken after the Free Association and the Inquiry or Clarification phases are done. At this point in the test administration we ask questions and encourage the examinee to talk about the responses, how the ideas came to mind, what feelings were present, and anything else that would allow a deeper understanding of the individual, and a more accurate interpretation of the test results (for more information on this approach see Choca, 2013).
We hope that following these three recommendations will help restore the Rorschach to something close to the position it had in a previous era. The Rorschach should be seen as an important instrument in our clinical armamentarium that quickly and cleanly magnifies the idiosyncratic operations of the person before us.
Carpenter, J. T., Coleman, M. J., Waternaux, C. M., Perry, J, Wong, H., O’Brian, C., & Holtzman, P. S. (1993). The Thought Disorder Index: Short form assessments. Psychological Assessment, 5, 75-80.
Choca, J. P. (2013). The Rorschach Inkblot Test: An interpretative guide for clinicians. Washington, DC: American Psychological Association.
Choca, J. P., Rossini, E. D., & Garside, D. (2016, March). The Practical Rorschach: Adapting the Rorschach to the 21st century. Symposium conducted at the annual convention of the Society for Personality Assessment, Chicago.
Exner, J. (2003). The Rorschach: A comprehensive system (Vol. 1, 4th ed.). New York: Wiley.
Grønnerød, C., & Hartmann, E. (2010). Moving Rorschach scoring forward: The RN-Rorschach Scoring System as an exemplar of simplified scoring. Rorschachiana, 31, 22-42. DOI: 10.1027/1192-5604/a000003
Kobler, F. J. (1983). The Rorschach test in clinical practice. Interdisciplinaria Revista de Psicología y Ciencias Afines, 4, 131-139.
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, 83-92.
Zulliger, H. (2012). Test proyectivo de Zulliger. Spain: Dwarf.
THE PASSING OF PHILIP CARACENA (RORSCAN) by Barry Ritzler
It is with sadness that we mention the passing of Philip Caracena this April. Phil was a good friend and excellent psychologist and a long-time member of the Society for Personality Assessment.
He developed RORSCAN – a computer program for use with the Rorschach Comprehensive System. He refined and distributed RORSCAN for thirty years. Many students and Rorschach psychologists benefitted from the availability of RORSCAN. Phil kept in touch with Comprehensive System developments and was quick to add any research supported changes to RORSCAN.
Phil died in Edmond, Oklahoma and is survived by his life partner, Margot Holaday, who, in her own right, is an accomplished assessment psychologist and a member of the society for Personality Assessment. It is important to note that because of Phil’s death, RORSCAN is no longer available for purchase.
FINAL CALL FOR THE TWO DAY ADVANCED PROGRAM- AUGUST 11 & 12
Thursday August 11 and Friday August 12, 2016, a two Day Advanced Program, Enhancing Your Rorschach Skills, will be held for psychologists who are already familiar with the Rorschach. Drs. Barry Ritzler and David Shmerler will be presenting challenging case protocols and discussing coding and interpretation. This is an opportunity to improve your Rorschach skills meet other experienced Rorschachers, and enjoy the offerings of the “Big Apple”. The Program will be held at the NYC Health+Hospitals|Kings County, 451 Clarkson Avenue, Brooklyn, NY, 11203, and will be providing 12 Category 1 CE credits for this Program. All information and details for registration are published on www.rorschachtraining.com.
For over-night accommodations a courtesy room block has been established at the Comfort Suites Hotel, 599 Utica Avenue, Brooklyn,, NY, 11203, (within a mile of the hospital). To take advantage of the discount call the hotel at 718-774-0018, ask for “Christi” and mention “Kings County Training.” She will offer the best rate possible. Summer dates fill quickly so make your reservation as early as possible. You can always cancel if plans change.
ENJOY THE REMAINING DAYS OF SUMMER!