Counseling 521 Individual Appraisal Essay

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Millon Test Summary

Counseling Test Review

What follows in this report is a summary of the Millon Clinical Multiaxial Inventory III, often referred to as the MCMI-III. One of the sources (but certainly not the only one) is the creator of the test, Mr. Million himself. Four other sources covering the Millon test are covered as well. There are a number of sections to this report and they are, in order, general information about the test, a description of the test, a technical evaluation of the test, a practical evaluation of the test and a summary evaluation of the test. A conclusion will wrap up the report.

General Test Information

As noted in the introduction, the title of the test involved here is the Millon Clinical Multi-Axial Inventory III. There is a "sister" test that is very similar and is known as the Millon College Counseling Inventory, with the main difference being that the latter test is catered to the mental health measurement of college students. The creators of the current test and in its current form are Theodore Millon, Carrie Millon, Seth Grossman and Roger Davis. As the title suggests, there have been three iterations of the test. The initial iteration was created in 1969 and was notated at length in Theodore Millon's book that was titled Modern Psychopathology. That test had 11 personality scales as well as 9 clinical syndrome scales (Millon, 1994)(Millon, 2008).

The second iteration, that being MCMI-II came about in 1987 and the number of personality scales went from 11 to 13 while the number of clinical syndrome scales remained at 9. The third iteration, the current MCMI-III was published in 1994 and it was revised when the DSM-IV standard was published. The aggressive/self-defeating scales were dropped in favor of depressive and PTSD, thus raising the total personal scale figure to 14 and the clinical syndrome scale to 10. A total of 5 correction scales were in place as well (Millon, 1994)(Millon, 2008).

The starter kit, as sold on the Pearson website, is $172 or $166, depending on the desired contents of the package. Administration materials and score/reporting documents are available as well on the Pearson website. As for who the test is proper for, the clinical syndrome scales are for anxiety, somatoform, bipolar/manic, delusional disorder, thought disorder, major depression, PTSD, drug dependence, alcohol dependence and dysthymia. These are the very same diagnoses that can be made using the Axis I of DSM-IV. The personal scale measurements are paranoid, schizoid, avoidant, depressive (those last two are related), histrionic, dependent, narcissistic, anti-social/aggressive, compulsive and two more that are also related, those being negativistc/masochistic. General assumptions are that people being scored using the Millon test (or even the related DSM-IV Axis I tests) is that the person being measure falls somewhere in the nexus of this test and it is simply a matter of finding out exactly where they fall (Millon, 1994)(Millon, 2008).

Test Description

The core of the Millon test is the scoring. Every patient that takes the test is assigned a raw score based on the results revealed. This raw score is translates to a Base Rate, or BR for short (Grove & Vrieze, 2009). The raw score's scale ranges from 1 to 115 and a median score is defined as 60, roughly (but not exactly) halfway through the dimensions.The conversion is complex, but a score above 178 or below 34 is almost always indicative of a patient fudging the responses and the test result is generally discarded. In such an instant, the patient is actively hiding something (or a series of things) that are relevant or they are actively lying when answering questions (Millon, 1994)(Millon, 2008).

The purpose of the test is to ascertain, based on the results, the likely mental issues a patient is having based on the results given. Just as a few examples, scores can indicate compulsive behavior, major depression, debasement, somatoform and so forth. If tests results are consistent over time, this usually does a lot to validate and prove the results of the test. There are 28 sub-scales that are broken into 24 clinical scales. The test is a series of 175 true/false questions and it takes about half an hour to complete in most cases. The theory behind the Millon test centers on four main domains or spheres and three polarities. The domain/spheres are abstraction, reproduction, existence and adaptation. The polarities are pleasure vs. pain, self vs. other and passive vs. active (Millon, 1994)(Millon, 2008).

Technical Evaluation

In terms a technical review of the test, there are some metrics that are not hard to find as far as the Million test goes. There are three main dimensions of validity that can be used to assess the efficacy and applicability of the Millon test to real life. The first one is external criterion validity. This is when a test can be correlated (or shown to be different than) similar tests. For example, the DSM-IV framework could be compared to the Millon test and such a test shows great correlation and overall similarity, even if the instruments are notably different in distinct ways. The second kind of reliability is internal/structural reliability, which points to the results for each dimension showing a correlation as opposed to be conflicting and out of place for the same patient. For example, a patient that is dressed is almost certainly not going to be narcissistic, as the two generally do not go together in the same person. The third dimension is theoretical and substantive reliability, which points to when results are consistent when expanding the sample to be very large in size. In a way, it is much the same thing as a test being reliable (Millon, 1994)(Millon, 2008).

Speaking of reliability, this is the idea that a test is consistent in terms of its results for similar patients and situations. In other words, if two different doctors use Millon tests on very similar patients with very similar histories and life situations, then the results of the Millon test between the two patients should be the same. If they are not, then at least one of patient is lying/obscuring, one or both of the doctors is not giving the test wrong or the test itself is not reliable. Using a sample of two is actually not fair to the test and it should be looked at with a much larger pool, as it has been, but the above is a good example of how it should work. Reliability is how consistent the test results are in similar/like situations and validity is the applicability and practicality of the data collected. If either one of those (or both) is amiss for a tool like the Millon test, it can have decreased to no legitimacy and/or usability in a clinical environment. Just as with the well-known and well-trusted DSM-IV, the Millon test satisfies the necessary measures of both reliability and validity as measured over time since the test's creation (Millon, 1994)(Millon, 2008).

Practical Evaluation

In terms of quality of test materials, the Pearson website shows a good array of tools and tricks that mental health professionals can use quite easily to implement and administer the Millon test in their practice. The buyers are able to mix and match as they see fit so as to get the right mix needed for the individual's use of the test. This is much better than an expensive and/or one-size-fits-all approach that pigeon-holes a mental health professional or practice into spending money that is really wasteful and not purposeful (Millon, 1994)(Millon, 2008).

The ease of the test is quite basic. The very simple nature of the true/false responses is refreshingly easy. The length of the test is a bit long at 30 minutes. However, this test-length squares just fine with the usual 30- to 60-minute sessions that mental health professionals use and the length of the test is no doubt in place so as to measure the consistency of different dimensions at different points in the test rather than just asking the question type once and hoping for an accurate result. The score's extremes lending themselves to the test being skewed is also a good sign, as this shows that there is some q quality control and data checking built into the test. This fetters out test manipulation and subterfuge. In the days of doctor-shopping and prescription bill abuse, that is very prudent (Millon, 1994)(Millon, 2008).

Summary Evaluation & Critique

The strengths of the Millon test include the fact that it is known to dovetail in terms of results quality and content with the famed DSM-III/DSM-IV standard. This helps the Millon's credibility immensely. Millon actually express in an interview that he had had a level of involvement in the DSM-III committee, so that drives the point home even more (Shaughnessy, 2008). Tests are constantly under way to test the efficacy and comparative accuracy of the DSM-III, the DSM-IV, the MBHI, the MBMD and the MCMI-III, the latter of which is covered in…[continue]

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