A psychological assessment improves treatment


A psychological assessment aligned with the DSM-5® helps a clinician improve patient evaluations and treatment

Ruth Tully, DForenPsy, Consultant Forensic Psychologist, United Kingdom

Dr. Ruth Tully, a consultant forensic psychologist, is the director of Tully Forensic Psychology Ltd., which provides psychological and treatment services across the United Kingdom. In the past, to conduct assessments of personality disorders and clinical syndromes, Dr. Tully had used the Millon® Clinical Multiaxial Inventory, Third Edition (MCMI®-III) from Pearson. The MCMI-III is aligned with the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV®). Clinicians rely on the DSM to diagnose and classify mental disorders.

When the DSM-5 was released in 2013, clinicians faced the challenge of finding psychological assessment tools that were aligned with it. Dr. Tully was pleased when Pearson developed the MCMI®-IV, created to align with the DSM-5, and she became a pilot consultant when it was officially released in November 2015.

When I’m writing reports on my patients or clients, it’s the DSM-5 that I’m referring to. So the fact that the MCMI-IV is up-to-date is one of the biggest benefits.

Dr. Tully has used the digital edition of the MCMI-IV approximately twenty times so far, but she evaluated both the paper-and-pencil and the digital assessment for use in various contexts.

In the MCMI-IV, “the test book is more client friendly. It’s easier for clients to complete it. That’s a huge improvement,” Dr. Tully noted.

As in the previous edition, clinicians have the option of using Q-global®, Pearson’s web-based platform, for administering and scoring the test and generating a report.

According to Dr. Tully, the enhancement to the profile summary graph included in Q-global is a “particularly useful” feature of the updated psychological assessment. In the previous edition, the graph included only numbers, but now it presents definitions of personality styles, types, and disorders, which have helped her interpret results with increased ease.

Updated Grossman Facet Scales, a series of therapy-guiding facet subscales that expand the basic personality scales, are included in the new assessment and in a graph in Q-global. Another new addition is the Turbulent scale, which provides clinicians with a deeper understanding of patients who are experiencing abnormal personality traits. These traits fall across the ebullient-exuberant-turbulent personality functioning spectrum.

The new treatment guide, part of the interpretive report generated by Q-global, provides short-term treatment options. It “is based on the identified personality patterns, as well as the clinical syndromes,” Dr. Tully said. “It offers useful guidance on the therapy approaches that might work for individuals with these prominent personality styles.”

According to Dr. Tully, Q-global makes the assessment process more efficient. She estimates that Q-global saves her two to three hours when scoring assessments and another two to three hours when writing reports because she integrates content from the Q-global reports into her own evaluations.

Estimated Time Saved by Using Q-global vs. Paper & Pencil



Dr. Tully finds that, as a result of the enhancements to the assessment, the MCMI-IV gives her a more complete view of patients than the third edition did.

The MCMI-IV has “allowed for a more comprehensive assessment of patients,” she reflected. “It allows for lots of subscales to be assessed. This one assessment gives us lots of different outcomes not just about personality, but about clinical syndromes as well. So that’s extremely helpful in time-limited situations and avoids lots of separate form filling on the part of the patient, which serves to enhance patient engagement.”

The MCMI-IV helps me reflect on the person in front of me, and reflect on his or her behavior and processes, to help me be a good clinician.

Dr. Tully regularly presents her reports, which have included comprehensive explanations of the MCMI findings, at parole hearings. “The reports have really helped the panel understand the person in front of them,” she said, “which helped them make a decision.”

When a patient is not responding well to treatment, Dr. Tully has used the psychological assessment to develop a more effective treatment plan. She also shares the assessment findings with patients.

“I’ve had positive feedback from clients in a variety of situations where looking at a formulation and understanding the different terms used for personality have helped them look back into their lives and realize where their personality stems from a little bit more. This process, assisted by the MCMI, ultimately helps them manage their behavior more effectively in the future.”

To learn more about the benefits of the MCMI-IV, read the full success story.

Read the full success story

Millon and MCMI are registered trademarks of DICANDRIEN, INC. Q-global is a registered trademark of Pearson Education, Inc. in the U.S. and/or other countries. iPad is a registered trademark of Apple Inc.