When a person is injured at work, they will go to a doctor or hospital to have tests to establish what their injury is, whether surgery is required and what the rehabilitation process involves.

However, when it comes to psychological injury in the workplace, the process is completely different. The worker will often present to their general practitioner who will, after diagnosing their mental status as meeting the criteria for a mental illness, refer them to a psychologist and/or a psychiatrist.

The worker, therefore, bypasses any thorough diagnostic process other than the conventional clinical interview. The worker will begin treatment before an insurer requests a second opinion on what the diagnosis and treatment plan is.

The clinical interview, therefore, plays a significant and determinative role in the diagnosis and treatment of a patient. But just how accurate and reliable is it?

A therapist’s or assessor’s experience will often form part of their curriculum vitae of expertise. The more patients a therapist has seen, the more experience and expertise they will have. Therapists who have seen patients in more than one setting, such as at a hospital and community mental health service, will have even greater expertise as they are able to compare and contrast how these conditions manifest in different settings.

The logic, therefore, is that the more patients in the more contexts a therapist has seen, the more reliable and accurate their opinion. If this logic is to be followed, then psychometric testing is far more accurate than any clinical interview.

A psychometric test combines the findings of over 20,000 patient interviews from all around the world. It always asks the same questions in the exact same order. It is completely devoid of any subjective or external factors, such as whether the medical professional is in a bad mood on the day of the interview.

No individual therapist could have seen as many patients in as many different settings. So how can we say that a clinical interview is as accurate as the psychometric test?

An orthopaedic surgeon would never be expected to testify about a broken bone, its exact size, location and functional impact, without the aid of medical tests such as x-rays and MRIs. So how can a psychiatrist be expected to do so?

Image: Practical Pain Management


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About the Author
Emma Mead

Emma Mead is an Accredited Specialist in Personal Injury Law, accredited by the Law Society of NSW. She is also a National Accreditor Mediator and has a Graduate Diploma in Family Dispute Resolution. She specialises in all personal injury and family law disputes, locally and across New South Wales.