John E Exner Jr. Rorschachiana. Volume 19, Issue 1. 1994.
Since the Rorschach was first published 1922, interest in its applications has grown steadily throughout the world. The test continues to be a focus of both theory and research, much of which centers on either of two major issues. The first concerns how the test works, that is, how is it that a relatively few samples of behavior (responses) yield so much information about the subject? The second concerns how the test can be used to differentiate groups of people, that is, what features of one group are idiosyncratic to that group, such a differentiating nonpatients from patients, schizophrenics from depressives, and so on. This latter category of issues is, in part, related to interest in using the test for differential diagnosis. A third area has received less attention. It concerns the fact that the test yields very important data about each subject as a unique person.
When Rorschach began his own research, first in 1911, and later during the period from 1917 to 1921, he tended to focus on the first two issues noted above. It was only near the end of his work that he perceived the test as being a useful way to capture some of the idiography of the subject. In effect, he had stumbled on to a way to study personality and individual differences. The issue of personality and individual differences has not been afforded much consideration in the Rorschach literature in recent years. This is unfortunate because many who use the Rorschach tend to disregard the potential applications of its richness when using the test.
The Rorschach provides a great deal of information about a subject, and obviously, that information can contribute in an indirect way to differential diagnosis. But that is a relatively minor aspect in using the test. The marvel of the Rorschach is the very personal picture of the subject that it offers. In doing so, it tends to emphasize how each person is different than each other person, even though they may be quite similar in some ways. In effect, it is a test of individual differences, the yield from which highlights the psychological strengths and weaknesses of each subject. This sort of information is especially important in the clinical situation because it can be used to identify treatment objectives when some state of disarray exists. It is this use of the Rorschach that seems to be neglected most often by those using the test, and that neglect probably limits the quality of treatment offered to those who have been subjects of the test.
Interest in people and their individuality has existed for centuries, but the notion of personality, as a subject for psychological study, is less than 100 years old. The works of Freud had, of course, received considerable attention beginning in the very late 1800s and the theoretical propositions of many neo-Freudians gained also gained much attention during the first two decades of the 20th Century. But, by 1920, no one in psychology had taken serious interest in the study of personality. Had Rorschach lived longer he might have given greater emphasis to the study of the individual, but that might not have been the case because psychology and psychiatry offered no basis from which to imply that such work had importance.
Allport (1937) noted that a movement called the psychology of personality gained interest only after 1920, yielding numerous, but conflicting theories and plentiful, but piecemeal research. Freud, and the neo-Freudians, failed to attract those attempting to address the challenge of defining personality, probably because many aspects of their theoretical models presented complex and untestable postulates. Allport certainly can be credited with bringing the issue into sharper focus. He reviewed some 50 definitions or descriptions of personality and neatly drew the composite into a logical conception by defining personality as the, “the dynamic organization, within the individual, of those psychophysical forces that determine his [or her] unique adjustments to his [or her] environment.”
In formulating this definition, Allport noted that the uniqueness of each person creates havoc for science in its search for ways to account for the uniformity of behaviors. He put forth a very compelling challenge; namely, that psychology can only achieve its true purpose when it can deal with the issue of individuality. Allport also offered a strong caution about research orientations that might tend to dismember the total person in ways that would present only fragments of information about whole people, and then attempt to extend that information in ways that would neglect individual differences.
Shortly after Allport’s classic book Personality was released, Henry Murray (1938) published another classic, Explorations in Personality. Murray did not attempt to define personality as Allport had done. Instead, he approached the issue of individuality from a different direction. He highlighted it by explicating the unique and sensitive integration of various characteristics within each person. To do so, he neatly illustrated how information, derived from many sources, including psychological tests, could be used to develop a very special picture of a person. Both Murray and Allport strived to distinguish between the idiographic and nomothetic approaches to the study of people. Each, in his own way, argued for an integration of both, that is, an approach which would not simply judge a person against others, but one that would contrast the unique features within one person against those found in others.
The arguments put forth by Allport and Murray stimulated much thinking about the objectives of the psychological study of people and, in effect, created a challenge to those interested in testing (or assessment). Subsequently, the idea of assessing personality and/or psychopathology began to capture much more interest of psychologists than had been the case previously. Although the practice of psychological assessment in the United States usually is dated to 1896 and can be traced earlier in Europe, most attempts to use tests to understand people did not include much personality testing. People calling themselves psychologists did considerable testing, but their efforts focused mainly on issues of intelligence, aptitude, achievement, interest, and so on, and the term personality was often used interchangably with psychopathology. A few attempted to devise methods to detect psychopathology during World War I, and some of those efforts did persist into the 1920s and 1930s, with the development of inventories designed to measure some trait-like features such as introversion, extraversion, neuroticism, and the like, but none were used extensively in the clinical setting. Issues of individuality typically were addressed by using data frawn from histories and interviews.
The interest in understanding people as individuals, as purported by Allport and Murray, increased notably during the late 1930s, partly because of the existence of the Rorschach, and mushroomed at an almost incredible pace during World War II with the huge expansion of clinical services provided by the military in several countries, and by the Veterans Administration in the United States. Concurrently, the clinical test battery approach became purported by many, but probably was best articulated by the Rapaport group at the Menninger Foundation during the mid 1940s, leading to the procedure that routinely became called psychodiagnosis.
The objective of psychodiagnosis involved much more than searching out a diagnostic label. It was a multi-test procedure designed to study the person as a unique entity. Implicit to the process was the premise that information about the subject concerning assets, liabilities, conflicts, and so on, would contribute in some significant way to the therapeutic well being of the subject. In other words, the findings contributed to a treatment plan. The notion underlying psychodiagnosis has always been that people behave in ways that are organized and recognizable. That is the basic tenet on which all of psychology is founded. Thus, the objective of the psychodiagnostic procedure was to detect those elements, within the individual, that routinely promoted various behaviors, including the presenting symptoms.
Throughout the 1940s and 1950s, clinical psychologists throughout the world became well recognized and highly regarded for their psychodiagnostic expertise and the input that they made about patients when issues of diagnosis and/or treatment were discussed. Unfortunately, those interested in the study of personality gradually began to take either of two positions. One, more empirically oriented, argued for the study of personality traits and their relationship to behavior. The second group agreed with many of the basic concepts of trait theorists, but also strongly argued that characterization of traits could not simply be defined in terms of their presence or absence. They preferred to think of personality as a unitary entity and argued that a trait is a descriptive, non-explanatory concept which, following from Allport and Murray, must be weighed in terms of its strength or importance within the individual. Conversely, those arguing for the study of traits maintained that, through the study of individual characteristics, the unitary personality might ultimately evolve, but that more importantly, the approach would be clearly empirical. This approach probably is best illustrated in England, where the work of Eysenck and his group have dominated the assessment picture during the past two decades.
The disagreement about how best to approach issues of personality and individual differences was made more complex beginning in the early 1950’s, when a falling out occurred between those who argued strongly in favor of a so-called objective testing approach, and a second group which became closely aligned with what was known as the projective psychology movement. The former argued for a more nomothetic approach to the study of personality, while the latter defined itself as more oriented toward understanding the unique individual. No one profited from that schism, and it was not uncommon in those days for advocates from one group to avoid advocates from the other. In other words, the emphasis on psychodiagnosis, or personality assessment as it began to be called, did persist, but with far less uniformity than had been the case previously.
During the late 1950s another force became prominent among some practicing in clinical psychology in the United States, and has gradually spread to other areas of the world, especially Europe. It is radical behaviorism, which brings with it the notion of the black box, and the message that there is no such thing as personality, or even if there is, it can not be measured through psychological testing. This movement has created a new group of psychologists who have not only avoided personality assessment, but who have campaigned very actively against it, favoring instead the tactics of observation and counting critical incidents as ways of determining targets for intervention. Thus, by the early 1960s in the United States and by the mid-1970s in Europe and some other parts of the world, the once reasonably homogeneous specialty of personality assessment had fragmented considerably.
This divergence probably had its greatest impact in the United States during the mid 1960s and through most of the 1970s as training programs in clinical psychology changed considerably. Students often objected to the laborious time required to learn about test batteries and their applications, and their objections were often reinforced by many in the academic community, from both clinical and non-clinical faculties who voiced opinions that the specialty of psychodiagnosis, or personalty assessment, had only limited value. As curricula changes occurred, many included a marked reduction in the emphasis on that segment of training that had focused on personality assessment and particularly the segment involving the Rorschach and projective methods.
It is sad to note that, in the United States during the 1970s and early 1980s, these altered programs produced huge numbers of graduates who knew little about assessment, less about personality and individual differences, and yet tended to glory in their newly learned therapeutic expertise. The assumption was that personality tests, such as the Rorschach, could not measure the structural features of personality, if they exist, in reliable and valid ways that truly evaluate their full weight in different situations.
These changes did not necessarily lead to less personality testing. In fact, several studies published in the 1980s indicate that the use of psychological testing remained at almost the same level in the United States during this controversial period. Unfortunately, those data may simply reflect the fact that psychological testing had become ingrained as a part of many of the routine procedures used with patients, especially inpatients. It is also sad to note that many clinicians continued to use assessment routines that had become little more than a byproduct of intellectual laziness. These are routines that hark back to the days when patients were subject to hours and hours of testing and interviewing, and clinicians took many days to write lengthy reports that often neglected much of the data that they had collected. But the main force that led to a reduction of training and emphasis on personality assessment procedures clearly came from the increased emphasis on therapeutic training and the variety of therapeutic methods that might be employed in different situations.
The reduced interest in personality testing and the study of individual differences has probably increased because an element outside of psychology. It involves the important changes that have been ongoing in psychiatry throughout the world. Beginning in the late 1960s or early 1970s training programs in psychiatry reduced emphasis on the tactics of individual therapy, and extended the emphasis on pharmacological issues as a basis for, or adjunct to intervention. As psychiatry has gradually changed in its emphasis, clinical psychology often paused from its own search for identity to condemn this so called medical model.
The medical model, of course, is strongly embedded in the DSM and WHO manuals that search out a listing of characteristics or traits that are determined to be equivalent within a particular syndrome or diagnosis. Thus, many in contemporary psychiatry now tend to perceive the role of the psychologist as being more competitive, and the procedures of assessment as being of little use unless they contribute to some DSM or WHO designation. They are seemingly unaware of the potential for describing the patient as a unique entity in a way that will contribute to the ultimate well being of the patient. Unfortunately, a lengthy period has ensued in which psychologists have neglected the opportunities to educate colleagues from psychiatry concerning their potential assessment skills, and the way in which those skills can contribute to more precise treatment planning. But even in the area of personality assessment, many of the issues of science have been cast aside. A notable decline has occurred in the area of basic research concerning personality and personality theory. In effect, the very people who might be best able to provide systematic investigations concerning the worth of personality assessment often have turned to different areas of research.
The new clinical psychology tends to focus on treatments, and it has been a confusing and wondrous experience to note the remarkable accumulation of fads concerning treatment that have been generated during the past two decades, most likely with the objective of enticing new clientele or explaining treatment failures. New propositions about entities such as borderlines, anorexia, bulemia, obsessive compulsive disorders, panic disorders, multiple personalities, anxiety reactions, anti-social personalities, post traumatic stress disorders, and the like, have created a cadre of specialists in those disorders. These specialists often suggest that their credentials provide an implicit promise of cure, or at least a clear understanding of the problem.
Unfortunately, personality assessment has played an almost negligible role in contributing to these propositions, and research concerning these issues struggles to reach even a mediocre level. Stated simply, people who purport themselves to specialize in the treatment of these disorders have little interest in personality assessment for, by their logic, they already know what is wrong with the prospective patient and have the methodology readily available for correction. This unreasonable logic neglects the individual as a unique entity, and even more important, is based on the naive assumption that symptom presentation dictates a specific form of treatment. In effect, it is an extension of the medical-model to which many professional psychologists seem to object so strenuously.
This situation has been clouded further by the fact that many psychologists who practice intervention seem to be motivated by the general premise that it is more important to entice the subject to become a paying client, or a client for whom someone else will pay, rather than to be concerned with what is really wrong with the subject and/or what is really best for the subject. Sadly, a substantial number of psychologists practicing in the clinical area perceive themselves to be therapists and have settled upon one or, at most, two methods of intervention with which they feel comfortable employing with each potential patient, and they apparently are not very interested in personality assessment.
However, it is also important to note that even those who do personality testing often do not maximize the use of their findings. In a recent study in the United States (Exner, 1994), the names of 600 psychologists were selected randomly from the Directory of the National Register of Health Service Providers. This was done with the purpose of attempting to learn more about the interest in, or practice of personality assessment by those working in the field, especially those who treat patients in private practice. To that end, the random selection was restricted to those whose addresses appeared to be residential or office, that is, none were selected who’s addresses included a university, hospital, or obvious state, city, or county mental health installation.
A brief twelve item questionnaire was sent together with a stamped, return envelope. Each question was stated in a manner that could be answered by selecting one of four options (1) never, (2) sometimes, (3) often (4) always. The first of the 12 questions asked whether the respondent administered (or had administered by someone else) personality testing prior to the third treatment session. The second question asked whether personality test results were used to plan treatment, such as deciding on treatment objectives, selecting a method of treatment, deciding on long term versus short term intervention, etc. The third question asked if the test results were used to formulate a diagnosis, and the remaining questions focused on the use of specific tests. Two of those questions concerned the use of the Rorschach and two concerned the use of the MMPI.
A total of 388 (65%) of the questionnaires were returned. Although the return is less than desirable, the data are quite striking and seem to send a message to those vested in personality assessment, and especially for those who are concerned with quality treatment planning.
Eighty-nine of the 388 respondents (23%) indicate that they never use personality testing. Sixty-two of the 89 indicate that they do not find them useful, and/or believe that they are invalid. Twenty of the 89 indicate that they are not sufficiently trained in their use. Seven of the 89 indicate that clients object to their use.
The remaining 299 respondents indicate that they do use personality testing, but only 201 of the 299 (67%) indicate that they use the results in planning treatment. This represents only 52% of the total number who responded.
One hundred eighty-four (92%) of the 201 respondents who do use test results for treatment planning always use a sentence completion blank and the remaining 17 respondents indicate that they use a SCB often.
One hundred twenty-three (61%) of the 201 respondents who use test results for treatment planning use the MMPI at times (sometimes = 34; often = 42; always = 28). Stated differently, about 32% of the total number of respondents use the MMPI, at times, to plan intervention.
One hundred twelve (51%) of the respondents who use test results to plan treatment administer the Rorschach at times (sometimes = 26; often = 56; always = 30). This represents on 29% of the total number of respondents.
Interestingly, 99 of the 112 who use the Rorschach often or always for treatment planning also use the MMPI often or always. Similarly, and 92 of the 123 who use the MMPI often or always for treatment planning also use the Rorschach often or always. These seem to be the people who are invested in the use of personality assessment for purposes of treatment planning, but collectively, they constitute a relatively modest proportion of the total group, only about 49% of those who use test results for treatment planning, about 39% of all respondents who do use personality tests, and only 26% of the total number of respondents.
There is no way to know about the testing practices of the 212 non-responders but an ominous guess seems reasonable. In some respects, this lackadasical approach to treatment planning is an unethical disservice to people. Psychologists can and should do much better but, thus far, that does not seem to be the case. The fault is not with the lack of reliable and/or valid tests, although this is not to suggest that psychology has reached the ultimate in precision concerning the best ways to assess personality or to detect the often subtly unique features that mark people and differentiate each from the other. Nonetheless, currently available personality tests are reasonably sophisticated. Findings from them, especially those such as the Rorschach which yield very individualized findings, can be used logically and empirically to generate realistic intervention plans if the data are used wisely, and in the context of a cost-benefit-analysis that will require the least investment by the subject.
Some have argued that personality testing is time consuming and that the same information will ultimately be revealed as treatment progresses. Actually, the procedures involved usually take no more than a few hours if done by those competently trained in assessment. What person who submit himself or herself to surgery or some other form of drastic medical intervention without first being assurred that all available tests had been completed and that the attending physician was thoroughly aware of the issues involved and had considered all treatment alternatives? Do people seeking mental health attention deserve any less?
A simple illustration may be useful. It is taken from two real life cases. In this instance, the results are derived mainly from the Rorschach, and seem to affirm the importance of reviewing individual differences in treatment planning among patients who may have the same presenting symptomatology. The illustration involves two women, one age 27 and the second, age 32. Both presented themselves to potential therapists with vigorous complaints of frequent and disruptive bouts of anxiety and frequent panic attacks. They live in markedly disparate parts of the United States and each was assessed by a psychologist not known to the other.
The woman in Case 1 is separated after four years of marriage, while the Case 2 subject is single. Both have completed at least two years of college. The Case 1 subject currently works as a secretary in an accounting firm. The Case 2 subject currently works as a costume designer for a theatrical company. If either appeared before a consulting psychiatrist, there is a good likelihood that each would be prescribed some kind of anti-anxiety medication. If either appeared before a psychologist specializing in anxiety or panic reactions, it is likely that each would be subjected to some form of tension reduction treatment and stress management control. The question is whether the form of intervention might be different if the subjects were evaluated more thoroughly with regard to individual differences and unique personality characteristics. Both subjects were referred for personality assessment by their respective therapists, and bulk of the testing included the administration of a sentence completion blank and the Rorschach.
The psychologist responsible for the for the Case 1 assessment reports that the results indicate that subject is quite defensive, in spite of the fact that she has considerable resource, and that her capacities for control and tolerance for stress are usually as robust as those of most adults. However, these features currently are less effective because of some situationally related stress, which probably has to do with her recent separation. The effects of the stress are relatively modest, but they have created a state of psychological overload. This overload appears to have created a potential for impulsiveness that is more likely to manifest in her emotional displays than in her thinking. Much of her stress appears related to an experience of emotional loss and probably translates as feelings of loneliness or neglect. As a result, many of her psychological operations are more complex than usual and, although she appears to have a long standing confusion about her feelings, this confusion has become intensified.
It is also noted that she is an intensely self-centered individual who greatly overestimates her self-worth. A direct product of this tendency is to focus much more on herself than on others. As a result, her interpersonal relationships usually are more tenuous and less mature. Thus, emotional losses or rejections are likely to have a greater impact on her because she perceives them as insults to her over glorified sense of personal worth. Actually, her self concept is based much more on imagination than real experience. Nonetheless, it is important for her to defend her inflated sense of self and, because of this, she usually externalizes responsibility, especially for negative events and tends to avoid or deny unpleasantness.
She also has a strong passive-dependent orientation. She seems prone to seek relationships that are both supportive and nurturing. Unfortunately, this increases her vulnerability to the manipulations of others. It seems likely that she has some awareness of this and she seems considerably less secure about her interpersonal relations than are most people. She attempts to conceal or contend with these feelings of insecurity by using an intellectual, somewhat authoritarian approach to many issues. Although she is open to social interaction, she is cautious and sometimes even reluctant to initiate interpersonal exchanges, especially those that may require more tact and sophistication. She is especially defensive about relationships that may create unwanted demands on her or pose hazards to her control of the situation.
She an intuitive person, who is influenced greatly by her feelings when required to contend with demands for coping or decision making. Typically, she merges her feelings together with her thinking. She prefers to test out her decisions through trial and error activity and probably is not very reluctant to display her feelings. In fact, she may often convey the impression of being excessively emotional or even impulsive. Her thinking is usually clear but her current stress state tends to interfere with her abilities to concentrate or attend to specific events. Often, when in stress situations, she creates a self imposed form of helplessness in which she relies heavily on the actions of others for decision making. She has no major problems in reality testing and seems as prone as most adults to make conventional responses when the circumstances of the situation clearly define expected or acceptable answers. In effect, she is a somewhat hysteroid-like person who is currently foundering and having much difficulty her sometimes very intense feelings.
The report concerning the subject in Case 2 indicates that she is a very conservative and cautious person who seems quite insecure about herself and her ability to deal effectively with her world. She is especially reluctant to deal with complexity and has developed a basic orientation toward coping or decision making that causes her to be prone to keep things on a very simple and easily managed level. Although this coping style is not necessarily detrimental, it does serve to reinforce her notions that she is not very capable.
She is a very ideational person who prefers to stop and think things through before reaching a decision or initiating behaviors, but unfortunately, she commits much of her thinking to the development of fantasy, which she uses frequently and often abusively to avoid the stresses of reality. Although her capacities for control are quite adequate she is vulnerable to disorganization under stress because she really has fewer resources readily available than do most adults. She is quite conservative about processing new information and seems especially fearful of her feelings in decision making situations. As a result, she tries to avoid emotionally provocative situations whenever possible. In fact, she often goes to the extreme of emotionally isolating herself from close relations with others to avoid the quandries of dealing directly with her feelings.
Overall, she is a somewhat psychologically impoverished, relatively fragile, and somewhat schizoidish individual who does not regard herself very favorably. She seems forced to defend herself in an overly complicated world by assuming a passive or submissive interpersonal role. Although she is interested in people, her conceptions of them are based much more on her experiences from her fantasy life than from real experience. Thus, although she is open to closeness, she seems bewildered about how best this might be achieved and concerned about what sacrifices she might be called upon to make in return. The result is a person who tends to live on the periphery of her environment, seemingly aware of what goes on, but unable to partake in deep or mature relationships.
The psychologist reporting on the findings for Case 1 issues a convincing argument that the findings clearly point to a need for some form of supportive intervention to assist in working through the current stress situation created by the separation. The findings also highlighted to stress the importance of her strong passive-dependant orientation in planning for a supportive routine. The report also emphasizes the tendency of the subject to externalize cause, and the sometimes apparent volatility manifest in the overt expression of her feelings as potential targets for intervention, but cautions that these issues probably will not be open to treatment unless a longer term form of intervention, ideally, a developmental model of treatment, can evolve from the supportive intervention. The report notes that she has several assets that can be used to facilitate treatment. She has considerable resource. She has a relatively consistent coping style. She makes a serious effort to process information and ordinarily, she does not distort perceptual inputs. Her thinking is reasonably clear and she obviously has no negative sets toward her environment.
The psychologist writing the assessment report concerning the Case 2 subject argues convincingly that most of all her symptoms have evolved because she seems to live a very fragile existence, depending upon others with whom she is not really close and not being able to predict how effective or ineffective her avoidance style may be in her everyday living. When she is viewed as a unique person, optimal intervention objectives seem easily identified but an actual intervention strategy is more difficult to define than for Case 1. First, she must be approached very cautiously. It seems clear that this woman suffers enormously from many developmental problems. She is not sure who or what she is, and seems equally confused about others. Her resources are more limited than would be expected and her abusive use of fantasy serves only to sustain her impoverished plight. She is the type of person who, if confronted with the need for some long term form of treatment, is likely to bolt because the prospect could be too threatening. Thus, it may be more appropriate to broach the treatment issue in a more specific but open-ended way, possibly by suggesting a focus on broadening social skills and contending with feelings more directly to ease some of her symptoms. It seems also logical to caution the therapist about her avoidant and oversimplifying orientation and her abusive of fantasy. Both will clearly cause problems in treatment but the former will tend to interfere most, especially when complex issues are addressed.
If the same therapist were to treat both of these clients, using similar treatment tactics with both, it is possible that success might achieved with one and not the other, but it is also possible that, if the treatment simply focused on anxiety reduction, neither would benefit. Stated differently, an intervention methodology that might work for one of these subjects could not be expected to work for the other. Even though their presenting symptoms are similar, they are very different psychological people and only an extreme optimist could believe that a singular form of treatment will profit both. One seems in need of some sort of supportive treatment that might evolve into longer term developmental treatment. The second clearly requires a more developmentally oriented form of intervention.
Although anecdotal, these illustrations afford some emphasis to the importance of personality assessment, to understand the individual more thoroughly, and to plan treatment more realistically. It is true that many issues concerning the assessment of personality and the efficacy of the Rorschach remain open to inquiry. Research about personality and personality assessment has slowed, mainly because those in the professional areas of psychology have shunned those who may be in the best position to study the predictive value of personality assessment, that is, those vested mainly in research. Thus, unfortunately, assessment as a specialty, and Rorschach use in particular, is almost data-less in terms of predicting response to specific intervention models. Some data, scattered here and there, do exist, (Applebaum, 1977; Exner & Sanglade, 1992; Gerstle, Geary, Himmelstein & Reller-Geary, 1988; LaBarbera & Cornsweet, 1985; Weiner & Exner, 1991), but the accumulated findings fall far short of offering a convincing need for assessment, or the use of the Rorschach in most or all cases.
It is also obvious that personality assessment can also be used to evaluate treatment outcome, but that is a far less common practice than should be the case, and data concerning this process is almost nonexistent.
If personality assessment, and Rorschach use in particular, is to be respected and successful into the next century, the purpose should be defined more concisely than seems to have been the case. Training in assessment, and especially in the Rorschach may be at fault. The Rorschach, or for that matter, any personality assessment instrument, should not be administered as part of an esoteric exercise. Often, students are trained how to administer and interpret the test, but sometimes, they are not taught how to use the resulting data to the fullest extent. Students training in the Rorschach should be taught to use the test wisely and in the context of the purpose for which the assessment is designed. If an emphasis on logically developed treatment planning is provided, the procedures will make more sense, not only to students, but to colleagues in psychology and psychiatry, and this will reaffirmed the expertise and integrity of the special skills available from the well trained clinician.