Projective testing in psychotherapeutics

Projective measures utilize ambiguous stimuli and minimal directions to encourage the examinee to utilize perception, apperception, associative processes, and memory to create responses to the examiner’s questions: the more ambiguous the stimuli, the greater freedom to form idiosyncratic responses that reveal aspects of individual personality. While intentionally opaque to the examinee, the majority of measures have been subjected to empirical validation, utilized in outcome research, and used to predict behavioral outcomes. The Rorschach inkblot method, for example, has surprisingly good accuracy in predicting suicide completion and attempt up to 60 days post-administration as well as predicting treatment response. In predicting treatment response, the Rorschach was found to be a better predictor of psychotherapy outcome than electrocardiogram stress tests in predicting subsequent cardiac disease. The broad empirical evidence base constructed over the last century aids clinicians in developing an accurate portrait of individual patient’s personality-their frailties, strengths, and potential response to treatment. The diagnostic facets of projective testing are frequently integrated into treatment recommendations for specific patients to help the therapist develop a working model of the patient’s functioning and to help predict potential therapeutic stalemates as well as positive developments.