555. Accuracy vs. Intuition: Stop Trying to "Sense" Effort

Clinical intuition is often little more than a coin flip when it comes to detecting suboptimal effort. We like to think we can spot a client who isn't giving their best, but the data suggests otherwise. In this episode, I dive into the necessity of using objective performance validity indicators rather than relying on gut feelings. I discuss the prevalence of failure rates in adult ADHD evaluations, the difference between malingering and a cry for help profile, and the technical balance between sensitivity and specificity in the tools we choose. I also share a practical framework for addressing poor effort in the moment using a three stage feedback sandwich to preserve the clinical alliance while ensuring the integrity of your data. Main Topics: ➡️ The limitations of clinical intuition in determining optimal effort ➡️ Prevalence of validity failure rates in clinical ADHD evaluations ➡️ Distinguishing between malingering and the cry for help profile ➡️ Balancing sensitivity and specificity in validity measure selection ➡️ The shift from legacy recognition tasks to multi stage symptom validity tests ➡️ The two failure rule and the utility of the $0 embedded indicator ➡️ Strategic scheduling and administration of PVIs throughout a battery ➡️ The feedback sandwich: affirmation, calibration, and the reset Cool Things Mentioned: The Testing Psychologist mastermind groups and business consulting Reverb: the premier AI-powered report-writing platform for testing psychologists