Assessing Haleema, Kasim, Chang and Gloria

Australia is one of the most culturally diverse countries in the world and this is only increasing. As outlined in the following case studies, clients from culturally and linguistically diverse backgrounds may be migrants, who move for better prospects and opportunities, or refugees, who seek safety because of the threat to their lives. There is also a trend toward young people entering Australia as international students. Many new arrivals come from very different cultures and often speak little, if any, English. They have to learn a new language while adapting to a new cultural environment. As a result, they may experience a range of psychosocial, emotional, academic and organisational issues.

Psychologists and other allied health professionals, who work in a range of educational, vocational, organisational, forensic, counselling and clinical settings, have to work with young people to investigate their issues and assist them after incorporating the best ethical and professional standards. This presents a unique set of challenges. It is important therefore, that psychologists have an awareness of the key issues that impact psychological work with people from culturally and linguistically diverse groups (CALD) to ensure appropriate services are provided.

Diverse characteristics of new arrivals

As seen in the case studies, young people from CALD backgrounds are not a homogenous group and vary considerably in their cultural history and practices. In addition, past experiences and their current situation differ widely, as can their reasons for coming to Australia. Many arrive with little or no English and with variable experiences of Western culture. This can make it difficult for psychologists to use what have largely been considered traditional means to be able to effectively evaluate a young person’s capabilities as well as their needs.

It is also important for psychologists to have an awareness of what life is like for people like Chang, Kasim, Gloria and Haleema, who arrive in Australia having led remarkably different lives, sometimes under difficult physical, social and financial circumstances. Everyday activities such as taking public transport, attending school and shopping may be challenging for CALD young people and their families who have to adapt and acculturate to a new physical, social and cultural environment. Some of these young people, like Kasim and Gloria for example, come from difficult circumstances including having been exposed to conflict, warfare, violence or trauma, and may also be experiencing issues associated with grief and loss. In some cases, young people like these will have been separated from their social network, and therefore have no family or social support to draw upon. This includes foreign students like Chang who are often sent to Australia alone.

What does this mean for testing?

When psychologists assess CALD young people they may, in some instances, be asked to use the most commonly used standardised tests for educational, psychosocial, mental health or workplace assessments. The use of standardised tests may not always be possible, and this is where the psychologist must consider the potential impact of the person’s culture, life experience and proficiency in English to form a judgement about whether administration of a standardised test will provide valid information.

It is important to consider questions such as the extent to which the test being considered might disadvantage the person because of their cultural background and familiarity with the English language, whether a more suitable test exists, or whether an alternative approach is possible that will be fairer and provide the information needed. If it is decided that it is not appropriate to administer a formal psychological test at this time, a recommendation that this occur at a later date when the young person has had a period of exposure to the Australian culture and the English language may be considered.

As well as the suitability of specific tests, there may be other barriers to the use of formal testing procedures. For example, assessment information that is required as part of valid psychological test administration, such as a person’s date of birth, may not be available for people from some rural locations where this information is not routinely recorded.

Most standardised tests used in Australia are language- and culture-bound. Some tests have been translated in other languages and non-verbal tests do exist which can overcome some of the language barriers but the cultural impediments generally remain as these are not easily overcome by simple translation. Similarly non-verbal tests may still be culturally laden. In Australia we seek to use tests that have been normed with an Australian population and where this is not possible, with a comparable Western population. As a result many psychological tests that are frequently used have been normed with population groups that are very different to many of the recent migrant and refugee arrivals to Australia making interpretation of scores problematic. Psychological testing is therefore often used as a guide and supplemented by other forms of assessment to provide interim information to shape the work with the young person.

Best-practice assessment

Cultural competency

In Australia there has been considerable focus on developing cultural competence in working with Aboriginal and Torres Strait Islander people. There is now an emerging emphasis on cultural competency as it relates to people arriving from outside of Australia or children of those who arrive from somewhere else. Psychologists can work towards increasing knowledge and understanding of the cultural values, practices, beliefs and expectations of the young CALD person through reading, supervision and through training programs. As it may not be possible to gain an understanding of all cultural groups, psychologists can acknowledge their limitations and can take a curious approach and learn from their clients. In the case of refugees, it is crucial to understand the pre-migration and transit related adversities often encountered.

Further, it is important to understand the post-migration stressors and acculturative stress of all those who relocate to a new country. As well as seeking training, cultural competency encompasses reflecting on and understanding our own professional limits. Psychologists’ attitudes towards the cultural group, including any preconceived ideas or biases they may have, and how these might impact on the work with the young person should be explored through supervision or peer consultation with other professionals. This will help the psychologist to address assumptions and frame services in ways that are appropriate for the young person. In some cases the psychologist may decide that a referral to another psychologist, who is experienced working with this client group, is the best option.

A holistic and a flexible approach

As already indicated, in some cases formal psychological testing may not provide valid scores. Therefore, it is necessary to exercise caution and data must be obtained from multiple sources. In these cases more weight must then be placed on other sources of information. This might include observational information as well as information sourced as part of interviews with the young person, their family and other significant people in their lives, along with other professionals such as teachers and health professionals. The psychologist might also adapt questions and create tasks that are in line with the concept that is under investigation taking account of the culture and practices in the country of origin of the person.

For example, if assessing adaptive functioning, rather than asking questions that focus on specific Western concepts and behaviours such as using cutlery or driving, the psychologist might explore universal behaviours such as ‘preparing food’ or ‘washing one’s body’. In the case of assessing problem-solving and judgement, problems can be based on situations that are from the young person’s background.

While these alternative approaches to gather information cannot provide valid and objective data they can assist the psychologist by providing preliminary qualitative information to allow the generation of hypotheses about how to proceed whether it be for the purpose of mental health or academic intervention or for educational or career planning. Down the track, when the person has picked up the English language and has been exposed to Australian culture for a period of time, psychological testing can occur to obtain more reliable information.

Caveats and tips

Psychologists working with Chang, Kasim, Gloria and Haleema will have to work in a culturally safe and appropriate manner. As a starting point, they have to determine the young person’s language proficiency. For those with limited or no English language proficiency, an appropriate interpreter has to be organised consistent with the APS Code of Ethics. Special care will have to be taken to develop rapport and to build a relationship as psychological services and assessment may be foreign to these young people and they may be intimidated by an authority figure. It will also be important to allow flexibility as young people may cooperate better in an informal or semi-formal setting.

Psychologists will have to take the time to socialise young people to the role of the psychologist and the significance of the assessment. As all the cases apart from Haleema are minors, special care should be taken to engage with a key carer or family member. Interviews need to be conducted with the client and their significant others. It will be important to understand the young person’s background and developmental context. Along with the commonly used probing questions, a detailed history about the young person’s life, values and culture in their home country, their migration journey and post-migration stressors will be significantly helpful. Their acculturation and acculturative stress have to be explored.

All the individual cases, except Haleema, have multiple difficulties. Priorities have to be determined to assist the young person (and his/her family). For example, although Kasim is not doing well academically, he may also be experiencing grief, loss and trauma. Psychosocial and mental health issues have to be identified and addressed before cognitive and academic functioning is assessed. Similarly Chang is isolated, missing home and not adjusting well. These issues have to be managed before the causes of his academic deficiencies are investigated.

As most of the tests are in English and based on Western concepts, particular emphasis will be placed on the young person’s appropriate level of second language development and exposure to the Western culture. These factors will determine if formal testing is appropriate for these cases. Alternative approaches, such as a sole reliance on qualitative methods, an application of modified items or an application of items developed by the psychologist may be considered.

As all of the cases may experience language and cultural barriers, commonly used formal tests used to measure abilities and aptitudes as well as cognitive, academic, psychosocial, and mental health functioning may not be useful. Observations, historical facts and a reliance on qualitative information can be beneficial to gather information and to generate hypotheses. For example, the past academic achievements of Chang may provide insight as to his cognitive abilities. Further, the way Gloria has managed her day-to-day problems and resolved her challenges can highlight her reasoning ability and maturity level. Non-verbal and pictorial, culturally fair tests may be more appropriate to assess the function in question. All of the cases may benefit from non-verbal tests that measure cognitive functioning. Due to the language barriers psychosocial and mental health issues have to be assessed through qualitative interviews. Mental health checklists and questionnaires can be converted into helpful interview questions to understand the psychosocial functioning.

For example the psychologist working with Gloria may have to convert a formal diagnostic measure into an interview to estimate her present mental health. In Haleema’s case, along with her abilities, interests and aptitude, her worldview and cultural values should be considered before suggestions are made regarding her career options. In these cases it may not be possible to arrive at a precise and objective finding. This limitation will be considered in any report. Further assessments at a later stage may be recommended.

As part of my role on the APS Test and Testing Expert Group I completed a practice guide, Psychological testing and assessment with young people from culturally and linguistically diverse backgrounds which may help support members undertaking assessment and testing with CALD young people.

Overall, the cases outlined here present a snapshot of the complexity associated in psychological testing with young people from CALD backgrounds. Nevertheless, working with these clients is also interesting and it is very rewarding to help a newly arrived person re-settle and focus on the positives in their life.

The author can be contacted at: [email protected]

Psychological testing and assessment with young people from culturally and linguistically diverse backgrounds Access guide