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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

Featured Resources

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About Dr. Jeremy Sharp

I’m a licensed psychologist and Clinical Director at the Colorado Center for Assessment & Counseling, a private practice that I founded in 2009 and have grown to over 20 clinicians. I earned my undergraduate degree in Experimental Psychology from the University of South Carolina before getting my Master’s and PhD in Counseling Psychology from Colorado State University. These days, I specialize in psychological and neuropsychological evaluation with kids and adolescents.

As the host of the Testing Psychologist Podcast, I provide private practice consulting for psychologists and other mental health professionals who want to start or grow psychological testing services in their practices. I live in Fort Collins, Colorado with my wife (also a therapist) and two young kids.

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555. Accuracy vs. Intuition: Stop Trying to “Sense” Effort