Rorschach Comprehensive System: Current issues

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Rorschach Comprehensive System: Current issues by Anthony D. Sciara, Ph.D., ABPP and Barry Ritzler, Ph.D., ABPP Introduction The Rorschach Comprehensive System as developed by John E. Exner, Jr., Ph.D. has been the predominant system in use for administration, coding and interpretation of the Rorschach since shortly after its inception in 1974. Dr. Exner died in 2006 leaving Rorschach Workshops, the legal rights to all his writings, and all his files to his family. While Rorschach Workshops still continues to sell his books and forms, there is no psychologist in the family to continue research, writing, and publication of new information. This article will look at the impact his death will have on the Comprehensive System (CS). For whatever reason, Dr. Exner did not appoint a successor. The lack of an identified successor to continue CS research has left a leadership void. There is a current initiative by some psychologists to develop a new system for use with the Rorschach. This plan for the development of a new system will be discussed along with how the CS will continue to grow and change in the future. Historical Overview Dr. Exner developed the CS as a scientifically valid, clinically useful, and reliable method of using the Rorschach Inkblot Test. He did this by working with a number of Rorschach experts (Klopfer, Beck, Hertz, etc.) and realized that no one system could be defended. While there was some research supportive of different aspects of each of the systems, none of them had a broad based research foundation. To help the Rorschach gain acceptance and utility, he developed a research plan to test various aspects of the test. In addition, he developed reliable and valid rules of administration. Part of his approach was to provide a foundation of research on non-patient individuals that would be a springboard for developing interpretative statements for deviations from that non-patient sample. The initial group of 600 non-patients has been used as the

basis for interpretation. Over time, the original sample became dated. Dr. Exner began a new research initiative in 1999. The purpose of that research was to determine if there had been any significant changes in the non-patient population in the United States since the selection of the original group. That led to a more recent non-patient sample of 450 individuals. Information regarding that 450 sample was published in the 2005 revision of Volume 2 of The Rorschach: A Comprehensive System (Exner & Erdberg, 2005). The research on the 450 sample also produced an article published in the Journal of Personality Assessment (Exner, 2007) regarding certain minimal interpretative changes based on what appeared to be differences in the non-patient sample. Those changes included: 1. A modification of the interpretative guideline for the FC:CF+C ratio 2. A modification of the interpretative guidelines for White Space responses 3. A modification of the interpretive guidelines for form quality variables (X+%, Xu% and X-%) Each of the changes identified were minimal, still used the same interpretative formulations and did not change the CS overall. This demonstrated that if the same method of selection that Exner used for both samples were used, there was very little change in the interpretation of the variables. He was trying to capture an average level of psychological functioning so that scores which deviated from the norm were interpretively useful. What Exner provided was a means of using a valuable clinical tool for personality assessment that had an evidence-based foundation, but was clearly meant to reflect what clinicians do in the real world. He believed it should help clinicians make decisions regarding personality functioning based not only on statistics, but also on clinical information regarding the patient. By having clear administration, coding, and interpretation guidelines, it allowed clinicians to use their experience with clients to make specific comments about their functioning and not just statements based on actuarial findings. In the Workbook (A Rorschach Workbook for the Comprehensive System, 5th ed., Exner, 2005) Exner states, The system now appears to stand about as complete as possible, but it is very likely that future research will lead to the development of new approaches to coding some types of responses, or the discovery of new variables or

strategies that will enhance the interpretive yield of the test. In other words, it would be foolish to assume that the Comprehensive System has reached the last pinnacle in its development. (Pages v & vi). This statement recognizes that the CS in its foundation is complete, but that enhancements may extend the usefulness of the test. It also suggests that there is no need for extensive or major changes to the CS. New Initiatives In the three plus years since Exner s death, the inevitable desire for a leader in Rorschach assessment has been noted. Exner never appointed a successor to take over Rorschach Workshops. There has been widespread concern that there is no one to guide research of the CS. This was compounded by the Exner family announcement that there would be no changes to the CS. From their perspective the system would remain as it existed on Exner s death. Statements such as the Comprehensive System is cryogenically frozen in time with no hope of change have been seen in various correspondences between concerned professionals. This led to the announcement by a group of five (G5) individuals (G. Meyer, J. Mihura, P. Erdberg, D. Viglione, and R. Erard) active in Rorschach research to seek to make changes to the CS. The attempt to make changes to CS was frustrated by the decision of the Exner family not to change the system. This raised potential legal concerns regarding copyright issues. It was decided by those individuals seeking change to develop a new system. The impetus for change appeared when a supplement to the Journal of Personality Assessment (JPA 2007) was published which combined normative studies on the Rorschach from a number of countries. This combining of information led to the development of the international norms. In that article, the authors called for an abandonment of both the 600 and 450 Exner norms to be replaced by the composite of the international norms. In an article published on the Rorschach Training Programs (RTP) website (www.rorschachtraining.com), Ritzler and Sciara reviewed the international norms article and expressed concerns regarding the methodology and findings included in those samples. Concern was expressed that it was premature to call for an abandonment of either the 600 or 450 sample in favor of the international norms. The concern regarding the international norms was based on potential methodological flaws.

Development of A New System Exner s comments about the completeness of the CS and its possible enhancements make it is clear the CS is a system that can endure for many years to come. It has the potential for adding enhancements, but there is no need for abandoning the CS as an effective system. The CS currently satisfies the needs of clinicians performing personality assessment as it has for many years and new, empirically-supported information can be added to the System. So why the call for a new system? The G5 have stated a new system must be developed because the CS cannot be modified. They have stated the CS requires significant change and have proposed changes in administration, norms and interpretation. While the desire of other individuals to construct their own system can be understood, there is no current need to abandon the CS. When individuals want to initiate their own, new, approach to an established product it is common to attempt to discredit the old, identify the new as being superior, and distinguish the new from the old in whatever ways are available. It then allows the new product to be developed and sold as something with significant value added. In the current situation, there are major questions about the need for change and whether a new approach would have any value added. The fact is, at this point, there is no new product, but only the first stage of attempts to discredit the CS and to assert that a new system would be better. To provide evidence of one s right to develop a new system, there often is an attempt to establish one s credibility as an insider with the old regime. In this case, several of the individuals involved mention their involvement in the Rorschach Research Council which Exner developed, funded and directed. The council consisted of individuals whom Exner chose to meet with and talk about potential additions to the CS. Involvement in that Council did not necessarily mean that their ideas would be integrated with the CS. Certainly, there will be more rhetoric in the future about the CS and the superiority of the new system. There will, however, be detractors. There are those who are comfortable with the CS and will reject learning a new system. There are also those who have a financial motive for change. Regarding the Comprehensive System, individuals and corporations who currently have secure copyrights to publish CS software will embrace change. This will allow them to continue making newer products to sell. On the other

hand, commercial entities will not be so inclined to embrace a new system in which they would have no rights and, therefore, no financial incentives. Their income would likely suffer as a result of any new system. They would be more willing to see modifications in the CS than the formation of a new system. New systems would be the property of the developers who could then sell software and other materials. Much has been made of whether the CS is a copyrighted system and whether a system can be copyrighted. That is a legal issue that can only be decided by court action. There is nothing that keeps someone from developing changes to the CS and introducing those changes as a new, improved CS other than the potential for litigation against their action. Developing a new system that does not include the pieces and parts of the CS is the best way to mitigate against the potential of litigation. Consequences Of Establishing A New System Much effort will be required to establish a new Rorschach system. For a new system to be unique and have the potential for added value, it should include research from the ground up. That means that administration, coding variables, and interpretative strategies must each be researched. It is impossible to develop a new system based on research from the CS. For example, while the international norms may be a cornerstone of a new system, it is inappropriate to use those norms for a new system as the protocols were collected using the administration, coding, and interpretation methods from the CS. Any new system must undergo the rigors of scrutiny by the professional community. The international norms have yet to undergo this scrutiny. A single publication of these norms does not meet any legal standard for inclusion as a foundation for use in court. Likewise, new administration procedures, new variables, and new interpretative strategies must be scrutinized over time to satisfy the needs of the forensic community for inclusion in evaluations to be presented in court. The CS has been accepted for years as an instrument that meets the requirements of the legal system (Exner, Weiner & Sciara, 1996). Even a challenge to the CS by Wood, Nezworkski, Lilienfeld, and Garb (2003) has not succeeded in undermining the acceptance of the CS in the courtroom. If a new system is developed it will take many years to be accepted by the legal and clinical communities.

Exner not only developed a system for use of the Rorschach, but also developed a training component to support clinicians attempting to use the CS. It is the training of any system that supports its use in a clinical setting. The training must be supported by written materials including books and workbooks. It is this network of support for any new system that will be necessary for widespread acceptance. It is easy to see that any new system has a long road with many issues to resolve before it could replace the CS. The reality is, the CS currently does an excellent job of evaluation when used appropriately. It has not yet been proven that any new system has enough to offer to replace the CS. Reaction from the International Community The promise of a new system was announced to the world during the European Rorschach Association meeting in Prague, Czech Republic in August, 2009. Immediately after that announcement, there was a period of about two months that produced numerous e-mail messages from Europe and around the world. The e-mails addressed many issues regarding the implementation of a new system. The international community has been quite proactive in its response to the challenge to the CS. The international community has formed the Research Organization for the Comprehensive System (ROCS) for continuing research on the CS. This organization will continue to research the CS. This organization will contribute to satisfying the research needs of both the United States and the international community. The CS has a rich history in other countries. Both Japan and Argentina, among others, have extensive research using the CS in their societies. This has yielded some changes in normative frequencies. This culture-specific research using the CS is an appropriate means of looking at differences. It is important that countries be aware of their unique deviations from the United States samples, while keeping intact the implementation of the CS procedures. While the G5 has offered the international norms as the most appropriate norms for the world, appropriately researched, culture-specific norms would be more desirable to expand the usefulness of the CS in different countries. This is yet another area that must be considered and which any new system must address.

The Position of Rorschach Training Programs Rorschach Training Programs (RTP) came into existence after the death of John Exner to carry on the training mission which was not continued by the Exner family. The focus of RTP was to teach the CS as developed by Exner and continue the training that was carried out by Rorschach Workshops. The issue of new developments has been reviewed and addressed by the board of directors of RTP and the focus for the future is clear. RTP will continue to teach the CS and use the foundation that was so adequately developed by Exner. New research will be continually monitored and will be included in the training programs presented by RTP after being carefully evaluated. Contributions by the Research on the Comprehensive System (ROCS) group will be constantly monitored for potential inclusion in RTP training programs. Enhancements or embellishments or supplements to the CS will be included in the training based on several criteria. First, the research on any new component must have included compliance with the administration and coding of the CS. Second, the new component must either expand the understanding of current variables, clarify the findings of current variables, or provide new areas of understanding of combinations of CS variables. Third, the component must meet the reliability and validity standards set by Exner when developing the CS. Fourth, the variable must be able to be taught within the basic structure of the CS. It is anticipated that Rorschach Training Programs will, on a regular basis, evaluate recommended components for inclusion in its teaching programs. As Exner pointed out, the System is complete, but enhancements could continue for many years without disrupting the integrity of the CS. A critical factor in maintaining the integrity of the CS will be to safeguard the standardization of its administration and scoring procedures. It is through a thoughtful, measured approach to modification the CS will continue to develop as a vital and effective instrument. The CS is recognized throughout the United States and the international community as a valid and reliable personality tool. Thanks to John Exner and colleagues the CS has a

strong foundation based on solid research and proven value by many years of clinician use. References Exner, J. (2005). A Rorschach Workbook for the Comprehensive System (5th ed.) Asheville, NC: Rorschach Workshops. Exner, J. (2007). A new U.S. adult nonpatient sample. Journal of Personality Assessment, 89, S154-S158. Exner, J. & Erdberg, P. (2005). The Rorschach: A Comprehensive System. Vol. II (3rd ed.). Hoboken, NJ: Wiley & Sons. Journal of Personality Assessment, (2007). Supplement on International Norms. Weiner, I., Exner, J., & Sciara, A. (1996). Is the Rorschach welcome in the courtroom? Journal of Personality Assessment, 67, 422-424. Wood, J., Nezworkski, M., Lilienfeld, S., & Garb, H. (2003). What s Wrong with the Rorschach? Science Confronts the Controversial Inkblot Test. San Francisco, CA: Jossey-Bass.