Projective Techniques Usage Worldwide: A Review of Applied Settings 1995-2015

Copious survey data, from the 1940s through the 1980s, attest to the clinical popularity of projective techniques in mental health settings worldwide, particularly in the USA (chronologically: Louttit & Browne, 1947; Frank, 1948; Burton, 1949; Sundberg, 1961; Hinkle, Nelson, & Miller, 1968; Lubin et al., 1971; Brown & McGuire, 1976; Wade & Baker, 1977; Piotrowski & Keller, 1978, 1989; Sell & Torres-Henry, 1979; Fee, Elkins, & Boyd, 1982; Tuma & Pratt, 1982; Lubin, Larsen, & Matarazzo, 1984; Piotrowski, 1985; Sweeney, Clarkin, & Fitzgiggon, 1987; Harrison et al., 1988; Bubenzer, Zimpher, & Mahrle, 1990; Archer et al., 1991). Thus, over these years, projective techniques were found to be popular in adult settings, used frequently in child and adolescent assessment (Cashel, 2002), relied upon by school psychologists (Hutton, Dubes, & Muir, 1992; Miller & Nickerson, 2007), and applied in forensic settings (Hamel, Gallagher, & Soares, 2001). Interestingly, the Rorschach and TAT have been accepted in the assessment armamentarium by clinicians harboring a behavioral orientation (see Piotrowski & Keller, 1984). Furthermore, applications of projective testing to culturally-diverse populations and ethnic groups have been evident in the research literature (e.g., Dana, 1998; Lindzey, 1961; Retief, 1987). Few survey-based studies on test usage outside the USA appeared in the 1970s; for example in Canada (La Pointe, 1974), in South America (Gonzalez, 1977), and in Germany (Schober, 1977). In the 1980s, test usage patterns were noted in a survey of the British Psychological Society (Tyler, 1986). Later, Piotrowski, Keller, & Ogawa (1992) reported on projective test usage patterns in four countries during the 1980s, i.e., USA, Japan, Netherlands, and China (Hong Kong). The analysis showed that projective tests were quite popular in clinical assessments across all these geographical regions. However, it must be noted that during these decades, the sentiment toward projective techniques was quite unfavorable across Europe (see Mahmood, 1988; Poortinga et al., 1982; Porteous, 1986; Rausch de Traubenberg, 1976). However, survey data from the early 1990s found that projective measures were quite popular in Japan (Ogawa & Piotrowski, 1992). Unfortunately, some published reports on test use internationally tend to omit discussion of projective tests (e.g., Cheung, 2004; Evers et al., 2012; Oakland, 2004; Paterson & Uys, 2005). Critical Appraisal of Projective TechniquesNevertheless, there were perennial concerns and critiques of projective techniques over the last 50 years (see Butcher, 2006; Piotrowski, 1984; Reynolds, 1979). It was not until the early 1990s that an onslaught of hardened opposition to use most projective techniques was evident from many quarters (Garb 1999; Garb, Wood, Lilienfeld, & Nezworski, 2002; Hunsley & Bailey, 1999; Medoff, 2010; Wood, Nezworski, & Stejskal, 1996; Ziskin,1995). In support of these rather reviled appraisals, extensive reviews of the literature concluded that validity evidence for projective techniques has been very limited (see Lilienfeld, Wood, & Garb, 2000; Mihura, Meyer, Dumitrascu, & Bombel, 2013; Motta, Little, & Tobin, 1993; Smith & Dumont, 1995), including reviews by European researchers (e.g., Wittkowski, 1996). However, other researchers, in reviewing meta-analytic studies, have reported positive differential diagnostic outcomes regarding several projective tests (e.g.,Kahill, 1984; Kubiszyn et al., 2000; Piotrowski, 1999). In psychometric theory, the central contention regarding assessment instruments rests on 'validity' metrics that reflect psychological and behavioral tendencies (see Abell, Wood, & Liebman, 2001; Bornstein, 1999; Messick, 1995). With regard to projective tests, the focus of criticism was predominantly targeted at the lack of validity per se. Based on this dramatic shift (commencing around 25 years ago) to expunge projective techniques from both training emphasis and clinical practice, it would be of interest to examine extant published data on clinical use of projective techniques in clinical and other applied settings since 1990. …