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 SIS J. Proj. Psy. & Ment. Health (2015) 22: 83-92

Clinical Instruction on Projective Techniques in the USA:

A Review of Academic Training Settings 1995-2014
Chris Piotrowski

Academic training with projective methods has been an enduring and enigmatic feature of the
assessment curriculum in professional and clinical psychology since the 1940s. However, the past 2
decades have witnessed a steady stream of rather disparaging commentary directed largely on the
lack of psychometric credibility of individual projective methods, particularly from the academic
community in the USA. The purpose of the current study is to determine whether this collective
movement, evident in the scholarly literature, against projective techniques has had a deleterious
impact on the extent of graduate-level training and instruction over the past 20 years. To that end,
the author identified, through an extensive literature review, published survey research in the USA
that reported on training emphasis in projective assessment, from 1995-2014. The 12 identified
studies served as the data pool to ascertain the extent of coverage of projective techniques within the
context of assessment training, both in academic and internship settings. The analysis showed that:
a) there has been diminutive emphasis on projective techniques in academic clinical/professional
programs, although some training with projective tests continues in PsyD practitioner programs, and
b) expectations of competency with projective assessment during internship training, touted in the
past, have largely diminished in recent years. Interestingly, a sizeable minority of graduate students
still desire advanced training in projective assessment. Several notable issues in the
clinical/professional milieu, in recent years, may account for this decline in interest in projective
techniques (see Piotrowski 2015 for further discussion): a) proliferation of graduate–level specialty
training has exacerbated ‘inclusion’ (and exclusion) of essential required coursework; b) evidence
indicates that instruction in assessment has steadily been reduced, particularly available courses in
projective techniques; c) due largely to managed care administrative policies, coverage for
comprehensive test batteries, which may include projective tests have been denied and reliance on
‘brief’ assessment instruments has become the standard; d) over time, younger faculty and internship
supervisors either hold very negative attitudes toward projective assessment or have sparse training
and experience with these techniques; and e) with the retirement of older, more experienced faculty,
instruction on projective tests tends to be de-emphasized or unavailable. Thus, it appears that
aspiring graduate students and interns, with an interest in projective techniques, either need to
pursue external professional training via workshops, individualized supervised instruction, or engage
in intensive self-study. These findings have implications for training in projective assessment
overseas. Since recent reviews of applied clinical settings show that projective techniques continue
to be valued by psychologists worldwide (Piotrowski, 2015), future research should elucidate the
status of education, graduate-level instruction, and professional/clinical training with projective
techniques in nations outside the USA.

Prior to 2000, academic instruction and Newmark, 1996; O’Donohue et al., 1989;
preparation in various approaches to Piotrowski & Keller, 1984, 1989, 1992; Russ,
psychological testing and assessment had 1978; Stout, 1992; Sugarman & Kanner,
always been a hallmark of both graduate-level 2000; Weiner, 1997), including teaching
and internship training in clinical/professional emphasis in projective testing (Dana, 1975;
psychology (Butcher, 2006; Craig, 1990; Durand, Blanchard, & Mindell, 1988;
Dana, 2014; Garfield & Kurtz, 1973; Handler Piotrowski, 1984; Pruitt et al., 1985; Ritzler &
& Hilsenroth, 1998; Janda, 1998; Kolbe et al., Alter, 1986; Ritzler & del Gaudio, 1976;
1985; Marlowe et al., 1992; McCully, 1965; Shemberg & Keeley, 1970; Silverstein, 1996;
…………………………………………………………………………………………………………………
Chris Piotrowski, University of West Florida, Email: cpiotrowski@uwf.edu
Keywords: Projective assessment, Projective technique, Clinical Instruction on Projective Techniques.
84 Chris Piotrowski

Stagner, 1984; Thelen et al., 1968). But even Durand, Blanchard, & Mindell, 1988;
during this zenith period of popularity in Piotrowski & Zalewski, 1993),
projective assessment, critical commentary on
directors of internship sites (Stedman and
the nature and efficacy of psychological
Colleagues, 1997, 2000, 2013), and clinical
testing was evident in the literature (e.g.,
students in training programs (Stedman,
Ivnik, 1977). Thus, it is noteworthy that by the
Hatch, & Schoenfeld, 2001b). Interestingly, it
mid-1990s, survey-based data of academic
was not until the 1990s that an onslaught of
settings indicated a slight decrease in training
hardened opposition to use of most projective
emphasis in objective testing and a more
techniques emerged from many quarters
notable decline in projective tests (see
(Garb 1999; Garb, Wood, Lilienfeld, &
Piotrowski & Zalewski, 1993; Watkins et al.,
Nezworski, 2002; Hunsley & Bailey, 1999;
1990). Moreover, research studies have
Motta et al., 1993; Smith & Dumont, 1995;
identified drastic changes in mental health
Wood, Nezworski, & Stejskal, 1996). In
administrative policy, largely due to managed
support of these rather disparaging
care constraints, as a major reason for this
appraisals, extensive reviews of the literature
decline (Phelps et al., 1998; Piotrowski, 1999;
concluded that validity evidence for projective
Youngstrom, 2013). At the same time, these
techniques is very limited (see Lilienfeld,
changing trends in emphasis on projective
Wood, & Garb, 2000; Wood et al., 2000;
testing may reflect an emerging academic and
Ziskin, 1995), including reviews by European
professional interest on specialty training in
researchers (e.g., Wittkowski, 1996). Even
applied psychology in such areas like
proponents of projective assessment
neuropsychological and forensic assessment
questioned the sustainability of academic
(e.g., Archer, 2013; Ready & Veague, 2014).
coverage of projective tests in graduate
During the 1990s, academic psychologists training (Tuber, 1995).
engaged in lively discussion and heated
While the status of projective assessment has
debate about the role of not only
been threatened over the past 20 years,
psychological testing in the clinical and
reviews on recent studies of ‘applied’ settings
counseling curriculum but also the efficacy of
have indicated that, for the most part,
traditional training models (Craig, 1992;
projective techniques continue to be valued
Retzlaff, 1992). In order to obtain an historical
and remain a mainstay in the assessment
perspective on testing trends during this
enterprise in practice (see Piotrowski, 2015).
transitional period, several reviews of the
But has the role of projective methods in
extant literature appeared (Evers et al., 2012;
graduate education and training been
Meyer et al., 2001; Piotrowski & Keller, 1992;
impacted aversely due to the onslaught of
Watkins, 1991). These extensive
negative criticism directed specifically against
examinations of survey-based studies
this group of tests? Interestingly, recent
concluded that although enthusiasm for
initiatives and directives toward enhancing
projective techniques was waning somewhat
competency levels in psychological
(Garb et al., 2002), instruction on specific
assessment during academic and internship
projective methods was still considered a
training (see Belar, 1998; Eyde & Childs,
valuable, coveted clinical skill by directors of
2000; Krishnamurthy et al., 2004; Stedman et
academic clinical training programs (e.g.,
al., 2013), include tests like the Rorschach
(Callahan, 2015; Hilsenroth et al., 2007).
 Projective Techniques in the USA: 85

Moreover, contemporary reviews and Training Emphasis on Projective

commentaries concerning cross-national Techniques: General Findings:
factors in education and training in
Based on the analysis of these 12 key studies
assessment have not excluded projective
on training emphasis with projective methods,
techniques (e.g., Byrne et al., 2009; Herzberg
several evolving trends were noted (see Table
& Mattar, 2008; Miguel, 2014). Accordingly,
1). Interestingly, there seems to be a
clarification on both attitudes and extent of
bifurcation in training emphasis. First, it
emphasis of projective techniques since 1995,
appears that over the past 20 years there has
during graduate clinical training, is sorely
been a steady decline in academic coverage
needed. To that end, it would be of interest to
of projective assessment in graduate-level
examine the extant literature regarding
instruction. This diminutive teaching of
graduate-level instruction on individual
projective techniques was most apparent in
projective techniques, both in academic and
that: a) coverage of projective tests has been
internship settings in the USA, over the past
frequently integrated within the general
20 years.
assessment curriculum, b) that offerings of
Current Study: advanced courses on projective tests have
continued to decline, and c) individual courses
In order to appreciate historical trends on the
on projective assessment tend not be
role of projective testing in training in
required. Nevertheless, survey data indicate
academic graduate-level programs and
that many clinical students have expressed an
internship settings, the author utilized
interest in advanced coursework on specific
bibliometric analysis of the published
projective techniques. Second, survey data
literature. To that end, a systematic search of
on attitudes of internship training directors (as
the database PsycINFO (published by the
well as a sizeable minority of interns) confirm
American Psychological Association) was
that competency in projective assessment has
conducted, as this research repository is
been a desired skill for clinical/professional
considered the leading scholarly file of
practice (e.g., Piotrowski & Belter, 1999;
research in the social and behavioral sciences
Stedman et al., 2001a). Moreover, training
worldwide. Since earlier reviews on
opportunities with projective tests have been
assessment training and education have
evident at a sizeable minority of internship
examined studies prior to 1995 (e.g.,
settings. Apparently, many interns have
Piotrowski, 1992; Watkins, 1991), Table 1
obtained supplemental training with projective
summarizes survey findings from key studies
instruments via workshops and individualized
of instructional emphasis on projective
instruction. It must be noted, however, that
techniques over the past 20 years. Thus, this
there has been a sharp decline over the past
analysis includes the (n=12) published
5 years in training emphasis with projective
survey-type studies of academic and
tests at internship sites in the USA (personal
internship programs in the U.S. that appear in
communication, Dr. James Stedman, 2015).
peer-reviewed journals.
Overall, while there has been diminished
interest in techniques like sentence
completion and HFDs types of instruments in
academic training, the Rorschach and TAT
still garner clinical interest of some faculty and
86 Chris Piotrowski

students. In fact, the Rorschach remains the Daniels, & Zickar, 2013; Ivnik, 1977). Thus,
most popular projective measure reflected the traditional clinical assessment
both by the survey data in the current analysis professional may truly be a dying breed, as
and by the high level of research interest aptly noted by Ready and Veague (2014),
devoted to this specific test (see Hilsenroth et “declining emphasis on projective tests may
al., 2007; Mihura, Meyer, Dumitrascu, & be due, in part, to retirements of more senior
Bombel, 2013; Piotrowski, 1996). Perhaps as faculty” (p. 281).
evidence for the high level of clinical interest
Conclusions:
in select projective measures, research teams
continue to explore creative adaptations to the Projective techniques have had a long but
Rorschach method and human figure drawing challenging history for nearly a century.
applications (e.g., Erard & Viglione, 2014; Moreover, there has been lively academic and
Handler & Thomas, 2014; Kato & Suzuki, applied interest in projective methods,
2015; Matto, Naglieri, & Clausen, 2005). reflected across copious studies and
extensive extant literature on a host of
Several critical factors have contributed to the
projective instruments (Murstein, 1965; Rabin,
de-emphasis in the teaching of projective
1986). Yet despite the perennial criticism
tests/techniques. The impact of managed
leveled against this unique approach to
care, lack of reimbursement, and shift to
psychological assessment, particularly in
alternative professional specialization have
recent years, projective techniques continue
already been noted. In addition, perennial
to a) garner scholarly interest and b) harbor
concerns on the limitations of psychometric
unique clinical value in clinical practice
validity regarding projective methods cannot
(e.g.,Basu, 2014; Piotrowski, 2015). In fact, a
be discounted (Catterall & Ibbotson, 2000;
Keyword search of the recent psychological
Clark, 1995; Wood et al., 1996, 2000).
literature, conducted in the database
Another central issue revolves around the
PsycINFO, reveals a total of 2,943 references
level of instructional competency of
on projective techniques, including 1,746
assessment faculty and disinterest in teaching
articles in peer-reviewed journals (from 2008-
specific courses on projective methods,
2012, the range= 18-33). Moreover, coverage
particularly younger faculty (e.g., Callahan,
of projective techniques remains robust as
2015; Eyde & Childs, 2000; Krishnamurthy et
evident in coverage in many contemporary
al., 2004). Finally, I would suggest that as the
graduate-level texts on psychological
graduate clinical curriculum has increasing
assessment (e.g., Groth-Marnat, 2009;
challenges for course inclusion from evolving
Harwood, Beutler, & Groth-Marnat, 2011;
sub-specialty areas and contemporary
McGrath & Carroll, 2012). Based on the
psychological approaches, traditional areas
findings of this review, a general conclusion
such as intellectual/cognitive testing and
can be confidently offered that there has been
objective personality assessment might also
a gradual recognized decline in training
be deleted from required coursework. Put
emphasis with projective tests in graduate-
simply, assessment might cease to be
level clinical psychology training in the USA
considered a central core competency of
over the past decade, and a lack of
professional training; an issue that has
instructional opportunities with these methods
confronted the clinical importance of
in internship settings over the recent past.
projective testing historically (see Carter,
Although the extant evidence suggests that
 Projective Techniques in the USA: 87

instruction on projective measures has been
tempered over the past 20 years, it appears
that projective techniques, particularly the
Rorschach and TAT, continue to be
considered a robust assessment tool by a
small legion of professional psychology
faculty. Indeed, lively discussion on the
attributes of the Rorschach continue to appear
in the scholarly literature (Bornstein, 1999;
Callahan, 2015; Erard & Viglione, 2014;
Hilsenroth et al., 2007; McGrath & Carroll,
2012; Meloy et al., 1997; Mihura et al., 2015;
Musewicz et al., 2009). Apparently, a select
segment of the psychological community
value the utility of projective techniques in
providing rich clinical data that foster potential
working hypotheses in idiographic
assessment.
Table 1: Summary and Findings on Instruction
with Projective Techniques in the USA (n=12; 1995-2014)
Finally, it must be noted that the current
review examined survey data based on
graduate-level and internship training in the
USA. There appears to be a dearth of studies
on academic and internship instruction and
training on projective assessment from other
nations (e.g., Raez de Ramirez, 1999; Rossel
et al., 2001; Viljoen et al., 1999). Moreover,
research on non-traditional populations should
shed some critical light on the importance of
competency training in multicultural
assessment specific to projective testing
approaches (Cheung et al., 2003; Dana,
2002). Thus, country-based studies are
needed in order to provide a more
comprehensive perspective on the status of
projective techniques in graduate-level
education and clinical training worldwide.

Study Sample Major Findings

Hilsenroth & 166 psychology graduate 50% of these students completed 2 courses on
Handler students’ (affiliates of the the Rorschach; 32% were required to administer
(1995) Society for Personality from 5 to 9 protocols; concerns were noted with
Assessment) views on regard to inadequate coverage of research
Rorschach instruction findings and integration of theory; respondents
noted a need for more direction for report writing
assessment evaluations
Rossini & Survey data on 50 directors 22% of this sample indicated no required
Moretti of APA-accredited clinical coursework on the TAT; specific instruction on
(1997) training programs regarding the TAT was integrated within general
didactic instruction on the assessment courses; 47% offered at least 1
TAT practicum course that involved TAT protocol
interpretation
Piotrowski & Extent of graduate-level 67% of directors covered Rorschach & TAT
Belter (1999) assessment curriculum was during seminars; 28% provided training on H-F-
rd
reported by training Ds & SCT; the Rorschach ranked 3 regarding
directors from 84 APA- most important psychological tests for practice;
approved internship however, 34% of these directors rated a
settings decrease in training emphasis with projective
techniques over the prior 5 years
Belter & 33 instructors of This sample held moderate views toward
88 Chris Piotrowski

Piotrowski psychological testing projective techniques and predicted a substantial

(1999) coursework in Masters-level decrease in graduate-level training and emphasis
clinical/counseling in projective tests
programs
Clemence & Surveyed 382 internship Internship directors supported graduate-level
Handler settings on use and training preparation in projective assessment as an
(2001) of psychological tests important component of professional practice, but
admit deficiencies in pre-internship academic
instruction on projective methods; 72% value the
Rorschach, 56% the TAT, as part of the ‘testing
battery’
Stedman et Assessed internship While all areas of testing (IQ, objective
al. (2001a) directors’ evaluation of personality, projective techniques,
clinical graduate students’ neuropsychological) were deemed important
pre-internship preparation competency areas, projective testing was
regarding assessment somewhat less valued than objective measures
training and competency by internship directors
Belter & Survey data on 82 directors Nearly 60% of the programs required a specific
Piotrowski of APA-approved doctoral course on projective testing; tests most
(2001) clinical/professional emphasized, Rorschach 80%/TAT 70%/H-F-Ds
psychology training 37%/SCT 28%; 27% of respondents view the
programs on assessment Rorschach as ‘essential’ for practice; however,
curriculum about 50% of directors confirm a decrease in
emphasis on instruction with projective tests over
the prior 5 years
Stedman et Based on survey data from Results showed that clinical students met or
al. (2002) 334 psychology interns, exceeded most expectations of internship training
determined extent of pre- directors by producing a median of 18 integrated
internship assessment testing reports; however, whereas experience
report writing experiences with the Rorschach seemed adequate (4 reports),
reports on TAT, H-F-Ds, & SCT were few
(M=1.5)
Childs & Course syllabi data, from 87% of the programs offer at least 1 graduate-
Eyde (2002) 84 APA clinical psychology level course that covers projective tests (79%
programs, determined require this course); the Rorschach (81%) and
coverage of projective TAT (71%) were most emphasized; the SCT
assessment techniques (29%) and H-F-Ds (24%) less emphasized
Mihura & Based on data from 254 While 87% of the respondents reported
Weinle APA graduate student coursework that included the Rorschach, only
(2002) affiliates, the extent of 25% were offered an advanced course on this
Rorschach training was test; Most of the students held very positive views
investigated on the Rorschach but desired more advanced
training; students from PsyD programs expressed
more favorable attitudes than those from clinical
 Projective Techniques in the USA: 89

PhD programs
Neukrug et Based on survey data from These instructors provide coverage on a wide
al. (2013) 210 counselor educators range of tests; 95% teach the Rorschach, 93%
across the U.S., this study the TAT, 89% the H-T-P, 71% the CAT, and 70%
examined graduate-level the Rotter ISB
coverage of assessment
instruments by instructors
Ready & Compared training in Although the response-rate was rather low
Veague psychological assessment (33%), several trends were noted; tests that
(2014) across 3 training models reflect evidence-based practice standards were
(Clinical-Science, Scientist- emphasized (no projective tests ranked in the top
Practitioner, Practitioner- 10); only practitioner-scholar programs offer
Scholar) in APA-Accredited coverage on projective techniques; younger
programs faculty express little interest or competency in
teaching specific projective techniques
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