A clinician has several options in obtaining objective and valid clinical evaluations. For example, precision and accuracy may be avoided and impressionistic reactions and "gut feelings" can be relied on; some clinicians feel they are able to do competent clinical work with this approach. Or a clinician can spend considerable time and care in the diagnostic and therapeutic evaluation of children and adults with the goal of assessing accurately and precisely the magnitude of diverse psychopathological processes within patients at different times. Another approach is to use various observer psychiatric rating scales, such as the Brief Psychiatric Rating Scale, the Hamilton Anxiety or Depression Rating scales or various self-report measures, such as, various adjective checklists. Although such measures are widely used in many research projects, their use carries with them a false sense of security since quite often no inter-rater reliability tests are done with the rating scales, the assumption being that anybody can follow the instructions for rating and no measurement errors are likely to occur. With rating scales, however, raters vary widely on how much of the range of ratings they use with the same subjects, and some raters characteristically select the lower range of the ratings; whereas others habitually chose the higher range of the ratings. With self-report measures, though it is true that the self-rating comes directly from the individual being evaluated, the assumption is that self-raters are all, indeed, in good and equivalent contact with themselves and are not likely to be falsifying, consciously or unconsciously, their self-evaluations.
These kinds of measurement errors in observer rating scales and self-report scales, usually disregarded by researchers and clinicians, are minimized in the measurement method of content analysis of verbal behavior. For the subjects being rated are usually not aware what speech content or form is being analyzed and have difficulty covering up, even if they have some notions about such matters. Furthermore, the unstructured approach customarily used to elicit speech avoids the questionnaire or "prosecuting attorney" method, and allows the subject to elaborate and use free-will to the extent desired by the self on choice of topics to verbalize. Emotions, self-reflections, doubts, and defensive maneuvers are recorded, and these all contribute to the content analysis scores eventually calculated. The content analysis approach to the measurement of psychological dimensions includes the strengths of both the self-report approach and the observer rating scale approach, and minimizes the weaknesses of both in terms of measurement errors.
Developing scales for topics of interest