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The Clinician in the Psychiatric Diagnostic Process pp 95–114Cite as

Origin and Development of the Assessment of Clinician’s Subjective Experience (ACSE)

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Abstract

This chapter introduces the clinical and theoretical foundations of a research project regarding the nature of the clinician’s subjective experience and its significance for psychiatric assessment. It focuses on the development and validation of the psychometric instrument Assessment of Clinician’s Subjective Experience (ACSE), which aims at investigating clinicians’ feelings, thoughts, and perceptions related to the clinical encounter.

The ACSE is a 46-item self-completed questionnaire, developed through a rigorous validation process, that reliably describes the clinician’s subjective experience according to five experiential dimensions: Tension, Difficulty in Attunement, Engagement, Disconfirmation, and Impotence. Each of these dimensions serves to characterize a different domain of the intersubjective dynamics of the clinical encounter, accounting for a number of clinicians’ experiences that are well known from clinical practice, such as alarming intercourse, empathic failure, sympathetic rapprochement, interpersonal rejection, and therapeutic frustration.

By the means of this multifaceted profile of reactions, the ACSE can enable an examination that synthesizes the emerging intersubjective dynamics of the encounter, drawing the clinician’s attention to his or her own subjective world as a source of knowledge about the ongoing interactive process. In addition, it can make the characteristics of the clinician’s subjective experience available for more detailed research, and prospectively for clinical applications.

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Author information

Authors and Affiliations

  1. Community Service for Prevention and Early Intervention in Mental Health, Rome 1 Local Health Unit, Rome, Italy

    Mauro Pallagrosi

  2. Centre for Behavioural Sciences and Mental Health, Italian National Institute of Health, Rome, Italy

    Angelo Picardi

  3. National Institute of Training, Italian Psychoanalytic Society, Rome, Italy

    Laura Fonzi

  4. Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy

    Massimo Biondi

Authors
  1. Mauro Pallagrosi
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  2. Angelo Picardi
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  3. Laura Fonzi
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  4. Massimo Biondi
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Corresponding author

Correspondence to Mauro Pallagrosi .

Editor information

Editors and Affiliations

  1. Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy

    Massimo Biondi

  2. Centre for Behavioural Sciences and Mental Health, Italian National Institute of Health, Rome, Italy

    Angelo Picardi

  3. Community Service for Prevention and Early Intervention in Mental Health, Rome 1 Local Health Unit, Rome, Italy

    Mauro Pallagrosi

  4. National Institute of Training, Italian Psychoanalytic Society, Rome, Italy

    Laura Fonzi

Appendix

Appendix

Here we show the English version of the ACSE. While it has yet to be formally validated, it has been developed through a rigorous process. We did not perform a formal iterative back-translation procedure and preferred to concentrate on making a good translation, because several scholars have argued persuasively against back-translation for theoretical and practical reasons [51]. Specifically, back-translation has been characterized as merely a suboptimal procedure for checking translations that achieves linguistic and conceptual equivalence, but does not devote attention to clarity and understandability and does not take adequate account of context and milieu [52, 53]. In order to produce a good translation, we followed well-known paths in the cross-cultural adaptation of psychosocial measures [54]. First, an initial translation was produced by two independent translators, who were fluent in both Italian and English. Then, each translator independently reviewed the other version and provided comments and suggestions. Then, each translator included those suggestions judged to be relevant in a second version. This process was repeated one more time, until consensus was reached. Then, the translation was further reviewed by a native English speaker who provided a number of suggestions that further improved clarity and acceptability, and finally, an overall consensus was reached. We are deeply grateful to Dr. Nicoletta Gentili and Dr. Neil Owens for their help with this process.

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Pallagrosi, M., Picardi, A., Fonzi, L., Biondi, M. (2022). Origin and Development of the Assessment of Clinician’s Subjective Experience (ACSE). In: Biondi, M., Picardi, A., Pallagrosi, M., Fonzi, L. (eds) The Clinician in the Psychiatric Diagnostic Process . Springer, Cham. https://doi.org/10.1007/978-3-030-90431-9_7

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  • DOI: https://doi.org/10.1007/978-3-030-90431-9_7

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