The Sentence Completion

When working with children, many clinicians will utilize a Sentence Completion Form (SCF) in their assessment of a child’s difficulties. This is essentially a list of incomplete sentences that the child is asked to fill-in with whatever comes to mind. A few items from the form might look like this:

Today I’d like to _____________.
______________ is dumb.
______________ makes me happy.

The theory behind this exercise is that the child will complete the sentences with words that reflect his own conflicts. This non-threatening activity, which is an example of what is known as Projective Testing, is thought by many to be an X-ray of the child’s personality. So, if the child’s answer’s to the above were:

Today I’d like to stab my therapist.
Your face is dumb.
Dr. Rob dying makes me happy.

then I might consider that I am working with a very aggressive child who despises me more than all of my ex-girlfriends. Combined.


In graduate school, we were trained to use the form with adults as well. I never agreed with this idea and felt genuinely stupid asking the clients to fill it out. Most could immediately tell what the purpose of the instrument was, and some felt that their intelligence was being insulted. It probably was.

Despite my protests, I was forced to use the form with every new client who came into the university clinic. I never considered myself the most confident graduate clinician, but I’m sure I appeared like a stammering imbecile asking them to complete the form. “Would you…mind…filling out this semi-blank piece of paper?”

“Why?”

“Because it’s…useful? I think?”

This feeling of buffoonery was exacerbated when I was being taped and/or watched live by my classmates. In graduate school, clients were notified of a camera in the upper corner of the room and told that they would be filmed and/or watched live for training purposes. It was common for them to feel skittish at first, but after being told that it was both a legal requirement (given that none of the students had a license to practice Psychology) and that the focus was on the student and not the client, most people quickly forgot that the camera was even there.

I drew the line on the SCF after my experience with an early 30’s, middle-class man who came into therapy at his wife’s behest for “passive-aggressive tendencies,” which were getting under the wife’s skin. “I don’t want to get divorced, man, so I guess I have to come in and check this scene out.” As part of the protocol for the first session, known as the Intake, I sat with him and talked about his current problems, relevant history, and pertinent medical information. I then blubbered through my little speech about how the SCF helps to provide a more rounded picture of a client’s difficulties, how the information is used in treatment planning, and other silly clinical statements. He looked at the form, looked at me, raised an eyebrow, and said “You’re serious?”

Unfortunately, I am. “Yes please.”

He chortled at this, I probably blushed, and he went to work on filling out the 20 incomplete sentences. Knowing that the other students and supervisor were watching me feeling and looking stupid, I considered flipping them off into the camera.

“Here ya go, Freud-to-be,” he said, handing me the SCF, the way any real man would hand a completed Paint by Numbers to a pseudo-man.

I took the client’s history form, sliding scale payment form and, of course, the SCF into the Audio/Visual room where my professor sat with a few of my classmates. Disgusted, I handed the professor the SCF, and he began to scan some of the items:

I will be happy when I’m Sixty-Four.
I feel Fine.

“Interesting,” he said in that academic way people talk when they don’t know what else to say. “No distinct pattern as of yet.”

As he continued to read, the responses got less subtle:

I want To Hold Your Hand.
Happiness is A Warm Gun.

“There could be something worthwhile here, Rob, but I can’t quite make out the arrangement just yet.”
Finally, the last few hit him on the head:

I am The Walrus.
Today is A Hard Day’s Night.
Yesterday I Saw Her Standing There.

After the professor had finished reading the last item, we looked at the T.V. monitor, only to see the client laughing out loud and pointing into the camera.

“Why that…boorish man!” bellowed the professor. “He’s making a mockery of projectives! Using Beatles’ songs no less!”

It was clever. “He’s doing a pretty good job of it too,” I noted.

“Wait! Don’t you see?” said one of my classmates. “He’s being passive-aggressive. Just like his wife said he was. The SCF was right!”

“But we already knew he was passive-aggressive.” I said, holding up his intake form. “It says it right here where you write in “Presenting Problem.” And we only needed one line to learn that, not an entire set list from England’s greatest export.”

“You go in there,” the professor said, “and you confront this behavior immediately. This is therapy interfering behavior!”

“But I’m just a first-year, I’m only doing Intakes. I’ve never done therapy in my life,” I protested.

“Dobrenski, get in there and assert your position as a man of integrity. If this man wants our help, he’s going to have to respect us and, more importantly, the SCF.”

During the professor’s rant, the client must have left, because when I got back to the room, there was just a note:

Rob, you seem like an okay guy, but please understand that it’s my wife who made me come here. That questionnaire was a joke. I don’t want to waste any more of our time. I don’t need “Help!” like she says I do. I’ve got my own “Ticket to Ride,” so there’s no need for you to “Carry That Weight.”

“All my Loving,”

X

I’ve yet to meet a more Beatles savvy person than that client in the ten plus years since that incident. Was the client a sociopath? Probably not, although he clearly had some disdain for the SCF, and probably psychology in general. I don’t use the SCF anymore, but I’ve seen them in child clients’ charts over the years in various clinics and hospitals. And when I see responses like “I like doggies,” I can’t help but think, “Damn kid, you can’t do any better than that?”

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34 Responses to “The Sentence Completion”

  1. Gordon says:

    Wow… I think I’d feel just as stupid filling it out as you would handing it to me, and that’d probably get in the way of my answers anyway.

  2. Wayland says:

    I love laughing out loud in class. Thank you. That was really funny. I look forward to the next one and I’m sure one day I’ll go back and read the old entries.

  3. mom says:

    Excellent, interesting, funny, one of the best. I can finally say I’m proud.

  4. Robin says:

    Great one, Dr. Rob. Very clever.

  5. Amber says:

    Today I’d like to _clean my house_.
    _The Edmonton cost of living_ is dumb.
    _Dancing and music_ make me happy.
    What does that say about me?
    Aw, your mom commented (it’s sweet that she reads your stuff).
    As for the gentleman in the story, I don’t blame him. If I had ever been handed one of those I probably would have done the same thing. Only with Godsmack songs. Or used a lot of bad language and hateful words.

  6. Scott says:

    I remember when I was around 12 or so my father took me to a therapist who tried to get me to fill one of them out..even at that age I felt very insulted by the test. In an attempt to try to get me to do it, she had my dad read one off infront of me..I could tell he thought it was as much of a joke as I did. Needless to say we never went back after that. I’m sure it works for some (very young) people..but just not my cup of tea.

  7. kakutogi says:

    A+ would read again!

  8. Anonymous says:

    “I can finally say I’m proud.”
    Finally?! No wonder ur in therapy urself!
    Dr. Rob: Tell me about it…

  9. Ric says:

    Kudos to that man for being the first to make me laugh today, no matter how long ago the incident happened.
    Anyway, Dr. Rob, you’ve very quickly become my favourite writer on this site. Almost makes me reconsider my decision to drop out of my psych major. Almost. Keep writin’ these great stories down.

  10. Bryan D. Currie says:

    “Here ya go, Freud-to-be,” he said, handing me the SCF, the way any real man would hand a completed Paint by Numbers to a pseudo-man.
    hahahah

  11. j says:

    doc rob you are hilarious keep the updates coming it’s the only reason at this point I come to the rudious site…

  12. thanks for the GREAT post! Very useful…

  13. Dog training says:

    Very interesting… as always! Cheers from Switzerland.

  14. :yb detsoP says:

    In high school,I was as sarcastic as one can be,especially towards teachers.So soon after,I was sent to the school psychologist,which rotate every year.Now,my first year was ok,but the second year I too had to take tests of this type which just proved to me interaction is more adequate than blunt and obvious procedure.

  15. J says:

    Most of your posts make me laugh. Whether that is unintentional or not, bravo.

  16. Bri says:

    Ya know, if I’d read this a couple of years ago maybe I would have filled that form out differently! I had to go to the university clinic to get one of the therapists to sign a form stating I was in fact a properly functioning member of society so I could participate in a now forgotten event. I sat there for almost an hour and had to fill out an SCF. It felt like something I would have done in preschool but like a good little person I filled it out anyway. Half way through I was so sick and tired of filling in the stupid half sentences that I started looking around the waiting room for items that could help me fill in the blank i.e. I like chairs. Poster of puppies make me happy. Luckily the therapist I talked with didn’t look at the form otherwise she might not signed off on that form! Oops

  17. Frank says:

    That man should divorce his wife, grow his hair long, and form a Beatles tribute band.

  18. ep thorn says:

    “Was the client a sociopath? Probably not, although he clearly had some disdain for the SCF, and probably psychology in general.”
    I’m not sure that having disdain for such a silly thing (the SCF) isn’t a symptom of sanity.
    I can’t imagine feeling comfortable talking to someone who was asking me to fill something like that out…

  19. liloldme says:

    Mom: “I can finally say Iā€™m proud.”
    Man, you must have done some nasty stuff in the past, if your mother wasn’t proud untill that day.

  20. I rarely if ever used an SCF with an adult….for similar reasons implied above. As a tool it is marginally useful with children because they appear to be less likely to reject it, though interpretation is still iffy. The irony in your story is that it confirmed exactly what you hypothesized.

    I’m surprised by the supervisor’s response, since you were given an excellent opportunity to gain more clinically relevant data about how the husband perceives and interacts with the world. He should have told you to talk to him about his experience, and not fall into a power struggle. Not only would the husband win on experience, but it’d confirm his fear about you trying to control him, and he’d never come back. Go figure.

  21. nixar says:

    I’m sorry, but what would begin to look like sociopathic behaviour here? A sociopath would play along.

  22. Rebecca says:

    Loved this one. I always get a kick out of reading posts where you describe your thoughts and opinions about different therapy tools.

    And the filming required in university clinics is so annoying! I always remember the camera is there, and feel like I’m in a documentary or something. Ugh.

  23. Dalia Vercher says:

    How I found this during a Google search for online shopping is beyond me, but this was a great read!

  24. Ren says:

    An assessment test that tells the Doctor wither or not a personality conflict exists between themselves and the patient would likely be the only viable reason for me taking an assessment seriously.

  25. Candice says:

    This one was hilarious!!! One of my favorites.

  26. I really relished you internet site. I wish I could have one like yours but it seems that you have put a lot more effort into it than I could manage. I will keep your website in my bookmarks so I can revisit and look at it again when it has some more information. Tremendous subject !

  27. When you go in unprepared, or do what most individuals do, not only will a get-together along with your ex girlfriend not result in you two obtaining back again jointly, it is going to probably wind up making things even worse.

  28. Annie says:

    I would lie in those sentece completion forms, specially because as an adult is best to be straight forward.

  29. Yindy says:

    I remember a trainee psychologist giving this to me at the end of a LONG, exhausting day of all kinds of tests. Poor girl made the mistake of telling me I should fill in the first thought that came into my head.

    I know it was quite immature, but the answers mainly consisted out of TV program names and all kinds of silly things, because that actually WAS the first thing that came into my head.

  30. Jessi says:

    I am appalled that it took your professor so long to catch on! I figured it out after the first sentence. Darn academics.

  31. Joanna says:

    Thanks Dr Rob…you made me laugh so hard my coke came out my nose šŸ˜›

  32. Melissa says:

    Classic šŸ™‚

  33. LS says:

    Humorous, but actual sentence-completion therapy that I’ve done both alone and with a therapist has been one of the most useful, time-efficient, and interesting types of therapy, much more so than ‘talking therapy’ in general. It has enabled me to discover what I’m thinking and feeling about many different subjects quickly and spontaneously. For example, if I complete six endings to the stem, “Sometimes Dad irritates me when…”, in a minute I will have a great summary of a part of my relationship to my father. Again, no other technique that I’ve utilized elicits meaningful and true responses as quickly or easily.

  34. Dr. Rob,
    Loved your piece on Sentence Completion Tests! It is great to see someone be honest and funny about the limitations of testing in our profession, usually we are too afraid.

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