Comparison of Social Workers' and Psychiatrists' GAF Ratings
To the Editor: I read with interest the article in the March issue assessing interdisciplinary reliability in the use of the DSM-IV Global Assessment of Functioning scale (1). The authors' conclusion is that with systematic training, social workers can provide reasonable assessments of a client's functioning. This conclusion is drawn from the results of the study, which showed a positive correlation between the GAF ratings that social workers and psychiatrists gave to discharged inpatients.
May I suggest three alternative conclusions? First, adequately trained psychiatrists can achieve the same level of competence as social workers. Second, trained by a psychologist, both social workers and psychiatrists can become competent in use of the GAF. Third, with similar training, interrater reliability among those using an instrument increases. Which conclusion is the most parsimonious?
Dr. Kopera is affiliated with the Community Counseling Centers of Chicago.
1. Harel TZ, Smith DW, Rowles JM: A comparison of psychiatrists' clinical-impression-based and social workers' computer-generated GAF scores. Psychiatric Services 53:340-342, 2002Link, Google Scholar