Hatira’s Projective Technique (HPT)

Description

Hatira’s Projective Technique (HPT) is a specialized projective assessment method developed to explore the personality, emotional functioning, and psychological adjustment of children aged 6 to 14 years living with severe chronic illnesses, particularly childhood cancer. The technique aims to facilitate the expression of emotions, concerns, internal conflicts, coping mechanisms, and illness-related experiences that may be difficult for children to communicate through conventional verbal assessment.

The HPT consists of ten stimulus cards depicting scenes from hospital settings, family life, and school environments. These images encourage children to create narratives and express their thoughts, emotions, perceptions, and personal experiences in a safe and non-threatening manner. Rather than relying on direct questioning, the technique uses projective principles to reveal underlying psychological processes associated with chronic illness, hospitalization, body image, and emotional adaptation.

The HPT is primarily intended for clinical psychologists, pediatric psycho-oncologists, mental health professionals, researchers, and multidisciplinary healthcare teams working with children affected by chronic medical conditions. It provides valuable qualitative information that complements clinical interviews and other psychological assessment methods.

Analysis and Data Interpretation

Unlike standardized psychometric questionnaires, the HPT is primarily interpreted through qualitative analysis rather than numerical scoring. Children’s narratives and drawings are systematically examined to identify recurring emotional themes, coping strategies, interpersonal relationships, fears, expectations, and representations of illness.

Interpretation focuses on several major domains, including:

  • Narrative content and emerging emotional themes.
  • Drawing characteristics, including style, organization, use of space, and color.
  • Body image representations and perceptions of illness.
  • Indicators of self-esteem and self-perception.
  • Psychological defense mechanisms and coping strategies.

Although the HPT is fundamentally a qualitative assessment, research applications may include quantitative analyses such as comparisons between clinical groups, longitudinal evaluations, inter-rater agreement analyses, and correlations with standardized psychological instruments assessing anxiety, depression, quality of life, or emotional adjustment.

Objective

The primary objective of Hatira’s Projective Technique is to provide an in-depth understanding of the emotional experiences and psychological functioning of children living with chronic illness.

More specifically, the instrument aims to:

  • Explore children’s emotional responses to chronic disease and hospitalization.
  • Identify concerns, fears, and psychological coping mechanisms.
  • Assess body image, self-esteem, and illness-related perceptions.
  • Support psychological diagnosis and individualized therapeutic planning.
  • Facilitate communication between children and healthcare professionals.
  • Contribute to clinical and research studies in pediatric psychology and psycho-oncology.

Scoring

The HPT does not employ a conventional numerical scoring system. Instead, interpretation is based on structured qualitative evaluation of children’s narratives and drawings according to predefined interpretative criteria.

Assessment focuses on the content of the stories, emotional expressions, symbolic representations, drawing characteristics, body image, and self-concept. The interpretation requires substantial clinical expertise and should always be conducted by appropriately trained professionals using standardized interpretative procedures.

Because the technique is projective in nature, conclusions should be integrated with information obtained from clinical interviews, behavioral observations, medical history, and other psychological assessment instruments.

Psychometric Properties

The psychometric evaluation of the HPT differs from that of conventional standardized questionnaires because it is primarily based on qualitative interpretation. Evidence supporting its validity includes comparisons between projective findings and children’s observed behavior, clinical evaluations, and associations with other validated psychological assessment instruments.

Reliability largely depends on examiner training and adherence to standardized interpretative procedures. Studies have reported satisfactory inter-rater agreement when experienced clinicians employ common interpretation guidelines. Ongoing research continues to examine the clinical utility, validity, and reliability of the technique within pediatric psycho-oncology and child clinical psychology.

References

Hatira, K. (1996). L’investigation psychologique à travers d’une épreuve spécifique. Athens: AB Publications.

Hatira, P. (1998). The Role of Drawing in Diagnosis and Therapy of the Child with a Chronic Disease: Hatira’s Projective Technique (HPT). Bulletin Prelude, 5, 56–62.