If you are thinking about getting a psychological evaluation, you may not know what all is involved and why. You have the right to be informed, so make sure you ask your psychologist any questions you may have!
Psychological tests do not diagnose people. Did you know that there are no tests that diagnose ADHD, OCD, Autism, or any other mental disorder by themselves? People often ask us to "test" them for a specific condition, but tests are only part of an assessment. Tests give the psychologist information about you compared to a norm group, and this information may help the psychologist reach a diagnosis. Tests are selected based on the psychologist’s judgment of what is appropriate for you – no more and no less. In fact, psychologists often diagnose or rule out mental disorders with no testing at all, and they will let you know if they feel that testing is not necessary for you.
No mental disorder can be diagnosed in a vacuum. Your psychologist cannot evaluate you for only one disorder and ignore the rest of your mental health, and to do so would run contrary to our professional standards. We do not simply give you a "positive" or "negative" result for a specific disorder you are interested in. Part of the diagnostic criteria for nearly every mental disorder is that the disorder must not be explained by another condition, so we must assess your mental health, not a disorder. For example, if you ask for a bipolar disorder assessment, we will assess for bipolar disorder as well as other possible explanations of your symptoms, such as depression, anxiety, personality disorders, trauma disorders, and substance abuse. You may be diagnosed with a different disorder or no disorder at all. Similarly, if you ask your primary physician for a flu test because you have a sore throat, and the flu test is negative, you'd still want to know why you have a sore throat!
It can be surprisingly expensive. You may end up with sticker shock if you assume that you are only paying for the time the psychologist is meeting with you. Your psychologist spends a lot of time on your evaluation when you aren’t present: scoring and interpreting tests, integrating clinical data, case formulation, diagnosis, treatment planning, report writing, and sometimes there are records to review, collateral interviews, and other behind-the-scenes tasks. We can check your health insurance benefits for you, but no health care provider can guarantee that your insurance company will pay for services.
You may be disappointed in the diagnosis or lack of diagnosis. No matter how convinced you are that you have a certain disorder, diagnosis involves much more than checking off symptoms you found during an internet search. Only a licensed mental health professional can diagnose you. Your psychologist will do their best to explain their conclusions and diagnosis, but you should be sure to ask any questions you have about the results.
We cannot guarantee a favorable outcome. You may have sought a psychological evaluation for some external gain, such as a certain medication, academic accommodations, disability benefits, or extra time to take the SAT. Psychologists don’t "sell" these benefits, but they will conduct an honest, evidence-based assessment that adheres to the highest professional and ethical standards.
We may recommend additional evaluation. You may be disappointed to find that, after several appointments and psychological tests, the psychologist recommends even more evaluation for you. Sometimes, one of the results of a psychological evaluation will necessitate a recommendation that you undergo additional testing or that you seek a neurological, speech, or occupational therapy assessment. We respect your time and will only recommend additional assessment if we feel it is needed.
It can be a lengthy process. At the very least, the psychologist must gather a comprehensive biopsychosocial history and ask you about a variety of emotional, behavioral, and cognitive symptoms. The psychologist may request your permission to interview one or more members of your family or to obtain your prior medical and/or mental health records. If testing is recommended by the psychologist, you may be given self-report tests, face-to-face testing with the psychologist, computer-based testing, or some combination of these. This process can take weeks, and the final report may not be completed for some time after your final appointment.
Here is a basic rundown of what might be involved in your psychological evaluation. Your psychologist will determine whether you need all of these stages and in which order to administer them:
Screening: Psychologists differ in their expertise, so our administrative staff tries their best to screen calls to determine if we have a psychologist who has the expertise to help with your specific concern. Sometimes, this cannot be determined before scheduling, but your psychologist will be honest with you during your intake appointment if they feel you would be better served by a different clinician. If this happens to you, please be patient with us as we try to find a provider who can help you and understand that our administrative staff cannot always predict ahead of time whether your needs are outside the psychologist’s areas of expertise.
History Gathering: You will be asked about your history and current status in various areas: personal, family, relationship/social, trauma/abuse, education, work, medical, mental health, and substance use. You may be asked about your culture, religion, and any other topic that might be relevant to your mental health, such as sexual orientation or identity.
Symptoms: You will be asked about the history of each symptom as well as the frequency, intensity, and pattern of the symptoms. You’ll be asked how the symptoms affect different aspects of your life.
Collateral Information: You may be asked for permission to release your prior medical and mental health records to the psychologist. You may also be asked for academic records or even permission to interview a family member.
Testing: If testing is recommended, you may be asked to complete self-report tests (multiple choice), computer-based tests, and/or face-to-face testing with the psychologist. Sometimes, the psychologist will ask that you allow people close to you to complete rating scales about you.
Integration: This is typically the longest part of the evaluation, but you are not involved at this stage. The psychologist scores and interprets tests, reviews records, integrates all clinical data, renders a diagnosis, writes a clinical report, and formulates recommendations for treatment or other interventions.
Feedback: The psychologist meets with you one final time to ask any additional questions that came up during the integration phase, explain the clinical findings, and discuss the diagnostic impression and recommendations. It is during this meeting that you should ask any questions you may have.
Following are some additional sources of information about psychological testing and assessment: