I Feel Stuck In Therapy, What's Next? (Part 2)

Psychological and Neuropsychological Assessments

Kelly Anderson, Ph.D.

In part one of our blog series, “I Feel Stuck in Therapy, What’s Next?” we explored the ways medication and therapy can work together to create meaningful and significant change. In part two, we delve into the role of psychological and neurological assessments in helping individuals break through barriers and achieve transformative progress in their therapeutic journey.

I’ve often shared with colleagues, that if I had the resources, every new client in the practice would receive a psych assessment before beginning therapy - that’s how invaluable assessments are to me and the therapeutic process. These assessments play a crucial role in identifying underlying issues, tailoring therapy approaches, and informing medication planning, ultimately empowering clients to overcome obstacles and move forward on their path to emotional well-being. Because assessments are time intensive and can be expensive, it’s not realistic that every client completes this kind of testing. Because of these barriers, psych or neuropsych testing can’t be used in every situation for every client.

I strongly recommend testing when:

  • A client has been engaging in therapy for some time and the therapy doesn’t seem to be working

  • A client was progressing in therapy and then seemed to “hit a wall” and progress stalled or regressed

  • A client and/or clinician is unsure of diagnoses, or a client has received many different diagnoses in the past

  • A client has difficulty discussing their internal experiences

Understanding Psychological Assessments

Psychological assessments are invaluable tools that provide a comprehensive evaluation of an individual's emotional, cognitive, and behavioral functioning. These assessments are administered by licensed psychologists and utilize a variety of standardized tests, questionnaires, and interviews. The information gathered helps to gain deeper insights into a person's strengths, challenges, and unique needs, enabling the therapist to create a more personalized treatment plan.

Identifying Underlying Issues and Roadblocks

At times, individuals may find themselves stuck in therapy, struggling to progress despite their best efforts. Psychological assessments help unearth underlying issues that may be hindering progress, such as unresolved trauma, personality traits, or cognitive patterns. By identifying these roadblocks, therapists can adjust their approach, offering targeted interventions to address the root causes and facilitate breakthroughs.

Tailoring Therapy Approaches

Every individual responds differently to therapeutic techniques, and what works for one person may not be as effective for another. Psychological assessments aid therapists in understanding a client's unique strengths and challenges, allowing them to tailor therapeutic approaches accordingly. Whether it's cognitive-behavioral therapy (CBT), trauma therapy, or dialectical behavior therapy (DBT), the assessment results guide therapists in selecting the most suitable approach for optimal outcomes. This improves outcomes and can save clients months or years of time struggling to find the approach that best suits them.

Guiding Medication Planning

Psychological assessments can play a vital role in choosing appropriate psychiatric medications. The assessment results can reveal specific psychological conditions or symptoms that may benefit from pharmacological support. This informed approach to medication planning ensures that clients receive the right medications targeted to their needs, further enhancing the effectiveness of their overall treatment plan.

Psych and Neuropsych Assessments Vs. Neurological Assessments

Psych and neuropsych assessments focus on emotional and cognitive aspects of functioning and can also examine memory, attention, impulsivity, planning, IQ, and reasoning. Neurological assessments are different and are aimed at providing insights into the brain's structure and function. These assessments, typically conducted by neurologists often involve brain imaging scans, such as MRI or CT scans, to detect any neurological abnormalities or brain injuries that could impact mental health and cognitive functioning. It is very common that after neurological testing is done, a psych assessment is requested. This could be if an issue was discovered (e.g., brain impact from a traumatic brain injury) or if neurological imaging was fine (e.g. when someone is experiencing memory loss and there are no abnormalities found on scans). The opposite is true as well. If findings from a psych assessment indicate structural or functional issues, a psychologist will refer to neurology for further testing. However, brain imaging is not done by psychologists and is not part of psychological assessment.

Psychological and neuropsychological assessments provide essential insights into clients' strengths, challenges, and underlying issues, guiding therapists in tailoring their approaches and facilitating progress. By combining assessment insights with medication planning and therapy, a powerful and personalized treatment plan emerges, assisting individuals to overcome obstacles and achieve emotional well-being.

Medication Management, Neuroscience, TherapyKelly Andersontherapy, medication management, assessment, psychological assessment