Psychological Testing 101 (Part 2)
Crystal Dixon, PsyD
In Part 1 of this blog, which you can find here if you haven’t already read it, the following concerns were covered:
What psychological testing is
Ways to seek diagnosis
How online testing services can be problematic
Here in Part 2 you can learn why someone would seek psychological assessment, what to expect from an assessment, and how to get started if you think testing would be helpful for you.
Testing is something you should consider if:
You are interested in a full work-up of your mental health. Think of it like getting a physical exam or getting lab work done by your doctor. You may have some questions about your mental health and would like clarity shed on certain areas. Or you may have suspected having something such as anxiety, but are unsure if it’s within a normal range or if it’s at a concerning level that requires more attention.
Maybe you have been tested before, and you’re interested in a re-evaluation to see if you’ve made any progress. Or maybe you are concerned you’ve been misdiagnosed. Maybe that concern means you’d like to be “undiagnosed!” Undiagnosing is the removal of an incorrect diagnosis that was given to you, and maybe you’re being harmed by this in some way. For example, it’s on your medical records and hindering certain job prospects.
Psychologists see many re-evaluations in which the individual is interested in a second/third opinion, the removal of an incorrect/harmful diagnosis, or just wanting to see if progress has been made since the last evaluation!
If you’re a student, you may have wondered whether you qualify for academic accommodations. Individuals who have ADHD, for example, benefit greatly from receiving extra time during examinations. This isn’t giving them a “leg up” to them as much as it is leveling out the playing field for them to function academically next to their peers. There is ample research to show why students with ADHD require such accommodations, and universities, the MCATS/LSATS/GMATS (etc.), professional state licensing boards, and other institutions have strict guidelines on who may qualify. The higher the stakes, the higher the requirements.
A formal psychological evaluation is typically required when requesting for accommodations for “high stakes testing,” even if you may already have been given a diagnosis given by your treating clinician.
You have already been in treatment, but you are feeling stuck in your progress. Maybe the medications do not feel right, or maybe you are stagnant in your therapy goals. It has been hard to pinpoint why you’re not moving forward in treatment, when “on paper” (or according to the treatment plan your clinician has devised) all the interventions align with your presenting problem. Testing is helpful in these cases, because it may help to capture a missing diagnosis, correct a wrong diagnosis, or just provide valuable information that may otherwise emerge from traditional talk sessions.
If you have trouble clearly describing what you’re going through, or even feel confused by what you’re experiencing, that’s normal. We don’t know what we don’t know. Testing can serve as an additional tool to learn more about yourself, and help give you the words in this language to help you communicate your experience.
If you believe you have a set of symptoms that belong to a certain diagnosis, chances are those symptoms also correspond to another diagnosis. We call these “overlapping symptoms,” which can make it very hard to distinguish the true origin without testing. For example, autism spectrum disorders, ADHD, anxiety, and obsessive-compulsive disorder share many characteristics, such as: executive functioning challenges, attentional issues, sensory sensitivities, repetitive behaviors and routines, social interaction difficulties, emotional dysregulation, genetic and neurological factors, and co-occurrences with each other (meaning individuals diagnosed with OCD are also frequently diagnosed with both autism and ADHD, as one example).
Doing the full workup in testing would allow you to better understand what you have, not only based off of what you have but also what you don’t have.
Personal growth and building introspection – if these are your therapy goals, then this is moving away from “mental illness” and more so toward a direction of “mental wellness.” Diagnostic clarification and medications are not necessarily needed in these cases. You may just be interested in learning more about yourself, building insight and awareness, and in implementing the best choices you can make to live your best life. Testing can serve as a wonderful tool here as well, focused on learning about your personality (Myers-Brigg, anyone?), relationships, values, and whether your life choices align.
What can I expect the process to look like?
You can expect to have at least 3, distinct sessions. First, there is an intake, which is a structured interview that may take 1-2 hours. It is usually done with the psychologist who is evaluating you. Then, your second session will likely be the appointment where the bulk of your tests happen. The psychologist will meet with you in person and administer a series of different tests, and this may take 2-4 hours on average. Alternatively, this may also be done with a psychometrist, who is a trained, sometimes certified, technician who assists the psychologist in administering and scoring your tests. This is the only portion where a psychometrist may have in your evaluation. After this, the psychologist will aggravate all your data, interpret your results, and integrate everything into a written report. You may be called to provide more information before the results are finalized, but not always. If not, then your third session will be your last, where you will be given a copy of your report and review the results with the psychologist. Recommendations that are provided in your report and explained in more detail during this feedback session as well, as well as addressing any questions or concerns you may have.
Where do I start first?
If you already have a therapist or psychiatrist, start with discussing your interest in testing with your clinician. They can help you initiate the process or provide referrals for a testing psychologist. If not, you can go onto your insurance website and obtain a list of psychologists who are in-network. You can also do an internet search for psychologists in your area as well. Keep in mind that a portion of the process is in-person, so consider if you want to find someone local. Once you have your results, you can share a copy with your treating clinicians so that they may implement the new information into their own treatment planning.