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James J. De Santis, Ph.D.
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Psychological testing is not easily described.  Psychodiagnostic assessment
is generally performed by a licensed psychologist who is qualified through
education, training, and experience to conduct testing.  It varies depending
on the clinician’s practice and philosophy and the specifics of the problems
the patient brings in for evaluation.  Assessment involves the measurement
and classification of psychological phenomena in an individual.  It is
intended to help understand such issues as a person’s personality,
emotional difficulties they may be having, or their ability to think in order to
identify causes of problems occurring in school, work, or social relationships,
predict the course of a problem, and select strategies to manage or solve a
problem.  

The Elements and Process of Assessment  

A number of different approaches can be applied to evaluating psychological
problems.  The first few sessions with your psychologist will usually involve
an initial interview where the doctor wants to hear about your concerns and
what you have observed.  The doctor will then select appropriate measures
to best assess the problem.  Very often, no single method will conclusively
diagnose a problem.  Comprehensive evaluation should rule out other
relevant difficulties that can mimic or complicate the suspected problem.  

During the course of an evaluation, a psychologist is likely to draw on
various approaches according in part to the nature of the problem being
evaluated and his or her judgement of what approaches will illuminate the
issue best.  A thorough evaluation may include a clinical interview with the
patient and/or family members, a review of personal history, review of any
prior records such as school report cards or previous psychological testing,
examination of school or work samples, consultation with your physician or
therapist, and completion of a set of structured questionnaires and
objective psychological tests.  The evaluator may want to observe the
school or work environment with your permission.  

Once all assessment procedures are completed, the evaluator explains the
results and conclusions in clear and understandable language.  Results may
be provided verbally in a concluding feedback conference with the patient
and/or family or in a written report that may include a summary of relevant
history, a narrative description and explanation of findings, a listing of test
scores, a diagnostic impression, and recommendations for addressing the
problem.  Your psychologist will be able to discuss with you his or her initial
understanding of your difficulties, whether you can benefit from certain
treatments, what the therapeutic objectives of such treatments would be,
the procedures used in the course of those treatments, and his or her
professional opinion about the possible and likely outcomes.  

Depending on the nature of the problem, a comprehensive plan of treatment
may include a number of suggestions, for example, individual or family
counseling, coaching, educational therapy, evaluation by other medical
specialists, attending a support group, specialized school placement, or
classroom or workplace modifications.  With your consent, consultations
with the referrer or other professionals may be included as well.   The
actual length of time required to complete an evaluation will depend on a
number of factors and cannot be predicted in advance exactly; however,
assessment can take from several hours to several days.  

When to Seek an Assessment  

Psychological evaluation is warranted when prominent symptoms are
interfering with life, and prior attempts to solve the problem have proven
ineffective. Psychodiagnostic assessment can help to clarify a confusing
diagnostic picture by distinguishing between different possible causes and
syndromes and to generate helpful recommendations about a plan of
treatment or remediation. A number of difficulties may benefit from
psychological evaluation, for example, academic underachievement,
symptoms of depression and anxiety, teenagers exhibiting behavior
problems, trouble functioning effectively in the workplace, difficulties with
interpersonal relationships, problems with recalling facts or instructions, or
word-finding difficulty.  

Advantages of Private Assessment  

When an evaluation is done privately, you have control.  You have control
of the quality of the evaluation.  A private assessment is essentially an
independent appraisal.  You can personally select an evaluator based on
professional education, training, and experience.   Evaluation can be
comprehensive in scope and include consideration of other significant
possible contributing factors.   The final report may have a significant
impact on a person’s life, and so you will have control of disclosure and
distribution of the results when testing is done privately.  You can obtain a
re-evaluation easily and as needed to assess the effectiveness of
interventions provided.  

Psychological Testing as a Part of an Assessment  

While not always a part of an assessment, psychological testing is a method
frequently used to evaluate psychological difficulties.  Conceptually,
psychological testing frequently uses a small sample of carefully chosen and
measured observations to infer larger generalizations about an individual. 
Psychological testing attempts to objectively identify, quantify, and
categorize symptoms, behavior, ways of thinking and feeling, or problems a
person is having.  It uses standardized written instruments, oral question
and answer, responding to pictures or symbols, or manipulating apparatus
like blocks or puzzles, that have been validated in clinical trials under
uniform procedures to measure differences among individuals.  Test scores
allow a standardized comparison among individuals.   Testing can take
several hours to administer to the patient, and can take several more hours
to score and interpret the results and then generate a written report.  

The Test Battery  

Most of the time, no single test or method is sufficient to accurately
diagnose a psychological problem or condition.  Therefore a collection of
tests, or test battery, is assembled to fully assess the problem.  Testing
then yields a pattern of scores.  Sometimes a battery requires only a few
selected tests that focus on a few specific measurements.  Sometimes a
battery is quite comprehensive, measuring a wide variety of areas.  

Clinical Interview  

A clinical interview is a conversation between doctor and patient.  The
interview in part may be to collect information about a person's background
and functioning in a variety of areas including medical, social, educational,
employment, and family.  The interview may also be to observe and explore
the patient's current mental state, including their thinking and emotions. 
Sometimes, the patient may be allowed to describe in their own terms what
they are experiencing, or they may be asked a series of pre-determined
questions.  

Personality Assessment  

Personality testing evaluates measuring non-intellectual factors such as
emotional adjustment, functioning in interpersonal relationships, motivation,
interests, attitudes, and ways of coping.  While symptoms are conditions
which are relatively transitory, developing and changing in response to
various life circumstances and experiences, such as anxiety or depression,
personality traits on the other hand are relatively enduring patterns of
behavior and thinking which may contribute to the development of
symptoms, such as dependency, compulsivity, or social avoidance.  

Psychoeducational Assessment  

Usually psychoeducational testing involves a comprehensive battery of
individually administered subtests that each measure an aspect of cognitive
ability and scholastic achievement.  Comparisons can then be made
between capability and attainment to determine if an individual has reached
full academic potential.  Interpreting the pattern of scores can contribute
to further understanding the difficulties which a patient experiences in
mastering certain learning experiences.  

Psychoeducational testing can be helpful in identifying students with
specific cognitive deficits that are impeding successful learning and
students who are gifted and need greater learning challenges.  This type of
testing can be helpful in advocating for admission to specialized programs,
schools, and colleges.  Psychoeducational assessment may rule out learning
disabilities or attentional deficits.  

Achievement testing is a component of psychoeducational testing that
specifically measures the effects of educational programs on students in,
for example, the areas of reading, spelling, written composition,
computation, math reasoning, or general knowledge.  Comparisons among
the patient’s achievement scores can determine if any significant relative
personal strengths and weaknesses exist.  Achievement scores are
customarily compared against what is expected for the individual’s
chronological age or grade level.  

Intellectual Assessment

Intelligence testing, sometimes considered a part of psychoeducational
testing, evaluates specific cognitive strengths and weaknesses.  It is
designed to identify children or adults who will benefit from the regular
classroom curriculum or who have special needs.  This type of testing allows
education to be customized to the individual.   Often intelligence testing
involves a series of separate subtests that measure various aspects of
intelligence, such as verbal comprehension, including the ability to use
verbal skills in reasoning and solving problems and the capacity to learn
verbal material, efficiency and integrity of the individual’s perceptual
organization, including non-verbal reasoning skills, the ability to employ
visual images in thinking, and the ability to process visual material.  All the
subtests may then contribute to an overall intelligence score.  

Neuropsychological Assessment

Neuropsychological testing evaluates those cognitive functions that are
sensitive to changes in the condition or degree of impairment of the brain
and central nervous system.  Often such testing involves a series of
separate subtests that measure various aspects of cognition that are
affected by brain function.  Such testing may evaluate visual and auditory
memory, visual-spatial perception, mental processing speed, fine motor skill,
word comprehension, tactile perception, attention, and expressive and
receptive speech.  With such measures, organic brain impairment can be
detected and localized.  A rehabilitation program can then be designed.  

Forensic Assessment

Whenever psychological conditions are a factor in deciding the outcome of
a legal matter, a forensic evaluation may be sought.  Forensic assessment
can include evaluation of cognition, mood, personality, or behavior, but it is
conducted specifically for a legal proceeding, either civil or criminal.  

Examples of legal matters sometimes necessitating evaluation are risk
assessment of potential for violence and dangerousness, criminal behavior
and juvenile delinquency, jury behavior and selection, the accuracy of
eyewitness testimony, the psychology of confessions and false confessions,
the dimensions and assessment of legal competency and insanity,
substance abuse assessment, personal injury, wrongful termination and
harassment, civil commitment and conservatorship, and domestic violence
and family law including custody evaluations.  A psychologist may also
provide forensic consultation to attorneys, usually in the form of reviewing
medical records including psychological and neuropsychological reports and
providing information about psychological and neuropsychological issues.  

The psychologist will often appear in either depositions or court hearings as
an expert witness to explain and answer questions about the assessment.  

Employment or Fitness for Duty Assessment

Psychological testing can be applied to the screening of applicants for
special employment situations to ensure that applicants are psychologically
healthy and suited to the tasks of the job.  Examples of situations that may
warrant fitness for duty evaluation include law enforcement, clergy, military,
or jobs requiring a security clearance.  

Vocational Assessment

Vocational testing typically centers on making optimal recommendations
about which occupations best fit an individual.  Such evaluations may
evaluate such elements as career development background, occupational
interests, vocational aptitudes, learning style, work habits and behaviors,
personal and social skills, values and attitudes towards work, self-concept,
and work tolerances.  

Such evaluations are useful for adolescents and young adults selecting from
among various career directions and the necessary preparation for those
careers.  Testing can recommend types of remedial strategies that will lead
to improved vocational preparation.  Testing can also be useful for people
considering a midlife career change and the steps required for a successful
transition, such as additional education or training.  

Custody Assessment

The primary purpose of a custody evaluation is to make recommendations
for assigning custody, allowing access to, and making parenting decisions
about children where parents are unable to resolve their own agreement. 
Decisions regarding child custody occur within several legal contexts,
including parental divorce, guardianship, neglect or abuse proceedings, and
termination of parental rights.  The evaluator’s goal is to assess the best
psychological interests of the child.  

The focus of the evaluation is on parenting capacity, the psychological and
developmental needs of the child, and the resulting fit between the two. 
The psychologist does not give any opinion regarding the psychological
functioning of any individual who has not been personally evaluated.  Areas
for assessment may include continuity and quality of attachments, child’s
preference for living situation, parental alienation, any special needs of the
child, the impact of custody on the child’s education, gender issues, sibling
relationships, each parent’s physical and psychiatric health, parents’ work
schedules and finances, styles of parenting and discipline, parents’
conflict-resolution skills, social support systems, cultural and religious
issues, and parents’ ethics and values systems.

Click here to view the Los Angeles Psychodiagnostic Assessment Directory

What is Psychological Testing?