Wednesday, 22 August 2012

Psychological Assessment

Doing Psychological Assessments or Psycheducational Evaluations is a mainstay in a Private Practice in Psychology. But what exactly does this mean, and how do we think it’s best done ?

In a quality oriented Psychological Practice, the actual assessment should be completed by the person who reports on the results. In our case here, all testing is done by PhD level Psychologists. This assures for the best service for clients and their families.

Psych testing involves the use of standardized assessment tools that give us information about the issues that may be getting in the way of optimal performance. Tests, whether they are about intellectual abilities, academic skills or emotional functioning are administered to our clients. These tests have been given (or standardized) on thousands of children, adolescents and adults. Results we obtain are compared to this vast bank of data and our results situate our client in the context of these data.

Psychologists receive special training in order to assure that the administration procedures are reasonably consistent across all who test, however there is bound to be some variation. In order to get the most accurate results, it is important to make sure that the client is engaged and comfortable in the whole testing process. Testing should be fun and not a chore. In our practice, we invest much effort to assure that we are connected to our clients and that they enjoy the process. Testing in our practice is done by one Psychologist. We do not use different testers for different aspects of the process.

Another reason why our testing is completed by one Psychologist is that Psych Testing, in our view, is as much an art as it is a science. While we are interested in quantitative data, the understanding of qualitative information can be as valuable as any ‘numbers’ we obtain. How a client does a task is as important as what he/she scores on the task. This is another reason why only PhD level Psychologists tests each client in our practice. All information should be collected by the practitioner who will integrate and report on the results.

We administer standard tests of intellectual ability (eg. Wechsler Scales), tests of academic skills including reading, writing and math, tests of processing ability (memory scales), tests of executive functioning, and tests of concentration and attention.We also administer tests of social and emotional functioning if there are presenting questions about issues in this area. Sometimes the tests are paper and pencil tests, sometimes there are tasks where material has to be manipulated, and sometimes we use computerized tests. Often we will get the client, and their Parents to fill in questionnaires. We have a wide variety of instruments to use and often change or add tests as the unfolding assessment process suggests.

Results are then scored, organized and recorded in a written report which is given to the client and his/her family. In our practice, we verbally disseminate our results, that is we meet first, before we provide a written report. We like to include information from this session in the final report. Our clients own their reports and we are not permitted to discuss, or pass on any information, without their explicit consent.

It is our view that Psych reports should be written in a manner which makes them readable and easily understood by our clients. As Psychologists we feel an obligation to organize the complex information we have obtained into a report that interprets the results in a readable and informed manner. Our job is to give you our opinion, our answers, to questions you have posed.

Over the years doing assessments I have come to understand that in a odd way, doing Psych Assessments is very similar to doing therapy, only we do this type of therapy with our instruments to help guide us.

Thursday, 5 January 2012

Our Hands On Practice

Our practice prides itself in being hands on.
What does that mean?
This means that all the work, whether it be therapeutic or assessment oriented is done by a PhD level Psychologist. Unlike many other practices, we do not use other staff to clinically engage with our clients and then have the Psychologists report on work they haven’t done themselves.
This is important for a number of reasons.
The  actual work that is done, the therapy or the testing, the time that is spent with the client, is completed with a the most competent and well trained professional in the practice. While this is a time intensive process, it is our belief that every referral  should receive treatment from the most qualified professional in the practice.
After many years of practice, I have learned that consulting to a case is not as good as actually doing the case yourself. You can’t get a real feel for the complexity of the issues by supervising someone who has actually logged the face-to-face time with the client. In order to do the best work, you have to do this yourself, experience the content, the issues yourself. While this model may be widely used in publicly funded institutions, it is not appropriate in a Private Practice setting where the client or the client’s family is funding the treatment themselves.
There is no substitute for actually logging time with the client. Too much information, both qualitative and quantitative is collected in face to face sessions. Incidental cues, what a client reports when actually doing a task or a test, their facial expressions, their demeanor, how they respond,  all are critical in any psychological process and are often easily lost in a supervised situation where one person does the work which is reported to the Psychologist who then directs the treatment direction.
Nowhere is this more apparent than in the case of Psychological Testing (an Issue that I will address in my next BLOG). To have a tester log the time with the child or adolescent and then report the ‘numbers’ to the Psychologist who is then responsible legally and ethically to provide the results to the Parents, is not the best model in a Private Practice situation. In our Practice, we do not use a middle person to work with our kids or adolescents or young adults. We do this ourselves.
Hands on, that’s what we mean.

There’s no substitute for personal interaction.
For us this is a critical component in a quality oriented Private Practice in Psychology.