The Value of a High-Quality Psychological Evaluation

Psychological evaluations are truly not a one-size-fits-all endeavor. Given the high cost of a quality evaluation, it’s important to understand who is conducting the evaluation, what types of tests will be included, the process and procedure for the testing, as well as the finished product. A high-quality complete comprehensive evaluation holds value in that it captures you or your child’s unique profile of strengths and challenges as well as recommendations for follow up. Typically, clients find that a well-done psychological evaluation provides a clearer path for supportive services, such as therapy to address direct life challenges, insight for medical professionals to know how to address specific needs, and differentiating between diagnoses. It represents a roadmap for you or your child’s future.

Who should conduct a high quality evaluation?

Evaluations should be conducted by a doctors-level psychologist or neuropsychologist, although a psychometrician can conduct assessments under the supervision of a psychologist. Also, masters level school psychologists are qualified to conduct school-based psychoeducational evaluations. When you are investigating who will be conducting the evaluation, make sure you ask questions about their specific qualifications. For example, ask what type of degree they have (master’s degree vs. doctoral degree), trainings they have completed, and the specific experience of the clinician who will be conducting the evaluation. The quality of the evaluation report will vary greatly depending upon the qualifications and skills of the evaluator. A psychologist or neuropsychologist typically has more training and an understanding of the brain processes and how it impacts a client’s functioning.

What should a highly skilled evaluator communicate to you?

It’s important from the very beginning of the pursuit of an evaluation (typically the first point of contact or intake interview) that the psychologist is listening to and answering questions that you want answered as well as describing the exact process and procedure for the evaluation. The psychologist may charge an hourly rate or flat fee for the assessment services, so be sure to ask what is included in the process. For example, typically evaluations require an 1) intake interview with the client, parents, and/or the child to gain background and developmental information 2) 4-6 hours of direct testing 3) multiple ratings (i.e. rating scales for social emotional, behavioral, personality, executive functioning, or attention) from multiple sources (parent, teacher, client, significant other) 4) data analysis and synthesizing of the data 5) written report 6) feedback session. A high quality evaluation process can take the psychologist 12-25 hours depending upon the selected battery of tests.

What is the typical process a skilled evaluator takes?  

Most scientist-practitioners (psychologists/neuropsychologists) have a working knowledge of forming various hypotheses based on the questions posed by parents/clients and based on the psychologists own questions (i.e., “rule outs” of other causes or diagnoses). The “referral question (s)” drives the choice of assessments, which are designed to answer the specific question(s).  For example, the referral question might be, “does the child have dyslexia?” If this is the referral question, a highly skilled evaluator will conduct direct testing of the area of concern (i.e., academic testing in reading comprehension, reading rate, and phonological processing), direct testing of potential underlying processes (i.e., cognitive assessments, neuropsychological assessments), and indirect testing which may be contributing factors to the reading difficulties (i.e.,rating scales for behavior, mood, etc. and observations).

What are essential components of a high-quality evaluation?

Essential components of a high-quality psychological evaluation, which will get you the most value for your investment, should include: 1) a full battery of tests that “rule in” or “rule out” diagnoses and answer specific referral questions 2) data that shows specific strengths and challenges of the client based on the data. (not just reporting the scores or what the test is measuring), 3) thorough analysis and synthesis of the data to create a holistic profile 4) specific recommendations based on the results of the data – recommendations should be linked to the unique testing result 5) A usable roadmap to help other practitioners and related service providers develop appropriate interventions, supports, therapies, medicine, or school-based assistance.

As a client, it is important to fully understand the psychological evaluation process and potential outcomes before engaging the process.