How to Ensure You are Getting a GOOD Psychological Evaluation

Many times people wonder why psychological testing requires such a commitment of time and financial resources. In order to ensure appropriate diagnosis and generate a useful treatment plan several steps are required. Many of these steps are minimized or skipped when clinicians are forced to work under the constraints of managed care. Though doing so saves money for the company and family initially, it often results in inadequate treatment. Thus, problems continue for longer and, eventually, more time and money are wasted on extended treatment. The family also experiences greater stress as the result of failed interventions. A thorough evaluation documents the diagnoses and provides a roadmap for treatment.

Here’s what to look for to ensure you are getting top quality care:
• Training: Licensed Clinical Psychologists are doctoral level mental health personnel who have studied the full range of normal human development (cognitive, personality, family functioning), the causes/symptoms/treatment of mental health disorders, and the biological bases of certain disorders. They have also completed their supervision years, passed national and state examinations, and have been granted a licensed by the state. Other psychologists who do testing have focused their training on educational testing or counseling.

• Tailored Battery: Ask whether the doctor gives a “standard” battery or changes the battery to meet each child’s needs. There is no point in having a child do tests that are not relevant to their particular difficulties. Testing should focus on defining their strengths and weaknesses, and the battery should be modified as needed to follow up on any issues that become apparent during the initial tests. Tests that often should be included are: IQ testing (provides an understanding of children’s ability, which helps us accurately interpret the other tests), achievement (if it’s a learning issue), and parent checklists (provide a quick way to screen for an array of learning and mental health problems).

• Standardized Tests: Although some very useful psychological tests are quite open-ended, requiring clinical experience to interpret, most tests used should provide a standardized score to allow meaningful comparison to other children. Test developers use large norm samples to determine how most people perform on a test, allowing us to understand how common or unusual the child’s ability or symptom level is.

• Clinical interview, Collateral Data and Multiple Tests: In order to obtain a full sample of the child’s functioning, the psychologist should interview the family, gather background history, and collect observations from an outside source (teachers, daycare providers) by phone interview or checklist data. Conclusions should not be drawn based on one test or by a brief observation in the office.

• Access to a Wide Range of Tests: In order to ensure that all aspects of the referral question (i.e. reason for coming in) are covered, the clinician should be capable of administering a wide range of tests and have those tests available to give. If the evaluation is a re-test, many previous tests cannot be given within a one year period. Therefore alternate ways of measuring those traits must be available. Also, some children have difficulty with certain types of tests, so it is helpful to have other options available.

• Time Commitment: A thorough evaluation typically requires several hours of face-to-face contact. Clinicians then spend many hours reviewing data, scoring the tests, interpreting the tests and integrating the tests into a report. The work that the family observes is often the ‘tip of the iceberg.’ The cost of the evaluation takes into account these hours as well as the face to face time.

• A Report and Feedback Session: The results of the evaluation should be provided in a report so that you can refer to it later, share it with the school, pediatrician or other professionals, and have a documented diagnosis. The psychologist should meet with you to discuss the results and allow you to ask questions. The face to face feedback session is crucial to your understanding of the testing and your child. Because many insurance companies will not cover it, some psychologists do not arrange for the meeting. Discuss ahead of time whether or not they do a feedback session and seek a professional who will.

• Recommendations and Referrals: The main goal of any evaluation is to provide a clear plan of how to help your child be successful. The evaluation should provide treatment recommendations, which may include therapeutic recommendations, educational modifications, or suggestions to seek other services (i.e. occupational therapy, speech therapy). The psychologist should also be able to refer you to professionals that can conduct these services or recommend ways to locate them.


Erika Madison, PhD
Licensed Clinical Psychologist
MindWell Psychology