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Psychological evaluations are used by mental health professionals, parents, guardians, school personnel, and other practitioners to assess individuals with emotional and behavioral problems. Often thought to supply all the answers, “evals” are not, in fact, the “last word.” If, and only if, they are well-done and placed in context, psychological assessments can provide guidance about treatment options.
Psychological evaluations are expensive and, let’s face it, consumers should know what they are buying. Knowing the purpose of assessment, the objectives of an evaluation, the content and structure of an assessment, the professional experience and analytic skill of the examiner, and the utility of a report allows parents/guardians to see the assessment as a learning process, one that is dynamic and still evolving. In other words, evaluations are not meant to peg someone for life. Evaluations are one piece of a big puzzle at a certain moment in time
Psychological evaluations are always meant to answer specific questions. These questions are referred to by psychologists as “rule outs.” For example, if a person is exhibiting chronic bad decision making, we want to know the underlying cause. Is there a cognitive impairment, an under-developed emotional life and/or a reading disability? A psychologist will administer a “battery” of tests developed to measure these possible “rule-outs.” If a rule out is a specific learning disability, then we would expect to see intelligence testing and achievement testing. Or, if a rule out is depression, we would expect to see projective tests (responding to ambiguous stimuli like pictures vs forced choice or self-report). Most importantly, specific questions or rule outs should be stated at the beginning of the written evaluation.
A skilled evaluator will analyze and synthesize all data from a battery of tests to capture an individual’s unique way of experiencing the world. There are commonalities or “norms” of human behavior and emotions. Each individual, however, will have a particular constellation or pattern of characteristics that describe a profile for that person. A skilled evaluator will reach a nuanced level of meaning.
A good evaluation will provide recommendations specific to the individual’s needs as described in the body of a report. If a child is diagnosed with ADHD, for example, there should be recommendations specific to that person’s experience of ADHD in the classroom. A recommendation such as “provide opportunities for controlled movement like standing at desk while working, gentle bouncing on feet, sitting on a ball to roll from side to side or gentle bouncing to focus on task at hand “is more helpful to a teacher than a general recommendation such as “provide seating at the front of the class.”
In my judgment, a good evaluation possesses five characteristics: (1) a comprehensive battery of tests relevant to rule outs, (2) presentation of data specific to the examinee (i.e., more than a description of what a test measures generally), (3) synthesis and analysis of all data (i.e., how data fit together to capture a holistic profile) and (4) recommendations specific to all of the above (i.e., the reader should be able to link each recommendation to the data and analysis). In essence, a good evaluation should come full circle.
Lastly, (5) a good evaluation should be “useable.” It’s a road map for practitioners to design and develop appropriate interventions or treatment goals and plans. In my own work, a useable assessment, along with various other sources of data—such as educational testing, discharge summaries, interviews with professionals—tells me what kind of therapeutic and/or educational environment and what kind of supports my client needs to thrive in residential placement.
When evaluations are done well and used in context, they can uncover the underlying causes of psychological problems and provide meaningful advice and guidance for treatment intervention. It’s important to keep in mind that a psychological evaluation is one piece of the puzzle. It is not gospel. It is part of the bigger picture.
Dr. Betsy Grigoriu is a Therapeutic/Educational Placement Consultant with the firm, ECS, LLC.
