By Jan Hittelman
Last month’s column on teen depression highlighted the importance of a good initial assessment. Several readers questioned exactly what an assessment is, let alone a good one.
You may be surprised to know that even within the mental health field there are a range of definitions regarding a psychological assessment. It is even more surprising that many mental health professionals are not extensively trained in conducting an initial assessment. The purpose of the assessment is to clarify the nature of the treatment issues to be addressed.
What is a psychological assessment? First of all it is different than a formal “psychological evaluation”, where standardized psychometric tests are administered (i.e. intelligence, academic, personality, and perceptual tests). Depending on the results of the assessment, a more in-depth psychological evaluation may be recommended. A psychological assessment typically includes several components:
• A detailed history (often from the parent if the client is a minor) that usually includes information on birth, educational, social, familial, and emotional experiences of the referred client.
• A one-on-one interview between the therapist and the client where additional detailed information is collected. This is sometimes referred to as a “Clinical Interview.”
• An opportunity to build a relationship with and empower the client, allowing him or her to be a partner in developing the treatment plan.
• An additional discussion with family members, which may include the client.
• Providing specific diagnoses and recommendations to the client (and/or parent) as a result of the information obtained.
Why is a psychological assessment so important? The assessment is a critical component in helping to develop a thoughtful treatment plan for the client that addresses their underlying social/emotional/behavioral issues. This is of particular importance when the client is a child or adolescent, because, unlike an adult, it may be unclear what the underlying issues really are. An example of why an assessment is critical is teen depression, as it is often misdiagnosed because it can look like anger or irritability. Another common misstep for a client that is a child or adolescent, which can be avoided through an assessment, is providing individual therapy when in fact family therapy may be what is needed. As you can imagine, there are many other examples of issues that are missed without a thorough initial assessment. The goal of the assessment is to better understand the initial concerns before investing a lot of time and money in treating the symptoms rather than the underlying problem(s). While there may be an additional cost in obtaining the initial assessment, it is well worth the investment and may reduce the overall costs by addressing the correct underlying issue.
What are the Right Questions to Ask? When considering psychological counseling, there are several questions that should be asked: Are you licensed? Do you have extensive experience working with someone this age and who presents these kinds of concerns? And perhaps of equal importance; what is your assessment process and what does it include? Doing a good job as a consumer will increase the odds that therapists will successfully do theirs.