Psychologicial Evaluation: An Introduction

     
If you or your child have been referred for psychological evaluation, this introduction is to help you understand the purposes, the methods and the products of such evaluation, and to give you some idea what to expect as we go along. Dr. Young conducts “forensic” evaluations (those are for administrative or legal purposes), but this introduction assumes that you are referred for “clinical” evaluation–by a doctor or other clinician.

Dr. Young conducts psychological evaluations of children and adolescents as well as adults. In most instances, the patient is referred by his/her doctor or therapist/counselor. In some cases, the referral comes from a school district or other agency. The purpose of psychological evaluation is to help the doctor or therapist better understand the psychological functioning of the individual. Often the aim of evaluation is to clarify the nature of the difficulties with which the individual struggles, a process termed “diagnostics.” This means clarifying the diagnosis, if there is one. There are two important and distinct facets to such diagnostics: (1) specifying what condition or disorder is present; and (2) specifying what conditions or disorders are not present. Clarifying what is not the problem is just as important as concluding what is the problem.

In most instances, Dr. Young’s evaluation will provide not only a diagnostic formulation, but treatment recommendations as well. He works closely with the referring clinician to take account of what treatments have been effective, what has not helped, and so on. Having a clearer picture of the patient’s psychological strengths, weaknesses and vulnerabilities enables the doctor and therapist to focus treatment more effectively. Dr. Young provides the referring clinician a full report that includes a description of each element of the evaluation, the findings, the conclusions, and recommendations for treatments most likely to be effective.

After the evaluation is completed, the findings and recommendations are reviewed in person with the patient/parents. Whether to include the child in such a meeting is discussed with the parents ahead of time. In some instances, evaluation findings can be reviewed adequately with the referring doctor after he/she receives the report. This is at your discretion.
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There are three main components to most psychological evaluations:
 
Review of available medical/psychiatric records and consultation with the referring doctor or therapist

Interviews: individual and (usually) joint interviews; interview with parents or others; some collateral contacts in some cases

Psychological Testing: Cognitive and Personality Tests; Behavior Rating Scales
 
 
 Every psychological evaluation is tailored to the individual case, and no two evaluations are exactly alike. That’s because people are too complex to assess and categorize in mechanical ways. Dr. Young decides upon the nature of necessary interviews and psychological tests as he learns about the situation, the history and the presenting problems and questions.

The procedure typically followed is this:
 
     1. Contact our office and let Shirley or Sandy know that you or your child have been referred for psychological evaluation. Tell us who referred you.
 
     2. We will send out a packet of materials for you to fill out along with things like maps and data forms. These aren’t too burdensome, and include (for children/adolescents) a Child/ Adolescent History Form. You will be asked to provide a $100 deposit (applied to any charges). Please complete and mail these back to us with the deposit. Be sure to let your doctor or therapist know that you are proceeding with evaluation so he/she can send whatever records are needed or be in touch by telephone. Be sure to have records sent ahead of time so that Dr. Young will have them for the evaluation. Also, please be sure to bring or send any school/ education testing or evaluation results that are available.
 
     3. After we receive the materials back, we can call to schedule appointments. We will schedule, in child cases (up to 18-20 years old), an initial one-hour meeting with parent(s), then two 2-hour meetings with the child (we may not need all that time). In many instances, the parent(s) judge that it is best to meet separately with Dr. Young prior to meeting with the child present because it may be easier to talk freely. In other cases that may not be necessary and the initial interview with parents is done with the child present. For younger children (under about 12), it is best for the parents to do the initial meeting without the child present.
 
     4. Psychological Evaluations consist in most cases of approximately equal parts interviewing and testing. The initial meeting begins with interviews. Dr. Young will review current functioning (the good things as well as the troubling parts); in most cases some developmental history (all the way back to birth); and educational and social history. Family history and current functioning are important in most cases. Sometimes much of that early history is already available from your doctor and need not be done over.
 
     5. The tests used depend upon the clinical history, the current issues, and the questions posed for the evaluation. In some cases your doctor or therapist will know fairly well what kinds of testing are needed; in other cases, the tests needed are decided only after the first interviews are completed.
 
     6. Dr. Young integrates the findings from the various parts of the evaluation and prepares a report. When the report is ready, it is forwarded to your doctor/therapist, and a meeting (in most cases) is arranged to review findings. You are provided your own copy of the report after it has been reviewed with Dr. Young or your doctor/therapist.
 
 
                                                                                                                                           June, 2008