What exactly is “psychological testing?” It doesn’t sound pleasant!
What do I mean by “testing?”
I agree – hours and hours of psychological testing doesn’t sound like much fun. Tests are things we have to take in school, for a grade, and they can be especially intimidating if we’re not prepared.
People request neuropsychological or psychological or psychoeducational testing from a psychologist when they’re looking for solutions to a problem. They’re struggling with something, or having difficulties with some aspects of learning, work, social-emotional/behavioral functioning, or some other aspect of daily life. Something that’s getting in their way, or that’s holding them back. Sometimes people just want to know why. My job is to figure out not only why, but what to do about it.
There’s no one-size-fits-all approach.
We use a variety of tools in addition to formal tests to answer those questions, with my evaluation battery varying across ages and referral concerns. Some of my tools are formal “tests,” but they are not like those you take in school. Rather, my tests examine functioning in various domains important for daily life – how one thinks and reasons with words, for example, or language, memory, attentional functioning, and more.
Just as important, I also look back at one’s history – developmental, educational, medical, and social-emotional/behavioral history – in addition to current functioning. I use clinical interviews (aka conversations) with clients and parents, spouses, children and related providers as needed in order to get a full picture and various perspectives. I also include standardized rating scales – a collection of questions about different ways individuals think, feel, or behave.
Highlighting strengths, not just challenges
In as much as testing often focuses on problems it’s just as important to focus on skills and strengths – assets one can build on in order to overcome challenges.
Evaluation reports summarizing findings should highlight those strengths, and not just weaknesses, as well as recommendations for interventions to address the referral concerns.
Diagnoses
Sometimes testing also yields formal diagnoses that can provide good starting points for conceptualizing the why’s, and for guiding treatment. Note that these diagnoses should be considered starting points, however, and not ending points or the end-all-be-all. A diagnosis in and of itself typically represents a relatively rare cluster of symptoms causing more challenges for the individual than the milder patterns of differences in individual brain function and behavioral traits that ae usually regarded as part of normal variation in the human population. Just like a set of clothes, however, each diagnosis fits each person a little bit differently, so we have to take particular care to continue to focus on the individual (and their context) vs. that label, as much as labels can help jump-start intervention planning.
Yes, as a culture we are sometimes too quick to diagnose…to label, and pigeonhole. And, I’m typically fairly stringent with my diagnoses, differentiating between “some features of __” and “__ ish” vs. providing a clear-cut diagnosis. I advocate for comprehensive testing so that all reasonable explanations for one’s challenges are thoughtfully considered. One of the challenges with brief, focused evaluations is that they’re sometimes like a fishing trip – what we find is what we went looking for.
The power of positive reinforcement
Regardless, most people of all ages find testing to be far less unpleasant than imagined – which is a good thing! None of us probably get enough unconditional, positive reinforcement for just showing up and trying, and telling others what we think, and that’s really validating at any age.
Personally, it remains one of my favorite clinical activities. Working collaboratively with children, adolescents, and adults to solve problems and to help them overcome them is personally and professionally very rewarding. Each person and each set of challenges is unique, and 25+ years later, it’s still never boring or routine.
