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You've been referred for an assessment 

February 2012

Perhaps you've been referred for a psychological assessment. What can you expect? What should you look for? What do you hope to gain from the experience?

Assessments are recommended by psychotherapists in order to aid in treatment planning or to help when the therapy appears "stuck." If this is the case, you should discuss this with your therapist; often an assessment can get things moving again and can point to overlooked areas for therapeutic exploration.

Sometimes a psychiatrist will recommend an assessment to clarify the diagnosis before initiating drug treatment. This can be very valuable and can eliminate many false starts by pointing in the direction of the correct medication the first time.

Perhaps you have been having trouble concentrating and your doctor wonders if you have Attention Deficit Disorder. This is a classic indication for psychological assessment. Although there are many self-rating scales for ADHD, these are based solely on a person's self report, and cannot distinguish among the various causes of problems in attention. Anxiety, depression, stress, are all potential reasons other than ADHD for someone having difficulties with attention and concentration. An assessment can pinpoint where the problem lies, identify the likely cause(s), and lead to the most effective treatment strategy. 

So now you've decided to go ahead with an assessment. What can you expect?

First of all, the assessment should be conducted by a licensed psychologist who is proficient in personality assessment. The American Psychological Association has designated personality assessment as a proficiency, and psychologists who are trained and experienced in this modality are designated as proficient. 

The psychologist will likely take a history. In order to choose the appropriate tests to answer the questions that you and your referring doctor have and to interpret them in the light of your unique situation, she will need to know about you and your life. She will want to know the important events, something about your relationships, your concerns, etc. It is important to be frank; remember, assessment psychologists operate under the same rules of confidentiality as do psychotherapists.

At this time, it is also important that you let the assessor know what your questions for the assessment are. These may be different from those of the doctor who referred you. It is important that your questions be addressed as well as those of the referrer. 

You will likely do a number of different tests; this may extend over several days. Some may be paper-and-pencil questionnaires, others more like puzzles, still others - such as the Rorschach Inkblot Method - may seem strange. You should feel free to ask about the purpose of the specific tests, although the psychologist may choose to answer you after having first completed it.

Finally, you should expect to receive both verbal feedback on the assessment as well as a written report. In addition, a written report is likely to go to the referring doctor as well. In times past, it was thought that the results of psychological testing was too "sensitive" to share with the patients themselves. We now know this to be untrue. A competent psychological assessment involves the active collaboration of the person being assessed and culminates in full and complete disclosure of the findings. Many patients find this to be one of the most enlightening experiences of their lives.

Psychological assessment can be time-consuming and costly, but it can be highly cost-effective if it shortens the course of subsequent treatment and makes it more effective.