anxiety

What happens in a psychological evaluation?

If you are thinking about psychological testing you probably want to know what an evaluation will look like.

You are nervous about making an appointment. What will happen? What will we talk about? Will it even make sense to me? What if they don’t answer the questions I have? How long will it last?

I’ve done enough evaluations to lose count so I know what method works for me and the people who like to work with me. I’ll break down what I usually do so by the end you’ll feel less scared about making that appointment (everyone has at least a little worry about these things!)

Most psychological evaluations involve talking to the psychologist about yourself and symptoms such as anxiety and trouble sleeping in an interview, doing some questionnaires about yourself, and possibly some activities that look at how your brain is working. By the end, you should be given feedback. Professionals sometimes have different workflows, but I can tell you how I do it here in Boise. (P.S. This starts after the process of seeing if I’m the right person for you and making an appointment.)

Sun setting at Canyonlands National Park

Sun setting at Canyonlands National Park

Psychological Interview

First, you come in to talk with me about your concerns and share important background information. Depending on the questions we have, this interview will take between one and two hours. If you have trouble talking about yourself (maybe speech or memory is one of your concerns), I will ask your permission to talk to someone who knows you well to make sure we are getting good information and not missing anything important. Honestly, I like to do this even when you can talk about yourself all day - it always helps to get another perspective! If you are still worried about exactly what we’ll talk about, here is a list of things I ask about and a short explanation for why I ask them.

Your current concerns

I hope it is obvious that I care about what is bothering you, and there might also be concerns that others have for you – these could be things like worrying too much, never feeling happy, always being on-edge, trouble sleeping, feeling distant from others, having trouble with relationships, struggling to cope with stress or other problems.

Medical

There are a lot of reasons this is important; so many medicines and hormones can impact how you are feeling, head injuries can change us, and there are a surprising amount of medical concerns that can cause psychological symptoms. It is also helpful to know what medications you’ve tried (if any) and how they have worked (or not).

Education and Work

This gives me information about how concerns might be impacting these areas of your life

Substance Use

I know this is scary but some of this information can tell me things like how you cope and if using a substance or withdrawal might be impacting how you are doing. It is super common for people with mental health concerns, especially trauma, to also use substances so I always ask. Which leads me to…

Trauma

You can see my last post for an explanation of trauma. I find that people don’t talk about it unless asked; which means it gets overlooked. Trauma leads to a lot of things in different people – anger problems, relationship issues, depression, anxiety, the list goes on. I can’t make the best recommendations for you if I don’t know whether or not trauma happened and how it might impact you.

Current Potential Symptoms

These are things like how you are feeling, what you are doing/not doing, sleep concerns, eating and appetite problems, thoughts of hurting yourself or others, and unusual experiences like seeing or hearing things that other people don’t see or hear. I always ask about everything because people sometimes don’t share unless asked directly.

Current Life

This is basics like who you live with, who you talk to, how you spend your free time, and who you are in a relationship with. I also ask about what parts of your identity are important to you (and how much detail you want me to know), such as sexual orientation, gender identity, religious beliefs, race, ethnicity, language preferences, immigration status – context can be really important to understanding the big picture!

This list is not exhaustive, but hits some of the big points. Each interview I do is a little bit different based on you and your concerns 😊 You might hope after talking about all that, we don’t just jump right into testing. I think it makes for a very draining day for some folks, so lucky for you - I don’t.

Canyonlands National Park arch with blue sky

Canyonlands National Park arch with blue sky

Psychological Testing

After the interview, I will plan what questionnaires and activities we should do to answer our questions. You’ll know the general things I want to look at more closely before you leave my office after the first interview. If there are any questionnaires that you or people you give permission for to answer online, I will send those out shortly after your interview. The rest of the questionnaires and activities we’ll complete at my office 1 week after your interview. In between these meetings I’ll be trying to contact anyone you gave me permission to talk to (such as a counselor, doctor, lawyer, or someone else who we think needs some input into your evaluation).

The assessments (and how much time they take) will be different depending on your questions . If you are worried about how your brain is working (like memory, attention, or concerns about your brain working too slow) I’ll likely do an intelligence (IQ) test with you and maybe one for executive functioning (this is basically your ability to plan, organize, and monitor your thoughts and behavior). I would also have you or someone who knows you well to do some questionnaires about your ability to function in the world and take care of yourself (also called adaptive skills) and your executive functioning (it is better to have more than 1 source of information when I can get it!).

If you have questions about why you are sad, worried, fearful, have intense up and down emotions, or keep getting into bad relationships then we’ll probably just do some questionnaires; some of those have to be done in my office. The questionnaires will ask a lot of questions and look at your personality and symptoms to make sure we aren’t missing anything. Common questionnaires I use are the MMPI-2-rf, PAI, and TSI-2. For people who speak Spanish many of the scales I use also are available in Spanish (hooray!) and when they are not available I try to find a good alternative.

Understanding your Results

Within 1-2 weeks after completing the assessments and questionnaires I’ll have your report completed and you’ll come to my office for 1 hour so you will feel clear about the results and confident in your next steps.

I do my best to answer all your questions during our feedback session. If I think counseling will be helpful I will give you specific recommendations for the type of treatments that are likely to work and if I know of anyone will include specific people. I also give you strategies that you can use at home, work, or school. If you find books or apps helpful I can usually recommend a few of those as well. You’ll get an electronic copy of the report (pdf) so you can share it with whomever you think makes sense (like your doctor or psychiatrist if you see one) and so you don’t have to remember everything we talk about in the feedback session.

Occasionally, the problem you have is something I have specialty in treating (anxiety or trauma) AND you really want to use me as your counselor. If I have any openings and we all agree it is a good fit, I am happy to do that.

Whew! I know that was a lot of information. But you’ve made it this far; you’ve got answers about the process.

Are you ready to get some answers about yourself?

Click to schedule a free 15 minute call with me to figure out if I’m the right person to help you and book your appointment. If I’m not your person, I’m happy to help point you in the right direction!




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