It's About Them

Young People … Our Greatest Resource

What is a Psychological Assessment? (Part Two)

WHAT IS a PSYCHOLOGICAL ASSESSMENT? (Part Two):

I’ve often wondered what makes up a comprehensive psychological assessment and how conclusions, diagnoses and recommendations are drawn from it.

In last post we addressed the first part of this question by describing how we would conduct such an assessment in order to gather as much information and as many impressions as possible. In this issue we’ll cover how this information is interpreted and applied.

PART TWO: Interpreting a Comprehensive Psychological Assessment

Interpretation:

1. Do the adults in this youngster’s life express any concerns they have in common? How do these concerns affect the child’s ability to function at home and school? Do there appear to be any sustainable solutions to the concerns?

2. Important: Are there any adults who appear to experience very little difficulty with this child? If so, what might account for such a difference?

3. Do the results of the assessment reflect any issues that could affect the youngster’s behavior? For example, does the child exercise appropriate reasoning and completely understand what adults are expecting of him? Are there potential difficulties with academics and learning? If so, what is the extent of these difficulties? More importantly, can these difficulties be corrected or addressed in some way?

4. Throughout the evaluation, were there any signs of defiant or noncompliant behavior, even subtle ones? What was the overall state of rapport with the youngster?

5. What value does the interview part of the evaluation bring to the whole “picture” of the youngster? Does he show remorse or concerns about issues such as failure in school or strife within the family? What would be his “message” to his parents or his teachers (see Part One)? What would be the significance of the message? Could it be addressed in treatment?

6. Is the youngster’s perception of adults reasonable and correct? If the perception is wrong (“Everybody HATES me”), how might it be changed?

7. Does the youngster see his behavior as a problem in any way? Does he have any thoughts as to how circumstances could be improved?

8. Are there any indications of other conditions, such as depression or anxiety? Is the youngster open to receiving help with these problems?

Diagnosis:

1. Is a diagnosis warranted at all? Are there alternatives to a formal diagnosis? Does the child meet criteria for a diagnosis in terms of chronicity of issues (to rule out temporary adjustment issues, such as the loss of a loved one or the stress of moving) and severity of presenting problems?

2. Is the youngster’s behavior severe enough to put him at risk for failure at school, loss of peer relationships or compounded strife at home? Unaddressed, is it possible these issues could affect functioning on into adulthood, such as securing and keeping employment or remaining in a marriage?

3. Is an additional diagnosis warranted (comorbidity)? What would it be, and why? Would this additional diagnosis add to or detract from overall understanding and treatment of this youngster?

Recommendations:

Recommendations flow logically from issues uncovered through the assessment. I have written reports containing close to 20 recommendations. Here are just a few of the more common ones.

1. Would tutoring or program changes at school address behaviors of resistance to academics?

2. In some cases, a good physical examination might be helpful.

3. Is medication indicated? If so, how can it be effectively monitored and adjusted? (This one obviously involves close coordination with a physician.)

4. Treatment in the form of counseling or therapy is often recommended, especially if the youngster is receptive to the idea. If the youngster is receptive, can he identify issues to be addressed? (Rationale: The child is more motivated to work on issues he can understand, experience and address himself. This makes a more successful starting point for therapy.)

Even when the youngster is not receptive to treatment, a trial of two or three sessions might just change his mind, especially if he sees benefits early on, and views the therapist as a resource.

5. One common issue with just about every youngster I have seen involves all they have lost. Everything has been taken away from them (toys, games, electronics, privileges, etc.) as a reaction to the child’s defiance. Although this is quite understandable, it can come with an “I just don’t care about anything anymore” price. This needs to be addressed for treatment to have a good start while, at the same time, honoring parental authority.

6. Another recommendation might to include some easy and quick compliance requests to get things rolling in a positive direction. It is important the adults make this gesture first so the youngster doesn’t believe they are trying to trick him in any way. In other words, they should meet the child more than halfway as a gesture of good faith. If the youngster doesn’t accept the good-faith gesture, that’s significant also.

7. A very important recommendation to the parents is the initiation of simple gestures toward a more positive relationship. Something as simple as a spontaneous hug or an unexpected, quick compliment can make a big difference in turning around a youngster’s perception a little at a time.

8. It’s important that we recognize any early indications of improvement and continue to encourage the youngster on an ongoing basis.

James D. Sutton, EdD, CSP

Consulting Psychologist/Certified Speaking Professional
PO Box 672, Pleasanton, TX 78064
(800) 659-6628 Email: suttonjd@Docspeak.com
Website: http://www.docspeak.com
Blog: https://itsaboutthem.wordpress.com

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May 23, 2011 - Posted by | Uncategorized

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