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Psychological Testing at Treatment Programs

Psychological testing often comes at a time of crisis and need for direction in treatment. It is an important opportunity to utilize testing data and a complete understanding of the client, to facilitate insight and change. In this succinct evaluation, the psychologist is able to: summarize salient historical and developmental issues, define strengths and weaknesses, and make individualized recommendations. Clinical professionals, treatment programs, and educational institutions rely on psychological testing to aid in treatment planning because recommendations create a specific, individualized, and effective path towards the best possible outcome. 

Psychological Testing helps create the road map for efficient and effective treatment. 

The Testing Process (more information here)
Sometimes a student can be tested prior to entering a treatment program. But often students are taken to programs in crisis, which means their participation is questionable at the time of admission. As a result, testing begins when they are deemed ready by their therapist. When the student is ready, the placement consultant and primary therapist make a referral for psychological or neuropsychological testing. The testing psychologist then comes to the program to test the student.

It is well understood that the time spent at a treatment programs serves as stabilization while the student begins a therapeutic process. It is a time to determine the best options for long-term treatment, which may include residential care. Psychological testing is an important part of the overall process because it gives crucial information for planning. Placement decision often wait on the results of testing.  

Testing Process:  (To expedite the process of information gathering and feedback)

  • Past records and reports should be sent directly to the tester prior to testing
  • A list of important professionals to contact should also be sent prior to testing
  • Parent and therapist interviews are scheduled within 3 days after testing
  • Verbal Feedback. Given to the therapist and consultant within 4 days after testing
    • Multi-disciplinary teleconference to share results within 7 days after testing
      When possible to include parents, therapist and consultant
  • Written Report. Given to parents, program and consultant. Emailed 7-10 days after testing 
    HIPAA compliant, password-protected email  


Verbal Feedback
Initial test data and results are given to the therapist and consultant as soon as possible so consultation about programs can begin. When possible, we set a teleconference call with all stakeholders to give feedback regarding testing and recommendations. This meeting includes parents, therapist, and an educational consultant. If the next placement is already determined, then the new therapist would also be invited to be on this call. This meeting facilitates an accurate and timely distribution of information and the necessary conversations regarding next steps. If the admissions department from prospective programs would like to speak with the testing psychologist separately, this can be arranged. 

Written Report
The report of test findings is very comprehensive and often lengthy. It is written from a developmental perspective and will give a thorough psychosocial history, developmental history, and review all essentials history that may be influencing learning, personality, and development. There will be a review of previous reports and therapeutic interventions. There will be a results section of current test findings for each domain that is evaluated. There will be a summary and formulation to summarize findings and diagnosis. And most importantly, there will be a detailed recommendations section which will be specific and tailored to immediate and long term needs of the client. 

Recommendations
Recommendations are specific to the client's needs and address current and future needs of the client. The psychologist understands that there are many stakeholders, including: the student, the family, the placement consultant, the therapist, the wilderness program, the potential residential program(s), and professionals in the future.

Individualized recommendations address:

  • Aftercare needs (immediate next steps)
  • Medications
  • Medical referrals (e.g. neurology, endocrinology, opthalmology, occupational therapy, etc)
  • Therapy (individual, group, family) and specific interventions
  • Academic issues (learning disabilities and accommodations)
  • Social development
  • Substance abuse 
  • Independence and individuation through executive functioning
  • Long-term issues such as vocational development 

Qualifications of the Tester
Testers are licensed psychologists with doctoral degrees (Ph.D.) that have specialized in psychological testing. Some testers have specialized training in neuropsychology, learning disabilities, autism spectrum disorders, neurodevelopmental disorders, or sexual risk. Experienced testers have worked within the NATSAP industry for many years and intimately understand the intricacies and complexities of this industry, and the available resources. NATSAP professionals are accustomed to the highest level of service, therefore our testers deliver the best possible service using a client-centered approach to testing and feedback, setting an industry standard for pace and quality of reports. 

Special Considerations
Testing in wilderness treatment programs requires special considerations for testing and analysis. Because the setting is not standardized, getting good testing results to make valid recommendations comes from a combination of factors including creating a good rapport with the student, and establishing best possible test setting with the least possible distractions.  

Additional Information:

Speaking at a national conference in 2011, Dr. Gandhi said this:  

"Psychological assessment is an opportunity to gather information from all sources [therapists, parents, student] and combine these histories with objective test data to create a complete understanding of the client. The feedback session becomes an intervention to help families and clients create the understanding and impetus to see therapy through, and find success. The report becomes a living document that guides treatment planning long into the future. When recommendations are specific to the client, this facilitates effective and efficient therapy and creates a road map to potentially the best possible outcome in the shortest possible time.

"There are also limitations that come with psychological testing. Diagnosis can sometimes be a drawback for clients because it allows them to then create excuses, or a crutch. Testing that is not performed well or with the proper expertise, severely limits further testing efforts because it can be expensive, and happens during the crucial moments of decision making. Also, testing that does not take biases into account, such as culture, race, language, family, and neurodevelopmental issues, may make incorrect assumptions and recommendations. 

"Additionally, not all students should simply have a standard psychological assessment. While a standard psych assessment is valuable for psychiatric diagnoses such as depression and anxiety and thought disorders, it has limited value for neurologic diagnoses including ADHD, autism disorders, seizure or concussion. A standard psych assessment can diagnose ADHD or Autism-spectrum by observation of symptoms, however, it cannot give conclusions about the "why" of a disorder, meaning what is really causing the ... problem. As an example, there are many etiologies that create attention problems but calling all of them ADHD based upon behaviors with a single approach to recommendations is unhelpful to clients and treatment. Simple diagnosis will not be nearly as effective as defining specific strengths and weaknesses and creating a custom treatment plan. This would be the same with other complicated disorders such as: dyslexia, asperger's, NLD, etc. Being a developmental neuropsychologist, I have seen that it is often these undiagnosed issues that cause internalization (depression and anxiety) or externalization (ODD, drugs) because a client never understands how these issues contribute to their failures. I believe neuropsychological testing has the potential for creating a more effective and efficient treatment plan, which leads to better outcomes."  
    - National IECA Conference, Dallas, TX, 2011

If you are a parent or a consultant and need assistance in setting up testing for your student, anywhere in the country, please contact us.

 

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NATSAP Psychologists

  • Parth Gandhi, Ph.D.
       Neuropsychologist
        Independent Consultant to Programs 

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