What is “Psychological Testing”?

by Dr. Karen McDowell

Psychological testing may sound kind of intimidating, but once you understand what it is and how it can help, you’ll find that it can be quite interesting and useful. If you’re experiencing symptoms like mood swings, memory problems, anxiety, sleep disruption, brain fog, or other signs that you’re not functioning at your best, testing can be a straightforward way to get some answers.

It starts with a question…

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There are lots of different approaches to psychological testing, but they all generally start with what’s known as a “referral question.” When I get a call from a psychiatrist, neurologist, or other professional, they’re usually asking me to answer a specific question – often something like this:

“Does this person have dementia? What kind of memory impairments are present?”
“Is it anxiety or something more severe?”
“What kind of depression are they experiencing?”
“Can you find out if this is bipolar disorder, or something else?”
“I suspect PTSD but need a formal diagnosis”
“Can this person tolerate a major surgery right now?”
“What kind of treatment does this person need?”

Although your medical doctor may recommend testing, you don’t need a medical referral to get testing – you can refer yourself! All you have to do is contact your chosen psychologist and tell them what symptoms you’re experiencing and what question(s) you want answered.

What happens at a testing appointment?

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All testing appointments include a comprehensive interview where you talk directly with the psychologist. This interview will last for about an hour, during which you’ll be asked about your developmental history, education and work history, medical history, mental health history, eating and sleeping habits, current living situation, and all of your questions and concerns.

It is important that the interview be thorough and that you are as honest as possible. Psychological testing has a lot to do with your specific situation and circumstances, so this information is a critical part of good assessment.

After the interview, the psychologist will administer what’s known as a “battery” of tests. Good psychological testing does not rely on just one test – instead, psychologists use a combination of tests to try to get a good picture of what’s going on from a variety of perspectives. Think of it like a net – we want to cast a wide enough net to cover all the potential issues, and see what comes up as a result. The testing battery refers to the specific tests your psychologist chooses to use for your situation – and there are thousands of reliable tests to choose from.

Much of the testing can be done via telehealth, but there are some components that may require in-person visits. Sometimes those in-person encounters can be done via telehealth if there is someone in your environment who can assist with the process.

Types of tests.

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Subjective tests
You will probably be asked to fill out some questionnaires asking you to describe symptoms, respond to prompts, or select preferred answers. These types of tests help us understand how you are functioning from your own point of view. For example, you might be asked to fill out a depression or anxiety inventory, or answer questions about your executive functioning. Sometimes, family members or other people are asked to fill out subjective inventories to get their perspective on what’s happening.

Objective tests
Depending on what question(s) your psychologist is trying to answer, they may choose some objective tests as well. These are performance-based tests that can measure tons of different things. If you’re testing for ADHD or learning disorders, your psychologist will want to know how you perform on working memory, processing speed, visual-spatial reasoning, verbal reasoning, and other cognitive tasks, as well as skills such as math and reading. If you are concerned about memory loss or dementia, objective tests can measure more in-depth performance on short- and long-term memory tasks, visual working memory, auditory memory, complex processing, planning, problem solving, and other executive functioning skills. These are just a few examples – there are thousands of objective tests for a variety of needs.

Projective tests
Sometimes, your psychologist will want to assess some things that can’t really be measured subjectively or objectively, because they are so unique to you. Examples of projective tests are personality assessments, interpreting a series of pictures, or the infamous Rorschach inkblot test. These types of tests are really interesting and do an amazing job at digging below the surface to figure out what’s going on. When these tests are used, they are typically combined with the comprehensive interview as well as subjective and objective tests, so that your psychologist gets an in-depth picture of how you are functioning.

After you’ve done the testing.

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Once you have completed the testing battery, your psychologist will need a little bit of time to put together all the pieces of the puzzle. They will review all your tests results in the framework of your life and your concerns, and they will identify any possible problem areas that may need attention. The psychologist will prepare a report that includes the information you provided, the results of all the tests they administered, and the conclusions they drew from that information. Then, the report ends with recommendations for next steps.

A week or two after your testing session(s), you’ll meet with your psychologist again for a “feedback session,” where they will go over all the test results with you, tell you any diagnoses they made, and then discuss the recommendations. You’ll have the chance to ask questions about the results and the recommendations during that meeting, and you can let them know if you need additional documentation.

Who gets to know the results?

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This is a common question – “will these results “follow” me around afterwards?” Just like with any other medical appointments, your information is protected by law and cannot be shared with anyone without your specific consent. Here are a few exceptions to that rule:

  • If you use insurance to pay for testing, the insurance company does have a right to request a copy of the test results and reports, and may keep those on file.
  • If you are a minor, your legal guardian has a right to access your records.
  • If a judge or the state licensing board orders that records be disclosed, the psychologist must comply.
  • If, during the course of testing, you disclose intent to harm yourself or others, your psychologist may be legally obligated to notify certain people.

When you meet with your psychologist, they will go over the privacy laws in your state to make sure you understand, and that you consent to the evaluation.

You may want your psychologist to provide the test results to your medical doctor or psychiatrist to help inform how they care for you. If so, be sure to let your psychologist know and provide a signed release. You may want to provide your school, workplace, or other organization with documentation of your diagnoses to ensure you can get appropriate accommodations or support. If that is the case, your psychologist can provide documentation of diagnoses without disclosing your entire testing process.

What if I don’t agree with the results?

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Psychological testing is both an art and a science, and you may find that you disagree with the results of an assessment. It is important to talk to your psychologist about why you disagree during the feedback session, so they have a chance to address your questions and clarify anything you don’t understand. If you continue to feel the results were inaccurate, getting a second opinion is absolutely an option – another psychologist can do a similar evaluation and compare results with you.

Culture and background have a lot to do with getting accurate test results, so psychologists are required to undergo training in multiculturalism and assessment issues within various populations. When selecting a psychologist to use for your assessment questions, be sure you are working with someone who has knowledge of and competence in any social or cultural identities you may live in.