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To Test or Not To Test…

By Dr. Dathan Paterno

Many times, people are asked about whether they or their child should be tested; sometimes it is referred to as “undergoing psychological evaluation” or some other similar phrase. Other times, a therapist will suggest that their client be tested (aka, evaluated). Quite often, this elicits a strong anxiety response, partly because many people don’t understand what psychological testing is for—and, conversely, what it is not for.

I evaluate children, adolescents, and adults for a number of reasons. Here are a few common examples:

  1. To understand someone’s strengths and weaknesses—what he/she is good at and not so good at—and comprehend how these might be getting in the way of some area of functioning, like relationships, work, or academics. Usually this involves guiding the treatment modalities that might be most helpful for an individual.
  2. To determine whether someone meets the criteria for a disorder so that that person can receive appropriate, individualized accommodations at work or at school. A good example is discovering whether someone struggles with a learning disorder or ADHD.
  3. On rare occasion, someone will ask me to determine whether they fit the criteria for a certain mental disorder, such as Bipolar Disorder, Attachment Disorder, or something else. Sometimes, this can be helpful in normalizing or validating a person’s experience and suffering.

As the reader can see, psychological testing answers questions. It is a bit like an x-ray: “Does the patient have a broken bone and where?” This helps the attending physician guide treatment. If there is no question to be answered, then psychological testing makes no sense.

Psychological testing can be quite complex. It involves gathering data from as many sources as possible, building hypotheses, then critically examining which hypotheses make the most sense and which are not supported by data.

Many psychologists focus their work on finding the “right” diagnosis. I do not. Because I am highly skeptical of the diagnostic manual (the DSM-5) and the validity of many of the current diagnostic categories, finding the right label for people is meaningless, except when that label helps someone secure services and help that otherwise would not be available to them.

Here are some other things that psychological testing is not:

  • Hunting for a diagnosis. I don’t care what label someone fits. The exercise of categorizing people is out of control in our culture and it is hurtful more often than helpful. People aren’t labels; they are humans who suffer. I want to understand a person’s suffering to help them, period.
  • Getting someone a “crutch” so they can get out of work (or school work). That is not the purpose of learning disability or ADHD evaluations.
  • Minimizing someone’s suffering by labeling it. People aren’t “depression” or “Bipolar”; to determine which category into which a person’s suffering falls can sometimes be helpful, but it must be balanced with the possibility of stigma and self-defeating behaviors and hopelessness, all of which are quite possible with a mental health diagnosis. This is why I avoid labels except when necessary and when the client can benefit from it and desires it.

If you are considering psychological testing and/or your therapist suggests it, feel free to ask your therapist questions about the purpose of testing and the confidentiality of the process/results. Alternatively, you may e-mail me with questions and concerns about whether you or your child would benefit from psychological testing.