When an adolescent is struggling it is often difficult to know what are the next best steps to take with the child. Issues are often complex and multi-determined which can add to confusion as to how to proceed. A psychological evaluation is often a good starting point, as a comprehensive assessment typically covers a number of key areas that can inform where the issues are of greatest priority. Diagnostic formulations generated by the evaluation also guide clinicians as to best therapeutic approaches. A good guiding principle to follow with teens of concern is early trumps later. That is, when concerns start to arise research and clinical practice show early assessment and intervention is better than waiting.
There are a number of different aspects to an assessment that are important to consider. While practitioners in the field often focus on the deficit areas of an individual, a good psychological assessment should be a balance between strengths and weaknesses, assets and liabilities. Some questions that a clinician should be considering are what does the cognitive profile tell us about the person’s abilities? Is he/she more comfortable with verbal tasks? Non-verbal? Are there any signs of processing deficits or weakness with working memory? Is the person a good problem-solver or do they become overwhelmed by more complex tasks and shut-down?
Assessment allows the clinician to get a feel for the person being evaluated and their characteristic style. While testing yields quantitative findings and a range of scores are generated, just as important are the qualitative indicators? Was the person thoughtful and considered in their approach to tasks or were they more impulsive? Did anxiety seem to play a role in the way the person performed? Did they become despondent and discouraged when encountering inevitable difficulty? What was the person’s demeanor and sense of personal connection? These and many other similar questions help to pull together a profile of strengths and weaknesses.
Assessment helps to validate concerns that have been raised (e.g., by parent, teacher, therapist) or disconfirm notions. For example, many teachers might suggest that a child has ADHD when in fact, the ADHD is less of an issue and anxiety and processing of information are combing to cause stress and difficulty. Validating parent or professional concerns when it is appropriate to do so serves to get people on the same page working together.
Good assessment can also lead to more targeted interventions. For example, let’s say that a presenting problem suggested anxiety, with possible ADHD variables and learning problems. Assessment allows you to consider different “fronts” to address the issue. The child may need good reading remediation, while also receiving CBT (Cognitive Behavioral Therapy) to address the anxiety. Testing also can assist schools in knowing more about the child and the variety of stressors that could be affecting him/her.
While an assessment often leads to a “diagnosis,” in some ways the label may be one of the least important aspects of the assessment. As has been said, “Labels are for cans.” The same applies to children. Labels are often overused and may not really convey the larger picture of the child, where a good descriptive assessment does.
In summary, a broad-based psychological assessment can be very helpful in determining best nest-steps to take with a child. The earlier the assessment is done, the better as there would be a more focused understanding of the child’s strengths, weaknesses and areas to intervene.