Project Management Columbia Psych Evals
Like a curious detective, I had to flex my investigative muscles while conducting psychological evaluations throughout grad school. Interviewing relevant parties, administering tests, accumulating observational data, and proposing recommendations based on formulated themes became practiced skills. Knowing when to dive into the details was essential in producing the correct outcome while balancing the interests of many. Here’s a quick look at the process.
Problem
How does someone know if they have a mental health disorder? Most of the time, things aren’t black and white and symptoms exist on a spectrum. Just because someone doesn’t meet criteria for depression, for example, doesn’t mean that they aren’t experiencing impairment and that we can’t help. Further confounding the mystery is the presence of perks like insurance benefits and academic accommodations that are dependent on a formal diagnosis. The challenge of psychological evaluations, then, is to properly build a case through the collection and organization of evidence and help reduce the effects of presenting problems regardless of whether or not a diagnosis is made.
Primary Methods
Project Management
As a lead examiner assigned to specific cases in a clinical training setting, I had to balance the needs and feedback of many in a cross-functional setting. Here are some hats that I wore throughout the process:
Client Success: Scheduling sessions, writing notes, answering questions or concerns, and providing feedback of findings.
Research: Interviewing, observing in session and in the field, administering surveys or psychological test measures, and report writing.
Liaison: Contacting and exploring viewpoints of third-parties. Ensuring a neutral outcome amidst potentially differing interests.
Consultation: Incorporating feedback from clinical supervisors and communicating negotiated changes to clients when modifications occurred.
Interviews
Conducted structured and semi-structured intake interviews with referrals to document and understand their demographics, presenting problems, as well as risk and protective factors.
Conducted interviews with relevant third parties, including medical professionals, teachers, school administrators, and family members.
Survey & Test Administration
Administrated and scored psychological assessment measures and surveys to produce the psychometric data needed to determine eligibility for a formal diagnosis. Examples below!
Observation
Tracked and coded behavioral observation data during testing sessions. Documenting fidgeting behavior, for example, was critical in ADHD cases.
Conducted detailed observations of clients in their natural school or work settings.
Storytelling
How does it come together? Once all the data was gathered, I sorted through the qualitative and quantitative evidence in order explain my results. Identifying themes and completing a case formulation were essential steps in constructing a narrative before seeing if a diagnosis was appropriate.
Sample of Test Measures & Surveys Utilized
Achenbach Semi Structured Clinical Interview for Children & Adolescents (SCICA)
Behavior Assessment System for Children, 3rd Edition (BASC-3)
Beck Depression Inventory (BDI)
Conners-3 ADHD Rating Form (CAARS)
Behavior Rating Inventory of Executive Functioning (BRIEF-2)
Wechsler Adult Intelligence Scale, 4th Edition (WAIS-4)
Woodcock Johnson Tests of Cognitive Abilities, 4th Edition (WJ COG-4)
Minnesota Multiphasic Personality Inventory, 2nd Edition (MMPI-2)
Personality Assessment Inventory (PAI)
Delis-Kaplan Executive Function System (DKEFS)
Beery-Buktenica Developmental Test of Visual Motor Integration, 6th Edition (Beery VMI-6)
Thematic Apperception Test (TAT)
Check out my sample report on a traumatic brain injury case with full findings and recommendations!
Grids with DSM-V criteria vs. collected evidence were useful tools in determining if a diagnosis was appropriate.
Impact + Lessons
Across two clinical rotations in New York City, I completed 4 integrated psychological evaluations with the following results:
Case 1: Criteria for Attention-Deficit / Hyperactivity Disorder not met and no diagnosis was given. Focal seizure symptoms were identified and the client was referred to a specialist.
Case 2: Criteria for Attention-Deficit / Hyperactivity Disorder: Combined Type met and a diagnosis was given. Stressor symptoms related to a domestic dispute were identified and the client was diagnosed with Adjustment Disorder w/ Mixed Disturbance of Emotions and Conduct.
Case 3: Criteria for Attention-Deficit / Hyperactivity Disorder: Predominately Hyperactive/Impulsive Presentation met and a diagnosis was given.
Case 4: Criteria for Attention-Deficit / Hyperactivity Disorder not met and no diagnosis was given.
Between reviewing interview scripts, scoring psychometric test results, combing through observations, and double checking documents, being able to see the forest from the trees was a major challenge. However, as I gained more experience, it also became easier to identify themes and understand where to allocate my evidence. Most importantly, conducting evaluations gave me a chance to practice condensing details from multiple sources and translating them into organized and cohesive narratives – project management and story telling skills that should come in handy in the future.
Resources
For more on my interviewing style, please check out my psych Blog!