Understanding psychological testing and assessment

If you or a family member has been referred for psychological testing, you probably have some questions about what to expect. Or you may have heard about psychological testing and wonder if you or a family member should be tested. Psychological testing may sound intimidating, but it's designed to help you.

In many ways, psychological testing and assessment are similar to medical tests. If a patient has physical symptoms, a primary care provider may order X-rays or blood tests to understand what's causing those symptoms. The results of the tests will help inform develop a treatment plan.

Psychological evaluations serve the same purpose. Psychologists use tests and other assessment tools to measure and observe a client's behavior to arrive at a diagnosis and guide treatment.

Psychologists administer tests and assessments for a wide variety of reasons. Children who are experiencing difficulty in school, for example, may undergo aptitude testing or tests for learning disabilities. Tests for skills such as dexterity, reaction time and memory can help a neuropsychologist diagnose conditions such as brain injuries or dementia.

If a person is having problems at work or school, or in personal relationships, tests can help a psychologist understand whether he or she might have issues with anger management or interpersonal skills, or certain personality traits that contribute to the problem. Other tests evaluate whether clients are experiencing emotional disorders such as anxiety or depression.

The underlying cause of a person's problems isn't always clear. For example, if a child is having trouble in school, does he or she have a reading problem such as dyslexia? An attention problem such as attention-deficit hyperactivity disorder (ADHD)? Difficulty with impulse control? Psychological tests and assessments allow a psychologist to understand the nature of the problem, and to figure out the best way to go about addressing it.

Tests and Assessments

Tests and assessments are two separate but related components of a psychological evaluation. Psychologists use both types of tools to help them arrive at a diagnosis and a treatment plan.

Testing involves the use of formal tests such as questionnaires or checklists. These are often described as “norm-referenced” tests. That simply means the tests have been standardized so that test-takers are evaluated in a similar way, no matter where they live or who administers the test. A norm-referenced test of a child's reading abilities, for example, may rank that child's ability compared to other children of similar age or grade level. Norm-referenced tests have been developed and evaluated by researchers and proven to be effective for measuring a particular trait or disorder.

A psychological assessment can include numerous components such as norm-referenced psychological tests, informal tests and surveys, interview information, school or medical records, medical evaluation and observational data. A psychologist determines what information to use based on the specific questions being asked. For example, assessments can be used to determine if a person has a learning disorder, is competent to stand trial or has a traumatic brain injury. They can also be used to determine if a person would be a good manager or how well they may work with a team.

One common assessment technique, for instance, is a clinical interview. When a psychologist speaks to a client about his or her concerns and history, they're able to observe how the client thinks, reasons and interacts with others. Assessments may also include interviewing other people who are close to the client, such as teachers, coworkers or family members. (Such interviews, however, would only be performed with written consent from the client.)

Together, testing and assessment allows a psychologist to see the full picture of a person's strengths and limitations.

Seeing a Psychologist

Psychological tests are not one-size-fits-all. Psychologists pick and choose a specific set of assessments and tests for each individual client. And not just anyone can perform a psychological evaluation. Licensed clinical psychologists are expertly trained to administer assessments and tests and interpret the results.

In many cases, psychologists who administer tests will then treat patients with psychotherapy. Some psychologists focus only on evaluating patients, and then refer them to other specialists for treatment after they've made a diagnosis. In either case, the testing and assessment process will help ensure that the client receives treatment that's tailored to his or her individual needs.

What to Expect

Psychological testing isn't like taking a multiple-choice exam that you either pass or fail. Rather, psychologists use information from the various tests and assessments to reach a specific diagnosis and develop a treatment plan.

Some people are tempted to peek at the tests ahead of time. If they suspect they may have a particular problem, they may look online for a practice test of that problem. That's a bad idea, experts say. In fact, practicing ahead of time usually backfires — when you try to take the test in a certain way, the answers may be inconsistent and make you appear to have more problems than you actually do.

Remember, psychological testing and assessment is nothing to fear. It's not something you need to study for. Rather, it's an opportunity for psychologists to determine the best way to help you.


Thanks to Michelle F. Eabon, PhD, and Dan Abrahamson, PhD, for contributing to this article.