Psychological Testing And Evaluation: What Can Psychological Tests Tell Me?

Modern psychological assessments use evidence-based procedures to evaluate, diagnose, and recommend treatment for different mental health disorders. The evaluation process is similar to the one medical providers use to diagnose physical health conditions. Both approaches rely on evidence-based decision-making, careful selection of diagnostic tools, and expert analysis of all data collected to reach a conclusion. Like a medical exam, a psychological examination doesn't always end in a diagnosis, but you'll likely know more about yourself and the mental wellness tools you have at your disposal. Keep reading to learn more about psychological testing, including when a test might be recommended and how it could be useful to your mental health and overall well-being.

Who conducts psychological testing and evaluation for mental well-being?

Psychological testing and evaluations are usually performed by a clinical psychologist, a mental health professional with advanced training in the tests used for an assessment. However, there are other professionals who can also assess, diagnose, and treat mental conditions.

Psychologists and psychological assessment

Psychologists hold doctoral degrees in psychology, counseling, or education. They have advanced training in psychometric testing and psychological test instruments. They are qualified to administer and interpret the most comprehensive and advanced assessment instruments, such as cognitive assessments or neuropsychological batteries. Psychologists are also qualified to perform psychotherapy and receive thousands of hours of supervised practice before evaluating and treating clients independently.

Psychologists often receive training in advanced or highly structured therapies, like dialectical behavior therapy. Compared to other professionals who provide psychotherapy, like counselors and therapists, psychologists typically receive significantly more training in assessing and diagnosing mental health concerns.

Unlike psychiatrists— their medical counterparts— psychologists do not typically prescribe medication. However, they often work as part of multi-disciplinary teams alongside physicians, nurse practitioners, counselors, and social workers. Usually, the psychologist is responsible for evaluating the patient and presenting assessment findings to the team, who works together to develop a treatment plan.

While psychological evaluations most often occur in clinical settings to treat an illness or reduce symptom severity, evaluations also happen in other settings.

Psychological testing: Forensic psychological evaluations

For example, forensic evaluations are psychological assessments undertaken to answer a legal question, such as whether a person is competent enough to stand trial. No matter the evaluation's setting, the psychologist still uses similar diagnostic tools and procedures.

Counselors, therapists, and social workers can provide mental health tests

Typically, the terms "counselor" and "therapist" refer to masters-level practitioners of psychotherapy. They may have titles like Licensed Professional Counselor, Licensed Marriage and Family Therapist, or Nationally Certified Counselor. Licensed Clinical Social Workers are also in that category. Becoming a masters-level practitioner requires a master's degree, passing a national comprehensive exam, and thousands of hours of supervised training.

They are qualified to evaluate and diagnose issues related to mental well-being, but they do not have the same specialized training in psychometric tests as psychologists. Some counselors and therapists seek additional training and utilize psychological testing in their practice. Others work in tandem with a psychologist, with the psychologist providing testing data and the therapist directing treatment based on the psychologist's report.

Counselors, therapists, and social workers will often perform some type of testing, but they may not be qualified or comfortable using advanced test instruments. Those who have received advanced training beyond what is typically offered in a master's degree may incorporate advanced testing into their practice.

How does the psychological assessment and test process work?

Psychological testing and assessment follow a similar process to a medical examination. Both are data-driven processes that rely on patient history, objective tests, and a thorough examination. While assessments are unique and all follow a slightly different path, typical evaluations tend to follow this structure:

1. Relevant History and Interviews
2. Psychometric Testing and Interpretation
3. Analysis of Observation Data
4. Determining a Diagnosis

Starting the psychological evaluation: Psychological history and interviews

At the start of the evaluation, most clinicians will ask you why you are seeking an evaluation and what concerns you have about your overall well-being. The clinician will also ask about your psychological, medical, social, and educational/work history. When the clinician understands why you are getting evaluated and your relevant history, the clinical interview usually begins.

Clinical interviews are tools for gathering information about a client's thoughts, feelings, and behaviors related to a mental health concern. They have three levels of structure: unstructured, semi-structured, and fully structured.

An unstructured interview allows the client free expression; they guide the process and can talk about whatever they like. The clinician provides a nonjudgmental environment for the client and notes trends or themes that appear as they speak. A semi-structured interview allows the client opportunities for free expression, but the clinician will eventually direct the client back to specific topics for discussion. A structured interview is a highly managed process with little room for free expression or questions other than what the interview protocol dictates.

Structured and semi-structured interviews are often designed to align with the Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnostic categories. The DSM is published by the American Psychiatric Association and contains comprehensive information about most mental health conditions. It is the authoritative guide to diagnosing mental health disorders in the United States and much of the rest of the world.

Gathering data: Psychological testing, assessment, and interpretation

After the clinician interviews you and anyone else who may have helpful information to offer, they use the information learned in the interview to select test instruments that target your areas of concern. There are hundreds of psychological instruments to choose from, but a few common categories of formal tests are listed below:

Aptitude assessments

A clinician may ask you to undergo aptitude testing to find out information about your future potential or what skills you will likely acquire. The SAT and ACT are common examples of aptitude tests that many people take outside of a clinical setting. Both tests attempt to measure how well a student will perform in college. 

Cognitive testing

Cognitive assessments, formerly known as intelligence tests, are common in formal evaluations. Cognitive assessments measure "brain-based" abilities like critical thinking, visual-spatial reasoning, knowledge retention, and processing speed. Cognitive assessments and similar psychological tests are typically norm-referenced tests, meaning that the test is "normed" to a test population before being used in clinical settings. The norming process allows clinicians to determine what scores the average person would achieve and compare their clients' scores to the "norm."

Achievement tests

Achievement tests are commonly used in psychoeducational evaluations. They measure how much a person knows about certain subjects or domains and are frequently used to assess how much information they have retained from their schooling. Achievement tests are also norm-referenced and can be used to compare a person's level of academic achievement to others of the same age.

Personality evaluation

Personality tests are used to gain insight into how a client thinks, feels, and behaves. Assessing personality can help a clinician understand how a client's attitude, outlook, self-perception, and perception of others impact their daily life. The utility and validity of personality assessments is debated frequently, but many clinicians find them useful for providing context and learning how their client views themselves.

Gathering data: Observations

During the evaluation process, the clinician will observe your demeanor, nonverbal cues, and responses to certain situations. Observations are informal tests; they allow the clinician to see how your behavior manifests in certain contexts. The observation components of an evaluation are similar to the physical exam in medical evaluations.  

Testing the limits

A clinician may also "test the limits" by asking you to complete certain tasks that are not typical in most evaluations and observing how you respond. If others are involved in your evaluation, the clinician will also observe your interactions with them.

Determining a diagnosis through psychological testing and evaluation

After your clinician has completed every assessment they consider necessary, including interviews, observations, psychometric testing, and other testing measures, they will synthesize the information from the evaluation and compare it to the diagnostic categories of the DSM to determine an accurate diagnosis. If you meet the criteria, they will share with you the diagnosis and discuss their impressions. You may also begin work on a treatment plan. Even if you don't meet the requirements for a diagnosis, the clinician will still share your assessment results and help you figure out the next steps for managing your symptoms.

A psychologist can improve your mental health in online therapy

Online therapy allows you to access a psychologist or therapist without having to leave your home. You can share your concerns with them and get help initiating an evaluation. Teletherapy-based solutions are increasingly common, and you may be able to complete all or part of your evaluation online. Online clinicians have the same training, credentials, and licensure as traditional clinicians and use the same evidence-based tools. With an online therapy platform like BetterHelp, you can get matched with a therapist who meets your needs and preferences. This means that if you have concerns in a specific area, such as parenting, anxiety, or trauma, you can connect with a provider who has experience and training in managing those concerns. This can alleviate any stress you might feel searching for the right therapist yourself, which may also be limited by where you live.

The efficacy of online therapy with a psychologist

If you have a concern related to your mental well-being, talking to an online therapist could help. You may not need a complete evaluation to start improving your symptoms. Online therapy has been extensively studied in recent years, and evidence indicates it is just as effective as seeing a therapist in person. One study found that therapy delivered via videoconferencing and phone calls was effective in treating depression, anxiety, and adjustment disorder. Researchers concluded that teletherapy could “potentially overcome barriers and increase access to psychological interventions.”