When I was first starting my career in psychology, I was certain I would be a therapist. I jumped into graduate school hopeful that I would change the lives of people with empathy and experience. As a therapy intern I worked in a multitude of settings, but most often worked with children and adolescents. I listened, advised, and practiced my craft for thousands of hours (literally), but at my core was a sense of frustration. For many of my clients, change was slow coming and unsatisfying. Therapy sessions were a chore and squeezed between sports, homework and all the business of family life. Therapy with teens was sometimes, although beneficial, not fast enough when the clock seemed to be ticking towards launching an adult. I wanted to discover a tool that could potentially fast forward some of the therapeutic process and more rapidly get to the heart of issues, needs, and concerns. For me, that tool is assessment.
One of the many things I tell parents in our first session is that I am not a sales person and would never needlessly expose a teen to unnecessary experiences during therapy. We want our kids to trust mental health care and seek help with confidence in the future, not shy away from assistance because they have been poked and prodded too much. An assessment recommendation from a therapist can leave a parent asking many questions such as “why do we need this?” and “what do we get from an assessment?” That said, explaining assessment is very challenging.
Assessment is a general term that can mean lots of different things, and is used in many applications from school readiness to the legal system. There are several major areas of assessment that compliment each other to respond to specific concerns. The most common areas of assessment are cognitive, achievement, and clinical.
Cognitive testing explores an individual’s processing in all four major areas of intellectual functioning: verbal, perceptual, working memory, and processing speed. The verbal domain measures abilities both using and receiving language. The verbal sub-tests examine using words to express knowledge and convey meaning and understanding language being collected from different sources from social conversation to teacher communication. The perceptual domain examines how an individual solves problems or performs tasks without the use of language. Abstract thought, visual-spatial organization, and pattern recognition are good examples of perceptual tasks. Working memory is a different category of memory, one that can greatly impact interpersonal and academic success. Working memory, simply put, is the brain’s ability to take in information and hold onto it long enough to have a response or output. For example, when a teacher asks a question to the class a student has to remember the question, apply meaning to it, decide if they know the answer, and respond accordingly. Those are automatic functions that working memory greatly impacts. Processing speed is a measure of how fast an individual processes information. I frequently tell students that my laptop has a speed at which it operates, and the brain is much the same way. The processing speed domain explores the rate or pace at which a person moves through or makes sense of information. In a typical brain the expectation is that these four domains will interact with each other in a fairly close manner, much like parts of an engine work with each other. If the four domains are spread out from each other or one domain is much higher/lower than the others a processing disorder may be at play.
Achievement testing is an in-depth examination of academic skill. Achievement tests are standardized measures that determine a student’s age and/or grade level, as well as percentile ranking, in numerous subjects. A very basic achievement test will screen for challenges in foundational areas such as math and reading. A detailed achievement test will expand several subjects into their component parts to determine exactly where there are difficulties in learning. In theory the scores obtained from a cognitive battery, described above, should predict how a student performs. By reporting on areas that fall outside of that prediction, specific recommendations and adjustments can be made to a student’s learning plan.
Clinical assessment is useful to quantify known emotional symptoms, pinpoint specifics about diagnosis, or discover potential root causes for social or academic issues. Many adolescents who have been labeled as “hyper” or “irritable” could be genuinely suffering from anxiety or depression. Knowing how an adolescent experiences mental health related symptoms might shift treatment decisions or generate important areas to be covered in therapy.
When an adolescent participates in an assessment, the resulting information may help gain clarity of diagnoses, improve communication both in the home and in therapy, and help teachers customize their approach. An assessment often gives teens a less threatening platform to open up. Many adolescents find the short term relationship of evaluation more freeing than having to disclose their vulnerabilities in person to a therapist they will continue to work with. In that same vein, many teens will reveal concerns or fears during assessment in an effort to inform their parents “indirectly” about their lives. While brief, the process of assessment can be intensely rewarding, providing kids and parents the kind of language and “ah ha” feeling to communicate with each other that may have been missing before.
Types of issues or concerns commonly addressed by adolescent assessment are:
• Learning disabilities and styles
• Cognitive processing challenges
• Social functioning difficulties
• Emotional struggles, such as anxiety and depression
• Behavioral issues and defiance
• Previously undiagnosed giftedness
• Updating school accommodations
I have nothing but respect for artistic and skilled therapists. I am thrilled that I embraced a career path that resonated so passionately with me that it is my full time practice. I frequently joke, as many parents do, that our kids did not come with instruction manuals. For me, assessment is as close as I can get in my profession to helping families fill in the blanks and work productively together.
JOIN THE DISCUSSION
Has your teen ever participated in a form of assessment? How did it improve their situation, from a therapy perspective or otherwise?
Do you think assessment would be a worthwhile activity for your teen?
Share your thoughts in the comments section below.
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LOS GATOS TEEN THERAPY CAN HELP!
Would you like additional guidance in this area? Los Gatos Teen Therapy provides individual teen therapy, family therapy, group therapy, parent support counseling, and in-home teen and family coaching 7 days a week, including afternoons, evenings, and weekends. For more information, contact us at 408.389.3538.