With most treatment modalities (i.e., CBT, DBT, etc.), there is an established protocol. However, with psychotherapy/counselling, it is important for the therapist to decide where a client should focus their attention in order to achieve their goal. At times, a therapist might decide that a new treatment modality needs to be introduced if a client is struggling to overcome a difficult issue on the path to achieving their therapeutic goal. It’s also important that the therapist be aware of which treatment approach the client is most comfortable with or be willing to make alterations to a particular treatment approach if it isn’t effective for the client.

It was mentioned earlier that ineffective patterns of thinking and behaving often contribute to problems or interfere with our ability to find solutions. At this stage of our clinical approach, the therapist will teach the client new skills and teach strategies that will help create effective patterns of thinking and behaving, as well as challenge limiting beliefs that could be interfering with achieving their goal. Effective progress in these areas can help the client to achieve their goal more expediently.

Studies show that evidence-based psychotherapy is highly effective at treating psychological/mental health issues. So, why doesn’t everybody who engages in psychotherapy/counselling achieve the results they want? 

We believe an important factor is that people can struggle to consistently implement strategies they learn in psychotherapy/counselling sessions. When this happens, they can lose confidence in the effectiveness of the strategy and that sense of uncertainty can make it less likely they’ll continue to use the strategy consistently. Therefore, it’s important that the therapist work with the client to help them to weave the strategies they have learned into their daily routine, so they can be utilized consistently.

The client’s role in all aspects of psychotherapy/counselling is crucial. Clients steer the course of psychotherapy/counselling by identifying what issue(s) they want to work on, the order they want to address their mental health issues (when there are multiple challenges), identifying what treatment modalities they are comfortable utilizing, how long or how frequently they wish to engage in treatment, etc. And perhaps most important of all, for psychotherapy/counselling to be effective, it must involve a strong partnership between the client and the therapist. 

Whenever there is an issue that can be measured with a psychometric test, it is important to administer the measure at different points during the therapeutic process. These results provide critical feedback, as it helps the client and therapist to determine if the client’s goal is being achieved and if it is occurring as quickly as anticipated. Based on these results, mid-course corrections might need to be made or things might be going exactly as expected! In that case, as the saying goes, “If it ain’t broke, don’t fix it.”.

Taking measurements at different points also helps to reinforce the “path of progress” approach. Clients can occasionally struggle with “all or nothing” thinking when it comes to achieving goals. With this type of thinking pattern, people can view goals as something they have achieved or haven’t achieved, with no middle ground. However, achieving a goal by 50% or 75% is clearly meaningful and will contribute to the client feeling better. Taking measurements at set times and seeing results will help the client and therapist feel confident that the treatment plan is working and that the ultimate goal can be achieved by continuing to follow the plan.    

For some treatment issues, an effective psychometric measure has yet to be created. In these situations, progress is tracked based on the client’s self-report, as well as the therapist’s observations (i.e., based on client feedback and how the client presents at appointments).

Based on the results of the clinical interview, and possibly a screening measure administered prior to the interview, the Psychologist will define the assessment question, establish a working hypothesis (e.g., query a learning disability, explore a particular psychological issue, etc.) and select the appropriate psychological measures. The results of these measures will help to determine if the hypothesis is correct.

The Psychometrist administers the psychometric measures (i.e., self-report questionnaires, performance-based subtests). Examples of self-report measures could involve questionnaires inquiring about difficulties with mood, anxiety, mental health, etc., while performance-based tests could involve tasks designed to help measure verbal and non-verbal intelligence, memory, academic achievement, etc. 

With psychological (mental health) assessments, self-report measures are typically administered. With more specialized assessments, such as psychoeducational and neuropsychological assessments, autism and ADHD, a combination of self-report questionnaires and performance-based tests are typically administered. The results of these tests will help to determine if the assessment question has been answered or if further measures need to be administered.

Once the original measures have been administered and scored, the assessment question may not be answered fully. For instance, when completing a Psychoeducational (learning) assessment, the original assessment measures may help to confirm the hypothesis that the client has difficulties with all levels of intellectual functioning. However, in this case, an additional measure would need to be administered for adaptive functioning to develop a better sense of the pervasiveness of this issue. 

Psychological reports can be complex, cumbersome and difficult to understand when laden with psychological jargon. During the past 18 years, we have continued to evolve our report writing process with the goal of creating more streamlined reports that utilize simpler language and aim to highlight the client’s strengths whenever possible, as opposed to focusing solely on the client’s areas of deficit.

With psychological (mental health) reports, we strive to keep our reports to 6 – 8 pages on average to help avoid overwhelming the reader and creating a more useful report. With more specialized assessments, such as psychoeducational and neuropsychological assessments, autism and ADHD, the goal is to generally complete reports within 10 – 12 pages. Based on the results of the report, customized treatment recommendations and/or accommodations are made specifically for the client.

A feedback session with the client (or with the client’s parents in the case of children and adolescent clients) is scheduled following the assessment. The Psychologist will review the results of the psychometric measures by outlining what each specific test was designed to measure and how the client responded or performed, in the case of performance-based subtests. The Psychologist will also explain how their observations from the clinical interview corresponded with the scores on the psychometric measures to explain the answer to the assessment question.

The final aspect of the feedback session is highly important, as the Psychologist will review their treatment recommendations and/or accommodations, as well as discuss how these suggestions can be implemented to best help the client.