Common Misconceptions About Psychological Testing and Assessment

Almost every week in my practice, someone sits across from me and asks some version of the same question: “But what exactly will this test tell you about me?” Usually the question carries a little apprehension, as though the assessment were a scan that might expose something hidden, or a verdict that will decide who they are.

It is neither. Psychological assessments provide a methodical, organized, and systematic approach toward better understanding how an individual perceives things cognitively, emotionally, learning and remembering behaviors, social interactions, and mechanisms for dealing with stress; and how those patterns relate to why they came in. However, due to misinformation garnered through movies, online surveys, and word-of-mouth experiences regarding the nature of tests, many misunderstandings exist regarding testing, and subsequently affect an individual's perception of the process prior to entering the testing area. The three most common are:

Misconception 1: Anyone can conduct a psychological assessment

I believe that this misconception has the highest risk of causing the most damage because of its far-reaching impact.

In India, all psychological assessments are given, scored, and interpreted by Clinical Psychologists, registered with the Rehabilitation Council of India (RCI). Licensing requirements do not restrict entry into the field solely for the purpose of controlling access. Developing competence in administering and interpreting psychological assessments takes years of supervision of test administration and scoring of results, as well as adequate experience working with enough patients to enable a competent psychologist to apply scores to a living patient instead of merely using a handbook. Test materials are also protected so that respondents will not recognize previously administered questions.

Practically speaking, this translates into an intelligence test being simply an intelligence assessment given on-line by a coach or counselor who is not RCI-registered with no training in assessment procedures; and an inventory given to clients and scored by an unlicensed practitioner is not a personality assessment. While coaches, counselors and wellness professionals without clinical registration can certainly be very knowledgeable and skilled in other areas (and possibly even very well-intentioned) they lack the knowledge base to develop a valid report. Reports result in actual decisions including making academic adjustments; determining whether certain medications should be prescribed; and starting the educational process of parents or guardians about their children. The qualifications required to administer/interpret reports are necessary because the results of reports can have significant consequences.

Misconception 2: Assessment involves scanning the brain

Individuals often come to sessions thinking that there will be some kind of equipment that scans their brains. They expect electrodes; a screen; some sort of device that measures neural activity and provides them with a diagnosis.

The truth is much less dramatic — and to my mind significantly more fascinating. The vast majority of psychological assessment is done via paper/pencil instruments, face-to-face interviews, and includes a series of tasks embedded within the interview. In addition, there are several major categories of testing tools:

• Personality assessments: Structured self-report inventories that ask a person to rate statements about himself/herself, typically assessing traits, coping style(s), and typical relational patterns.

• Projective instruments: Ambiguous stimulus materials (e.g., ink blots, pictures) that allow for access to aspects of the individual that direct questioning would likely fail to obtain.

• Intelligence assessments: Standardized tasks that measure reasoning, comprehension, working memory, and processing speed — interpreted as a pattern of relative strengths and weaknesses rather than as a single number.

• Neuropsychological assessments: Batteries of standardized tests examining attention, memory, executive functioning, language, and visuospatial skills — used when there is suspicion or evidence of brain dysfunction following trauma/injury/illness or in cases involving developmental disorders/neurodevelopmental disorders.

Misconception 3: “I don’t need an assessment — I already know what the problem is”

This misconception makes sense as it stems from a logical assumption. We generally do know ourselves. However, knowing you have difficulty focusing (or) that you've felt flat since your car crash is quite different from knowing why.

The symptomatology for inattentiveness can be attributed to several causes. In addition to being indicative of Attention Deficit Hyperactivity Disorder (ADHD), inattentive behavior can also indicate symptoms of Depression, Anxiety, Trauma, Sleep Disorders, Unrecognized Learning Disability(s), or simply that no structure was available to help you manage the demands of daily living. Similar examples exist for low mood. In addition to possible indications of Depression, flattening associated with a Head Injury or Exhaustion associated with the failure of a relationship can occur. Therefore each requires a different type of intervention.

When a professional treats the incorrect formulation of a problem they waste their client's Time, Money and Hope -- and frequently lead them to conclude that Treatment doesn't work.

An assessment provides the differential answer.

In addition, an assessment will identify preserved strength(s).

Therefore, when a report indicates what is impeded, what exists, and how the existing strength(s) can be utilized to address the impediment, this is much more valuable than a diagnostic label.

Misconception 4: Test results are always accurate

While there are very few tests that are completely fallible, anyone who states that tests provide 100% accuracy is providing a gross overstatement. Performance on tests can be influenced by fatigue, anxiety caused by taking the test, motivation to perform well on the test, language proficiency, level of education achieved prior to the test, and cultural background.

In addition, while some of the most commonly administered assessments were standardized on Western Populations (and therefore require cultural judgment for meaningful interpretation) none of the most commonly administered assessments can be interpreted mechanically based solely upon scores.

Therefore, an assessment is never merely an administration of a test. Findings are triangulated using multiple assessment tools, Clinical Interview, Developmental/Medical History, Collateral Information from Family/School/Workplace. A Score represents Data Points -- the Formulation represents the Clinical Product.

Misconception 5: A person can outsmart the test

All professionally developed inventory measures incorporate Validity Scales. Items included in these scales are specifically designed to measure inconsistent responses, Exaggerated Symptoms and Impression Management. Most attempts at presenting oneself as significantly better/worse than one actually is will result in elevated values on these scales.

Additionally, there is little advantage to attempting to deceive during testing. A distorted Profile generates a Treatment Plan based on inaccurate assumptions regarding the individual receiving the assessment. This is detrimental to the individual assessed.

Misconception 6: Assessment is only for serious mental illness

Assessment happens throughout life and in different places: for a child who is having trouble reading, for a teenager whose behavior has changed, for adults who are seeking clarity about late diagnosis of ADHD or autism, for older people worried about memory, or couples stuck in repeating cycles. Applications range from schools to organizations, rehabilitation and legal medical contexts.

Seeking clarity is not itself a diagnosis; it is reasonable when you don't really understand something about yourself. Psychological assessment is not a test you pass or fail and it is not a machine that reads your mind. It is careful and qualified effort to answer a question that is important to you.

Ask for it from someone who is trained to give it.