How to Make the Most of a Psych Eval, Part I: Finding the Right Psychologist

A psychodiagnostic or neuropsychological evaluation is an investment of time and money, and if you are seeking a psych eval, you want to make the most of your investment.  In this series, I’ll share some tips for how to do that.

Expect to Share a Lot About Yourself During a Psych Eval

I encourage potential patients (both for therapy and neuropsych testing) to look for a good fit.  During a psych eval, you will be spending essentially an entire day with your psychologist, and telling them a lot of personal information.  A clinical interview includes questions about:

• Social history (family, relationships, partners, marriages, children)

• Medical history

• Any history of abuse

• Mental health symptoms, diagnoses, and treatment

• Drug and alcohol use, past and present

• Problems you are having in your day-to-day life

These interviews can feel very vulnerable, and working with a psychologist who you feel comfortable with makes the process easier.  During testing, it’s even more important to feel at ease, because anxiety can impact your test results!

Don’t Be Afraid to Ask Questions When Seeking a Psych Eval

In addition to feeling comfortable during your psych eval, it’s also important to find a psychologist who is qualified and experienced in the type of evaluation you need.  For example, some psychologists primarily do psych testing for children, others work only with adults.  There are also usually practical things to consider, like cost, location, and timeframe.  Here are some questions you can ask as you seek a psychologist for a psychodiagnostic evaluation:

• Where is your office?  (Some psychologists, like myself, see testing patients at several offices around Los Angeles and Orange County)

• How often do you test patients for (adult ADHD, dementia, autism, traumatic brain injury, capacity, or whatever else you specifically need from testing)?

• How much have you worked with (ADHD, dementia, capacity, TBI, cancer, etc)?

• What is your specialty?

• What do you charge for this type of psych eval?

• Are there ever additional costs beyond this?

• Do you have a wait for psych testing?  If so, how long is the wait?

• How do you accept payment for psychological assessments?

• When can I expect a report after psych testing is complete?

• Do you offer a feedback session after testing?  

These questions can help you learn practical things, but the psychologist’s answers should also give you an idea of their style and how you feel talking to them. 

Green and Red Flags to Keep In Mind When Finding a Psychologist for a Psych Eval

I would love to believe that anyone out there promoting him or herself as a qualified assessment psychologist is being honest.  But, the truth is that becoming competent in psychological assessment takes many years of education, supervised training, and experience, and not all psych evals are the same.  Here are some markers of quality in a psych eval, and some red flags to watch out for.

Green Flags (Signs that Point to a Quality Psych Eval):

• The psychologist is open about his or her experience, training, specialty, and other questions you ask.

• He or she seems knowledgeable about the concern you have

• They are able to explain what to expect from testing and a clear timeframe for receiving a report.

• They include recommendations in their report.

• A feedback session is included as part of testing (this means the psychologist will go over the report and results with you).

Red Flags (Signs that Raise Questions About Quality)

• The provider is not a psychologist.  Only psychologists are trained and licensed to provide psychological and neuropsychological assessments.  No one in mental health with a Master’s Degree (LMFT, LPCC, LCSW), or in another field (nursing, physician, occupational therapy) is qualified to do a comprehensive psychological assessment to diagnose a mental health or neurological disorder.  If they are advertising this way, move on!

• The psychologist is defensive or vague when you ask about their training, education, or specialty area.

• They won’t give you a clear idea of cost.  Sometimes the cost changes because of differences in time required, for example, if there are a lot of school and medical records to be reviewed, or because once testing starts, it becomes clear there is a need for additional tests. But in general, the psychologist should be able to tell you a specific number (e.g., $350 per hour, and about how many hours are expected, OR a flat rate, like $5,000 for the psych eval).  

• They do not offer a feedback session.  This is an essential part of psych testing and gives you both the opportunity to fully understand your results and to ask questions about anything you don’t understand in the report.

Begin Working With A Psychological Evaluator in Los Angeles, CA

Finding the right evaluator can take time, but it is vital in receiving the best support possible. Dr. Reger provides psychological evaluations at several locations in Southern California. You can schedule an appointment by following these steps:

1. Contact (424) 262-1925 to schedule your appointment

2. Meet with a Los Angeles Psychologist for your QME psychological evaluation

3. Get answers that you need to continue with your work comp claim

OTHER COUNSELING SERVICES OFFERED BY Dr. REGER in los angeles, ca

I know you may experience a number of mental health concerns. This is why I’m happy to offer multiple neuropsychological and psychological assessments. Other assessments include cognitive and dementia testing, pre-surgical assessments, and med-legal evaluations. In addition to evaluations, I also provide individual therapy, counseling for older adults, and mental health consultations and presentations.

What to Look For in a Work Comp Psych Evaluator

If you are an attorney or a worker in need of a work-related psychological evaluation, you have two options through the California Division of Workers’ Compensation (DWC).  The first is a panel Qualified Medical Evaluator (QME), and the second is an Agreed Medical Evaluator (AME).  I’ll discuss the differences and similarities, as well as my thoughts on what to look for in a work comp psych evaluator.

Psych Eval for Work Comp in Los Angeles: Qme vs. Ame

All psychologists who conduct workers’ comp psych evaluations in the entire state of California have a few things in common:

• Doctoral level education in psychology (a PhD or PsyD)

• License to practice psychology in California

From there, a QME and an AME can vary quite a bit.  A psych QME:

• Is certified by the state, by passing a test

• Has at least five years of clinical experience after licensure

• Is selected from a panel of three possible evaluators that is randomly generated by the state

• Is chosen based on location – nearness to the worker’s home address, usually

In contrast, a psych AME:

• Can be certified as a QME, but does not have to be

• Is only available to workers who have hired an attorney to represent them for their work comp claim

• Is agreed upon by the attorney for the worker and the attorney for the employer

• May or may not be located close to the worker’s home

If you have an attorney and opt to be evaluated by an AME, you waive your option to have a panel QME.  The major benefit of going with a psych AME instead of a psych panel QME is that AMEs are often well-established within the workers’ comp world, and have a lot of experience doing work comp psych evals.  Typically, if both sides can agree on an AME, it is because that psychologist has done high quality work that the attorneys are aware of, and they both trust the AME will come to evidence-based and balanced opinions that reflect the reality of the work injury.

Does This Mean a Psych Qme Work Comp Eval Isn’t as Good?

Not at all!  Many psychologists are certified QMEs and available as AMEs as well, and there are many well-trained psychologists starting out as QMEs who simply aren’t yet well-known to attorneys.  There are plenty of psych QMEs doing excellent work comp evals.

Markers of a Good Psych Qme or Psych Ame Eval

Regardless of whether you end up in a work comp psych eval with a QME or an AME, there are a few components that will be part of any thorough psych evaluation:

• A clinical interview.  You will be asked about your personal, educational, occupational, and medical history.  These invasive questions all help the psychologist in evaluating your work comp injury

• Psychological testing.  You will have to take several psych tests for a work comp eval.  These can be brief, or very long.  Just know they are providing evidence to support your psych QME or psych AME in reaching medical opinions about your work-related injury.

• A record review.  Your work comp psych evaluator will review records provided by the attorneys.  These may include medical records from an incident related to work, and general health records, sometimes dating back years.

• A report.  Whether you see a psych QME or a psych AME, that psychologist will write an integrated report that includes all of the information they gathered throughout testing, interview, and record review.  They will include opinions about a diagnosis, the cause of any diagnosis or symptoms, and appropriate treatment.  They will also comment on work restrictions if there are any.

Begin Working With A Psychological Evaluator in Los Angeles

Finding the right evaluator for a work comp eval can take time, but is worth it in the end. Dr. Reger provides psychological evaluations at several locations in Southern California. You can schedule an appointment by following these steps:

1. Contact (424) 262-1925 to schedule your appointment

2. Meet with an LA Psychologist for your QME psychological evaluation

3. Get answers that you need to continue with your work comp claim

Other Counseling Services Offered BY Dr. Reger in los angeles, ca

I know you may experience a number of mental health concerns. This is why I’m happy to offer multiple neuropsychological and psychological assessments. Other assessments include cognitive and dementia testing, pre-surgical assessments, and med-legal evaluations. In addition to evaluations, I also provide individual therapy, counseling for older adults, and mental health consultations and presentations.

ADHD In Women: Unique Challenges and The Importance of Testing

Many women have felt overlooked in their own healthcare; research shows that doctors tend to dismiss complaints of pain from women and are more likely to assume psychological causes of physical symptoms reported by women. 

In addition, much medical and psychological research in the past was conducted with only men, which means that our understanding of some diagnoses and treatments are based on studies of only half of the population. This can result in women being misdiagnosed or overlooked because they present with “atypical” symptoms…actually, those symptoms may be very typical for women, but women weren’t included in the studies! In the case of ADHD, the “traditional” symptoms that get the most recognition tend to show up more in boys, so girls and women with ADHD face unique challenges throughout life.

ADHD in Girls

ADHD is neurodevelopmental (symptoms usually begin in childhood), and often looks different in girls vs. boys.  There are two main types of ADHD symptoms, with some examples:

1. Inattention

1. Poor attention to detail

2. Seeming not to listen when spoken to

3. Failure to follow through on tasks

4. Difficulty organizing activities

5. Losing things 

1. Hyperactivity/Impulsivity

1. Fidgeting

2. Difficulty staying seated

3. Running or climbing when inappropriate

4. Unable to take part quietly in leisure activities

5. Talking excessively/interrupting

If you suspect you have ADHD, you might recognize some of these behaviors in yourself. 

Girls and women with ADHD tend to have inattentive symptoms more often, and boys and men tend to have hyperactive/impulsive symptoms.  (These are general patterns, not necessarily true for every individual).  

Because hyperactive and impulsive symptoms tend to be more “external” and disruptive, boys are more often noticed and diagnosed with ADHD.  Inattention symptoms in girls with ADHD often go unnoticed and they may quietly miss out on the support they need to learn and succeed in mainstream settings. 

Without a diagnosis, more girls go untreated for ADHD.  Treatment can involve medications, but it can also involve therapy to help build organization skills as well as coping skills to help protect against the emotional wear and tear that can come with having a neurodivergent brain in a neurotypical world.  If a child is undiagnosed, their ADHD-related behaviors are often viewed as purposeful, which can lead to painful and confusing experiences of being disciplined, ridiculed, or labeled for things they don’t understand. 

Effects Into Adulthood: Women with ADHD

Because many girls with ADHD don’t have the support to build organizational skills over time during childhood and adolescence, adult women with undiagnosed ADHD often feel like they are falling short, or missed some class everyone else took. 

Brain function is impacted by the natural hormonal shifts that happen across a woman’s lifespan, and in a brain with ADHD, times of hormonal change like adolescence and menopause can cause symptoms to get worse. For women with undiagnosed/untreated ADHD at any age, aspects of adult life feel impossible.  Things like:

• Maintaining a schedule

• Meeting work deadlines

• Being on time

• Finishing projects 

• Managing household tasks

• Saving and financial planning

The Value of Neuropsych Testing for ADHD in Women

If this resonates with you, a neuropsychological evaluation for ADHD may help. A neuropsych assessment for ADHD involves an interview to gather information about your history and symptoms, as well as paper-and-pencil or computer testing to measure brain function in several areas (like executive function, memory, attention, processing speed, and visual-spatial function).  This is for a few reasons:

• To reach an accurate diagnosis

• To rule out other problems or explanations for your symptoms

• To make sure we don’t miss anything

Sometimes people ask why ADHD testing is so comprehensive when we already “know” what’s going on.  ADHD can come with other problems that cause or worsen symptoms, like learning disabilities, depression, anxiety, or OCD.  A thorough evaluation ensures we’re addressing everything that contributes to your symptoms because we make recommendations based on the test results.  Recommendations inform you about the best treatment options for you, and if we don’t do thorough testing, we might miss something that impacts your treatment success.   

For women in particular, I’ve found that neuropsych testing for ADHD can be powerful and healing. 

Because women with ADHD are often misunderstood, testing can provide a new view of themselves and their experiences.  It is healing to know that your struggles are not personal failings, but simply signs of a brain that is functioning differently. It is healing to know that there are things you can do to support your brain and strategies you can use to succeed in environments that thrive on deadlines and projects if that is what you want.  It is also, hopefully, a very compelling reason to offer yourself compassion and grace as you navigate a new understanding of yourself.

Begin Adult ADHD Testing in Redondo Beach, CA

ADHD testing can help you better understand your symptoms and how your unique brain operates. As a Los Angeles Psychologist, I would be honored to help provide the insight to help you better understand yourself. You can learn more about what you can expect from neuropsychological testing with Dr. Reger by doing the following:

1. Reach out for a free consultation.

2. Schedule neuropsychological testing with Dr. Reger.

3. Start the ADHD testing process!

Other Therapy and Testing Services Offered in Los Angeles, CA

I understand you may need more support in addition to neuropsychological testing. This is why I’m happy to offer several types of assessments and services around Southern California. I also offer psychological evaluations for workers’ comp, preoperative assessments, individual therapy and therapy for older adults. Visit my blog for more helpful information today!