Key Takeaways Key Takeaways
  • Psychological and neuropsychological evaluations were defined as tools for diagnosing conditions like ADHD, autism, and dementia. Testing provides crucial insights into cognitive, behavioral, and emotional functioning, helping to tailor treatment plans and therefore, provide a more targeted approach to symptom relief.

  • There are situations where testing may not yield valid results, such as when people are too dysregulated or unable to focus. Knowing when to pause testing promotes accurate and meaningful outcomes.

  • Testing can be especially valuable when treatments fail to work. For example, identifying unresolved trauma or a personality disorder can redirect therapy and medication, potentially leading to breakthroughs and better outcomes for people.

Psychological Testing: Understanding Its Purpose and Benefits

I think there’s a lot of misunderstanding about what psychological testing is and what it’s used for. Let me start by sharing a little bit about my journey and how I came to specialize in this field.

I didn’t start out in psychology. My career began in business, but as I approached 30, I realized it wasn’t fulfilling for me. Psychology had always been in the back of my mind, so I decided to take the leap and go back to school. I initially planned to become a therapist, but everything changed when I took my first psychological testing class. It was like a light bulb went off—I knew this was what I wanted to do. I dove in, took every opportunity to learn, and now I’m the Regional Testing Director for LifeStance Health, overseeing psychological and neuropsychological testing across Texas, Colorado, and Oklahoma.

What is Psychological Testing?

So, what is psychological testing, and what is it used for? In general, it’s the assessment of behavior, mood, and personality, as well as aspects of cognitive functioning that help us understand a person’s symptoms. Testing is often used for diagnosing conditions like mood and other mental health conditions, ADHD, intellectual disabilities, personality disorders, learning disorders, and developmental disorders like autism.

Common Psychological Tests and Their Uses

Psychological tests can involve inventories where a respondent answers questions about themself or a loved one, and/or performance-based measures where a patient is asked to complete a task (such as building, drawing, or remembering something). Some of the most common tests we use include:

  • IQ Tests: These measure intellectual functioning and are used to help us identify strengths and weaknesses across different domains of intelligence.
  • Measures of Attention and Executive Function: These focus on how the frontal lobe is functioning, looking at things like working memory, the ability to shift between tasks, and organizational skills. These tests are sometimes used to help diagnose ADHD.
  • Achievement Tests: These are used to help diagnose learning disorders like dyslexia or difficulties with math and writing. They can also help guide academic services or recommendations.
  • Personality Assessments: These are used to help us determine an individual’s underlying characteristics, allowing us to consider how those characteristics contribute to the clinical picture. They are also used to help us distinguish between personality traits and disorders.
  • Cognitive Tests: These cover domains of thinking such as memory, attention, language or visual spatial skills. They are often used to assess for conditions like dementia, or to determine the impact of neurological conditions like traumatic brain injury or stroke.
  • Behavioral Measures: These tests involve patient interaction and observation and are often used to assess for developmental conditions such as autism spectrum disorder, especially in children.

Each test gives us specific insights that contribute to a clearer picture of what’s going on with the person being assessed.

Neuropsychological Testing vs. Psychological Assessment

Psychological testing and neuropsychological testing have some overlap, but there are important differences. Psychological testing often includes questionnaires and assessments of mood, personality, and aspects of cognitive functioning such as baseline intellect.

Neuropsychological testing, on the other hand, is much more brain-based. It focuses on learning, memory, executive functioning, language skills, visual-spatial skills, and abstract thinking. Instead of asking questions about symptoms, neuropsychological tests require performance—people perform tasks, and we measure how they do. Neuropsychological evaluations do clarify diagnosis, but they also cover how any diagnoses impact specific thinking skills.

For example, if someone has a traumatic brain injury or signs of dementia, neuropsychological testing often helps us determine the extent of their cognitive impairments. I’ve also worked with individuals who have undergone cancer treatments or been exposed to toxic substances like lead, where neuropsychological testing often helps us understand the effects on their brain.

When Testing May Not Be Appropriate

There are times when psychological testing isn’t the right choice. The main reason we might hold off on testing is if the individual cannot meaningfully participate in the process. This might happen because the person is too dysregulated, because they refuse to participate, because they are using substances, or because they don’t put forth adequate effort.

For instance, I’ve worked with young kids who came in for autism assessments but were also dealing with ADHD. Sometimes, they couldn’t sit still or focus long enough for us to gather valid results. That might mean ending sessions early, breaking testing up over multiple sessions, or proceeding once the child’s ADHD symptoms have been successfully treated. It’s not appropriate to proceed with testing if results won’t provide accurate information about the individual’s abilities.

Similarly, during my internship at a state hospital in Massachusetts, I encountered patients who were experiencing active psychosis or manic symptoms that interfered with test taking. Anytime we can’t get valid results that truly reflect someone’s functioning, it’s better to wait until they’re stable.

Why Psychological Testing Matters

The purpose of psychological testing is to provide diagnostic clarity and guide treatment planning. People often know testing exists, but they don’t always know what it’s for.

Testing is often especially helpful when there’s uncertainty about what’s going on. For example, if a child is struggling with reading, testing can often help determine the “why.” If they have a learning disability like dyslexia, testing can help suggest strategies to support them. If testing shows that reading challenges are related to inattention and poor working memory, a diagnosis of ADHD might be appropriate, and recommendations might include therapy or medication.

Similarly, testing can help differentiate between normal cognitive aging and conditions like dementia. We can tell someone, “Yes, you’re experiencing memory decline faster than expected for your age,” or “No, your cognitive abilities are perfectly in line with what’s typical for someone your age.” In fact, neuropsychological testing can not only help diagnose mild cognitive impairment or dementia but can also help clarify the underlying process (such as Alzheimer’s disease vs. Frontotemporal or vascular dementia). This is essential to understanding prognosis and developing a better treatment plan.

Testing is often especially helpful if a child is struggling with reading; testing can often help determine the “why.” If they have a learning disability like dyslexia, testing can help suggest strategies to support them.

Another important time for testing is when treatments aren’t working. For example, if someone has been in therapy for more than six months with little improvement, or their medication isn’t helping, testing can help uncover what’s really going on. It might reveal that their symptoms are rooted in trauma rather than depression, or that a personality disorder is affecting their treatment response.

The Big Picture

Testing often helps us get to the root of the issue. It allows us to provide better recommendations—whether that’s therapy, medication, accommodations, or other resources like speech or occupational therapy. It also connects individuals to specialists (such as neurologists) when needed, such as in cases of faster-than-expected cognitive decline or where additional evaluations for developmental disorders are appropriate.

Ultimately, testing is about seeking clarity. It’s about understanding what’s happening in a holistic and individualized way and creating a roadmap for moving forward. If you’ve been struggling to find answers or feel like your current treatments aren’t working, psychological testing might help you uncover the next steps.

Authored By 

Monica Durham, PsyD, MBA

Monica Durham, PsyD is a licensed clinical psychologist in Texas who specializes in therapy with adults and neuropsychological/psychological assessment of both children and adults. In terms of therapy, Dr. Durham has considerable experience working with individuals suffering from anxiety, depression, grief/loss, trauma, adjustment issues, and eating disorders. Her approach is casual and patient-centered. She is trained in multiple therapy approaches and tailors her therapy to the needs of each individual. Dr. Durham also specializes in comprehensive psychological and neuropsychological evaluations of both children and adults with a wide range of medical and neurobehavioral concerns.

Types of evaluations including ADHD, learning disabilities, speech/language impairment, autism spectrum disorders, dementia, personality, behavioral and emotional concerns, and bariatric surgery. She is a strong advocate for all patients but is especially committed to making sure children get the services they need within school systems. Getting services through schools can be challenging at times so Dr. Durham is happy to attend special education planning meetings and/or work with parents and schools to make sure children get the services they are entitled to by law. Monica earned her Doctorate in Clinical Psychology with a specialty in neuropsychological/psychological testing from William James College in 2013.

Her internship was at a state hospital in Massachusetts and her post-doctoral fellowship was with a private neuropsychological assessment practice. She also has a Masters in Business Administration and has extensive experience working in the business world. Her work history includes working in community mental health, running her own private practice, working for the Boston Veterans Administration, working at an eating disorders clinic, providing services to nursing and rehabilitation facilities, and teletherapy.