What is a Psych Evaluation?

If you’re new to therapy or exploring different options for treatment, it’s natural to have questions about the first steps. A common but often misunderstood initial step is the psychological or “psych” evaluation.

It might sound intimidating, but a psych evaluation is a simple way for your therapist, psychologist, or other type of health care provider to understand what you’re going through right now. Read on to learn more about psychological evaluations, including when it might be time to get one, what types there are, and what you can expect from the process.

When to Get a Psych Evaluation

A psych evaluation can help identify the cause of mental health symptoms. If either you or a loved one has shown signs of a mental health condition, it may be time to talk to a professional.

Signs that someone may need a psych evaluation might include: 

• Sudden mood changes
• Unexplained memory loss
• Social withdrawal 
• Difficulty concentrating
• Uncontrollable crying  
• Changes in sleep or eating patterns 
• Problems at school or work 
• Loss of motivation or interest in activities, especially in those that were once enjoyed 
• Increased sensitivity to noise, visuals, or being touched
• Paranoia 
• High levels of anxiety 
• Feeling disconnected from what’s happening around you 
• Sudden bursts of anger
• Depression 
• Exhibiting symptoms of anxiety
• Other uncharacteristic behaviors

While these symptoms aren’t always a cause for concern, it’s wise to seek out a psych evaluation if several new or unusual symptoms occur. It’s essential to schedule an evaluation if symptoms are interfering with relationships, day-to-day life, or the ability to function daily. It’s essential to talk to a professional immediately if someone is struggling with thoughts of self-harm. 

Main Types of Psych Evaluations

There are multiple categories of psychological tests that mental health professionals use during a psych evaluation. They may use one or more during the assessment process. The primary types of evaluations are:

Clinical interview 

During a clinical interview, mental health professionals talk with patients to learn more about their symptoms. They’ll follow a semi-standardized interview format known as the Structured Clinical Interview for DSM Disorders (SCID). 

Another form of assessment is the Clinical Diagnostic Interview (CDI), which is a non-structured conversation between a professional and a patient. CDI questions are fairly broad, while SCID questions are more specific. 

“The psychological evaluations have been researched to be accurate based on self-disclosure. In other words, your honesty about your emotions and how they are affecting you are key to the evaluation’s accuracy.” – Talkspace therapist Dr. Karmen Smith LCSW DD

Assessment of intellectual functioning (IQ)

IQ tests, on the other hand, are formal tests designed to measure cognitive functioning. They can provide more information about spatial skills, memory, concentration, communication, intellectual capacity, and more.

There are 2 main categories of IQ tests: intelligence tests and neuropsychological assessments, which measure brain function. 

Behavioral assessment

Behavioral assessments are a structured and detailed analysis of behavior. Typically, several tools are used to gather information about behaviors. This can include interviews, observation, and questionnaires. While it’s very common to use behavioral assessments when evaluating children or adolescents, this test is used on patients of all ages. 

Personality assessment

Mental health professionals use personality testing to learn more about someone, so they can provide an accurate diagnosis. 

One commonly used personality test is the five-factor model (FFM), which identifies 5 basic personality traits: 

• Extraversion (also sometimes spelled as extroversion)
• Neuroticism (also sometimes referenced as emotional stability)
• Agreeableness
• Conscientiousness
• Openness to experience (also sometimes referenced as intellect)

Other types of personality testing commonly used by psychologists include the Minnesota Multiphasic Personality Inventory (MMPI), Thematic Apperception Test (TAT), and the Rorschach test.

What to Expect from a Psych Evaluation

Mental health assessments may include a variety of components, including:

• Formal questionnaires
• Checklists
• Surveys
• Interviews
• Behavioral observations 

Often, the depth of evaluation will depend on the person, their concerns or symptoms, and what they need assessed. 

In general, you can expect parts of a psych evaluation to take between 20 and 90 minutes, depending on the reason behind testing and which test or tests are administered. Keep in mind multiple visits might be required. Some parts of the assessments can be completed virtually or in person. Things you should be prepared for include:

Physical exam

In certain cases, a physical illness can cause symptoms that mirror some mental health conditions. A physical exam can help determine if a physical disorder (such as a thyroid disorder) or a neurological issue are to blame for symptoms. Be sure to inform your doctor about any conditions you already have or any medications you take.

Lab tests

During a psych evaluation, you may be asked to complete blood work, a urine test, or a brain scan. These tests are designed to rule out any physical conditions. You may also be asked to answer questions about drug and alcohol use to confirm what you’re experiencing isn’t a side effect.

Mental health history

You will likely be asked about how long you’ve been experiencing certain symptoms, about your personal and family history of mental health, and about any psychiatric or psychological treatments you may have received in the past. 

Personal history

Medical and mental health professionals may ask questions about lifestyle and personal history to determine the largest sources of stress in your life. They’ll ask about any past major traumas. For instance, you may be asked about your marital status, occupation, military service, or your childhood.

Mental evaluation

In this instance, you’ll likely be asked questions about your symptoms in more detail. This evaluation portion will focus specifically on your thoughts, feelings, and behaviors. It’s also important to know how you’ve tried to manage symptoms on your own thus far. Your doctor will observe your appearance and behavior to help get a sense of your overall mental health.

Cognitive evaluation

This differs slightly from the mental evaluation, as here, the intent will be to gauge your ability to think clearly, recall information, and use sound reasoning.  

“The evaluation does ask questions about your feelings, thoughts, and behavior. You can also ask questions about your prognosis and length of treatment. You and your therapist can discuss the results and partner together on the treatment plan. Evaluations can be an effective way to show progress during and after treatment.” – Talkspace therapist Dr. Karmen Smith LCSW DD

Connect with a Mental Health Professional

Psych evaluations can help you understand your symptoms so you can get the help you need. If you or a loved one is experiencing psychological symptoms that are having an adverse effect on your life, you may need professional help. Therapy can provide the support and guidance you need to get an accurate diagnosis and develop an effective mental health treatment plan.

Talkspace, the online therapy platform that makes getting help easy and affordable, offers mental health evaluations that can help determine next steps for treatment and recovery. Don’t wait another day. If you’re in pain and need help, Talkspace is there for you. Learn more about how to start therapy with Talkspace today.