What happens in a psychological assessment?

There are different types of assessments that psychologists perform.  At Steps Psychology, we offer the following assessments and will consult with you to determine the one best suited to addressing the questions or concerns you have:

Psychoeducational Assessment

This assessment is designed to gain a comprehensive understanding of a child or adolescent’s learning strengths and needs.  It generally involves evaluation of:

• intellectual functioning (i.e., thinking and reasoning or cognitive skills);

• academic skills;

• information processing skills (e.g., memory, oral language, phonological processing, visual-motor ability, attention, executive functioning); and, occasionally,

• adaptive skills (age-appropriate behaviours necessary for people to live independently and to function safely and appropriately in daily life).

While a psychoeducational assessment would not generally explore a child or adolescent’s social-emotional functioning in great detail, brief screening measures are used to rule out any difficulties in these areas.

Psychoeducational assessments may help to identify or rule out learning disabilities, intellectual giftedness or delay, and Attention-Deficit/Hyperactivity Disorder (ADHD).

Social-Emotional Assessment

This assessment is designed to gain a comprehensive understanding of a child or adolescent’s strengths and any issues that might be impacting on his/her social, emotional, or behavioural functioning. 
 

Social-emotional assessments may help to identify or rule out anxiety disorders, mood disorders, and/or Attention-Deficit/Hyperactivity Disorder (ADHD).

Gifted Assessment

This assessment is designed to help evaluate whether a child or adolescent might meet criteria for intellectual giftedness, as determined by his/her school board or private school.  (For more information, please read the question and answer regarding giftedness on our FAQs page.)

*NOTE

Occasionally, the findings from one assessment suggest another type of assessment may be warranted. If we feel this is the case, we will discuss our findings with you and will suggest ways to integrate multiple sources of data in order to gain the most comprehensive picture of your child.

General Information Regarding Assessments

Assessments usually involve 4-5 separate appointments.  These include:

• an initial intake meeting with parents to discuss current concerns and referral questions (usually 1-2 hours);

• two or three individual assessment sessions* with the child (usually 2-3 hours each); and

• a feedback meeting with parents to discuss assessment results and next steps (usually 2 hours).

Note - Gifted assessments involve shorter intake and feedback meetings and a single assessment session.

Feedback meetings with children/adolescents are encouraged.  Furthermore, feedback can be provided to your child or adolescent’s school at your request to facilitate access to appropriate supports.

A written report detailing assessment findings and practical recommendations for home and school settings will be provided following the feedback meeting.  Recommendations are tailored to your child’s strengths and needs and may include classroom learning strategies, treatment suggestions, and/or referrals to other professionals.

The entire assessment process typically takes 4-5 weeks to complete (less in the case of gifted assessments).

*Numerous sources of data are utilized in the course of an assessment.  These may include:  direct testing with your child; parent-, teacher- and/or child-completed questionnaires and rating scales; interviews; observations; and review of report cards and any other relevant documents (e.g., previous medical or psychological assessment reports).

What happens in therapy?

The therapy process begins with an initial intake meeting, held with both the child or adolescent and his/her parent(s)/guardian(s), to gather information about their concerns or areas of difficulty and their goals for treatment.  This meeting is typically 1-2 hours in length.  Potential clients will have the opportunity to ask questions about therapy to ensure that the approach being proposed fits their expectations. 

If all parties agree to proceed with therapy following this meeting, individual therapy sessions lasting 50 minutes are scheduled on a weekly basis.  Depending on the referral issue, many children and adolescents are ready, by around the 10-week mark, to reduce the frequency of sessions or to discontinue therapy altogether (with booster sessions available as needs arise).  However, for more persistent or longstanding issues, further sessions may be required.  These decisions will be worked out with clients as therapy progresses. 

While the format of sessions varies depending on the age and needs of the individual client, principles of Cognitive-Behavioural Therapy (CBT) provide a framework from which the therapy process is structured. 

Cognitive-behavioural therapy

• is a relatively short-term approach that addresses the connections between a person’s thoughts, feelings, and behaviour;

• emphasizes the idea that the way we think has a powerful effect on our feelings and our behaviour;

• is goal oriented and focused on the here-and-now;

• is structured, educational, and collaborative, requiring the child or adolescent’s active participation;

• uses a variety of techniques to help young people learn to adjust their thoughts and behaviours and, in turn, their feelings;

• is, according to research, one of the most effective treatments for anxiety and mood problems.

In a typical session, the child or adolescent will be guided to think about the thoughts, assumptions, and beliefs that may be contributing to his/her problems.  He or she will be encouraged to experiment with new ideas and behaviours and will be coached to develop skills and techniques to manage difficult symptoms.  Practice between sessions is essential to reinforce new learning and move clients toward their goals.

How much will this cost? Are psychological services covered by OHIP?

While psychological services offered in a private practice setting are not covered by the Ontario Health Insurance Plan (OHIP), many private health insurance plans provide some level of coverage.  Please contact your insurance provider for information about your coverage and guidelines for reimbursement. Psychological services may also be tax deductible as a medical expense. 

At Steps Psychology, fees are set according to the guidelines suggested by the Ontario Psychological Association, a professional organization that represents psychology in Ontario.  Please call or email directly to obtain the current fees.  Payments are accepted in cash or by cheque.

Can we meet you first to make sure there's a good fit?

Of course!  Goodness-of-fit is crucial to positive outcomes in therapy; it can also contribute to a smooth assessment process which may yield more valid test results.  At Steps Psychology, we want you to feel confident in your decision to secure assessment or treatment services.  Most services begin with a one-hour parent consultation that allows us to meet, discuss your concerns, and come up with an action plan.  Teens are welcome and encouraged to be a part of this initial meeting.  While younger children are also welcome to join, most parents appreciate the hour to speak candidly and without interruption.  The choice is yours!  If, after an initial consultation, you decide not to move ahead with Steps as your service provider, we'd be happy to help you find a professional better suited to your needs.

What should I tell my child about coming to see you?

You may wish to explain, in age-appropriate language, who a psychologist is.  For example, “A psychologist is someone who meets with children/adolescents to help them learn about their strengths and weaknesses and work on any problems they may be experiencing.”

You may also describe the type of service your child might receive:

• Psychoeducational assessment

“The psychologist will do some activities with you to find out about what things you are good at and what things you might need help with.  Some of these activities are like puzzles or games, while others are more like the things you do at school.  Once she’s met with you a few times, she’ll write up a report that tells us all about how you learn best and how we can help you with your school work.”

• Social-emotional assessment

“The psychologist will do some activities with you to find out more about how you’ve been feeling/acting lately.  She will do some activities with you to try and understand your strengths and also what things you might need help with; she will also talk with you and ask questions about what your life is like.  Once she’s met with you a few times, she’ll write up a report that helps us to understand why you might be feeling/acting this way and how we can help you to feel better.”

• Therapy

“The psychologist will talk with us about how you’ve been feeling/acting lately.  She will probably ask us lots of questions so she can really understand what makes you feel/act this way and what your daily life is like.  If we think she can help you with the problems you’ve been having, then you’ll come and see her once a week for a while to talk and learn things that will help you to feel better.”

The office itself is set up as a friendly and welcoming space.  Most children enjoy participating in an assessment or coming for therapy.  At times, these processes can elicit difficult or distressing emotions; we are sensitive to how your child may be feeling and aim to work through these feelings with you.  At all times, you and/or your child have the right to take a break or to terminate the session.

Psychologist? Psychiatrist? Psychotherapist? I'm confused!

Psychologists are trained in the assessment, treatment, and prevention of behavioural and mental conditions. They diagnose psychological disorders and dysfunctions and use a variety of approaches directed toward the maintenance and enhancement of physical, intellectual, emotional, social, and interpersonal functioning.  In Ontario, only members of the College of Psychologists of Ontario (CPO) may use the title ‘Psychologist’ and identify themselves with the designation C.Psych.  To qualify for registration as a psychologist requires a doctoral degree (e.g., Ph.D.) in psychology, supervised professional experience, and successful completion of three examinations required by the College.  A member of the College is required to practice in accordance with applicable legislation, regulations, standards of conduct, professional guidelines and professional codes of ethics.

A psychiatrist is a medical doctor (MD), regulated by the College of Physicians and Surgeons of Ontario.  A psychiatrist has a degree in medicine, may prescribe medication, and provides services that are covered by OHIP.

Currently, “psychotherapist” is not a protected term, meaning anyone, regardless of education or experience, may use that title when providing therapy in Ontario.  However, the recently created College of Registered Psychotherapists and Registered Mental Health Therapists of Ontario (CRPRMHTO) will soon become the governing body for psychotherapists in Ontario and the title will be restricted to members of that College. 

My child's teacher thinks he might be gifted. What does that mean?

“Giftedness” is a term defined by the Ontario Ministry of Education as “An unusually advanced degree of general intellectual ability that requires differentiated learning experiences of a depth and breadth beyond those normally provided in the regular school program to satisfy the level of educational potential indicated.”  While it is not a psychological diagnosis, school boards use the results of psychological testing (specifically, intelligence tests) to determine whether a child meets criteria for giftedness.  Most school boards consider children to be gifted when their intellectual test scores are greater than those of 98% of children their age, however specific criteria vary; please consult with your child’s principal for more information.

Steps Psychology offers gifted testing using the Wechsler Intelligence Scale for Children – Fourth Edition (WISC-IV), the test most commonly used by public school boards and private schools in Ontario, as well as parent/child interviews and review of school records. 

My child's teacher thinks she might have ADHD. What does that mean?

Attention-Deficit/Hyperactivity Disorder (ADHD) describes a pattern of behaviour characterized by developmentally-inappropriate levels of inattention (e.g., easily distracted, does not follow through on instructions, does not pay close attention to details, does not seem to listen when spoken to directly) and/or hyperactivity/impulsivity (e.g., fidgets, leaves seat, talks excessively, is “on the go”, interrupts others).  Children with ADHD demonstrate symptoms in multiple settings (e.g., school and home) that are present before age 12 and cause significant impairment in social, educational, or work settings.
 
At Steps Psychology, we conduct comprehensive ADHD assessments that may include developmental history interviews and questionnaires, observation of the child in our office, behavioural rating scales completed by parents and teachers (with consent) and, if necessary, testing to rule out other learning or social-emotional disorders.  With consent, we may also observe a child in his/her school setting and speak with classroom teachers to obtain further information.

Will my child's school or doctor find out that we came to see you?

No.  In compliance with privacy legislation, the information collected during the course of any psychological service will be held in strict confidence.  With some exceptions that will be discussed with you prior to engaging in service with Steps Psychology, no information will be released to another party (e.g., teachers or school staff, medical professionals, friends, other family members) without your written consent.

Detailed information regarding the collection, use, and disclosure of your personal health information is available in our Privacy Policy, which will be provided to you at intake.