Assessment, Diagnosis, and Test Use
Assessment items test competence with instruments, test security, the reach of the controlled act of communicating a diagnosis, and the discipline of integrating data rather than over-reading one score.
Before testing
Obtain informed consent for the assessment specifically: purpose, audience, who will see the report, limits of confidentiality, fees, and expected feedback. Confirm language, culture, education and disability considerations, and select instruments with appropriate norms and demonstrated validity for this population. Consent for an assessment is not implied by consent for therapy.
Test security and integrity
Test materials, items and protocols are protected. Do not publish items online, do not release protocols to unqualified persons, and do not allow untrained staff to interpret scores. Computer scoring is clerical; the clinical conclusions are the psychologist's, and the psychologist who signs the report owns those conclusions even if a psychometrist administered the tests.
Diagnosis
Communicating a diagnosis identifying a disease or disorder as the cause of symptoms is a controlled act. It must be performed by an authorised member within their competence, and communicated appropriately to the client with explanation and feedback. Diagnoses should rest on multiple sources - interview, history, observation, standardised measures, collateral information - and be revised when new data conflict.
Reports and feedback
Reports should distinguish observations from inferences, state limitations, answer the referral question, and be written for a defined audience. A feedback session is part of the service, not an optional extra, and should be documented.
Worked example
A parent demands the raw protocol from their child's cognitive assessment. Test security and copyright mean the psychologist does not release the protocol to the parent. The psychologist provides a full explanation of results, interpretation and recommendations, and releases raw data only to another qualified professional, or where legally compelled.
Traps that cost marks
- Using outdated norms or instruments with no validity evidence for the population assessed.
- Diagnosing from a single measure or a computer-generated narrative.
- Releasing test items or protocols to satisfy a records request.
- Failing to document feedback and the limits of the conclusions.