Assessment, records, and legal process
Match methods to the question
An assessment begins with a defined professional question, not a desired result. Choose methods and an information base suited to that purpose. A screening result is one piece of information, not automatically a diagnosis. Test norms, language, culture, administration conditions, response sources, and instrument age can affect interpretation. If a parent completes a child's self-report measure, identify the actual respondent instead of treating the result as the child's standardized response. If interpretation or another adaptation changes administration, explain material limitations and integrate appropriate additional evidence.
State conclusions honestly
Separate observations, collateral accounts, test findings, and professional inferences. Conflicting reports should be evaluated and attributed, not silently converted into directly observed facts. An unusual validity indicator does not, by itself, establish intentional deception or motive. A review conducted without direct examination should say so. Opinions about an unexamined person, a legal conclusion, or a task-specific capacity need an adequate basis and careful limits. A payer or retaining attorney cannot supply missing evidence by insisting on a particular result. Correct material errors transparently when they are discovered after a report is released.
Distinguish records, data, and materials
A treatment record, test data, and secure testing materials may involve different access and protection issues. Apply the actual governing rules rather than assume a copyright label answers every request. Protect instruments and answer keys from inappropriate public exposure while addressing lawful access to an individual's information. Verify requester identity and authority. An unpaid bill does not automatically remove record-access rights. Retention planning should identify the applicable period, its triggering event, any rules for minors, and any legal hold. Practice closure does not automatically end custody, confidentiality, or access duties.
Treat legal process precisely
Confidentiality concerns everyday information handling; evidentiary privilege concerns protection against disclosure in legal proceedings. They overlap but are not identical. Identify who holds the privilege and obtain appropriate guidance about subpoenas, orders, warrants, waivers, and exceptions. A lawsuit involving emotional distress does not justify assuming that the entire lifetime file has become public. Apply the actual scope of a valid obligation and preserve the record's integrity. Do not destroy, backdate, or alter records to avoid disclosure. In forensic work, explain the role and anticipated recipients before proceeding; supportive behavior should not imply that an evaluation is private psychotherapy.