Why are psychological evaluations so expensive?
An AnaLogy
Imagine a person trips on a curb and falls onto their wrist. They go to the doctor and say, “I think my wrist might be broken.” The doctor performs an exam, takes an X-ray, and does a few other tests. They say to the patient, “Good news! Your wrist isn’t broken, but you tore a ligament.”
Then the patient says, “I disagree. I Googled my symptoms, and I know my wrist is broken. I’m not paying you!”
Most of us would agree that the patient is not paying the doctor to tell them what they want to hear - the payment is for the doctor’s time, their expert knowledge of the proper methods to determine the most accurate diagnosis, and any relevant medical supplies.
There Is No Single "Test" for Psychological Diagnoses
Contrary to popular belief, there is no single “test” for psychological diagnoses. It’s not as simple as plugging in numbers from a questionnaire and spitting out a result. Some diagnoses are more straightforward, and in those cases, a comprehensive assessment would not be necessary.
The Problem with Single-Diagnosis Evaluations
Recently, there has been a rise in clinics offering evaluations for a specific diagnosis, such as ADHD. These clinics promise a quick and cost-effective evaluation, and unsurprisingly, most folks walk out with an ADHD diagnosis. If an evaluation only looks at ADHD symptomology in a particular hyperactive child, they will likely diagnose ADHD. However, without looking at other domains, they may not understand that the child’s hyperactivity is a result of anxiety, boredom in class due to giftedness, or PTSD. Testing for only one diagnosis is like wearing blinders. It puts us at risk of confirmation bias - only seeing what we want to see.
What Makes a Comprehensive Psychological Assessment Different
A truly comprehensive psychological assessment is a holistic and evidence-based method to arrive at a diagnosis. We review data in various domains, including cognitive and executive functioning, behavior, mood, personality, developmental, and academic. We administer tests that only doctoral-level psychologists are qualified to administer and interpret. We go through extensive training in data analysis, clinical reasoning, and differential diagnosis to produce a rigorous evaluation. We have personally curated a library full of testing materials to assess a wide variety of concerns, and we generally pay a few hundred dollars per assessment for materials alone.
The Investment Behind Every Assessment
Psychologists take on the role of statisticians, clinicians, diagnosticians, and authors during an assessment, which averages around 20 hours each. We interview the patient and people who know them well, conduct approximately a full day of testing, interpret the data, and craft a 30-40 page report summarizing the findings and offering personalized recommendations. These recommendations are designed to guide the patient’s mental health treatment, academic trajectory, and identity development for years to come.