Therapies, Interventions & Evaluations

Once you have connected with a mental health professional, you may encounter one or several of the following therapies, interventions and evaluations. To best prepare for your appointment, read the information below. As with all information shared, be sure to discuss your options and possible side effects with your mental health professional.

Therapies

The two main types of therapy utilized for mental health disorders are psychotherapy and drug therapy. In some cases, the best treatment plan for an individual involves both psychotherapy AND drug therapy.

What is Psychotherapy?

Psychotherapy (or counseling) is a type of treatment that is meant to improve your emotional and mental well-being by discussing your challenges with a licensed mental health professional, such as a psychologist, psychiatrist, social worker or mental health counselor. Psychotherapy can teach you new ways to approach difficult situations and cope with challenging emotions.

  • Cognitive Behavioral Therapy (CBT): CBT explores relationships between a person’s thoughts, feelings and behaviors. During CBT, a therapist will actively work with a person to uncover unhealthy thought patterns and how they may be causing self-destructive behaviors.
  • Psychodynamic Therapy: The goal of psychodynamic therapy is to help the client connect their past to their present behavior – by uncovering a person’s unconscious thoughts to identify how they manifest in present day behavior.
  • Expressive Therapy: These methods include the use of movement, art or music to express emotions and are especially effective for individuals who cannot otherwise express themselves.
  • Family Therapy: Discussion and problem-solving sessions with multiple members of the family.
  • Group Therapy : Includes a small group of people who, with the guidance of a trained therapist, discuss individual issues and help each other with challenges.

What is Drug Therapy?

Drug Therapy, also called pharmacotherapy, treats psychological disorders with medications. The patient should ask about risk, possible side-effects, interaction with certain foods, alcohol and other medications. Medication should be taken in the prescribed dosage and intervals and should be monitored daily.

Medical Interventions

There are other treatments that do not involve therapy or medication and are usually referred to as medical interventions. Two of the most common are Electroconvulsive Treatment (CT) and Transcranial Magnetic Stimulation (TMS).

  • Electroconvulsive Treatment (ECT): ECT is a procedure in which electric currents are passed through the brain, intentionally triggering a brief seizure. ECT seems to cause changes in brain chemistry that can quickly reverse symptoms of certain mental illnesses. ECT is usually used for treatment-resistant forms of major depressive disorder, schizophrenia, and mania.
  • Transcranial magnetic stimulation (TMS): TMS is a procedure that uses magnetic fields to stimulate nerve cells in the brain to improve symptoms of depression. TMS may be tried when other depression treatments haven’t worked.

Evaluations

A psychiatric or psychological evaluation is the process of gathering information about a person with the purpose of making a diagnosis. The evaluation is usually the first stage of a treatment process. The nature of the evaluation will depend on whether it is being done by a psychiatrist, psychologist or other mental health clinician.

  • Psychiatric Evaluation: A psychiatric evaluation is a comprehensive, medically focused, assessment done by a psychiatrist (physician with psychiatric training). The psychiatrist inquires about physical, behavioral, and cognitive histories, evaluates (by observation and interview) general mood and mental status, conducts reality testing and more. The psychiatrist may order medical exams and blood work to further evaluate the condition. After an extensive interview, the doctor will arrive at a psychiatric diagnosis (if appropriate) and recommend
    treatment options such as medication and therapy. If the individual starts a medication regimen, they will return to the doctor for follow-up checks to ensure side effects are managed and dosage is accurate. While most medications can be prescribed from a regular physician, it is recommended to seek care from a psychiatrist. They have more experience and are better able to manage the complications that may come up with psychiatric medications. 
  • Psychological Evaluations: Psychological Evaluations (also known as psychological testing or assessment) are offered by doctoral level psychologists. These evaluations cover much of the same history and mental health status as a psychiatric evaluation would and similarly, provide a diagnosis when appropriate. However, the difference lies in their use of standardized tests. The psychological evaluation uses this information to provide a snapshot of behavior, cognitive functioning, or mood by contrasting the individual results against a peer group.
    For example, a child may complete a test to evaluate an attention deficit. The psychologist collects data from multiple data points (test data, interviews by client, family observations, etc.), compares it to others in the same age group, and uses the compiled data to make interpretations and recommendations for ongoing care.
  • Neuropsychological Testing: Neuropsychological testing is administered by a neuropsychologist who is a doctoral psychologist with specialized training in neuropsychology. This evaluation is more comprehensive than psychological testing alone and includes assessments for intelligence, emotions, receptive language, memory, social interaction, and screening for Autism Spectrum Disorder.

In many cases, psychologists who administer tests will then treat patients with psychotherapy. Some psychologists focus only on evaluating patients and refer out for specialized treatment. In all cases, the testing process helps ensure that the client receives treatment tailored to their specific challenge.

  • Psychoeducational Evaluation: A Psychoeducational Evaluation is a thorough individual assessment that involves gathering developmental, family, school, social, emotional, personality and health histories to administer and interpret norm-referenced tests. The compilation of this information is then used to help formulate a profile – strengths, challenges, behaviors, and life circumstances – so that specific recommendations can be made to help the individual reach his/her potential. The entire psychoeducational assessment process generally takes 20 to 30 hours, depending on individual needs.
  • Core Assessment: This assessment determines whether an individual meets a particular diagnosis and includes:
  • 5-6 hours of one-to-one cognitive and achievement testing
  • Parent(s), teacher(s), and child (or adolescent or adult) interviews and questionnaires
  • Test scoring, analysis of cumulative information, and interpretation
  • Feedback meeting and a comprehensive written report
  • Follow-up meeting with school and or work personnel (with permission and as appropriate)
  • Copies of the assessment report

This assessment helps identify whether an individual is eligible for special support services, adjudication for secondary and post-secondary institutions and accommodations within an adult work-place.

  • Core Assessment with Additional Diagnostic Testing: In addition to the Core Assessment, further diagnostic testing is sometimes required to better understand the area of difficulty. Such diagnostic testing determines how and when the breakdowns in performance are occurring, and what factors may be contributing to the challenge. This information can then be used to further refine a management program – at home, school, and work. The additional testing requires 2 to 4 hours of one-to-one testing or a compilation of multi-rater questionnaires and interviews. The following list of diagnostic tests include test scoring, analysis of cumulative information, interpretation and report writing:
  • Process-oriented diagnostic testing (e.g., reading, math, writing, etc.)
  • Memory assessment
  • Language assessment
  • Auditory processing testing
  • Social/emotional/behavioral or executive functions, or temperament multi-rater questionnaires
  • Cognitive processing testing (e.g., auditory, visual, visual-motor)
  • Comprehensive Clinical Assessment: A Comprehensive Clinical Assessment is conducted when a clinical diagnosis or multiple diagnoses are likely. (for example, a comorbid diagnosis of ADHD, Gifted, Learning Disabilities, Nonverbal Learning Disabilities and/or social/emotional/behavioral components, Asperger’s Disorder, Autism, and Pervasive Developmental Disorder)

This assessment includes:

  • 10-12 hours of one-to-one testing with a combination of cognitive, memory, diagnostic achievement, language, motor, adaptive and/or emotional, social, behavioral testing (as deemed appropriate)
  • Parent(s), teacher(s), and child (adolescent or adult) clinical interviews
  • School observation (with permission) Questionnaires collected from multiple observers (e.g. from parents, caregivers, teachers, co-workers, self-reports)
  • Feedback meeting and a comprehensive written report
  • Follow-up meeting with school personnel (with permission)
  • Copies of the Assessment report

What can one expect from an assessment?

Managing and coping with complex learning difficulties can leave individuals and their families feeling isolated and confused. The goal of a psychoeducational assessment is to help individuals and/or families feel more empowered to make immediate changes in their school (or work) environment. Armed with concrete tools to work with identified strengths and challenges, many individuals experience a sense of hope.