Psychological assessment: understanding before intervening
Before choosing a technique, we need to understand well what you are going through and what keeps it going. Psychological assessment is the process that makes this possible: it combines the interview with validated tools, and it continues throughout therapy to check that what we do is really helping you.
What is psychological assessment?
It is a structured process of gathering information, from the first session to the last. It is not about “taking a test” and receiving a label, but about precisely describing the difficulty, explaining what triggers and maintains it, and then checking whether the treatment is working.
Three complementary sources of information
The interview
Your history, what you are going through today, in which contexts it appears and what you have already tried. It is the central tool.
Validated questionnaires
Tools whose reliability and validity have been studied, which measure the intensity of symptoms and compare it with reference data.
Self-monitoring
Notes on specific situations (what happened, what you thought, what you did) that bring in information from daily life.
Ideally, each important aspect is measured with more than one source, to reduce measurement error.
The steps of the process
According to the model of Fernández-Ballesteros (2013), a reference in psychological assessment, the clinical process includes:
Clarifying the request
What brings you here, what you would like to achieve and which behaviours, thoughts or physical reactions are at the heart of the difficulty.
Gathering information
Elements of your history and current situation (family, work, relationships) and the relevant personal and biological factors.
Formulating hypotheses
Possible explanations of what keeps the difficulty going, tested against the data.
Clinical formulation and plan
A shared explanation of what is happening, from which the goals and techniques follow.
Evaluating the treatment
Measuring again to see whether there is change, how large it is and whether it lasts.
The clinical formulation is shared with you and revised: it is a working hypothesis, not a verdict.
Why measure
From impressions to data
Both patient and therapist can be wrong when judging progress: a bad day can make it feel as if nothing is changing, and the wish for it to work can make things look better than they are. Measuring helps correct these biases.
Baseline measurement
A clear starting point: how you are at the beginning.
Monitoring
Short measurements during therapy to track how things evolve.
Adjustment
If something is not progressing as planned, we spot it early and adapt the plan.
Final measurement
We compare with the beginning and with defined criteria for change.
Research distinguishes a statistically reliable change (greater than the tool’s measurement error) from a clinically significant change (when the score reaches that of people without the difficulty), a proposal by Jacobson and Truax (1991) that is still widely used.
What research says
Measuring progress regularly is not a formality:
Routine outcome monitoring
A meta-analysis by Lambert and colleagues (2018) showed that giving the therapist regular feedback on the patient’s progress improves outcomes, especially when therapy is not going as planned.
Spotting problems in time
In those cases, monitoring is associated with fewer dropouts and less deterioration.
Science and clinical judgement
The APA defines evidence-based practice as the integration of the best research evidence with clinical expertise and the patient’s characteristics and preferences.
Questionnaires do not replace clinical judgement: they inform it. A score is always interpreted in the context of your history.
How I apply it
First sessions
An in-depth interview and, when useful, questionnaires suited to the difficulty (for example the BDI-II for mood, the STAI or BAI for anxiety, the PSWQ for worry or the PCL-5 for post-traumatic symptoms).
Feedback
I explain what the results show, in plain language, and we build the case formulation together.
During therapy
We regularly review your progress, with short measurements and your own sense of how things are going.
At the end
We compare with the starting point and prepare relapse prevention.
I also discuss situations in clinical supervision with colleagues, another way of testing my hypotheses against an outside view.
What it is not
It is not putting a label on you
A diagnosis can help guide treatment, but it does not define who you are.
It is not an exam
There are no right or wrong answers: what matters is answering honestly.
It is not a magic test
No questionnaire on its own reveals “what you have”; it is combined with the interview.
It is not public
Results are confidential and covered by professional confidentiality.
Gonzalo Garzo
Clinical psychologist · integrative approach
I have been a clinical psychologist since 2018, and I am also an anthropologist. For years I combined psychology with management positions (see my LinkedIn profile), before dedicating myself fully to clinical work.
I work with an integrative approach: third-wave CBT (ACT, DBT, mindfulness) and EMDR, adapted to each person’s needs.
I have lived in several countries and I work in English, French or Spanish, online or in La Rochelle.
Frequently asked questions
Are the questionnaires compulsory?
No. I suggest them when they provide useful information, and I always explain what they are for.
How long does the assessment take?
It takes up mostly the first sessions, but it continues throughout therapy in a briefer form.
Will you give me a diagnosis?
If it is useful for you or for coordinating with another professional, we talk about it. What matters most is the formulation: understanding what keeps the difficulty going.
Can I ask for a written report?
Yes, I can write a clear report suited to its purpose.
Can the assessment be done online?
Yes. The interview takes place by video call and many validated questionnaires exist in digital format.
Shall we talk?
Sources
- Fernández-Ballesteros, R. (Dir.) (2013). Evaluación psicológica: conceptos, métodos y estudio de casos (2nd ed.). Pirámide.
- Caballo, V. (Dir.) (2006). Manual para la evaluación clínica de los trastornos psicológicos. Pirámide.
- Jacobson, N. S. and Truax, P. (1991). Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59(1), 12-19.
- Lambert, M. J., Whipple, J. L. and Kleinstäuber, M. (2018). Collecting and delivering progress feedback: A meta-analysis of routine outcome monitoring. Psychotherapy, 55(4), 520-537.
- American Psychological Association (2006). Evidence-based practice in psychology. American Psychologist, 61(4), 271-285.
- Consejo General de la Psicología de España (2015). Código Deontológico del Psicólogo.
This page is for information only and does not replace a professional assessment.