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[00:00:00] Hey everybody. I’m Dr. Jeremy Sharp. This is The Testing psychologist podcast episode number 1.

Hello, and welcome to the Testing psychologist podcast episode number 1. I’m Dr. Jeremy Sharp. Nice to be here with you. This is our very first episode. I’m excited to be sharing some thoughts, experiences, and information with you all about testing, assessment, how to incorporate testing in your practice, how to build testing services, and how to grow a practice that has assessment as part of it. All of these things are going to be part of our podcast going forward. I’m really excited to get started. I’ve been thinking about this for a long time and here we are.

Today, I just want to talk a little bit about how I got here, why this feels important, what testing is, and who can do testing- just some basic information just to get us started as we get into the podcast with lots of other information coming up in the future.

A little bit about me. I’m a licensed psychologist. I am practicing in Fort Collins, Colorado. I went to Colorado State University where I got my doctorate. I graduated in 2008. I did a post-doc and then started my private practice in 2009. My practice has not always focused specifically on testing. There’s been a bit of a journey to get here. That’s where I have learned a lot along the way, and have stumbled a lot along the way.

[00:02:00] Where I started out was with a generalist practice. I saw primarily adults and parents. I did a lot of therapy. I had a pretty full therapy caseload of 20 to 25 clients a week. I did that for two years and really did testing on the side more than anything else. I did 1 or 2 evaluations a month. I had a lot of training in testing back when I was in grad school but got away from it through my internship and through my post-doc and then just did it here and there when I got into private practice initially.

But what I soon found out is that there was a big demand for testing in our community. There was one point, now I’ll tell the story maybe a little bit down the road, but the short version is that I found myself one month with about 10 to 15 times the typical testing referrals all at once. So I had to figure out pretty quickly how to scale my practice and take on all of these new referrals. So that is basically a miniature version of what I’ve been doing for the last probably 5 or 6 years- it’s just figuring out how to scale this testing practice as it gets more and more busy. I have eventually taken on a few employees and continued to build this testing business.

I had a lot of struggles in the beginning. Like I said, I was doing 1 or 2 evaluations a month, which was great, but then all of a sudden I got these referrals and I had to figure out a lot of different things. I had to figure [00:04:00] out how to get measures. At that point, I was borrowing measures from a friend and from my grad school clinic. So I had to figure out how to purchase these measures and finance them.

Then I had to figure out how to fit all these evaluations into my schedule. I knew that I liked testing and I knew that I wanted to take on these referrals, but at that point, like I said, I had a full caseload of therapy clients. And so, I had no time on my schedule. Luckily this was before we had kids and I could work a little extra compared to these days. So, I had to have the time of my schedule.

I had to quickly figure out if I needed to hire someone to help me do the testing. Once I did that, I didn’t know really how to bill for their time or what to pay them, or how to structure that. So, I learned a lot over that first probably six months or so after that initial wave of referrals. But since then, things have been continually challenging, but continually awesome as well as the assessment part of our practice has grown.

So the reason that I’m really launching this podcast is because back then I did so much Google searching and tried to find information as best I could about how to really navigate a testing practice and scale a testing practice and I could not find much. I ended up doing a lot on my own. I ended up making a lot of mistakes. What I’m hoping is that this podcast might be a resource for others of you who are really interested in testing and want to either add testing services to your practice or build an assessment practice from the ground up, or even for those of you who’ve been doing it for a long time that [00:06:00] maybe hope to get more efficient or want to hire other clinicians to help you out, all of those things will be things that we’ll be talking about. So hang with me. I’m going to talk a little bit about more basic information about testing here today and get that groundwork in place. And then in future episodes, we’re going to do some deep dives into the different aspects of testing and the business side of testing.

A lot of people ask me, first of all, why do I do testing? This is a question I think in the psychologist community and mental health community. When I tell people that I really do like to do testing, honestly, I get some looks like, are you kidding me? It seems like not many of us enjoy doing testing, but I love it. I love it for a few reasons.

The biggest thing is that it helps me understand people in just a deep, different way than therapy can. I did a lot of therapy. I did emotionally-focused therapy. My therapeutic alliance and connection with my clients were amazing. And being the person that I am and the way that my mind works, I really like the data-driven aspect of assessment because it gives me a chance to get to know the clients, like I said, in a just a different way, and then it allows me, at least in my case, because I work with primarily kids, it allows me to communicate that information to parents and sometimes to the kids themselves.

And just giving people that opportunity to know themselves or to know their kid in this entirely different way to have a really good idea of what their brains are up to, what their personalities are, how that all weaves in with the environment and other circumstances, these are all really cool [00:08:00] things about testing that you just don’t get through day to day therapy.

So another thing that I really like about testing is that it helps me exercise that different part of my brain that likes to put puzzles together and figure things out. It also gives me time to write, even though writing clinical reports is, you’re not going to make it to the New York Times bestseller list or anything, it still gives me the opportunity to do some writing, which I really like to do and was not doing much of that at all when I was doing therapy.

The other piece that really got to be more and more important is that testing allowed me a lot more flexibility in my schedule than doing therapy did. When my kiddos did come along, it was so much easier to take a day out of the office and spend a lot of the day writing reports from home, but be able to take breaks and play with my kiddos and just do other things around the house and help out when that was necessary. Whereas with a therapy practice, you’re in the office for every hour that you are trying to earn income. So, you are tied to those hours that clients can actually physically be there. So a lot of reasons that I love testing. I continue to love testing. As I get deeper into it and continue to learn, it’s just fascinating and super useful to people. I have loved building a practice around assessment services.

Some of the reasons though that other people don’t enjoy it, for one, I think the writing is a big one. I hear people say a lot that they like the testing process but hate the writing process. Totally understandable. We’ll talk in later episodes about how to actually make time for [00:10:00] writing and definitely talk about some tools to help you be more efficient with writing. But that’s one reason people don’t like it.

Another piece is the insurance reimbursement. If you do decide to take insurance in your assessment, that can really get to be a pain, especially the learning curve initially is to figure out what insurance will reimburse in terms of diagnostic codes and how much time, what kind of services, CPT codes, that kind of thing. Again, we’ll talk more about that down the road, but that is one reason that keeps people from doing it. So if you have said to yourself, oh, I’d love to do testing, but it doesn’t get reimbursed or I don’t know how to bill for it, totally normal. I can reassure you that it is doable. And we can certainly talk through that and help you learn how to do that.

Now, another piece though that really gets in people’s way, I think is the cost of entry. This is going to vary depending on the type of evaluations you’re doing, but if you’re just maybe doing personality assessments or behavioral checklist here and there for really short evaluations, then it’s not going to be too much, to be honest, but if, like a lot of psychologists, a big part of our specialized training is in cognitive and personality assessment and really doing more of a full battery, the cost for measures to administer a full battery is pretty expensive and can certainly get more and more expensive the more you do. Sometimes that’s a turnoff. I’ve definitely talked with other folks here in the community and elsewhere about testing and they say, yeah, I would love to do some testing, but it’s just so expensive to get started. So we’ll certainly be talking about how to overcome that hurdle as well.

Now, I probably should have [00:12:00] jumped into this a little bit earlier, but just to define testing, I’ll use the words, testing, evaluation, and assessment pretty much interchangeably, when I say testing, the actual definition as far as I could lookup is an objective and standardized measure of a sample of cognition and behavior. I think that’s pretty straightforward. What I really think of testing and evaluation is using these objective measures that have been normed and standardized on representative populations and using that data to make diagnostic conclusions and treatment recommendations.

We have all types of testing and assessment at our disposal and depending on where you went to school, what your training is, and what you’ve pursued post-graduate, there is any number of types of evaluations that you might pursue in your practice. My graduate program was pretty heavy on what most people would probably call psychoeducational testing. We did a lot of full batteries that included intelligence, academic skills, and attention. We also did behavior checklists, personality assessments, and school observations and wove all of that together to create a hopefully coherent picture of what was going on with folks. I say psychoeducational because we didn’t do a whole lot in grad school that veered into neuropsychology territory or forensic territory or anything like that but we did a lot of that kind of core intelligence and academic testing. So psychoeducational testing is one thing that you might be good at or that you might want to pursue.

[00:14:00]Now, psychological testing, I think of this as a more straightforward personality assessment or just using a behavior checklist, for example. So not delving so much into the cognitive functions, but really sticking with that personality piece and that behavior piece.

Now, another type of testing you might be trained in or be familiar with is neuropsychological testing. Neuropsychology is a subspecialty of clinical psychology looking more specifically at the relationship between the brain and behavior. So really solid grounding in brain structure and function and how that translates into cognitive and behavioral aspects and how that leads to diagnostic conclusions.

I will say at least here in Colorado and many other parts of the country, neuropsychologist designation is a whole separate specialty. There’s a board certification to be a neuropsychologist and in some states it’s a protected term where you can’t call yourself a neuropsychologist unless you have pretty, let’s say well-defined training. But neuro-psych testing is another aspect of evaluation that you might do.

Forensic testing is another piece. There’s a lot of overlap with some of the other domains that we’ve talked about. I think a lot of forensic testing incorporates psychological testing. So there’s a lot of personality, there’s also a lot of intelligence and cognitive testing that goes into forensic evals. Basically, the thing that sets a forensic eval apart from any of the others that you may have heard of is that those evals tend to fall under the legal system. So it’s any [00:16:00] evaluation that might be used in legal proceedings, court cases, and things like that. Again, a forensic designation is another board specialty. So, just keep that in mind.

Other types of testing. You can get into any number of nuances- different aspects of personality, testing, or scenarios where that might be helpful.

Things like adoption evals, custody evals, PRES, egg donor evaluations, and things like that that typically have personality testing as their primary component.

I should mention school psychologists and the evals that happen in the schools as well because that’s a huge part of the evaluation community. So school psychologists, at least in Colorado can be psychologists or mental health professionals with a variety of degrees. We have an education specialist degree, we also have school psychologists with PhDs and we also have school psychologists with master’s degrees. They typically focus on academic functioning, but also look at specialized measures of language, motor skills, adaptive functioning, and different cognitive abilities that are relevant to the school environment.

So, just a brief overview of all the different types of evaluations. I know, obviously, I did not cover every single type of valuation and probably made some distinctions between some of these different domains of testing that some of you might disagree with or maybe defined differently, but I’m just trying to give a basic idea off the types of evals that you might do.

[00:18:00] Now the question of who can do testing is also pretty important. I would imagine a lot of listeners are psychologists, but a lot of you may also be master’s level clinicians. And that really, I think, affects the testing capabilities that you might have. In most cases, the individual who can write the interpretation and the summary and make diagnostic conclusions has to be a licensed psychologist and they will be the ones to sign off on the report.

Now, psychologists don’t always do all of the testings, however. So, like I said earlier, in some cases, especially in schools, master’s level clinicians or non-doctoral clinicians can call themselves psychologists and administer and interpret a variety of tests. The distinction seems to be that they cannot necessarily make diagnostic conclusions and offer what a lot of people would call a medical diagnosis that corresponds to the DSM-V or the ICD-10.

Now, other folks can administer tests, however, and that’s something that comes into play in a lot of testing practices where the psychologist will conduct an interview, but then someone else might do the testing. That person is typically called a psychometrician and that person could be a master’s level clinician. It could be a bachelor’s level clinician with a certification. That person has specialized training in the administration of test measures but then passes that data off to the psychologist who then again, does the interpretation and typically does the feedback.

I know there’s been a big push around the country here over the last several months and maybe years to certify [00:20:00] psychometricians. There’s a licensing board or a certification board for that that is growing in popularity. So, just a piece about who can actually do testing. And when you get into the different testing measures, they will always have some designation about who or rather what level of training you need to administer and interpret the testing, and a lot of places where you purchase test materials will require that you have a licensed individual or a certified individual who can basically sign off and say, yes, I’m qualified to administer and interpret these measures.

So, this is just a really basic overview of testing and I think more importantly why this podcast is even happening. Like I said, I have had quite a journey over the years. Back in the beginning, I did not have many resources on how to be successful in building a testing practice. So I am just really excited to share some of my experiences and get some other folks here on the podcast to share their experiences to really just help you grow your assessment practice.

So as we get going here, huge favor, you may know this, but here for new podcasts, it’s really important to subscribe and rate and review the podcast. You can do that on iTunes, Stitcher, Google, wherever you listen to your podcasts. That would really help me out here in this initial period after we launch. Other things, if you are looking for more information or some articles to continue learning about testing and growing your practice, the website is thetestingpsychologist.com. [00:22:00] Make sure to put the “the’ there at the beginning. We have, like I said, some blog articles and other resources for you to check out.

So, like I said, it’s great to be here. Great to be talking with you. Episodes coming up are going to have a lot of information about the financial parts of testing, how to get yourself ready to actually have a testing practice and integrate those services into your existing practice, how to schedule, how to write reports efficiently, and how to bill. We have a lot of good stuff coming up. So thank you again for tuning in to our very first episode. I look forward to talking with you next time. Bye-bye.

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