Welcome everybody to another episode of The Testing Psychologist podcast. I’m Dr. Jeremy Sharp. Today I am talking with Jen Knopp, a counselor here in Fort Collins, Colorado, and a longtime friend of mine. Jen and I have known each other for probably going on five years now. We were in the same consultation group for many years and got to know each other there through our clinical work. And that gradually shifted over the years to where we do work together here clinically, but I would say our main interest is our shared love for running.
I will put in a little plug for Jen. She is an amazing runner. She’s going to Boston here in the spring for the second time in a row. So a little congratulations there.
Jen: Aww, thank you.
Dr. Sharp: Of course, I have to give props to another runner. But what we’re here to talk about is assessment, of course. I wanted to talk with Jen because she has been a therapist here in our community for several years. We have shared several clients back and forth. She is a therapist here in town who I think really values the process of assessment and the value for her therapeutic clients.
We’re going to talk about a lot of things assessment-related primarily from the therapy side. So, Jen is going to have a conversation with me today to address some of those pieces. But before we dive into that, let me do a little bit more of an official bio for Jen, [00:02:00] just to let you know who she is and what she does.
Jen earned her undergraduate degree in psychology with a minor in sociology and her master’s degree in counseling psychology from Saint Martin’s University. She moved to Colorado in 2009 and opened her own private practice, Freedom First Counseling. She also works a large portion of her time at, Beyond the Mirror, a local agency that specializes in disordered eating, wellness, and self-esteem for adolescents and young adults. There at Beyond the Mirror, Jen serves as the Assistant Director and one of the primary therapists at the agency.
Jen, that’s just a little introduction. Is there anything else you’d like to add about your professional work or your personal life that people should know about you?
Jen: Well, I moved to Colorado here in 2009. I’ve really enjoyed opening my private practice and being able to work with Beyond the Mirror. In private practice, it’s pretty unique in that you get a lot of benefits of being able to be flexible and have a really open schedule, but one of the challenges is that it can be isolating. And so, being a part of Beyond the Mirror and being able to connect and consult groups and with teams and with you Jeremy has been really helpful because it helps us feel like we can really serve our clients even if we’re not in a clinical setting, like a community mental health that we can really work with everyone.
And so having done a lot of those different types of jobs in the past, working in the schools and working at residential places, I felt that it’s really helpful what we have here in Fort Collins to be able to work together individually, but as a team too.
Dr. Sharp: Sure. I think that’s a really good point that private practice can be isolating and we’re [00:04:00] fortunate enough to live in a community where we think have a pretty good connection with the other therapist here in town and are able to collaborate on services pretty often.
Jen: Absolutely. And I do have to put a plug that Jeremy you’re part of why I actually have made it to Boston and been able to do that. So also that may be something you may or may not know about Dr. Sharp, but he is quite the impressive runner as well.
Dr. Sharp: I haven’t talked much about running here on the podcast, so maybe that’s something that I’ll get into from time to time, but yes, Jen and I have done a fair amount of training together, and always a good time.
Thank you for that little introduction and a little bit more information about you. Like I said, Jen, I just wanted to have the opportunity to pick your brain as a therapist who appears to value assessment and evaluation in your work with clients, and just have a conversation with you about what assessment looks like from the therapy side and some things that are helpful, not so helpful. And we’ll just see where the conversation goes.
Jen: Yeah, that sounds great.
Dr. Sharp: Okay, cool. Well, so I think one of my first questions is as a therapist, what is running through your mind when you’re working with clients that maybe lets you know that that person could be appropriate to refer for an assessment? How do you know that?
Jen: That’s a really good question. I think that in the settings that I’ve worked in before, a lot of the clients had had an assessment before they had even come to me.
What’s very different in private practice is that I may get a client that has had a lot of counseling before, I may get a client that this is their first session that they’ve ever come and they’ve never done any counseling before. And so [00:06:00] that’s going to really have an impact on the amount of information that they know, and then the insight that they have and what they’ve tried, or if we’re starting fresh and new.
And so, on one hand, I think that there’s really not a bad time for an assessment and that actually most of my clients could benefit from them because it gives so much more information. And the more information we know as therapists and the more information the clients know about themselves, we’re going to be able to treat them more effectively, more efficiently, more fluidly, and help meet a lot of their needs.
More commonly, I would say where I find myself referring or having that question come up is when, I have a client who maybe they’ve done a lot of different types of therapy, whether that’s with me, I’ve used a lot of different strategies or they’ve already done that in the past and they’ve struggled consistently. And while they may or may not have something identified as going on, like, all right, this is definitely anxiety, or this is definitely a mood disorder or this, they may have heard a lot of that language or even been diagnosed in the past, but it seems like a lot of the standardized treatments have not been successful in really matching what they need.
And so that may be the case for me individually too and working with them, where I have all of these tools and I have a pretty good idea of what’s going on, but something is missing. There’s a piece to the puzzle missing that’s interfering with our treatment and our effectiveness. And that’s a really difficult process for the client to go through and also for me as a therapist.
And so at that time, it becomes pretty crucial for us to get a different perspective to see what’s missing. Whether we’re also needing to see that may be impacting this that’s not showing up in therapy or that we haven’t identified yet. And so, that’s probably one of the more common times that I would [00:08:00] refer.
Dr. Sharp: I got you. I certainly would consider you a fairly seasoned clinician who has a pretty big range of interventions and good clinical sense about your clients, but it sounds like maybe there are some times when you get to the place where it feels like there’s something missing or the client has had some varying diagnoses over the years and you might need to supplement that or clarify things to guide the treatment. Is that right?
Jen: Yeah, absolutely. And I think that there are certain things that I would say I’m really specialized in. And so, I’m familiar with how all of the different ways or many of the different ways that that can present, but that there’s other areas or other components that may come in that I’m not as trained on, or I don’t have as much expertise on or hasn’t really shown up in that way.
And so, we as therapists, are working day in and day out with the client and we’re doing our own assessments consistently, but we’re also dealing with whatever’s coming in the room at the moment. And so, it’s a lot of moving parts. And in that, I think that it gives us a really unique perspective of the client and we would know them really well, but it can also possibly make us miss something because we’re in it and dealing with all of the pieces at the same time.
I get a pretty good sense of, wow there’s just something that either I don’t think is really right, or as far as the diagnosis or the treatment that we’re doing, something feels like it’s really not effective. Or maybe I don’t know at all, or maybe I have a hunch of what it is, but it really isn’t in an area that I know a lot about. So I want to know what’s going on, what referrals do we need to make and how can I be more effective.
Dr. Sharp: I got you. Sure. That really makes sense. It’s interesting. I think the two processes, [00:10:00] therapy versus assessment are a good match because each addresses the flip side of the other, right? Like you have a really good working knowledge of your client and sort of that long-term sense of what might be going on for them. And then, an assessment can jump in.
I really like dropping into someone’s life for a pretty short period of time, but have it be really focused and look at these really specific pieces of functioning and then use that to integrate with what you already know about them and supplement the work that you’re doing with them.
Jen: Yeah. And I think that is really helpful because knowing them or not knowing them is really going to be… you can’t have that knowledge in the other perspective without being able to come in fresh. And so, that fresh set of eyes. And then in addition to that, I don’t do testing as a therapist. And I don’t do the same types of assessments. And so, the expertise that you have and what you’re able to do at your center is very different in what it can provide. And so that is another piece that’s really helpful for me.
Dr. Sharp: Cool. Yeah, I’ve talked on here before about one of the things that I really like about testing is getting to know people in a fairly intimate way, but it’s a very different intimacy than happens with therapy, right?
Dr. Sharp: Yeah, hopefully, complementary services.
Dr. Sharp: I was curious also when you do refer someone for an assessment, what are you hoping for in terms of outcome or recommendations or what you take away from that assessment when it comes back to you?
Jen: I think when I refer, there are a couple of different areas that I’m looking for. Myself as a therapist, I’m looking to understand the client more [00:12:00] fully to see what all pieces may be impacting the symptoms or what’s going on. What are some of those underlying things that maybe are going to help me be able to support the person moving forward, but also what recommendations do you have based on that that are going to help guide my treatment planning or help guide the team that I am trying to put in place to support the client? What referrals, what kinds of things in that way are going to come from that.
And then for the client, my main goal is, I talk about it in an exciting way, like this is a super helpful to know what ways in which you think, what is going to be some of your strengths, what are going to naturally be some of your challenges, all of us have these things.
And so this isn’t something where the purpose is to go and gain a label. That’s just so we have a common language to be able to discuss things, but that it’s really about finding out about yourself more deeply, which can really help come over some of the barriers that are happening in their lives or help bring in the support for some of the things that maybe they don’t know, aren’t things that they can necessarily change, but there are things that they can be more effective in addressing and gain skills in.
And so, I think that both of those sides. And then also for the families, I think that that’s a big part that it’s helpful in too is educating the families and support people around them.
Dr. Sharp: So, you really got into something that I wanted to ask you about, which is how do you talk with clients about an assessment when you’re making that referral? And maybe there is a difference. Maybe you could speak to this, if there’s a difference between how you talk with parents about the referral versus how you would talk with a young adult you would refer to assessment.
Jen: Sure. And I think that part definitely depends on the person. I think some of my clients are more [00:14:00] interested in it or maybe excited about it, whereas others feel really tentative to do it, or they don’t want to, or they’re having no clue what it really is. And so, it’s that feeling of like anxious and is something wrong with me. Do you think something’s wrong? It’s going to be another thing, that I’m going to feel shameful about?
And so, I think part of it with clients because of their level of vulnerability and where they’re at any given point and their openness to it, I’m talking to them about what it is; what our real goals are, not, Hey, this is the exact test that’s going to happen, and this is how it’s going to go, but more in the sense of how it’s going to help them, how it’s going to serve them, how it’s really about gaining information so that we can help support them moving forward. That it’s just as much also for me to be able to confidently be able to lead them in a direction that they want to go.
And I think that’s one of the most difficult parts in therapy when we don’t have something accurate, like a diagnosis or some of those underlying things is that I see clients feel a sense of hopelessness. Like this is never going to get better. I’ve tried all of these things. And while there may be a lot of reasons for that, I think that there are a lot of times where it’s because we don’t know something and that when they’re able to find that, there is a greater sense of hope for them.
Dr. Sharp: Yeah. I was curious about that. That got me thinking. I work with kids primarily, so I talk with parents a lot about the pros and cons of having a “diagnosis or a label.” I wonder, do your clients bring that up much with you? The pluses and minuses of that label or the diagnostic process. How do they talk about that?
Jen: I think it is definitely client-dependent. [00:16:00] I have a good portion of clients who they really want to know. When they find out what is going on in terms of an actual label, their life can begin to make sense, like all of these different parts that maybe they felt like I struggled in every area, but they’re seeing the reason that I struggle in every other area simplifies it in a way, or at least validates, this is a thing, this isn’t just something that I’m not trying hard enough or I’m not doing that.
On the other hand, I think people, some of my clients that have had a lot of therapy and maybe throughout the years, and that they have gotten a lot of diagnoses or they’ve heard a lot of that language or that it’s been talked to them in a negative way like something that wrong, like always trying to figure out what’s wrong with you, that can be really damaging. And so then with those clients, I really talk about the purpose of it to how it too. How that really isn’t what we’re looking for.
Parents, a lot of times, I notice at least with the clients who I work with, are a little bit more concerned about how the diagnosis is going to impact their child in the future. Are they going to be labeled on everything? How is this going to impact them? And I’ll get a lot of those questions when I talk about referring too.
Dr. Sharp: Got you. So just for my own curiosity, I’m curious how you frame that for them when they voice those concerns.
Jen: The parents?
Dr. Sharp: Yeah.
Jen: I validate them in saying that, of course, there is stigma out there. There are impacts. I understand where they’re coming from and I understand their concerns. And I explain to them a lot about the confidentiality process, and really again, why we’re doing this in the first place is [00:18:00] that we’re looking at, if we don’t know what’s really going on, we’re going to constantly be feeling the struggle, and that it’s going to serve them rather than hurt them in getting what they need. And that the assessment is a lot about gaining information. They can choose what they do with that information. I think knowledge is power in that way.
Dr. Sharp: I like that. I like the way that you say that they are able to choose what they do with the information.
There are some rare cases that I run into, I think about court-ordered stuff, mostly where the parents or the individual, they’re obligated to release the report to someone else, but in the vast majority of the cases, that’s not true. And so, I take the approach of, let’s present them with all of this information and talk through it and try to present it in a healthy way, and then it really is their choice what they do with it. And I’ve just given them the tools to, well, to work with, and then they can take it where they want to take it.
Jen: Right. And I think, that’s a big part of therapy in general or moving towards goals is that, we try and do the best we can to identify what we’re seeing and be able to provide what we can, and that they really are going to choose what to use and how to utilize that.
Dr. Sharp: Sure. I was also curious, I think I’m switching gears more to I’d say the practical or logistic parts of the assessment, but I’m curious for you what makes a useful report?
Jen: That’s a great question because I think, in the past, I don’t think I knew really a lot about what was even in a psychological evaluation. Working in the settings I did before, I may connect with the psychologist and get an overview, look at it, [00:20:00] but I really have learned a lot since being in private practice and since connecting a lot more with psychologists in the community for me to know what the benefits are and what ways that that can serve me.
And so, I think in the actual report part, the recommendations are such a huge part for me because we are in the depth of everything with the client and working through so many different pieces that I think it helps me to step back and see, it could be a very simple thing that, of course, I would know, to write down a client’s goals. I think that was one of them that you told me which may seem simple.
At the end of the session, write down the client’s goals. This person really needs that. A tangible, visual reminder in that way because of the way in which they think. And while that may seem simple, we have a whole lot going on. And so having that overview, that recommendations refreshes me on some of the things that I may already know in that way, but also, a lot of the things that I may not have thought of or not known. Those pieces are really helpful for sure for me in a really practical way in therapy.
Also, knowing exactly what is going on for them in terms of the diagnosis is really helpful because I may have not looked at it in that way before. And that can really help me either identify if I’m able to work on that with them, or we need some other pieces in place of support to address certain areas.
Dr. Sharp: I got you. So it sounds like the recommendations are really a key part of the report for you as a therapist?
Jen: Yes, for sure.
Dr. Sharp: I think that something that as evaluators, speaking to psychologists or mental health professionals who do [00:22:00] testing, one thing that gets brought up a lot is the length of the report. And we have these discussions amongst ourselves about how long is too long. What information do we include? And I’m talking primarily outside the recommendations. So just the text and the results and that kind of stuff. So I’m really curious from your perspective as a therapist, how do you feel about the rest of the report outside of the, let’s say, interpretation and recommendations?
Jen: For me personally, I find it interesting and I look through it and that I can gain pieces of information from that, but that’s less helpful for me in terms of what I’m actually going to be doing with it. And so I think, again, that could really vary between a variety of different therapists, but I can sometimes get maybe even more lost in it just because of what my focus is and what my training is, and what I’m looking to gain from that.
So it’s more of, I guess, an educational part for me, but also it can get long. We don’t have a lot of time to be able to look through every single part or understand every single part, but there are a lot of the parts and really the summary that I think hit on the essential pieces for us.
Dr. Sharp: Yeah, there are some talks and there are some models out there of folks who do assessment where they actually put the summary and recommendations right at the front of the report, underneath all the basic demographic info and referral question, and then just put the results and the test tables and numbers toward the back. And so I wonder from your perspective, would that be more helpful? Do you think?
Jen: I do think so because of the [00:24:00] setup of it and now I have a pretty good idea of how it’s set up. So I do find myself going to that part. For me, it helps give me more of a framework for, okay, where are we going? The rest are a lot of specifics that are really important in understanding and are necessary for sure to be looked at and to be included on the report, but that pieces it together differently for me with looking at that part first.
The other piece that I really like that I wanted to hit on in the report is the strengths section. And I think that that’s a huge part that is helpful for clients, especially when they’ve gone through so much testing. There’s a lot of anxiety with that sometimes, and they’re really not sure what is going on with me and they’re sometimes used to looking at what’s wrong, that that part is equally helpful because we can really lead with that. All right, here are all of the things that are really strong for you. And even sometimes because of those things, these other pieces are going to be challenging.
And so it helps to be able to explain the other parts that maybe they are having challenges on in a more empowering way. And I think that that’s the biggest piece that’s helpful for clients or what I like about it the most is like, then they can be empowered to be able to know what’s going on with them and get what they need support wise.
Dr. Sharp: Got you. That was a shift that I made, I don’t know, 3 or 4 or 5 years ago. I don’t know when that was when I had a conversation with somebody else in the community and they were talking about evaluation in general, not necessarily our reports, but this person said something like, gosh, those reports, the summary just always focuses on what’s wrong and how to fix it. And I got to thinking like, yeah, that’s right. [00:26:00] Maybe we should bounce that a little bit and started adding a bigger section on strengths in there and really emphasizing that. Even though in my mind, I was always thinking about strengths and appreciating them, I think putting it in writing to make it more permanent until that clients really latch onto it is pretty helpful and necessary.
Jen: Yeah, and I think it helps them be more open to the feedback of the other pieces that they can see, all right. I’m being looked at as a whole person. And again, that part that I really focus on is, this is about understanding the way in which you work more. And that there are a whole lot of tools to help in the areas that are not going well. We really need to know all of these pieces to be able to use the right one. And so, I think that that openness to receiving the feedback for my clients or even getting them in the door really helps to be able to say, this is also going to look at what is going well for you, what is going to come easier for you. And that is equally valuable.
Dr. Sharp: Sure. Absolutely. Well, this has been great. I feel like I need to ask, we talked about all the good things about assessment, but I’m really curious about the things that are more challenging from your side, or maybe what makes a bad report or a bad “assessment process” and things just to keep in mind with future referrals.
Jen: Yeah. I think that the main barrier is before we even get the client in the door. When I think of assessments it’s like, how do we actually get them there? And all of the logistical things like what insurance do they have, or what does that look like? Schedule-wise, how booked out? Those types of things. Those are the natural barriers that are going to be [00:28:00] there, but that I think have really worked out well, especially, as you’ve expanded and everything. So, that’s a huge part.
People, once they’re committed to going, of course, want to be able to have it all happen quickly. And that that’s not part of the process that that really can happen in that way because it takes time to assess someone and it takes a big investment for them to go in and do all the testing and do all of that. And so, I think that them valuing that is important and it’s important that it takes that amount of time, but that can be something that’s a struggle for the client.
Other pieces, I think along the way, like I may not really know exactly what I’m looking for. I know that I don’t have all of the pieces. And so, that can be a part that I struggle with. Intuitively, I feel like I need more information and that there are parts missing. I’m sending them to be able to have some of those pieces looked at and put together, but I may not really know, even maybe a learning disorder, maybe it’s something entirely different. And so that can be a part of that comes up for me.
Other pieces are, when they’ve gone through the process and they’re in between before getting the feedback session, they’re wanting to ask me a lot of questions, and of course, naturally I’m not going to have that information. And so, I try and help support them in waiting and collecting their questions and asking them during that time.
The feedback sessions are really helpful. And I also think it’s a lot for clients to take in at that time. It’s a lot of information and that’s exactly what they want and exactly what they need. And it can be overwhelming. So many of the questions [00:30:00] that will come to their minds are after that session is over. And so those are a lot of the ones that I get in that time before we have all of the information or I have the report. And that there’s a lot of questions, that’s the time that we’re where I’m also recommending that they wait while we gather more information, or refer them back to you. That can be a time where they’re wanting to know or they’re maybe confused and they’re not sure what to do right now.
And then just really what’s the next step is the other piece. What’s the very next step that we take is, is usually what they’re asking me as well.
Dr. Sharp: After the feedback, you mean?
Jen: Yeah. So it’s like, okay, we have all of this information and we have a lot of recommendations. What’s the very next thing that we should do today. And so, in that piece, I think it is helpful to have really prioritized way of knowing what is most important.
Dr. Sharp: I got you. That makes me think about how we structure feedback and what we leave people with, and wondering if, making it more clear as they take off could be helpful for them almost like giving a roadmap or a checklist or something like that to help guide them.
Jen: Yeah. And I think that that’s part of why I really liked the summary too, is that I can know, okay, we’re going to go here and I may be able to see a little bit more clear. Definitely, I can see more clear what that roadmap is and what some of those next steps are. For them, maybe they’re taking in the information and trying to absorb that. And that may take a little bit longer. That piece may be helpful to just have a simpler [00:32:00] part at the end of saying, here’s what I would really prioritize or focus on in the coming weeks.
Dr. Sharp: That’s great. Thank you.
Dr. Sharp: Well, I really appreciate your time today and your willingness to come on here and talk with me about assessment from the therapeutic side: what you’re looking for, what doesn’t work so well, and how to really help integrate those services for our clients.
Jen: Absolutely. I’m really glad that you had me on and I really do value the assessment and testing process and the work that you all do there. It makes my job not only easier, but sometimes more possible, more hopeful, and that I can feel more confident in helping people and that they can feel more compassionate to themselves and understand themselves more. And so I think that that’s just a really valuable place that you’ve created to be able to support clients in that area.
Dr. Sharp: Yeah, absolutely. Well, before we totally take off, let me ask you, Jen, if there is anything else, just keeping in mind that a lot of our listeners are probably psychologists who are doing testing and evaluation, anything from your side that feels really important for them to know, what’s helpful, what’s not helpful, any parting words of wisdom?
Jen: Sure. I think that one of the things as a therapist that I would put out there to psychologists and people that are doing testing and giving us the information is to not be afraid to really directly let us know like what is probably going to be working and not.
As therapists, we have a lot of different types of training of course, and we have maybe a lot of information and we’re specialized in certain areas, but we definitely don’t have a lot of the information that you have specialized in a lot of [00:34:00] different areas. And so that there’s really nothing too simple to tell us or too complex to explain like that as important.
And so to really not assume that we may know or not know, but let us have the information that you feel is important that’s going to help us aid our clients because we may not have it. And so that I think could be the biggest one. I really appreciate it when someone can say, yeah, I don’t really think that this is going to work very well, and here’s why. This is maybe going to be a better path and here’s why. That is a very helpful piece for me.
Dr. Sharp: I got you. Well, thank you. That’s super helpful. And again, thank you so much for your time. It was great to chat with you. We do a lot of talking on our runs and consulting with clients. It was really cool to be able to do a little bit more of an interview and hear some of these thoughts that you have.
Jen: Absolutely. Thank you so much.
Dr. Sharp: Yeah. Take care, Jen. Bye-bye.
Jen: You too. Bye.
Dr. Sharp: All right. Thanks for listening to our podcast today. It was a great interview with Jen Knopp, giving you some perspective from the therapist’s side on what makes a helpful assessment and report.
As always, if you enjoyed the podcast, do me a huge favor, and head to iTunes. Google Play, Stitcher, take 30 seconds to subscribe to the podcast. That really helps here as I’m getting started. If you are interested in more resources about testing, you can always head to the website, thetestingpsychologist.com.
If you really want to take some steps to boost your testing practice and add some services or grow your testing services, you can check out the four-week email course. It’s called the four-week blueprint. You can find that at thetestingpsychologist.com/fourweekblueprint, and all you have to do is enter your email address and you’ll get a weekly email for the next four weeks with pretty concrete action steps to really help you build or [00:36:00] grow your testing services in your practice.
If you want to just connect with other psychologists who are doing testing, head over to Facebook, we have a Facebook community called The Testing Psychologist Community. You can click and search at the top of Facebook, or you can go to the website, which is thetestingpsychologist.com/community.
Thanks again, everybody. I’ll talk to you next time.