How Much Testing and Time is Involved in a Psychiatric Evaluation?

Reader’s Question

When a psychiatric evaluation is done on a person…what is the type of testing usually used and how long should would this type of test be?

Our Clinical Psychologist’s Reply

There is a wide range of Psychiatric and Psychological Evaluations. The testing, time, procedures, and ethical/legal issues depend on the situation and request for the evaluation:

• Some evaluations are for a “clinical opinion”. We encounter these in many medical, injured worker, disability, and treatment situations. The examiner (Psychiatrist or Psychologist) is asked for his/her opinion regarding the case. These are probably the shortest evaluations in terms of time and can include a 30-minute hospital consultation, a 60 – 120 minute office examination, or an interview with some additional personality testing.
• Testing in Psychiatric and Psychological evaluations can involve one to several hours, depending on the tests selected. Individually-administered instruments, such as IQ testing, may require two hours. A true-false personality instrument may require one to two hours. A complex testing battery, such as an assessment for neuropsychological functioning (following a head injury, brain surgery, etc.), may require more than six hours. Tests are typically selected to answer the referral questions such as 1) Is the individual mentally ill? 2) Are they intellectually limited? 3) Can they work? To answer these questions, several instruments can be selected, at times requiring an entire afternoon or day at the office.
• Some evaluations are for a clinical and “legal” opinion. These evaluations are more involved and may require many hours to address such issues as child custody, not-guilty-by-reason-of-insanity, potential for violence or to reoffend, or examinations at the request of the court system. The more complicated the legal or clinical issue, the more complicated and complex the examination. In high-profile court cases, a psychiatrist/psychologist may work for many hours over several months before submitting a report to the court. Overall, these are very time-consuming, expensive, and complex evaluations.
• Some evaluations are in response to specific questions. Psychologists frequently receive requests for evaluations related to IQ, learning disability, ability to work, etc. In these cases, a combination of examination and psychological testing may be used.

In clinical practice, most evaluations are under three hours and may or may not use personality or other testing. If you are being referred for a legal or criminal case, you can expect a longer examination with psychological testing. Again, the more complex the referring questions or situations, the longer and more expensive the examination.