This week’s blog was contributed by Carrie Champ Morera, PsyD, NCSP, LP. Carrie is a licensed school psychologist and the lead project and content director at PAR.
The increased use of telehealth—including teleassessment—has changed psychological assessment practices. Although many of us have adjusted our assessment practices to keep up with the times, we have to keep in mind that, when engaging in teleassessment, our practices must be ethical—just as if we were providing in-person assessment services.
Here are 10 ethical considerations for practitioners to consider when providing services via teleassessment.
1. Obtain informed consent. Just as you would do with in-person assessment practices, obtain informed consent prior to providing telehealth services. Informed consent is more than a form—it’s a process.
2. Train and practice. Carefully review standardization procedures for the assessment. Practice the assessments several times using the technology and platforms with which you plan to administer them.
3. Consult with colleagues. Talk about ethical dilemmas with colleagues, consult the literature, and continue to update your ethical guidelines. It’s important to lean on one another for practice, support, and guidance.
4. Follow the publisher’s guidelines. PAR developed a statement on telehealth that addresses test security and measurement concerns. The integrity and security of the tests must always be maintained.
5. Keep forms and data secure. Make sure paper protocols and electronic forms are stored securely. Consider password protections, encryption, and malware protection and keep backups.
6. Establish and maintain professional boundaries. It can be tempting to relax your professional boundaries in a telehealth setting. Dress professionally, reduce distractions, and set clear expectations with your clients.
7. Consider cultural factors. Consider the implications for clients from traditionally marginalized backgrounds or various socioeconomic and ethnic backgrounds or those with less computer experience.
8. Document the use of digital and remote assessments. Include a statement in your report that assessment was conducted via telehealth. Record any technical issues, and disclose any modifications or alterations of standardized procedures.
9. Consider the psychological effects of the pandemic in digital and remote assessment. We’ve seen a general increase in anxiety, depression, grief and loss, and isolation. Go beyond scores and evaluate individual item responses. Stressors all contribute to these psychological effects, perhaps now more than ever.
10. Take advantage of PAR resources. We have many teleassessment resources and a wide selection of products available for administration, scoring, and/or interpretation on PARiConnect—and we are always adding more! Need to brush up on your teleassessment skills? Check out this video from PAR’s Director of Customer Support, Daniel McFadden, or visit the PAR Training Portal for more insight. You can use PAR products via telehealth technology while retaining the integrity and security of the measures. PAR has several tools available to help you navigate this challenge.
Digital options to help us complete the work we do are increasingly important as digital interactions become more common in psychological assessment. We at PAR are committed to helping you serve your clients and recognize your increasing need for digital materials. Digital assessment options (like online and remote products, e-Stimulus Books, and e-Manuals) offer several benefits, including improved flexibility and support for your practice—whether you work in school, hospital, private practice, or other settings. Digital solutions can also provide increased accessibility and security in addition to environmental benefits like reduced use of paper.
We want to provide you with more options for test administration (e.g., on-screen vs. paper-and-pencil) while reducing the number of materials you need for administration and addressing concerns about hygiene with printed materials. We are expanding our library of e-Manuals, e-Stimulus Books, and remote assessment tools and adding more products offering administration, scoring, and interpretation via PARiConnect. We now offer more than 100 e-Manuals, which are easily accessed from our new Digital Library in PARiConnect. These digital versions of PAR professional manuals are also downloadable (limited to a single user and device). See our full list of e-Manuals.
Our In-Person e-Stimulus Books allow for easy, safer administration of stimuli via tablet and are designed for in-person testing sessions. Convenient and user friendly, these digital tools provide flexibility and confidence in testing and are hygienic and easy to clean. Visit parinc.com/e-stim to see what’s new. We also offer remote tests designed to be administered via videoconferencing. Learn more about our remote assessment solutions.
Finally, our online assessment platform, PARiConnect, allows you to administer and score tests from most internet-connected devices. Designed in strict adherence with HIPAA, this flexible tool is adaptable for any organization, from small, solo practitioners to large, multilocation groups. More than 75 assessment tools are currently available, and we are continually adding new products. New to PARiConnect? Get three free uses just for signing up.
No matter your setting, we have a digital solution that can help take your practice beyond paper and pencil!
This week’s blog was contributed by Maegan Sady, PhD, ABPP-CN. In addition to being a licensed psychologist and board-certified neuropsychologist, Maegan is a project director in PAR’s research and development department. She worked as a pediatric neuropsychologist for nearly a decade before joining PAR.
Psychological assessment allows for three types of clinical decisions: diagnosis, treatment planning, and measuring change over time. Assessment involves integrating information from multiple sources—tests, rating scales, observations, and interviews—to answer a given referral question and provide recommendations.
To best serve clients and patients, providers should engage in evidence-based assessment (EBA; related terms include evidence-based medicine, evidence-based practice, empirically based assessment, and evidence-based instruments). EBA relies on scientific knowledge to help providers make clinical decisions. Although EBA has been a longstanding goal in psychology, clear documentation of EBA standards has been in place for only the past 15–20 years.
Choosing reliable, valid assessment tools is the foundation of EBA. Basic psychometric strengths include representative normative samples, strong internal consistency, sound construct validity, and test–retest statistics (built-in change metrics are a bonus!). Because validity applies to the use of a test for a specific presenting problem in a particular individual, studies using discriminant function analyses and base rates identify the clinical utility of tests for given populations.
To use an EBA approach, ask: What tools can I use to rule the proposed diagnosis in or out? For which related conditions do I need to screen? What else do I need to know about this client to recommend an appropriate treatment? Which tests are sensitive to change in the constructs being targeted?
Increasingly more tools are available to providers to address real and perceived barriers to practicing EBA. Special issues of journals are devoted to using EBA for various conditions, books contain systematic reviews of instruments, and professional organizations have position papers on topics including serial neuropsychological assessment and effort/malingering.
To keep up with advances in research relevant to your practice, create Google Scholar or PubMed alerts to generate periodic emails (use search terms like “evidence-based assessment,” “meta-analysis,” or “systematic review,” along with key disorders) and organize the literature in a free citation manager. For an informal approach, follow known researchers and EBA gurus and join social media groups for your clinical interests. Subscribe to professionally focused podcasts and queue up relevant episodes for your next commute, walk, or hammock session.
At PAR, we aim to propel the growth of EBA by working with our customers to make it easier to search for information about tests and to collaborate on clinical data repositories. Visit the PAR data collection page for more information.
Browse parinc.com/resources for training and supplemental materials, put our products to the test in your clinical research, and reach out to us if you have data on clinical samples. Though the initial adoption of EBA practices takes time and effort, you’ll see the results via more precise decision making and buy-in from clients. It’s never too late to jump on the bandwagon!