Counseling or Psychological Testing?

Q: We are trying to determine the best 1st step towards addressing our daughter ‘s challenges. She is in 4 th grade. We don’t know whether to start with testing or start with counseling. Some behaviors of concern include: refusing to participate in class activities and work, withdrawing by hiding hr face, age inappropriate tantrums, negative self image, inability to handle frustration, strong need for control, strong need for inclusion. Help… T.

A. Dear T,

In general psychological testing can more quickly give you a deeper understanding  about the sources of your child’s behavior.  It can also answer questions that counseling cannot answer.   Also, if you understand subtleties of your child’s functioning and how they came to be that way, you can often get to the issues much more quickly in therapy.  In your case, the testing administrator would seek to answer the following questions:

1) What are the most likely reasons your child refuses to participate in class activities.  Does she have a learning disability that underlies her resistance?  Does doing school work make her feel bad about herself and therefore she avoids the work to keep herself from feeling bad?  Has your daughter developed some obstanence as a way of coping in general.

2) How did your daughter come to have a negative self-image.  What aspects of her self-image make her the most unhappy.  How severe is this as compared with other children her age;

3) What impedes her ability to handle frustration? What can she do to overcome this?  How can you help?  How can her new counselor help?

4) What underlies her strong needs for control?  Children develop control issues for a number of reasons including:  obsessive tendencies, anxiety, early attachment difficulty or trauma and many other reasons.  If we have an idea of the reasons for that we have much more hope of finding a solution that works.

5)  What is her strong need for inclusion about?

Many of these questions can be answered during the course of therapy with a good psychotherapist but it is likely to take longer.  The question that can’t be answered in counseling is whether she has a learning disability that may be the source of many of her other issues.  The advantage of starting with psychological testing is that you have a lot of information from the beginning and can often cut several months off the start of therapy if you have a good testing report.

The reason why some parents choose to start with counseling is that the behaviors are so unmanageable either for the parents or for the school that jumping into therapy may alleviate some of the problems just because your daughter will have an outlet and you and your daughter’s teachers will have some support and advice.

There is also the option to begin both simultaneously, getting the best of both worlds.  In this case you would probably have one person do the testing and another person do the therapy.  This is necessary because having a counseling relationship that is close, trusting and therapeutic may invalidate the testing results or alternatively, the demands of the testing situation may impact the close, trusting relationship your daughter has with her therapist.

My suggestion is you make an appointment with a therapist and discuss the specifics.  Once the therapist gathers more information and gets a good history of what your child’s life has been like up to this point, he or she will be in a better place to give you advice on the best way to proceed.

The thing to keep in mind is that no matter which way you go, you are helping your daughter to become more emotionally healthy, happy, and resilient.

Cynthia Divino



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