Update as to the impact of COVID-19 on psychological assessments

We are still working and using telephone and video-conferencing approaches (if clients have access to computers – telephone is probably going to be the most common approach). We anticipate completing addendums later to address any gaps in the assessments caused by remote working. The situation is evolving as psychologists and it is mostly working well so far, however the main issues for assessments are:

1) Cognitive assessments with adults especially are more limited, however it is mostly still possible to crudely determine whether someone has cognitive difficulties. It helps a lot if the client has access to a laptop/computer.

2) Assessing attachment directly is challenging with under-7s as contact observations will be difficult where there are not extensive contact observation notes or if the contact sessions can’t be observed remotely when they go ahead (this method is being used successfully too). Assessing attachment in under 11s will also be difficult, but there may be scope to gain useful information. Attachment is also largely assessed from historic information, so this will still be possible. Drawing techniques are also used a lot for assessing attachment, which may be possible, for example, if the child can be interviewed using videoconferencing and has access to pens and paper. However, there are likely to be difficulties with this. 

3) Assessing parents will be more straightforward than assessing children as this can be done over the telephone in large part. 

4) Assessing children age 7 – 11 will be hardest over the phone, but will be down to individual children. 

5) Assessing adolescents over the phone will be easier, but again will vary across individuals.

6) Visual information will be lost without video-conferencing. This may affect whether we can detect visual signs of mental health issues in adults and children/adolescents (e.g. depression, social anxiety) and neurodevelopmental issues (ADHD, autism) – as we practice more assessments remotely, I anticipate that other ways of assessing this will become obvious.

7) A key concern for remote working is who is in the room (parent or carer) as this may affect the reliability of the information provided by the interviewee particularly for children and vulnerable adults – the expert will advise participants that no-one else should be in the room where appropriate and that, if someone is, this will be stated in the report. The expert may also ask people, where possible, to move the camera to prove no-one is present. Obviously, people can still be within earshot and this is difficult to resolve. 

8) Another concern is about who is completing the psychometric forms – many will be read out by the expert, but not all can and will be posted in advance – precautions as per point 7 above will be taken. Also, tests will be posted in an envelope within an envelope and the interviewee can open this in front of the psychologist to prove that they have not been tampered with in advance. Both points 7 and 8 are more of an issue where a child lives with a parent or where parents believed to be in abusive relationships are co-habiting.

We will still be able to:

1) Read the bundle

2) Liaise with parents, foster carers, teachers and other professionals as is commonly done by telephone already.

3) Complete a large number of psychometric tests by telephone (something that is already done)

4) Areas that can be assessed well over the phone include:

           Parents: 

Full personal history (early life, educational/employment history, relationship history (dv), mental health history, reflective functioning (attachment), forensic history, current mental health (without visual information of meeting them), relationship with children, financial circumstances/support, statutory support received. They will also be able to provide a developmental history for the children. 

           Children:

Assuming they can be interviewed by phone, we can gain information about their educational, academic, emotional and social wellbeing, relationship to parents and siblings (attachment) and all psychometric tests. Often children do not talk to experts under ordinary circumstances for lots of reasons (e.g. coercion, split loyalties, social anxiety, neurodevelopmental issues etc) so some aspects of the assessment may not be too different in that regard.

This alone will produce a substantial amount of information. Overall, although reports will probably be less comprehensive, there is still a lot of useful information to be gained and I am confident they reports will still be able to address the Court’s needs to a large extent. As we move to this way of working, more opportunities (and issues) will emerge I expect and I will keep you update this page accordingly. 

 

What helps?

  • The client having access to a computer as this makes screen sharing much more viable and helps with cognitive assessments in particular. Also interpreters can just join a virtual meeting and this is working well.
  • If children are in care already, we just liaise with their carers to help with the interview and assessments are progressing really well in these circumstances
  • A reliable adult being present to assist children or vulnerable adults with the tests, the technical equipment and so on.

 

Safeguarding and risk procedures for remote working

  1. Psychologists do not take the email addresses or telephone numbers for children and young people, rather they will arrange teleconferencing using parent/carer telephone numbers and email addresses.
  2. Where we assess children living with biological parents or parents living alone, the psychologist will make sure they have the social worker’s number and the duty number as a backup – if they witness any incidents, the psychologist will contact the social worker (or police if there is immediate risk). They will also let the social worker know when a meeting is taking place.
  3. If someone living with a family member or alone expresses suicidal ideation, psychologists will use standard practice, i.e. encourage them to speak to a GP, go to A and E or call an ambulance, and will be prepared to contact emergency services if necessary. They will also contact the social worker immediately as they will be best placed to co-ordinate a response. 

 

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