Evaluation may be useful for patients who are:

• in an acute state, cognitively impaired, or non-responsive to interview procedures and treatment recommendations
• learning disabled or developmentally delayed
• experiencing subclinical dissociative processes, guardedness, or oppositional disorders that interfere with usual methods of evaluation and treatment
• subclinically neurologically impaired due to effects of trauma, dissociative, or transient disorder
• experiencing atypical, subclinical medical complaints, fibromyalgia, chronic fatigue, chemical sensitivity, severe atopic allergies, transient sensory impairment, or atypical medication reactions
• cognitively and motivationally impaired due to substance use
• experiencing complex, co-occurring biological and psychological disorders that are responding atypically to treatment

Psychological and neuropsychological evaluation provides a "map" or "x~ray" of how information is being processed, and where information is getting stuck and not being processed. This data allows differential diagnosis and recommendations for treatment. When individuals are cognitively impaired or using substances, a written "map" may be particularly effective in cutting through confusion, opposition, or denial.

Multiple diagnoses are usually found. Recommendations often include medical evaluation and management of biological I medical factors, cognitive/behavioral rehabilitation strategies for coping with neurological impairment and dissociative processes, and a range of treatments for psychological issues and family issues. Specific guidelines for managing acute states and preventing acute episodes during recovery from immunological and dissociative disorders are included if needed.

If a trauma component is identified, recommendations may include a brief trial of hypnoanalytic therapy to see whether it can be cleared. Sometimes patterns that look like life-long learning disabilities or characterological syndromes can be shifted dramatically if a trauma component is involved in the development of this pattern. Dissociative processes that do not respond to talking therapy often shift dramatically in response to hypnoanalytic work with parts of the self split off due to trauma.

If patients are in c:risis, evaluations can often be done on an emergency basis, with report to physician and/or therapist within a few days. A test report can help create a holding environment (visual structure persists in time) that contributes to stabilization without hospitalization.

Adjuctive evaluation does not interfere with the primary treatment relationship with therapist or physician.

If these services would be of use to you, colleagues, or patients, please give me a call.

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