When you first start EMDR therapy, your therapist may ask you to complete certain psychological assessments. These assessments provide an objective and systematic insight into your mental state, behavior, and personality. Psychological assessments provide your EMDR therapist valuable information that will help guide the EMDR process. You may be given one or multiple assessments to complete during or before your session. Often, testing is redone to see if there have been any improvements.
At Dr. Mazzei’s practice, she utilizes various psychological tests for EMDR therapy. Some of the tests examine broad psychological issues, such as anxiety and depression, and assist with diagnosis. Other tests aim to identify any issues with dissociation.
What Are Psychological Assessments?
An assessment includes norm-referenced tests, informal tests, surveys, observational information, and clinical interview data. Categories of tests include intelligence, neuropsychological, face-valid symptom inventories, projective tests (e.g. Rorschach), and personality tests (e.g. MMPI-2, PAI-2, NEO). These assessments may be very brief or take hours to complete.
What Assessments Are Used in EMDR Therapy?
For EMDR therapy, understanding how your traumatic past has impacted you is very important. This will help determine what to target during EMDR and how best to support you through the process. If you have any dissociative symptoms, this will be essential to know prior to starting EMDR. Depending on the level of dissociation, your therapy may be adjusted to ensure that you are able to tolerate EMDR.
The following are the main assessments that Dr. Mazzei utilizes during EMDR treatment:
The Patient Health Questionnaire (PHQ): A self-administered test to determine symptoms of common mental health disorders. The PHQ consists of five modules covering frequent mental health disorders, including depression, anxiety, somatoform, alcohol, and eating. This instrument was developed from the Primary Care Evaluation of Mental Disorders (PRIME-MD) and is used in multiple healthcare settings.
Symptom Checklist 90-R (SCL-90R): A 90 question self-administered test evaluates a wide range of symptoms that you have experienced within the past week. The 9 symptom scales are somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation and psychoticism. Additionally, a global severity index provides a level of overall psychological distress. This is a longer, but more in-depth assessment than the PHQ. The test takes approximately 15 minutes to complete.
Dissociative Experiences Scale (DES-II): This scale measures various types of dissociation. Higher scores are indicative of dissociative symptoms. This test may be used for both adults (28 questions) and adolescents (30 questions). Questions about dissociative experiences prompt you to answer a scale of always or never. This type of format is referred to as a Likert scale. A score above 30 indicates some level of dissociation and a very high score would prompt a lengthier interview to determine if Dissociative Identity Disorder (DID) is present. One goal of EMDR therapy would be to reduce DES-II scores.
The Multidimensional Inventory of Dissociation (MID): The MID is a comprehensive diagnostic instrument to assess the dissociative phenomena and clinical diagnosis. The MID is a much longer version of the DES-II with 218 questions asking you about dissociative experiences on an always or never scale. The test takes approximately 1 hour to complete. The instrument contains 168 questions directly related to dissociative symptoms and 50 validity items. Test developers include validity items to ensure that participants are answering consistently and honestly. Scores range from 0 to 100 and a score above 30 is indicative of dissociative symptomology.
Impact of the Event Scale (IES): Identifying the nature and severity of traumatic experiences is part of the first phases of EMDR therapy. The IES facilitates this process by asking you about how certain experiences impacted your life. You will be asked 22 questions about a specific event and the extent to which it bothers you within the past 7 days. The IES specifically assesses for intrusion, hyperarousal, and avoidance behaviors.
How Are EMDR Assessments Administered?
Psychological testing may be completed in Dr. Mazzei’s office or virtually for online EMDR therapy. Dr. Mazzei will provide you with these self-administered tests and will assist you in completing them as needed.
Unlike school tests, there are no right or wrong answers to any of these instruments. You can’t get a “wrong” answer, as you are being asked about your own experience. When answering questions, the best approach is to be honest and forthcoming. This will ensure that the assessments provide the most accurate and helpful information, which will be used for treatment planning. Once Dr. Mazzei scores the assessments, she will review the outcomes with you. You should feel free to ask any questions or provide additional information.
