How do psychologists perform functional capacity assessments?
Psychologists are in the best position to provide functional capacity assessments for people whose primary disability is a psychiatric condition, as well as those with co-occurring physical and psychosocial disabilities.
Support coordinators and families are often surprised to find out that psychologists can provide functional capacity assessments. There is good reason for the popular perception that only occupational therapists provide functional capacity assessments. Historically, occupational therapists have been trained to do functional capacity assessments using a variety of well established tools and have done so with great rigour in a variety of settings.
However, when it comes to mental illnesses as well as other conditions with significant psychological, cognitive, and behavioural components, such as autism, dementia, acquired brain injury and so on, psychologists are indeed in the best position to comment on functional capacity - both separately as well as in collaboration with occupational therapists.
Why get a psychologist to comment on functional capacity?
- Specialist training in mental illness, neurodevelopmental (e.g. autism) and neurocognitive (e.g. acquired brain injury) conditions
- Knowledge of comprehensive cognitive assessments to comment on specific functional implications.
- Skills to collaborate with occupational therapists or physiotherapists and assess psychological, cognitive, and behavioural factors affecting physical functioning.
How do psychologists go about doing functional capacity assessments?
Psychologists use a variety of tools to determine functional capacity and will typically use a combination of them to establish a consistent and accurate picture of one’s presentation.
Tool #1: Clinical interviews
Semi-structured clinical interviews with NDIS participants, their families and/or carers to elicit information on nature of symptoms, severity, associated beliefs, behavioural and emotional expression, and functional impact. The clinical interview is based on the criteria established in the DSM-5 or ICD-10 that outline symptoms and functional impact associated with mental illnesses, neurodevelopmental conditions (such as autism, ADHD, etc.), and neurocognitive conditions (such as acquired brain injury, parkinson’s disease, etc.).
Tool #2 Standardised and validated assessments
Using comprehensive assessment tools that have comparison guidelines established such that each person’s performance may be compared to the relevant population (such as by age, gender, type of disability, etc.) to determine exact nature of challenges, strengths, level of functioning, and predicted future outcomes. These assessments come in a variety of forms:
- Performance-based assessments: These are assessments that rely on information gathered through an individual’s actual performance on specific tasks (e.g. the Wechsler Adult Intelligence Scale-IV or the Test of Non-Verbal Intelligence, etc.)
- Self-report-based assessments: These are assessments specific to the disability that rely on self-reported details regarding symptoms, severity, and functional impact (e.g. Panic and Agoraphobia Scale, Beck Depression Inventory-II).
- Parent/Carer-report-based assessments: These are assessments again, specific to the disability that rely on information got from parent/teacher/carer observations regarding symptoms, severity, and functional impact (e.g. Vineland-3 Adaptive Behaviour Scale - Parent/Carer/Teacher forms).
- Behavioural observation-based assessments: These are validated assessments specific to the disability that rely on the psychologists’s observation of symptoms, severity, and functional impact when working with the participant (e.g. Mental State Examination, Positive and Negative Syndrome Scale for Schizophrenia, Bech-Rafaelsen Mania Rating Scale).