Frequently Asked Questions
“What if I don’t want to be labeled with a disorder, or don’t want my child to be?”
There are at least three issues to consider here. First, accurate diagnosis is the essential first step to identifying the best recommendations for treatment, intervention, or otherwise resolving the issues for which a person seeks help. This is true for anyone seeking any kind of professional assistance. Whether in a medical or mental health setting, a diagnosis is not a label for a person. Rather, It is a concise description of the issues with which that person is dealing at a certain point in time. When making a clear and accurate diagnosis is appropriate, to avoid doing so is to risk genuine harm to a person. For some, it might mean stumbling through a series of ineffective treatment or intervention approaches, hoping by trial-and-error to find one that is helpful. For others, it might mean failure to receive help altogether, with undesirable outcomes as a likely result. A thorough and competent assessment is the best way to prevent this. A diagnostic description or “label” is only harmful to a person when it is incorrect, incomplete, or absent when it should be available.
Furthermore, the outcome of any diagnostic evaluation procedure is confidential, legally-protected information that is generally only available to the client, the treating professionals and their staffs, and the person’s health insurance carrier (when and if insurance is used). Those parties in turn are legally obligated to protect that information from further disclosure, which cannot take place without the written consent of the client or, for minors, the parent(s) with legal custody. In other words -- the scope of who is allowed to know about a client’s diagnosis or other protected information is narrow, and disclosure to parties outside of that scope is nearly always under the complete control of that client. For Dr. Nelson and other helping professionals, protecting your privacy (or that of your child) is the first-priority obligation under all but the most extreme circumstances (such as in cases where there is clear and imminent danger of harm).
Finally, people tend to change over time, and for many reasons. As a result, diagnostic “labels” are often not permanent, and will not always necessarily follow a person for the rest of his or her life. The primary objective of treatment is usually to help a person’s functioning improve to the point where that person no longer meets the diagnostic criteria for his or her original presenting issues. In other instances, a person may simply grow or develop out of a given condition. This is not always the case, but finding out whether a person’s difficulties will be lifelong, temporary, or somewhere in-between starts with a clear and accurate diagnostic assessment.
“Will I need medication?”
Not necessarily. For many disorders, a combined treatment approach involving both medication and other forms of support has been identified by research as most likely to be effective, although this is by no means true in all cases. For certain conditions, where neurobiology is known to play a large role, medication is a first-line approach to treatment and should not be deferred until other treatment approaches have been tried. (Examples of this include moderate-to-severe ADHD, Bipolar Disorder, and disorders such as Schizophrenia where psychotic symptoms are present). In other instances, non-pharmacological interventions may be more appropriate. Again, accurate diagnosis is the key to answering this question. When a referral for medication is advisable, Dr. Nelson works to refer the client to an appropriate physician having expertise with the specific issues at hand.
“How much will this cost?”
The total fee for an assessment can vary significantly, depending upon the complexity of the case and the types and number of assessment procedures necessary to produce a comprehensive and accurate evaluation report. The total fee will include: time billed for interview and observation; administration, scoring, and interpretation of all tests; preparation of the written report; and a feedback session to review and discuss the findings.
Certain common types of evaluations may be eligible for billing at a prepaid flat rate, rather than hourly, depending upon method of payment. Be assured that Dr. Nelson strives to keep his services affordable to those who need them, and will never employ more tests or procedures than are necessary to produce a high-quality result. Please use the contact form linked at the top of this page to request a consultation, and Dr. Nelson will attempt to provide an estimate based on your needs.
“Do you take insurance?”
Dr. Nelson provides assessment services on a fee-for-service basis and does not bill insurance companies directly (there are limited exceptions at Dr. Nelson’s San Pedro office, particularly for those whose coverage is through ILWU - please contact us for more details). Fees may be paid in cash, by check, or by most major credit cards.
You may wish to consult your medical insurance carrier to determine whether psychological testing is a covered benefit under your plan. For many plans it is not, and for others only a portion of the costs are eligible for reimbursement. Determining whether insurance will reimburse for psychological testing performed by an out-of-network provider is the client’s responsibility. When contacting your insurance carrier, it is also a good idea to ask whether there is a deductible, whether a primary care physician must make the referral for testing, and whether the insurer requires prior authorization before testing may commence.
Upon request, Dr. Nelson will provide clients with a superbill for services rendered and the appropriate billing codes. The client may then use this documentation when requesting reimbursement from an insurance carrier. Any portion of the fee not covered by insurance is the client’s responsibility and is due at the time services are rendered.
A note on privacy: Please be advised that involving an insurance company will always involve some risk of having to disclose the results of the assessment to that company, in order to satisfy their requirements for payment or reimbursement. For that reason, clients who place a high value on maximum confidentiality and discretion are advised to avoid involving insurance companies or third-party payors whenever possible.
“Do you perform child custody evaluations?”
Dr. Nelson does not perform child custody evaluations, but may be able to refer you a provider specializing in this area of practice, depending on your needs and location.
“My child already got tested by the school psychologist, but I’m not satisfied or don’t agree with the findings. What can I do?”
Psychoeducational assessment is available to all children attending public school without charge. However, it is important to keep in mind that school psychologists are more limited in their training and scope of practice than are clinical psychologists. They are also primarily tasked with determining a child's eligibility for special education services or, sometimes, for placement in programs for gifted children. The time and resources available to a school psychologist are also often quite limited. For these reasons, assessments conducted by school psychologists often do not capture a sufficiently complete picture of a child's cognitive, emotional, and psychosocial functioning. Issues that are quite important to that child's success may therefore go unidentified or unaddressed by the the recommendations of a school psychologist.
For parents who are concerned that their child may not be receiving all of the educational support to which he or she may be entitled, a comprehensive psychoeducational assessment by a competent, independent clinical psychologist may be the best way to facilitate advocacy on the child's behalf. Helping parents and children in these situations is one of the most frequent services that Dr. Nelson provides.