Bridge House was founded in 2017 with the strong belief that individuals seeking mental health care within the current landscape needed a different and more holistic approach to assessment.
The traditional psychological evaluation, which had been considered the gold standard of assessment for many years, often missed the mark when utilized in isolation with complex clients. When founders, Dr. Chris McRoberts and Rod Andrus, conceptualized what a comprehensive assessment might look like, their vision included a non-institutional setting where a multidisciplinary team of professionals could truly get to know a person both within a safe, structured residential setting and also while out in the local community engaging in various normative activities and tasks. In a first-of-its-kind approach, Bridge House has helped hundreds of adults and their families understand in great detail their strengths, areas of weakness, levels of functioning in various settings, and many other measures that go beyond a traditional psychological evaluation. It is a comprehensive process that provides a holistic understanding and outlines a direction guiding all aspects of healthy living.
What is a psychological evaluation?
Co-founder Dr. Chris McRoberts spent much of his 26-year career administering psychological evaluations for a wide range of people in various settings. He says a psychological evaluation provides a “snapshot” of the current mental health and cognitive status of a person. A traditional psychological evaluation can include different elements such as standardized tests to measure cognitive functioning, personality inventories like the MMPI, and projective measures such as the Rorschach Inkblot Test. A psychologist can also administer measures tailored to the individual being tested’s needs – for example, using an Autism Diagnostic Observation Schedule (ADOS) if there is a question about autism spectrum disorder, measures to assess substance abuse, or vocational tests.
While some test measures in routine psychological evaluations, such as full-scale IQ or personality dynamics, can remain consistent over time, such evaluations are limited in that they primarily reflect current functioning in the specific setting where testing occurs. Additionally, Chris points out, psychological evaluations focus largely on deficits rather than on an individual’s strengths or on their ability to adapt and function across settings.
A traditional psychological evaluation is typically given over the course of several hours in one or several days, often either in an outpatient context or within the structure of a psychiatric or behavioral health hospitalization, although this can vary depending on individual circumstances. Ideally, it will include information from the person being tested as well as family members or other important people, such as teachers and providers. Usually, the report itself is between twenty and forty pages in length and includes important aspects of the person’s history, a summary of the tests administered, a diagnosis, and recommendations.
How is a Bridge House assessment different?
At Bridge House, a psychological evaluation is one part of our assessment process, but our overall assessment includes a breadth of information gathered in many different settings and contexts. Rather than assessing a person over the course of a few hours, Bridge House’s assessment process spans three to four months. We use this time to observe and understand how our residents respond in a wide variety of scenarios, both on our property and immersed in the larger community at different types of activities. The Bridge House assessment team is constantly observing, learning, and understanding the different scenarios where our residents thrive and where they become overwhelmed. We are learning what interventions prove successful for residents, and what their capacity limitations are versus motivational limitations in any given scenario. We also spend that time gathering in-depth information from family members, previous providers, and anyone else who can help us understand the resident better. This immersive and integrated approach brings an assessment that is a true, comprehensive functional assessment, far beyond a psychological evaluation.
At Bridge House, we also consider other factors that influence a person’s mental health and day-to-day presentation. The Bridge House team administers and uses medical, dietary, occupational therapy, genetic, and a variety of other assessments to clarify whether a resident has other factors impacting their mental health and ability to function in a healthy way in their day-to-day life. Many of our residents have co-occurring medical and mental health issues that have been overlooked in previous settings due to the limitations of a brief psychological evaluation. If a resident would benefit from medical, physical therapy, sleep, imaging, or other assessments, we will arrange those evaluations with appropriate professionals outside of Bridge House. At Bridge House, we take the time to observe and tease out the nuances of how each factor impacts a person’s daily functioning.
The community immersion piece is perhaps what makes Bridge House’s assessment process most unique among assessment-oriented programs around the country. As long as safety is not at risk for an individual or the larger group, we offer our residents multiple opportunities throughout the week to go off-site and take part in “real-world” activities. These activities include everything from hiking, going to the gym or grocery store, to visiting world-class museums or professional sports events in Salt Lake City. While our residents take part in these activities for fun, our larger objective is to observe and understand how each individual responds to different stimuli, stressors, and social and community factors beyond the structured environment of our program. Understanding how a person functions in “real life” allows us to develop recommendations that will benefit the resident across settings and over the long rather than short term.
A typical psychological evaluation usually includes recommendations from the psychological evaluator outlining what interventions or supports would be helpful for the individual based on the report’s findings. At Bridge House, we flesh out those recommendations far beyond what a typical evaluation would provide. We have a Diagnostic Formulation Meeting in which we explain our assessment findings and recommendations in depth to the resident, appropriate family members, and involved professionals. We ensure all of our residents and their families fully understand what we are recommending and why. We approach these conversations from a place of trust, relationship, and rapport that we have developed over our time working together. We take the time to ensure our residents have dialed in their next step living arrangements and clinical support services, reinforcing their new knowledge about themselves and preparing for the next steps in their health journey. We work with involved professionals to find and introduce each resident to aftercare resources. We prepare them to accept and fully engage with those resources, whatever they may be. Before anyone leaves our program, the entire treatment team and family have collaborated extensively with the care team who will be overseeing services in the next step after Bridge House, in order to establish a solid aftercare plan which will carry forth the progress and objectives outlined in the comprehensive functional evaluation completed at Bridge House.
Conclusions
A psychological evaluation plays an important role in pinpointing specific challenges for people, but it also has its limitations. Bridge House’s comprehensive psychological and functional assessment process goes far beyond the measures employed during a psychological evaluation. When a family or an individual has questions about complex or “treatment-resistant” presenting problems, a more in-depth assessment like what Bridge House provides can ultimately set someone up for the best long-term success, helping both the individual and family understand the many factors at play and the ideal supports for a plan moving forward.
