Foresight Psychology is uniquely suited to help people move from confusion to clarity using a structured blend of psychotherapy and targeted psychological assessment. Many clients enter treatment with overlapping symptoms—anxiety mixed with ADHD traits, depression complicated by trauma history, or relational problems shaped by personality patterns. Individual or couples treatment alone can illuminate these issues, but without assessment, treatment can take longer, stall, or move in the wrong direction. Therapy Testing is our way of combining the best of both worlds—clinical insight and data-driven understanding—to create a faster, more accurate, and highly personalized therapeutic path. Here we go over the therapy test measures we use, and also a description of couples therapy testing.
We use therapy testing when clients:
- Aren’t sure what is causing their symptoms
- Want faster clarity and direction
- Feel misunderstood or misdiagnosed
- Had therapy before that didn’t “stick”
- Have complex or layered concerns
- Want to guide treatment with objective information
Our philosophy: assessment should be therapeutic, collaborative, and empowering—not cold, clinical, or overwhelming.
In many cases, people are referred to us by therapists who are looking to help their clients move forward and reach new or elusive goals. In others, clients come directly to us because they feel stuck (in these cases we suggest that they speak to theor provider before we start). And finally, sometimes people self-refer before starting therapy so that they can find the best match in a therapist and have the process sped up.
What Is Therapy Testing? 
Therapy Testing is a structured, goal-focused psychological evaluation that does not replace your treatment—it enhances it by providing clarity, data, and insight.
It typically includes:
- A collaborative discussion about what questions need answers
- A customized battery of psychological, emotional, cognitive, and/or executive-functioning tests
- Interpretation sessions where the therapist shares results in a supportive, understandable way
- Integration of findings directly into goals and planning
It functions like a diagnostic spotlight, illuminating underlying processes that may not be apparent through talk therapy alone.
Examples of questions therapy testing answers:
- Is this ADHD, anxiety, trauma, depression, or a mix?
- Why does the client shut down in relationships or become emotionally overwhelmed?
- What cognitive strengths and weaknesses are impacting work, school, or daily life?
- What personality traits or attachment themes shape the client’s relationships?
- When do emotional triggers consistently disrupt progress?
How Therapy Testing Enhances Psychotherapy
- Accelerates Insight and Treatment Effectiveness
Therapists often spend months trying to determine root causes. Inidvidual or couples therapy testing rapidly clarifies underlying issues, allowing therapy to focus on the right targets quickly.
- Matches Clients With the Right Interventions
For example:
- High avoidance → ACT and exposure work
- Low emotional clarity → DBT mindfulness
- EF deficits → coaching, environmental structuring, ADHD strategies
- Attachment anxiety → attachment-based therapy, IFS
- Trauma symptoms → EMDR or somatic work
- Increases Client Motivation and Engagement
Data helps clients feel validated, understood, and hopeful. Many describe the experience as “finally having a map.”
- Helps With Complex, Overlapping, or Misleading Symptoms
E.g., ADHD, trauma, and anxiety all can cause forgetfulness—but testing differentiates them clearly.
- Provides Measurable Outcomes Over Time
Clients and therapists can track progress using standardized tools, improving therapy responsiveness.
Therapy Test Measures
Below are the most common categories and tools used in therapy testing, with deeper descriptions of what each measures and why it matters for psychotherapy.
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Symptom & Diagnostic Therapy Test Measures
PHQ-9 (Patient Health Questionnaire–9)
- Assesses severity of depression
- Items cover sleep, mood, energy, concentration, motivation, and suicidality
- Helps distinguish situational stress from clinical depression
- Useful for tracking symptom change session-to-session
GAD-7 (Generalized Anxiety Disorder–7)
- Measures severity of anxiety
- Helps clarify whether anxiety is global, situational, or secondary to another condition
- Results shape treatment direction (e.g., CBT, ACT, exposure, somatic work)
PROMIS Emotional & Behavioral Health Scales
- Highly sensitive measures for depression, anxiety, anger, social isolation, sleep, and functioning
- Normed against large populations
- Great for progress monitoring
PCL-5 (PTSD Checklist)
- Measures trauma symptoms across four domains (intrusion, avoidance, negative mood, hyperarousal)
- Helps differentiate trauma responses from anxiety, ADHD, or emotional dysregulation
OCI-R (Obsessive-Compulsive Inventory, Revised)
- Clarifies the presence and type of OCD symptoms
- Differentiates perfectionism, anxiety, autism rigidity, and true compulsive patterns
-
Personality & Interpersonal Measures
MMPI-3 or MMPI-2-RF
- Gold-standard personality and psychopathology measure
- Helps identify:
- Emotional instability
- Anxiety patterns
- Unconscious defenses
- Trauma response tendencies
- Interpersonal functioning
- Somatic sensitivity
- Extremely helpful for stuck therapy cases or chronic patterns
PAI (Personality Assessment Inventory)
- Measures stability, stress tolerance, interpersonal style, trauma symptoms, borderline features, and more
- Excellent for understanding relationship patterns
- Gives insight into how clients manage emotions and conflict
Attachment Measures
- Identify secure, anxious, avoidant, or disorganized patterns
- Crucial for couples work, trauma, and relational therapy
- Clarifies why clients react the way they do in close relationships
Parts Mapping (IFS-based questionnaires)
- Helps visualize internal conflicts and protectors
- Useful when clients feel “torn,” overwhelmed, or reactive
-
Executive Functioning & Attention Tools
Barkley Deficits in Executive Functioning Scales (BDEFS)
- Measures time management, organization, emotional regulation, self-restraint, and self-motivation
- Excellent for adults who suspect ADHD or EF challenges
BRIEF-2 / Adult BRIEF
- Real-world EF functioning based on self-report, parent/teacher report
- Identifies whether EF challenges are due to ADHD, trauma, anxiety, ASD, or environment
Conners-4
- Highest-quality ADHD measure currently
- Identifies inattentive, hyperactive, emotional, and learning-related patterns
IVA-2 CPT (Continuous Performance Test)
- Computerized test measuring sustained attention, response control, processing speed
- Helps differentiate ADHD from anxiety or fatigue
-
Cognitive Tools (Brief, Targeted, Not Full Neuropsychological Batteries)
WAIS-IV/WAIS-V Subtests
Often include:
- Digit Span (working memory)
- Coding/Symbol Search (processing speed)
- Similarities (abstract reasoning)
- Matrix Reasoning (nonverbal problem solving)
These reveal cognitive strengths and vulnerabilities impacting therapy or daily functioning.
Raven’s Progressive Matrices (Short Form)
- Nonverbal reasoning, highly culture-fair
- Useful when verbal expression is limited
Trails A/B
- Processing speed and cognitive flexibility
- Valuable for adults experiencing burnout, stress, or mild cognitive concerns
-
Emotion, Trauma, and Behavior Tools
DERS (Difficulties in Emotion Regulation Scale)
- Measures reactivity, impulse control, emotional awareness, and clarity
- Critical for DBT-oriented therapy
Trauma Symptom Inventory
- Identifies dissociation, intrusive memories, hyperarousal, numbing, avoidance
BASC-3 (for Teens)
- Parent, teacher, and self-report
- Measures behavior, mood, social functioning, and emotional patterns comprehensively
-
Therapy-Process & Progress Tools
ORS/SRS (Outcome & Session Rating Scales)
- Track progress and alliance
- Predict therapy success better than diagnosis
- Helps therapists make quick course corrections
Therapy Testing Case Examples
The following therapy testing case examploes highlight how these services can help:
Case Example 1: Teen With Emotional Outbursts and School Decline
Client:
Mia, age 16
Presenting Concerns:
- Frequent emotional explosions at home
- Difficulty turning in assignments
- Worsening grades
- Social withdrawal
- Parents unsure if she is “defiant,” depressed, or overwhelmed
Therapy Concerns Before Testing:
Her therapist sensed dysregulation but wasn’t sure if the root cause was trauma, ADHD, depression, anxiety, or executive dysfunction.
Tools Administered:
- BASC-3 (self, parent, teacher)
- BRIEF-2
- DERS
- PHQ-9 / GAD-7
- WAIS-IV: Digit Span, Coding
Findings (Detailed):
Emotional Patterns:
- DERS showed high emotional sensitivity and difficulty calming after stress
- BASC-3 highlighted elevated internalizing symptoms and social stress
- Not depressed — PHQ-9 mild; anxiety moderate
Executive Functioning:
- BRIEF-2 showed significant deficits in inhibitory control, shifting, and emotional regulation
- WAIS-IV Coding significantly lower than expected, indicating slow processing speed
- Working memory mildly reduced
Interpretation:
Mia was not rebellious—she was overwhelmed. Her emotional and EF vulnerabilities made school and social interactions extremely taxing.
Therapeutic Impact:
- Therapy shifted to DBT skills, focusing on distress tolerance and emotion labeling
- Parents received training on co-regulation
- School accommodations implemented: reduced workload, EF support, extended time
- Therapy normalized her struggles, reducing shame
- Within 3 months, outbursts dropped by 70%
- She rekindled two friendships and passed her classes
Case Example 2: Young Adult With Overlapping ADHD and Anxiety Symptoms
Client:
Alex, age 21, a college junior working 30 hours a week.
Presenting Concerns:
- Trouble focusing
- Chronic procrastination
- Feeling “scattered”
- Panic during exams
- Fears of academic failure
Therapy Concern Before Testing:
The therapist couldn’t tell whether this was ADHD, perfectionism, anxiety, burnout, or a combination.
Tools Administered:
- Conners-4
- Adult BRIEF
- GAD-7 / PHQ-9
- IVA-2
- WAIS-IV (Digit Span, Matrix Reasoning, Symbol Search)
- ORS progress monitoring
Findings (Detailed):
Attention & EF:
- Conners-4 did not show a consistent ADHD pattern
- BRIEF showed moderate EF issues, but mostly in emotional regulation and organization—not core ADHD
- IVA-2 performance significantly improved when anxiety decreased during the test → anxiety-based attentional disruption, not ADHD
Cognitive Profile:
- WAIS-IV Symbol Search low → slowed processing speed (often linked to fatigue or burnout)
- Working memory mildly below average, but inconsistent (often seen in anxious clients)
Emotional Health:
- GAD-7 very high
- PHQ-9 mildly elevated
- He met criteria for chronic anxiety and academic burnout, not ADHD
Therapeutic Impact:
- Therapy transitioned to CBT for anxiety, workload planning, perfectionism work
- Sleep stabilization and burnout recovery were prioritized
- EF strategies tailored for anxiety, not ADHD
- Test-taking accommodations were requested for anxiety
- After 8 weeks, his GAD-7 dropped by 40%
- His EF scores improved organically once anxiety and exhaustion decreased
Case Example 3: Adult With Persistent Relationship Conflicts
Client:
Dana, age 43, a professional who felt relationships repeatedly fell apart in similar ways.
Presenting Concerns:
- Intense closeness early in relationships
- Fear of abandonment
- Over-texting, panic during conflict
- Emotional withdrawal when partner becomes distant
- Shame and confusion about why patterns repeat
Therapy Concern Before Testing:
Therapist wondered if these patterns were attachment-based, trauma-driven, or part of a personality style.
Tools Administered:
- PAI
- Trauma Symptom Inventory
- Adult Attachment Questionnaire
- DERS
- MMPI-3 (selected scales)
Findings (Detailed):
Attachment:
- Clear anxious-preoccupied attachment pattern identified
- High fear of abandonment scores
Emotion Regulation:
- DERS showed difficulty calming after emotional threat
- Impulse control shaky during relational conflicts
Trauma:
- TSI revealed subthreshold trauma symptoms from childhood emotional neglect
- Hypervigilance in relational contexts
Personality Pattern:
- PAI showed sensitivity to rejection but no personality disorder
- Interpersonal scales indicated a tendency to overinvest early in relationships
Interpretation:
Attachment injuries, not pathology shaped Dana’s patterns. Her emotional reactivity was an adaptive response to earlier relational unpredictability.
Therapeutic Impact:
- Therapy shifted to attachment-based work (EFT + IFS)
- Focus on identifying “younger parts” triggered during conflict
- Practiced communication scripts for emotional safety
- Trauma-informed self-soothing strategies added
- Over months, she entered a new relationship and reported staying grounded during conflict for the first time
What Is Couples Therapy Testing?
Couples Therapy Testing is a targeted assessment process used within couples treatment to understand relationship dynamics, communication patterns, emotional triggers, conflict cycles, and individual contributions to systemic issues.
It differs from regular therapy by using structured tools and assessments to help couples see the “map” of their relational system. The couples therapy testing process blends clinical interviewing with evidence-based relationship measures to clarify not only what is happening, but why it happens and how to change it.
A couples therapy test is not about identifying who is “at fault.” Instead, it reveals interactional patterns that maintain distress — and the strengths that can help create positive change.
Why is a Couples Therapy Testing Helpful
Relationships are complex systems. Symptoms in one partner or child often reflect pressures, communication breakdowns, or relational injuries within the system.
Couples therapy testing helps:
- Clarify attachment patterns influencing closeness, distance, or conflict
- Identify communication styles that escalate or de-escalate tension
- Understand emotional regulation differences between partners
- Detect family-of-origin impacts
- Reveal unspoken expectations, needs, and resentments
- Identify parenting style mismatches
- Explore power dynamics and role imbalances
- Provide a roadmap for repairing trust
- Improve empathy through shared understanding
It gives couples a neutral, objective, and emotionally safe way to understand problems and move toward repair.
Couples Therapy Test Measures
- Dyadic Adjustment Scale (DAS) / Revised DAS
- Measures relationship satisfaction, cohesion, shared activities, and agreement
- Highlights areas of alignment and areas that consistently generate conflict
- Gottman Relationship Checkup (Online Assessment)
- Extremely detailed tool assessing:
- Friendship and connection systems
- Communication skills
- Conflict patterns
- Trust and commitment
- Intimacy
- Life dreams and shared meaning
- Produces a structured report guiding targeted interventions
- Prepare/Enrich Assessment
- Ideal for couples pre-marriage or in long-term relationships
- Identifies strengths, growth areas, stressors, and compatibility
- Includes exercises for communication, conflict management, and goal-setting
- Five Love Languages Profile
- Useful as part of therapeutic discussion
- Highlights preferred ways of giving/receiving love
- Helps reduce misinterpretation and unmet expectations
- Attachment-Based Measures (e.g., Adult Attachment Interview, questionnaire versions)
- Identify anxious, avoidant, disorganized, or secure patterns
- Clarify how early experiences influence current relationship behavior
- Family Systems Tools
- Genograms: visual maps of family relationships, roles, patterns, and trauma
- Family Environment Scale: measures cohesion, expressiveness, and conflict
- Parenting Stress Index for parent–child dynamics
- Strengths and Difficulties Questionnaire for child behavior patterns
- Interpersonal Process Tools
- Conflict pattern mapping (pursuer–distancer, parent–child triangles, etc.)
- Gottman “Four Horsemen” assessment (criticism, defensiveness, contempt, stonewalling)
- Communication inventories
- Emotional reactivity scales
These couples therapy test measures provide a structured way to uncover dynamics that often remain invisible or unspoken during traditional talk therapy.
What a Couples Therapy Test Assesses
Couples therapy testing clarifies key relationship domains:
- Attachment Patterns
- How each partner seeks closeness or protection
- What triggers withdrawal or pursuit
- How past trauma influences current reactions
- Communication Styles
- Direct vs indirect communication
- Emotionally safe vs reactive patterns
- Listening vs defending
- Openness vs shutting down
- Emotional Regulation Differences
- Speed of emotional escalation
- Ability to repair conflicts
- Reactions to perceived threats
- Conflict Cycles
- What starts the cycle
- How each partner participates
- How escalation happens
- What prevents repair
- Trust and Commitment Factors
- History of ruptures
- Fear of betrayal or abandonment
- Barriers to vulnerability
- Division of Labor & Roles
- Parenting
- Household responsibilities
- Emotional labor
- Decision-making
- Strengths and Protective Factors
- Shared values
- Humor, friendship, and rituals
- Intimacy
- Support systems
A couples therapy test creates a holistic picture of the relationship system—strengths, vulnerabilities, and pathways forward.
How a Couples Therapy Test Enhances Treatment
- Makes the Invisible Visible
Couples often argue over surface issues (dishes, time, money), but the core problems lie in deeper patterns. Couples therapy testing explicitly and compassionately reveals the underlying dynamics.
- Reduces Blame
Objective data helps partners see that both contribute to interaction cycles. This reduces defensiveness and increases empathy.
- Gives Clear, Practical Direction
Instead of vague goals (“communicate better”), couples therapy testing leads to targeted strategies based on specific deficits and strengths.
- Improves Treatment Efficiency
A couples therapy test often speeds up because the therapist knows exactly which domains to focus on.
- Helps Partners Understand Each Other’s Internal Worlds
Attachment patterns, love languages, and emotional triggers become shared knowledge, reducing misinterpretation.
- Strengthens the Therapeutic Alliance
Both partners feel understood deeply and objectively, increasing trust in the process.
Who Benefits Most from Couples Therapy Testing?
- Couples with recurring conflicts
- Parents struggling with child behavior issues
- Families dealing with stress, transitions, or trauma
- Couples rebuilding trust after betrayal
- Couples preparing for marriage or major life changes
- Partners unsure whether to stay together or separate
- Individuals with differing communication or attachment styles
- Blended families navigating role confusion
A couples therapy test is particularly powerful for partners who feel:
- Stuck in repetitive fights
- Misunderstood or invalidated
- Confused about what the real issues are
- Unsure how to repair after emotional injuries
- Like therapy in the past didn’t “get to the root”
Expected Outcomes
Through couples therapy testing, partners typically gain:
- A clear map of relationship strengths and stress points
- Deeper empathy for each other
- Improved emotional and communication skills
- More effective conflict resolution strategies
- Understanding of each partner’s needs, triggers, and expectations
- Decreased defensiveness and blame
- A shared vision for the relationship
- Greater commitment and intimacy
- Faster therapeutic progress
Conclusions and Our Work
Therapy testing empowers clients and therapists by bringing clarity, compassion, and direction to the therapeutic process. Rather than treating symptoms blindly or relying only on subjective impressions, therapy testing offers a structured, insightful, and deeply personalized understanding of why clients think, feel, and behave the way they do.
Indivudual and couples therapy testing helps:
- Teens struggling with emotional regulation
- Young adults navigating identity, learning, and stress
- Adults navigating big decisions, life transitions, stressful family dynamics, or career stress
- Couples confronting long-standing relationship trauma, or emotional patterns
Most importantly, therapy testing transforms psychotherapy into a more precise, collaborative, and effective journey toward lasting change.
If you are interested in learning more about therapy testing, including individual or couples therapy testing, or would like to set up services to get started, please feel free to contact us or schedule a consultation anytime. You should discuss this with your therapist first. If you are looking for this testing prior to entering therapy in order to speed the process, we can help you find a provider that fits after the assessment is finished.
