Child and adolescent psychological assessment: Current clinical practices and the impact of managed care.

Which psychological testing measures are clinical child and adolescent psychologists most commonly using? How has managed care influenced the practice of assessment for these professionals? This study provides survey data from 162 child practitioners employed in independent practice and in hospital, outpatient, and school-based settings throughout the United States. The results demonstrate marked consistency with recent surveys of clinicians working with adults, and a list of the 30 most frequently utilized measures is provided. Over 40 % of the sample reported significant limitations in psychological testing due to managed-care policies. Strategies for maintaining an assessment practice are discussed. Over the past 25 years, the professional practice of psychology has undergone dramatic changes attributed to the medicalization of mental illness, the expansion of efforts to obtain reimbursement for services through health insurance, and the evolution of managed-care organizations (Acklin, 1996). In fact, since the passage of the Health Maintenance Organization Act in 1973, clinicians have gradually witnessed a remarkable truncation of a wide range of psychological services that were formerly available in many health care plans (Butcher, 1997; Dana, Conner, Allen, 1996; Miller, 1996). Recent articles have suggested that insurance policy con-straints have placed significant limitations on psychological as-sessment practice (Butcher, 1997; Piotrowski, Belter, Keller, 1998; Stout, 1997) and, at least in some instances, have led to the improper diagnosis and treatment of patients (Miller Luft, 1994). Notably, the majority of test utilization studies have pri-marily focused on procedures for adult clients (Watkins, 1991). As the field struggles to reconcile continuing changes in health service provision, similar studies evaluating current practices in child and adolescent assessment and the impact of managed care are clearly needed (Schaefer, 1999). Test utilization studies of practicing clinicians have a lengthy history within the field of psychological assessment, beginning in 1935 (Louttit Brown, 1947). Results from national surveys