Professional Psychology: Research and Practice Copyright 2000 by the American Psychological Association, Inc. 2000, Vol. 31, No. 2, 131-140 0735-7028/00/$5.00 DOI: 10.1037/,~735-7028.31.2.131 Problems and Limitations in Using Psychological Assessment in the Contemporary Health Care Delivery System Elena J. Eisman Massachusetts Psychological Association Robert R. Dies New Port Richey, Florida Stephen E. Finn Center for Therapeutic Assessment Lorraine D. Eyde U.S. Office of Personnel Management Gary G. Kay Georgetown University Medical Center Tom W. Kubiszyn American Psychological Association Gregory J. Meyer University of Alaska Anchorage Kevin L. Moreland Fort Walton Beach, Florida Psychologists report limitations on psychological assessment services and problems gaining authoriza- tions and reimbursement for these services from third-party payers. Documentation and categorization of these problems and limitations is based on responses from well over 500 psychologists responding to a broad solicitation for feedback. This article explores the barriers to access for assessment services, including resistance to psychological assessment, difficulties in the preauthorization process, problems with reimbursement, the clinical decision-making process, and larger systems issues. The authors make recommendations for redress of these problems through work with the profession, other mental health professionals, managed care, and patients-consumers and through political action. Psychological and neuropsychological assessment services are un- der assault from organized health care delivery systems, managed mental health care organizations, and health care payers. As a pro- fession, psychology must respond to this attack with advocacy and a credible explanation of the value and usefulness of assessment if it is to survive as a covered health care service. This article reviews issues in the current applications of psychological assessment in health care settings and recommends appropriate responses. The message from health care delivery systems is clear. Critics argue that psychological assessment is time consuming, expensive, ELENA J. EISMANreceived her EdD in 1975 from Boston University. She is currently the executive director of the Massachusetts Psychological Associa- tion and a faculty member at the Massachusetts School of Professional Psy- chology. She maintains an independent practice in Newton Highlands, MA. ROBERT R. DIES received his PhD from the University of Connecticut in 1968 and spent most of his academic career at the University of Maryland before leaving to enter full-time clinical and forensic practice in the Tampa Bay, FL, area in 1996. STEPHEN E. FINN received his PhD from the University of Minnesota in 1984. He is a clinical psychologist who specializes in psychological as- sessment. He is president-elect of the Society for Personality Assessment and is an adjunct assistant professor at the University of Texas at Austin. LORRAINED. EYDE received her PhD in 1959 in industrial organizational psychology from Ohio State University. She is a personnel research psy- chologist at the U.S. Office of Personnel Management, where she is an expert in leadership competency models. GARY G. KAY received his PhD in 1984 in neuro-clinical psychology from Memphis State University. He is an associate professor of neurology and psychology at the Georgetown University School of Medicine. He also maintains an independent practice with Georgetown Neuropsychology Associates in Washington, DC. TOM W. KUBISZYN received his Phi) in 1979 in educational psychology from the University of Texas at Austin. He is an adjunct associate professor in the Department of Educational Psychology at the University of Texas at Austin. 131 GREGORY J. MEYERreceived his PhD in 1990 in clinical psychology from Loyola University Chicago. He is an associate professor of psychology at the University of Alaska Anchorage and the coordinator of graduate clinical training. KEVlN L. MORELANDreceived his Phi3 in 1981 from the University of North Carolina at Chapel Hill. THE OPINIONS EXPRESSED IN THIS ARTICLE 81"e t h o s e of the authors and do not necessarily reflect the official policy of the U.S. Office of Personnel Management. THIS ARTICLE ~SDEDICATED to the memory of Kevin L. Moreland, who died tragically in an automobile accident August 31, 1999. A YERSXON OF THIS ARTICL~ was initially prepared by the Psychological Assessment Work Group organized by the Board of Professional Psychol- ogy. The work group was chaired by Stephen E. Finn. We arc grateful to the following American Psychological Association staff members for their support and assistance: Geoffrey M. Reed, Christopher J. McLaughlin, Mary Ann Wilson, and Russ Newman of the Practice Directorate; and Diannn C. Brown of the Science Directorate. We also thank Georgia Sargeant for her editorial assistance. CORRESPONDENCE CONCERNING THIS ARTICLE should be addressed to Elena J. Eisman, Massachusetts Psychological Association, 195 Worcestor Street, Suite 303, Wellesley, Massachusetts 02481. Electronic mall may be sent to eisman@masspsych.org.