Services & Process

Approach to Assessments and Consultations

Procedure

Standards – What are the Benchmarks?

The foundation consideration for any consultant, evaluator or practitioner lies in the licensing or national standard for the work they are performing. Fully respecting other disciplines, each discipline has its own guidelines or standards typically established with licensure or provided by publications from a national association. It is important to know that some licensing Boards may not require a thorough examination of an applicant or licensee’s training, supervision, or experience to do the work involved with assessments, consultations, or evaluations. Likewise, certain disciplines licensing Boards may not have requirements for conducting more specialized services. So, the consumer of forensic services, as well as those of other behavioral healthcare services, would do well to be informed about these guidelines, licensing requirements, and national standards, or, their absence…

After years of practice in Montana and noting concerns about the absence of a similar licensing process for other disciplines engaging in the work (see Open Letter from The Montana Psychologist), Dr. Bütz began prefacing any consultation or psychological assessment with a Consumer Notice.

In addition, and pertaining to more specialized services within the State of Montana, licensed psychologists also are required to adhere to the following statements on custody assessment or evaluations, or parenting plans; here properly referred to as Parenting Plan Evaluations under the Administrative Rules of Montana: http://www.mtrules.org/gateway/ruleno.asp?RN=24%2E189%2E801

At a national level the American Psychological Association has also provided important guidelines for two very different kinds of specialized work that licensed psychologists engage in, and in this example the aforementioned custody assessment or evaluations-parenting plans and Child Protective Services work. But, before providing those guidelines it is important that consumers are informed that it is generally recognized within the field of psychology that before one holds themselves out as a professional who provides these specialized assessments and/or evaluations that they have extensive background and training with child development, marital and family dynamics, and at least adult psychopathology. This takes many ‘years’ of training, supervision and experience beyond licensure; and, beyond the years of preparation to conduct specialized forensic services.

As one last set of considerations, and working with your attorney, it is important to consider the professional’s history of work in a particular area and/or their area of specialization. While consumer reviews provide one source of information (see Reviews/History page); there are others such as District and Supreme Court rulings for complex and involved cases. Several cases with which Dr. Bütz has been involved have required the Supreme Court’s review, and these include work on desk reviews, complex custody situations involving multiple providers, and detailed information about psychometric aspects of psychological assessments, as well as what has been increasingly referred to as Parental Alienation (note publications and presentations on the topic and related matters elsewhere in the website).

When sizing up Dr. Bütz’s capacity to be of assistance in your case or the case of your client, it is suggested to gauge what has been described above, as well as other information across this website and make knowledgeable comparisons. It is entirely appropriate to ask what licensing and practice standards a provider has, what method they will be using to make an assessment, consultation, and/or intervention or treatment. If the provider cannot offer a reasonable explanation or direct you or your client to similar licensing and national standards such as those described above this conspicuous absence should raise some concerns.

Scope of forensic services

Dr. Bütz addresses a wide array of forensic matters by way of consultations and assessments including:

  • child-custody work
  • parental capacity
  • Child and Family Services cases
  • competency
  • criminal intent at the time of the offense
  • serving as an expert witness, fitness for duty assessments
  • prescreening community service employees
  • independent medical assessments
  • independent educational assessments
  • system service quality consultations
  • and other related matters.

He also has an array of other clinical specializations that overlap with his forensic practice: children and adolescents, couples work, family therapy, developmental disabilities, clinical neuropsychology, as well as cross-cultural considerations.

Service Systems and Areas

Given his experience working as an advocate, clinician, executive administrator, and accreditation surveyor Dr. Bütz is accustomed to working with private parties, defense and prosecution, city, county, federal, state and tribal governments, as well as, for-profit and non-profit organizations. Dr. Bütz provides services in Billings at his office in the Transwestern Plaza, and he frequently provides services throughout the state of Montana, the larger region, and out of state with appropriate arrangements.

Approach

There Needs to be Questions!

Effective assessment or consultation starts with questions, clarifying questions, not answers. Before jumping headlong into these services, there are several questions that need to be asked to understand the functions, needs, and wishes of those seeking services.

  1. What is the nature of the service requested should be the first question when it comes to this kind of work? Stated another way, what is the outcome being sought?
  2. What is envisioned at the end of this process, is this a onetime involvement, or, is the assessment or consultation seen as part of an ongoing effort set of services?
  3. What degree of support does the assessment or consultation have and from whom?
  4. What degree of resources will be committed to the assessment or consultation; both initially and in an ongoing fashion once the services are underway?

Informed Consent

Each recipient of an assessment or consultation service should know what to expect from the process, a timeline for how long the service is estimated to last and what the potential results will be – good, bad or otherwise. Informed consent outlines a variety of matters, but in essence it lays out the plan for services that all involved agree to at the outset. In our experience, however, there is always the risk of unexpected changes, changes within the larger environment, developments in the case, changes in the parties involved, leadership, or support that may compromise or complicate the assessment or consultation. In other words, factors that lay outside the consultant or evaluator’s control, but may impact the work being done.

Psychological Assessments and Consultations

What is being assessed or consulted upon, what is the question that is being asked? The first step of any good assessment or consultation, is to clarify what is called the “referral question” so that everyone knows what the purpose of the assessment or consultation actually is…  The average person would be surprised at how often a client comes in for one of these services, and when asked “Why are you here?” – they do not know.

So, this needs to be addressed right up front, and here at Aspen Practice, P.C. this important question will be clarified at the very beginning of the assessment or consultation process as part of the informed consent process.

While consultations are often a starting place that provides direction or ongoing interactions, thorough assessments as events are key to any events that may follow, a variety of forensic dispositions, therapeutic work, hiring or an individual’s work future. It follows that if there is not a clear conceptualization of the case; the case will be centered on the wrong issues or missing the mark.

Consultations are a starting place or part of an ongoing process, and so the length and detail of these may vary. On the other hand, the majority of assessment reports completed at Aspen Practice, P.C. are about fifteen pages in length, and are shorter or longer depending on the complexity of the case.  Each assessment includes, at minimum, the following elements, dependent on the referral question.

  • Referral Question
  • Instruments Administered
  • Collateral Data
  • Current Medications
  • Social History (Medical and Psychiatry/Psychological History)
  • Intellectual, Cognitive and Academic Abilities
  • Personality Assessment
  • Substance Abuse Assessment
  • Mental Status Interview
  • Diagnostic Impressions
  • Recommendations

All assessment will provide a diagnosis or no diagnosis, a rationale, and recommendations.  All clients are also offered a Results Session based on who holds privilege to assure that they understand the findings, and the rationale for findings as well as handle any questions associated with the assessment.