Hey yáll, welcome back to another episode of The Testing Psychologist podcast. Great to be back with you this week. I took a little bit of a break last week for Memorial Day. I have to say it wasn’t exactly a planned break, but I did give myself permission at the beginning of the weekend to say, we’ll see how this goes. If I have some time to put together a podcast episode, I’ll do it, but if not, I’m going to relax a little bit and spend some time with the family. That’s what I ended up doing and it turned out nice.
We finally, I think have gotten to summertime here in Colorado. We’ve got a nice run of about [00:01:00] 80-degree weather here for the last few days and the next few days. It’s super sunny and that’s pretty awesome. Yesterday was our first pool day. So that’s cool to see the kiddos jumping around in the pool and having a good time. For me, summer elevates the mood and puts me in a nice space in general.
I hope things are going well wherever you are at and getting some summertime sunshine and maybe taking some vacations. All those things are super important, especially when you’re working pretty hard. That’s where my break came from last weekend. I think it was a good one. It gave me some time to reflect as well on the business and the podcast and come back with some great content, I think.
Today, I am doing another solo episode. I’m talking to y’all about kind of an extension of the vulnerability episode. I did an [00:02:00] episode on the vulnerability of psychological testing back in episode 13. During that episode, I mentioned at the beginning, a story about how a family had come in for an evaluation, and for various reasons, I didn’t feel like I gave them the best service that I could have and how they were pretty upset about that.
At that time, I didn’t finish that story or discuss the outcome on the podcast. So I got a lot of inquiries from folks about what the outcome was. That got me thinking about this topic of how to handle it when you mess up. That’s something that happens to us from time to time. That’s a pretty human experience, especially here in testing, going back to the vulnerability piece, this is something that folks put a lot of stock in, families come in with a lot of [00:03:00] investment of time and money and energy. It’s a big deal to get themselves evaluated or their kiddos evaluated. And so there’s a lot of risk for them there. Not to say that that does not happen with therapy by any means, but I think when there’s this concrete product, the evaluation, and the report that comes out of the testing process, it just heightens that sense of responsibility that we have to deliver something quality to the family.
Along the way, mistakes are going to happen, certainly. I’ve had a number of mistakes over the years, but I got to thinking about some of the most typical ones that come up and how I’ve developed means of handling those. I thought I’d chat with you all about that today over the next several minutes. Let me go ahead and dive into it.
One of the things, I’ll actually [00:04:00] just to back up, I’m thinking about walking through the testing process, how mess ups can happen at different stages, and how I’ve learned to handle some of those mess ups.
The first one that I wanted to talk about is what happens during the initial scheduling process or even the initial contact and what happens if you mess up there. I use the term messing up pretty generally, but when I say messing up, I mean, anything that doesn’t go exactly as you might want it to or as the client might want it to.
For me, the biggest pitfall initially is missed emails or phone calls or not getting back to people in a timely manner. My hope and my expectation for getting back to people is that I always return phone calls or emails for new clients within 24 hours.
When it was [00:05:00] just me here in the practice, that became increasingly more difficult and it got to a point where I had on my outgoing voicemail that I may not return phone calls for 48 hours. Looking back on that now, that seems crazy because I’ve moved to a place where I’m fairly militant that we get back to our new clients within the same business day. That seems like a long time ago, but I think it speaks to how things can get busy and it is hard to set aside time to return phone calls.
There are two things proactively to do with that to try to make sure it doesn’t happen. One is that I have shifted my schedule to have a half hour or 45 minutes at the end of each day, whenever possible, to sit down and return phone calls and emails. Another thing that I’ve done is that we brought on an in-office [00:06:00] administrative assistant who answers the phones full time. That has helped a lot. I’ve had to go back and almost redistribute my contact number so that people are calling the main administrative number now instead of my personal number, because if people leave me personal voicemails, that increases the likelihood that I may not get back to them.
I don’t know about y’all, but I have a really hard time with voicemails. For some reason, I would much rather read an email or a text, but when there are voicemails, it feels hard to sit down and listen for some reason. With the voicemails though, because I do still get a few calls that go to my direct line, what I’ve done is, I have an iPhone, I can’t speak to Android and whether this works there, but on the iPhone, there is a function in the voicemail when you’re listening to it, [00:07:00] it looks like a page with an arrow icon, it’s basically the share icon. I have a practice management system or project management system that I share with my admin assistant that allows me to share the voicemail directly from my phone to his task list, and that has helped greatly.
So, in the past, what I might do is I would listen to a voicemail and then not have time to return it or say that I’ll do it the next day or something like that, and that doesn’t work very well and it’s not great for clients. So, I figured out a way to share that directly with him if it’s someone that he can call back and schedule, which is the majority of the phone calls.
Now, that still leaves the situation where you might have a missed phone call or an email that you don’t return for two days. That does happen certainly. As you’ll see as we go along [00:08:00] with a lot of these examples, my general response to that is to be direct and honest.
Usually, there is some reason that I have not been able to return messages. Maybe I had to leave to pick up my kiddos early. Maybe there was a crisis here in the practice where I ended up stuck on the phone with someone solving another problem.
Usually, there’s some legitimate reason and I will usually share that with the client when I email them back. I always try to do that in a way that does not feel like it’s making an excuse or anything like that. I’ll just say, “Hey, thanks for reaching out. I apologize for not getting in touch within a business day. That’s fairly atypical. We had an emergency yesterday and that ate up more time than I was expecting. Thanks for your patience. I’m excited to talk with you at this point.” Just being direct and [00:09:00] explaining what happened and usually people respond pretty well to that.
The next part in the evaluation process that people get frustrated is often with scheduling. Scheduling is challenging sometimes for us. I always try to… We tell people that we try to wrap up the evaluation within a day and do all the formal testing in one day. I always try to meet with the kiddo or the client that day as well to do the individual interview, but sometimes that does not happen.
So again, I do my best. If I am not available to wrap up the testing and complete everything that we need to, I’m just very direct with the parent or with the client and say, here’s where we’re at. It looks like our time is running low or it looks like I’ve had a scheduling conflict come up, and again, usually try to explain [00:10:00] some aspect of that like what led to that scheduling conflict, of course, without revealing any other client info or anything like that, but just being honest and letting them know. And then I always try to get them scheduled as soon as possible.
To be honest, that typically involves shifting my schedule a little bit and bending a little bit from some of my scheduling boundaries, but that’s just my philosophy that once people are in for the evaluation, it feels necessary to take care of them. Sometimes I do have to bend a little bit to make sure that they get in in a timely manner so that we can wrap up the evaluation. So, just being willing to flex your schedule a little bit, not to the point of being resentful or anything, but being willing to flex just a little bit so that you can get people in a little bit sooner, I think helps.
A variation of that is [00:11:00] with the report turnaround. At least in our clinic, we do a feedback session and then write the report afterward. Our expectation is that the report is always delivered to the client within 2 or 3 weeks, 3 weeks is max most of the time. But again, sometimes, that initial timeline is not acceptable for clients and they get frustrated with that, or sometimes it does take a little longer than that for one reason or another. Maybe I’m out of town on a vacation or have some other clinical issues that come up or something that eats into my report writing time, or again, a sick child. That’s a theme of time that gets taken unexpectedly.
One thing that I’ve tried to do that helps ameliorate that a little bit is, I’ve put together a template [00:12:00] for what we call an evaluation summary. It’s a one-page document. It hits all the important bullet points of test results, diagnosis, and recommendations. I can usually put that together pretty quickly within 10 or 15 minutes. We have started to let people know that they can have that evaluation summary pretty quickly. I can sometimes do it that day or the next day. That’s pretty straightforward. People seem to respond well to that. It’s like a bite-size acceptable version of the evaluation that doesn’t take much time on your end but gives them something to hold onto and latch onto.
I also make sure as people take off from the feedback session that they have something to hold in their hands. So oftentimes, I’m giving a lot of referrals to different services out in the community. I will always give them [00:13:00] a referral sheet with some options checked off and some directions for the next steps so that even though they don’t have that full report, they can walk out and make some phone calls or take some action if they would like to.
Speaking of the feedback session, one of the things that comes up at some points over the years, it’s not super common, but it does happen sometimes. So again, we do a feedback session where I deliver the results and then write the report afterward. What happens sometimes is, that you’ll be talking with a parent and delivering some of that feedback and they may share new information or they may ask questions or ask about results or offer something that makes you think a little bit differently about the evaluation.
I typically come into the feedback session with, let’s say a 95% certainty, [00:14:00] maybe 98%certainty of the diagnostic picture and tend to deliver that fairly straightforwardly, but sometimes this new information will say things a little bit. So if we get into one of those conversations, then, one of two things happens. I might adjust on the fly in the feedback session and say, “This information sounds different than what I was working with before. I think this is important. So, I’ll tell you what, I’m going to back off from this diagnostic certainty and go back and try to integrate all of this data and see what comes out of it.”
Parents, I think, appreciate that a lot of the time because it often is a reflection of my being willing to hear and understand their concerns and integrate new information as they feel is important. So, usually, they react pretty well to [00:15:00] that.
The other situation that can come up is that, I’ll do the feedback session and be pretty convinced of the diagnostic picture, but then as I go back and write the report, pull everything together, and synthesize the information, sometimes what happens is my brain processes things differently. I see the data a little differently, or maybe I consult with a colleague and things change. In that case, I do think that we have some obligation to re-explain the results in the context of this new diagnosis and recommendations.
So, I’ll often write an email to the parents or the individual and say something like, “I was going back and putting the final report together. As I did, things shifted for me a bit. I think that the diagnostic picture and recommendations are a little different than what we talked about in the feedback session.”
Now, if it’s a major [00:16:00] shift, then I will implore the client to schedule another feedback meeting, which I typically will do complimentary since it was my priority, I suppose, or my mistake, to have to bring them back in. So I’ll do that complimentary. If it’s not such a major shift, if it’s something like maybe I’m adding a writing disorder to an existing reading disorder diagnosis or something like that, I’ll just write out an email and say, here’s the new picture. Here’s the information that I used to make that. It’s all explained well in the report. Let me know if you have any questions about that. I always offer to get together again for another meeting if we need to discuss those extra results. And that seems to work pretty well.
Now, the situation that came up back in episode 13 that I discussed was probably, I would say the worst [00:17:00] scenario that has happened here in our practice and certainly to me personally and that’s why I did want to talk about that because it was the best example of how to fix it when you mess up because I think I messed up pretty badly on this one.
I will say, not to keep you on the edge of your seats, it turned out great. So that’s all good. I worked with this family, there’s a typical evaluation with their kiddo. What happened is, they came to the feedback session. This is a family who drove from a significant distance away, and that maybe lent a little more importance to it for me, even though, it probably shouldn’t, but just knowing that they were putting so much effort into coming here made it super important for me.
So, they came for the feedback session and what ended up happening [00:18:00] is, the night before, I think our little girl was up sick and had kept us up a lot of the night. Basically, I was not on my game during this feedback session. I used some of my downtime during the day to work on some other things and to try to save some energy and rest a little bit.
I didn’t save as much time as I typically do to prepare for the feedback session and look over the records and that kind of thing. And so when we got to the feedback session, this is hard to admit or acknowledge, but I ended up doing an okay feedback session. It did not feel super personal to this family or this particular kiddo.
I usually speak [00:19:00] pretty specifically to recommendations that are appropriate personally for each kid. This time I spoke more in generalities. I asked the parents some clarifying questions that I had already asked them in the initial interview, which was certainly embarrassing. I could just see, as the feedback session was going along, that the parents were disappointed. Their faces were falling. They eventually voiced this disappointment that they thought the feedback was going to be more specific to their kid and it felt like it was not personalized and that I’d missed some important information. Of course, all of those things were true at the moment. For me, that’s my worst nightmare. A big reason that I do this, and I think a big part of our [00:20:00] reputation here in the community is being fairly attentive to families and providing really good service. So this was pretty heartbreaking for me.
In the moment, I did apologize. I didn’t say a lot, but I apologized and acknowledged that I could understand that this was not exactly what they were hoping for, and said that what I would do is look back over everything and get back in touch with them with some recourse. I let that let that ride for two days. I think that was a Friday. Over the weekend, I thought about what would be appropriate here.
What I ended up doing is I wrote a pretty genuine, heartfelt email to the family. [00:21:00] I was honest. I did not go into extensive detail about my daughter being sick and all of that, but I did say, yes, I totally understand how you could have been disappointed. I was admittedly not as thorough as I should have been. I did say. “I was not at my best for a number of reasons, and I apologize for that. You’re completely right to feel the way you did. Here are the things that I would like to do to change things a bit.”
In the email, I offered some additional explanation in the context of this kiddo’s diagnostic picture. I won’t go into detail about that, but I offered some more information there. I did give them one of those evaluation summaries and beefed it up a little bit to make sure that they had some concrete info to take to the school for their school meeting.
[00:22:00] The main thing that I did was, I said, “Listen, I’m going to look through all the data. I’m guessing the report is going to be a lot more comprehensive and contain a lot more information than what we talked about in the feedback session. So I am happy to do another meeting with you to address any concerns. That will be complimentary. We can have as many conversations as we need to sort through all this information and make sure that we’re all on the same page.”That went over really well. We did end up meeting again. We had a great conversation. One of the parents was extremely well-versed in the diagnostic picture and special education and that sort of thing. So we had a great in-depth conversation about little nuances of the report and what the [00:23:00] evaluation looked like.
I also put a lot of attention into that report. I try to do a pretty personalized report no matter what, but with this particular kiddo, I would say that I maybe even went above and beyond just to make sure that I was speaking to each of the little components that were particularly important for that kiddo. So, when I delivered the report to them, it was maybe a little bit more thorough than even typical. And I think that was really appreciated.
So I think the theme with a lot of these instances of messing up is owning it. The times, maybe in the past that I honestly can’t recall, but I know that I’ve done, I think there’s that inclination to get defensive and maybe brush it off or say [00:24:00] the client was too demanding or something along those lines, that never goes well. If you’ve found a situation where it goes well, let me know. But for me, owning it is super important.
This is nothing revolutionary necessarily, but at least I know for me, when I get into this situation, owning it can be one of the hardest things to do because it means admitting that you made a mistake and running the risk that someone is going to be disappointed or maybe leave a bad review or something like that. But, at least in my experience, it seems like owning it and offering some matter of recourse can help out greatly and has always been received pretty well.
The last piece that I wanted to talk about is billing. That wraps up the whole eval process. We do take a lot of insurance. I’ve talked about that here and on other podcasts before about taking insurance in [00:25:00] testing. With that, we do run into situations sometimes where the bill comes back differently than was expected. We do have an insurance verification team that checks benefits. We always try to give people an estimate of their out-of-pocket costs before they get started, but sometimes that is different than what we were quoted for whatever reason. In those cases, I always… when I was doing this on my own, this is how it worked, and now that we have an admin assistant, I trained that person to do the same thing, but I always give people the benefit of the doubt basically when it comes to billing.
You may have been on the other side of this maybe with one of your own medical bills, but when you’re calling and there’s money involved, things can get tense, and defensive and can go downhill pretty quickly. [00:26:00] That’s often the case. When people are calling us, they’re on the defense or even maybe think about being offensive, where they’re trying to talk us down or negotiate a balance or something almost like they expect you to be defensive in return. What we do is we always give the client the benefit of the doubt. We totally employ those active listening skills and try to understand their perspective. If it’s a really straightforward issue like deductible versus copay or something, we’ll just explain that and try to do that pretty clearly: Here’s your deductible. Here’s what that means. Here’s why the charges went to that and it was more than you were expecting.
The other piece is that, if it’s relevant, we will always do one appeal on the client’s behalf. Most insurance companies will allow you [00:27:00] to submit paperwork or give them a phone call and try to do a retroactive authorization or something like that. That’s part of our, I guess you’d say customer service is that, I will let our staff do that, have our office admin assistant do that is just do one appeal. It might take 15 to 20 minutes, but I think it goes a long way in the client’s mind.
If it doesn’t work, we have a form letter that we send that basically says, “Hi, so and so, we just wanted to get in touch about this balance. We know it’s different than you expect. We did perform an appeal on your behalf and unfortunately, that was not granted. We do not have the time or the resources to continue to appeal this, but we’re happy to provide you with any documentation you might need to appeal on your own. In the meantime, we kindly ask that you remit your payment for this balance.”
When you [00:28:00] try to go that extra mile just to assure people that yes, we’re on your side, we’re not just trying to collect this money and send you on your way, that makes a big difference. We’ve had a lot of folks who, just by virtue of that conversation and that letter, will say, “Thanks for doing that. I really appreciate it. Let me just pay the bill right now. I’ll contact you if we need any documentation to appeal it.” So. I think just being human and being kind goes a long way and acknowledging that that’s really inconvenient for the balance to be different than what they expected. That’s not a nice surprise. Of course, we’ll help them out.
Let’s see. I think that’s it. That’s all that I have in terms of ways to handle it when you mess up. There are any number of examples of how this might come up when you’re doing testing. I would love to hear if anybody else has any stories of how you [00:29:00] handle it when things do not go exactly right, or how you handle it when clients are upset because this is something that we all deal with to some degree. It’s helpful to have some tools in your tool bag for how to work through that.
As we move along, this will be, I think, my last solo episode for a while, which is pretty exciting. I have some cool interviews coming up. I think over the next 2 or 3 weeks, I will be talking with 2 guys from Q-interactive. If you don’t know Q-interactive, that is an iPad-based test administration software platform. A lot of people are jumping on board with it. It’s getting pretty popular. I’m talking with 2 guys here soon about the development of that, how to implement it, cost and pros and cons, and all those different pieces. So, that’s going to be pretty exciting. I’m [00:30:00] really looking forward to that one.
I’m also going to be talking with two practitioners that I’m really excited about. This coming week, I’m going to be talking with Dr. Bryn Harris, down in Denver, who specializes in cultural competence and assessment specifically with autism spectrum assessment. She’s going to be talking with me about cultural issues. Then two weeks down the road, I’m going to be talking with Dr. Karen Postal, who is the author of Feedback that Sticks, which is a fantastic book about how to do a feedback session, delivering difficult feedback, and how to work through pretty tough diagnostic pieces with parents and families. I’m really excited. We’ve got some really cool conversations coming up.
In the meantime, I hope that all of you are having a great summer, maybe taking a cool vacation or two. We are headed next week to South Carolina, which is where I grew up. [00:31:00] We’re going to spend a week at the beach, let my kids play with their cousin, see some family, and get some sunshine. So that sounds incredible.
I hope all of y’all are doing well. If you do want to connect or talk with other psychologists who are doing testing, we have The Testing Psychologist Community on Facebook, which you can search for there in that bar at the top of Facebook. The website, thetestingpsychologist.com also has resources and links to past episodes and things like that.
Of course, if you want to think about or move toward growing testing services in your practice, I am always happy to talk with you. We can do a 20 or 30-minute call just to get a sense of what’s going on and what you’re thinking about. Then we can figure out if consulting is, is the right direction for you. Or if you’d like to maybe explore some other options, which I could talk you through. So don’t hesitate to give me a call if that feels [00:32:00] relevant for you.
Take care, y’all. We’ll talk to you next time. Bye. Bye.