Assessment, Diagnosis & Treatment

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PSYCHOLOGICAL ASSESSMENTS FOR ALL AGES

We provide comprehensive, individualized psychological and neuropsychological assessments. Our practice specializes in the assessment, diagnosis, and consultation of treatment for children, adolescents, and adults to evaluate cognitive strengths and weaknesses.

We provide careful interpretation of results and appropriate recommendations designed to help our clients get the most from their evaluation. We also work closely with referral sources to guarantee a comprehensive treatment plan.


What is a Clinical Neuropsychologist?

A clinical neuropsychologist is a professional within the field of psychology with special expertise in the applied science of brain-behavior relationships. Clinical neuropsychologists use this knowledge in the assessment, diagnosis, treatment, and/or rehabilitation of patients across the lifespan with neurological, medical, neurodevelopment and psychiatric conditions, as well as other cognitive and learning disorders.

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Dr. Alefiyah Bharmal
Dr. Alefiyah Bharmal obtained her undergraduate degree from the University of Texas at Austin in 2007. In 2008, she moved to the Washington DC area to complete her Masters and Doctorate in Clinical Psychology from the American School of Professional Psychology (APA Accredited). She then specialized in pediatric neuropsychology by accepting a fellowship with Kaiser Permanente in Oakland, California (APA Accredited). Although it was hard to leave California, Texan at heart, she made her move back to the DFW area in 2014 to reunite with family.

Dr. Bharmal is a licensed clinical psychologist who specializes in clinical neuropsychology. This means that her expertise is in understanding and evaluating the relationship between brain disorders and behavior. She has several passions related to her field including neuropsychological evaluations, and cognitive rehabilitation for individuals who have endured insult/injury to the brain and are in recovery, or individuals suffering from dementia. She works with individuals from age 2 years old through geriatrics. Dr. Bharmal conducts evaluations for a wide range of referral questions. Please explore the website or call to learn about the different types of evaluations!

Dr. Bharmal also is devoted to working with individuals of all ages on issues related to anxiety, depression, oppositional behavior, building coping skills, direct or vicarious trauma, parenting skills, parent-child relationship, and life adjustment difficulties. She is genuinely dedicated to encouraging others, using a strength-based approach, and empowering their growth towards a “healthy mind.”


Dr. Kamaria Chisolm
Dr. Kam is a psychologist who strives to understand the mental capacity of individuals in preparing treatment plans to conduct counseling sessions accordingly. She knew at an early age that she wanted to be someone who helps others in need and set out to reach this goal. Dr. Kam earned her Bachelor’s Degree in Psychology from Howard University and her Master’s Degree in Mental Health Counseling from Canisius College. She completed her Ph.D. in Counseling Psychology from The Pennsylvania State University with a unique ability to conduct tests, assessments, evaluations, diagnosis, and interventions on mentally challenged individuals. Dr. Kam enhanced her individual therapy, group therapy, and assessment skills through a predoctoral internship at The University of Wisconsin’s Student Health Center. Upon completion of her doctoral program, Dr. Kam completed her postdoctoral residency at a Juvenile Detention Center in Columbia, SC, where she provided forensic assessment services and managed the “Girl’s Program”. Dr. Kam then sought out more diverse clinical experiences by providing consultation services in Abu Dhabi, UAE. Dr. Kam is trained in evidence-based therapies and has a strong acumen for executing complex assessments and interventions on patients. At Healthy Minds Psychological Services, Dr. Kam is excited to offer psychological assessment services to adults experiencing a wide range of difficulties including, but not limited to: obesity, distress, anxiety, depression, trauma, and grief/loss.

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Neuropsychological Assessment


What we assess for:
We assess for many neurocognitive disorders, conditions, and problems.  This includes (but is not limited to):
  • Dementia (e.g., Alzheimer’s disease, frontotemporal dementia, and diffuse Lewy Body disease)
  • Multiple Sclerosis (MS)
  • Stroke
  • Epilepsy
  • Parkinson’s-related cognitive decline
  • Auto-immune conditions (e.g., lupus, sarcoidosis)
  • Lyme disease
  • Encephalitis
  • Attention Deficit Hyperactivity Disorder (i.e., ADHD)
  • Traumatic Brain Injury
  • Post-concussive syndrome
  • Cognitive effects of psychiatric disorders
  • Learning disabilities
  • Medication-related cognitive decline (both temporary and permanent)
  • Cognitive effects of fatigue

Who should receive a neuropsychological evaluation?
A neuropsychological evaluation may be indicated for individuals with the following histories:
  • Traumatic brain injury (TBI) and concussions, and associated impact on brain function.
  • Medical diseases (including infections, cardiovascular difficulties, and degenerative disorders) and decreased mental functioning.
  • Substance abuse, including chemical agents such as heroin, cocaine, alcohol, marijuana, hallucinogens, synthetic drugs and prescribed medications, which can impact brain functioning.
  • Attention Deficit Hyperactivity Disorder (ADHD) and associated difficulties with attention and executive function.
  • Learning difficulties, including specific weaknesses in academic areas.
  • Neurodevelopmental delays
  • Treatment resistant clients, which can reveal underlying neurological issues that may be impeding therapeutic progress.

What does a neuropsychological assessment include? 

A full neuropsychological assessment includes evaluation of cognition and intelligence, executive functioning skills, attention and concentration, motor skill development, language, learning, and memory. Each evaluation additionally includes a comprehensive psychological evaluation, focused on assessing mental health, emotional functioning, and personality development.

What does a NP assessment provide?
Neuropsychological testing provides quantifiable data about the following mental functions:
  • Short-term and long-term memory
  • Intelligence
  • Problem solving and conceptualizing
  • Ability to learn new skills and solve problems
  • Ability, concentration, and distractibility
  • Logical and abstract reasoning functions
  • Ability to understand and express language
  • Visual-spatial organization Visual-motor coordination
  • Planning, synthesizing and organizing abilities
  • Functional impacts on learning and information recall
  • Psychomotor Performance
  • Executive Skills
  • Concept Formation and Reasoning
  • Academic Ability and Achievement
  • Emotional and Behavioral Status

Psychological Evalution


What is Psychological Evaluation?
Your personalized psychological evaluation from Healthy Minds Psychological Services may include a range of tests and assessment tools used to help psychologists and other mental health and medical professionals better understand your behaviors. Perhaps more importantly, these assessments can also help you better understand your own strengths and weaknesses. Psychological evaluations can work as problem solving tools for patients who need to better understand their behaviors; refine their therapy goals; and meet challenges in personal, professional, and educational settings.
Who Should Receive Psychological Evaluation?
Some common reasons people reach out to us to schedule testing for themselves or a loved one include:
  • Anxiety – Feeling anxious in certain situations is a perfectly natural emotional response, but for people with an anxiety disorder, these feelings may not go away, become worse over time, or are heightened in certain situations.
  • Depression –Symptoms may include feeling discouraged, sad, hopeless, unmotivated, or disinterested, as well as struggling to perform your regular, daily activities.
  • Difficulty regulating mood – This may be any combination of behavioral changes that seem to occur and linger without your being able to redirect your emotions. Again, people experience periods of time where it is more difficult to regulate moods, but if these times are constant or begin to interfere with your ability to lead a healthy, happy, or productive day to day life, you may need to seek diagnosis and treatment.
  • Oppositionality – This can be more difficult to define for many people, especially teens and young adults who are establishing independence and may naturally express some of these characteristics. However, like other concerns, this condition becomes problematic when the oppositionality is constant, leads to violence, or impedes success in personal, educational, or professional settings.
It’s important to remember that psychological conditions are just as real and detrimental to health as physical conditions, but they are also just as treatable. You should feel comfortable reaching out to our expert team for help diagnosing these conditions and finding appropriate therapies that will work for you. We can help you understand and address any psychological concerns. Psychological evaluations may also be used to help those already engaging in therapy to receive necessary clarification to help them improve their treatment goals.
What Kind of Testing is Involved?
Psychological testing from the team at Healthy Minds Psychological Services may include a variety of evaluative measures. Our team always creates personalized assessment plans. Assessment methods may include written tests, rating scales, and computerized testing instrument that evaluate strengths and weaknesses in cognitive, academic, and behavioral function. Our team members may also use behavioral rating scales to gain a better understanding of the severity and frequency of your experiences. One of our clinicians will also conduct a one-on-one interview to get to know and understand your unique situation. Interviews with or information from others who know you well may also be gathered.
The goal of psychological testing is to help you understand your behavior and assess areas of strengths and weaknesses to create practical means of addressing challenges to daily function. Psychological evaluation is meant to educate patients about their own skills and abilities. It is not necessarily a diagnostic tool so much as a way to help you develop a plan to better meet your therapy goals. At Healthy Minds Psychological Services we provide evaluations, documentation, practical recommendations, and consultation. However, we encourage patients who do not already have an established therapeutic relationship to make a plan for continued therapeutic care beyond your psychological evaluation.

Baseline & Post-Injury Concussion Testing


Using the program ImPACT, we conduct Baseline Testing prior to an injury as it provides a frame of reference for a child’s improvement after a concussion has occurred. In the event of a concussion during recreational activities, an accident, or sports, the same test is taken again, yielding comparative scores from before and after the injury. These baseline tests and post-injury tests are computerized assessments that measure Reaction Time, Memory Capacity, Speed of Mental Processing, and Executive Functioning of the brain. They also record baseline and measures of concussion symptoms over time and provide information about the athlete’s history with concussions. The tests are used in coordination with medical management of concussion treatment
We use ImPACT testing for ages 6 and up.

ADHD Evaluation


What is ADHD?
Attention-Deficit/Hyperactivity Disorder (ADHD) refers to difficulty controlling a group of neurological functions referred to collectively as the executive functions. This group of brain activity is responsible for controlling our ability to focus on a specific task, organize thoughts and our environment, and effectively use working or short-term memory. When our brains do not effectively control these executive functions, it can be difficult to lead safe, healthy, and productive lives at any age. Children with ADHD often struggle in school, and adults can have difficulty maintaining jobs and/or relationships. ADHD sufferers often display behaviors like impulsivity, hyperactivity, or inattention. Current diagnostic guidelines outline three types of ADHD: predominantly inattentive; predominantly hyperactive-impulsive; and combined presentation.
Who Should be Evaluated for ADHD?
While many patients seek ADHD diagnosis for their children, this disorder can affect patients at any age, and testing can be completed for both children and adults. Before seeking diagnosis of ADHD, we encourage patients to review the following symptoms:
  • Difficulty maintaining attention or impaired concentration and performance across settings (school, work, social, and home).
  • Difficulty or inability to pay careful attention to details especially when a task is not particularly interesting or is mentally taxing.
  • Hyperactivity which can be expressed by fidgeting, moving, or talking constantly, and patients are frequently described as seeming to be constantly in motion as if driven by a motor.
  • Difficulty or inability to control impulses which may be expressed by frequently interrupting others, struggling to follow through with commitments, and anger management issues.
It’s also important to understand that most people experience these behaviors or symptoms at some level. This does not necessarily mean you are suffering from ADHD; furthermore, many other disorders have core symptoms that can mimic ADHD. That’s why we have customized test batteries to help determine whether or not patients suffer from this disorder. Patients who struggle with ADHD-type symptoms may also be experiencing a number of other conditions including autism spectrum disorder and certain learning disabilities.
What Kind of Testing is Involved?
In some cases where patients demonstrate significant difficulty with concentration and/or hyperactivity, we may recommend focused testing for just ADHD. Because the signs and symptoms of ADHD are common to other disorders, we may recommend patients receive a more advanced battery of neuropsychological assessments. In order to ensure accurate diagnosis, we may use any number of testing components, including:
  • Clinical interviews
  • Rating scales
  • Neuropsychological batteries
  • Achievement testing
  • Cognitive evaluation
  • Observation
In addition to our own assessments, we ask that parents or patients also provide us with any additional medical history, reports from education professionals, and/or past reviews from school counselors and others who have provided feedback that may be relevant to accurate ADHD diagnosis.
In addition to subjective ratings of behavior, one of the most common and effective tests we use to provide diagnostic information is the continuous performance test (CPT). Administered via computer, these tests evaluate a patient’s ability to sort through stimuli and pay attention to only relevant factors. These evaluations can also be performed to help us better understand the effectiveness of potential treatment options.

Psychodeducational/ Psychological Evaluation


What is a Psychoeducational Evaluation?
Psychoeducational/educational evaluations are types of comprehensive assessments for learners that identify cognitive, academic, and behavioral strengths and weaknesses in regard specifically to how they impact the educational experience. These evaluations are used to analyze the cognitive processes that may underlie a student’s educational difficulties and barriers to success. The personalized battery of tests can be used to identify learning disorders, including dyslexia, dysgraphia, and dyscalculia. They can also be used to diagnose mood or behavior disorders that may be present. The customized battery of assessments provided by the clinicians at HMPS meet the Texas Education Agency (TEA) requirements for the diagnosis of specific learning disability (SLD) when such a diagnosis is in question. These requirements must be met to determine student eligibility for special education support and accommodations.
Who Should Receive Psychoeducational Evaluation?
These psychoeducational/educational evaluations may be used to assist learners in getting the educational support they need at all levels of education – elementary, middle, and high school as well as college and beyond. Students may also seek an evaluation prior to taking college placement exams like the SAT and ACT while still in high school. They are also provided to colleges as documentation to ensure students receive the support they need to be successful in the college learning environment. Additionally, you may need to complete psychoeducation/educational evaluation to receive accommodations when taking graduate placement exams and professional licensing exams.
What Kind of Testing is Involved?
You may hear psychoeducational/educational evaluations referred to as learning profiles. These assessments may include a comprehensive variety of testing methods, including:
  • Cognitive and achievement testing that focuses on academic strengths and weaknesses
  • Emotional and behavioral assessments
  • Clinical interviews
  • Classroom observations
  • Educational and assessment histories
  • Interviews with parents, teachers, and others who can valid data about the learner
  • Medical history questionnaires to identify health factors that affect learning
The main portion of the testing will be the educational evaluation through cognitive and achievement testing. Your child will be assessed on their abilities in reading comprehension, spelling, writing, and mathematics. In addition to these specific educational topics, the learner will also be assessed for their use of multiple cognitive processing abilities including verbal and nonverbal reasoning, processing speed, organization, and attentiveness. Behavioral and affective testing may consist of interviewing and observation of the student as well as reviews of past educational support and successful past learning accommodations. We may also interview or gather information and ratings from parents and teachers as well.
Following the personalized battery of tests, we provide a report outlining the findings of the student’s psychoeducational/educational evaluations. The report will include recommendations for continued educational support and accommodations to remove barriers to learning during academic testing and college education. The aim is to help learners continue to achieve their educational goals while completing college-level work. If you have questions about the results of a psychoeducational/educational evaluation, please don’t hesitate to reach out to the HMPS team. We can review the results of your assessment and help you better understand our report. If you need help working with colleges or testing administrators, we would be happy to provide consultation services to work as your advocate to schools and test providers

Immigration Psychological Evaluations


Waiver from US Citizenship Examination
The N-648 is the disability waiver that exempts applicants for U.S. citizenship from
1.      Demonstrating they can speak, read, and write English, and/or
2.      Passing a test of U.S. history and civics.
With a waiver, the applicant can have the interview in his/her native language and will not have to answer questions about U.S. history and government. U.S. Citizenship and Immigration Services (CIS) relies on the medical opinion of the applicant’s doctor in deciding whether to grant the waiver.  CIS generally makes a decision as to whether to grant or deny citizenship at the naturalization interview. Under current law, the N-648 must be submitted at the same time as the N-400 application for citizenship.
Cancellation of Removal from US
Deportation and removal is the area of immigration law in which a psychological evaluation is most likely to be required. In an immigration removal case a non-permanent resident must establish that his or her removal would cause “extreme and unusual hardship” to a qualifying relative (i.e. their U.S. citizen or legal permanent resident spouse, child or parent). When extreme psychological hardship is uncovered through a psychological evaluation, pending deportation may be cancelled by the court (“cancellation of removal”) and legal permanent residence granted (“green card”).
Denial of Admission to US
An area of immigration law in which psychological evaluations are often used is in support of adjustment status or visa application when a waiver of overstay (or other inadmissibility problem) is necessary (e.g. I-601 Waiver). A well-drafted psychological report can persuade immigration court that “extreme” psychological hardship to the applicant’s U.S. citizen spouse, child or parent will result if the application for legal admission to the United States is denied. The result can be a grant of legal permanent residence in the United States.
Political Asylum
Political asylum are refugees who often have been exposed to political imprisonment, religious persecution, extreme deprivation, torture and various forms of psychological distress in their home country. They seek “asylum” or safety from their country of origin within the U.S. under the Immigration and Nationality Act (U.S. Code Section 208a). Quite frequently, these asylum applicants experience post-traumatic stress disorder (PTSD) or other emotional difficulties which make “telling their life story” difficult or impossible. The nature and extent of their psychological impairment can be established by a thorough psychological evaluation, which should be conducted by a psychologist trained in detecting post-traumatic stress disorder (PTSD). The DSM-5 notes that the clinical expression of the symptoms of PTSD may vary culturally.
Permanent Residency with Domestic Abuse
Non-permanent resident victims of domestic abuse who are married to a U. S.citizen OR a permanent resident may be eligible for permanent residency in the U.S. if they can establish through a psychological evaluation that verbal, physical or sexual abuse has occurred within their relationship. The Violence Against Women Act (VAWA) provides for immigration benefits to men as well as women who have been physically and mentally abused by their U.S. citizen spouse.VAWA relief is also available to parents AND children of USC/LPR’s who have been subjected to extreme cruelty or physical abuse.
Deferred Action for Childhood Arrivals (DACA)
On June 15, 2012, the Secretary of Homeland Security announced that certain people who came to the United States as children and meet several guidelines may request consideration of deferred action for a period of two years, subject to renewal. They are also eligible for work authorization. Deferred action is a use of prosecutorial discretion to defer removal action against an individual for a certain period of time. Deferred action does not provide lawful status. NOTE: On November 20, 2014, the President made an announcement extending the period of DACA and work authorization from two years to three years.
This benefit is denied to any young person who has a serious criminal conviction like domestic violence unless rehabilitation is established. The psychological evaluation can help determine if the conviction may have been the result of a mental disorder, prior parental abuse, or other cognitive deficit.
U-Visa / T-Visa
A U-Visa may be granted to an non-permanent resident living illegally in the U.S. if that individual is able to demonstrate, through a psychologist’s evaluation, that they have suffered substantial mental or physical abuse as a result of being a victim of a crime that occurred in the U.S. and that they were helpful to legal authorities (e.g. police, U.S. gov’t) in providing information that assists with prosecution of the crime.
A special T-Visa is available for victims of human (sex) trafficking. In each case, a psychologist’s evaluation can be extremely helpful in highlighting the hardship issues pertaining to the case.
Reference:
http://www.uscis.gov/humanitarian/consideration-deferred-action-childhood-arrivals-daca

Fit for Duty Evaluation


What is a Fitness for duty Evaluation? 
A psychological Fitness For duty Evaluation (FFDE) is a formal, specialized examination of an employee or potential employee to provide objective test data in order to determine whether the employee is capable of effectively performing his or her essential job functions. We see individuals from the military, police department, and aviation industries. 

Who can complete an FFDE evaluation?
In the state of Texas, the Examiner must be a licensed psychologists or psychiatrists with education, training, and experience in the diagnostic evaluation of mental and emotional disorders.

What is the Evaluation Process?
Depending on the referral question and the examiner’s clinical judgment, HMPS strives to utilize multiple methods and data sources in order to optimize the accuracy of findings. We integrate various data sources including: a review of the relevant background and collateral information, relevant psychological testing using assessment instruments and norms, a comprehensive clinical interview and mental status examination, collateral interviews with relevant third parties if deemed necessary by the HMPS examiner, and referral to, and/or consultation with, a specialist if deemed necessary by the HMPS examiner. 

What will I get from my assessment?
Customarily, a HMPS examiner will provide a written report to the client agency that contains a description of the rationale for the FFDE, the methods employed, and whenever possible, a clearly articulated opinion that the examinee is presently fit or unfit for unrestricted duty. Because FFDEs may become part of an adjudicative process, we strive to maintain detailed records that allow scrutiny of our work by others. We strive to present our conclusions in a fair, nonpartisan, and thorough manner. 

Can I be re-evaluated if I currently am deemed unfit for duty?
Our findings and opinions are based on data available at the time of the evaluation. If additional relevant information is obtained after completion of the FFDE or it is determined that the original evaluation was based on inaccurate information, the employer may request that we reconsider our conclusions in light of the additional information. In this case, a reevaluation may be completed and his or her fitness has been restored. A reevaluation may also be considered if the individual has completed all recommendations made by HMPS in the original FFDE and would like to be reevaluated at this time. 

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