The waiting room is quiet, but your mind is screaming.
You're running through the script, rehearsing answers to questions you haven't been asked yet. You're trying to package your chaotic, non-linear life into a neat, chronological story that will make sense, that won't sound "crazy," that will make the clinician believe you. You're preparing for a final exam you didn't study for.
If this feels familiar, it's because you've been training for it your whole life. You were the "good student" in class. The "easy employee" at work. The "low-maintenance friend." You learned — early and often — that your safety and success depended on figuring out what the person in charge wanted and giving it to them.
You are an expert at being a good patient.
I need you to stop that.
The Traditional Model Was Designed for the Clinician, Not for You
Let me be honest about what the traditional assessment model looks like — because you've probably experienced some version of it, and it probably felt terrible.
The "expert" with the clipboard. The sterile room. The inherent power imbalance. The four-hour testing block where you're supposed to be at your cognitive best even though you barely slept, your anxiety is through the roof, and you haven't eaten since coffee at 7 AM. The weeks (or months) of silence before you get a report full of jargon that describes you like a broken appliance.
That model was designed to make the clinician's job easier. It was not designed to help you feel seen, understood, or safe. It's a system that rewards performance over truth, compliance over authenticity.
Here's the paradigm shift that changed how I practice: assessment is not something that happens TO you. It's something we build TOGETHER.
Research supports this approach — collaborative assessment as a Tier-1 intervention is backed by evidence showing that the assessment process itself is therapeutic. Instead of a cold measurement you endure, it's an active partnership that starts helping from day one.
What "Collaborative" Actually Means in Practice
I should probably explain what I mean, because "collaborative" gets thrown around a lot in therapy marketing. Here's what it looks like in my office:
You get to ask questions too.
"Can you tell me in your own words what you're hoping this assessment will provide for you?" — that's literally my first question. Not "rate your symptoms on a scale of 1 to 10." Not "tell me about your childhood." YOUR question first. What do YOU need from this?
We break it up.
We don't force everything into one high-stakes, exhausting marathon. Our assessments are spread across multiple, shorter sessions — 60 to 90 minutes — because I need to see the real you, not the depleted version showing up at hour four.
Your "wrong" answers matter more than your "right" ones.
This is the part that surprises people. The moments you get stuck, the questions you disagree with, the times your story is messy and contradictory — that's not failure. That is the richest data you can give me.
Your Anxious Brain: "Did I answer that right? Was that too much? They probably think I'm making this up. I should have just said I was 'stressed.'"
My Actual Brain: "This is incredible data. The way they jumped between topics just gave me a perfect window into their associative thinking. Their hesitation is telling me more than a simple answer ever could. I'm so glad they feel safe enough to be messy."
You get support from the very first session.
You don't wait for a final report to start getting help. We discuss what I'm seeing as we go. If something is clearly going on — if I can already see the pattern — I'll say so. You won't spend weeks in the dark wondering what's happening.
Why This Approach Gets Better Results
There's a reason I built my practice this way, and it's not just because it's nicer (though it is). It's because the data is better.
When you're performing — holding it together, masking, giving the "right" answers — I'm not seeing you. I'm seeing your mask. And a diagnosis based on your mask is a diagnosis of your mask, not your brain.
When the assessment environment feels safe — when you're not performing for a judge but problem-solving with a partner — the real patterns emerge. The executive function challenges show up naturally instead of being hidden by anxiety. The sensory sensitivities surface because you're not spending all your energy managing them. The burnout becomes visible because you're not burning energy pretending it doesn't exist.
In clinical language: collaborative assessment reduces performance anxiety, minimizes masking, and produces more ecologically valid data. In Liz language: you get a more accurate result because you're not spending the whole time trying to pass a test.
What You Don't Have to Do
Since you're probably still rehearsing, let me give you the anti-script:
- You don't have to have your story organized. Messy is fine. Tangential is fine. "I don't know where to start" is a perfectly valid opening line.
- You don't have to downplay anything. If it's affecting your life, it's worth saying. I'd rather hear too much than too little.
- You don't have to "prove" anything. This is not a courtroom and I am not a judge. If you're here, something brought you here, and that's enough to start.
- You don't have to be likeable. Be honest. I can work with honest. I can't work with a performance.
You have permission to be messy.
You have permission to say "I don't know."
You have permission to "fail" the test. Your real story is more valuable than any "right" answer.
The Bottom Line
You've spent your whole life trying to get an "A" on the test of being a person. In this office, there is no test. There are no right answers. There is no way to fail.
I believe you are the expert on your own life. I'm just here to help you read the data — to see the patterns your brain has been running without your conscious permission, and to translate those patterns into a Brain Guide → that actually makes sense for how you work.
When you're ready to stop being a patient and start being a partner: Let's talk →
Part of: Assessment Hub → | Related: The ADOS-2 False Positive Crisis · Why Testing Is So Expensive
