If you have been referred by your physician for a psychological evaluation because you are planning a surgical or other medical procedure, it is likely for one of two reasons: Psychological clearance is often a requirement of insurance coverage for certain surgeries or other procedures, and many surgeons require psychological clearance as their standard of care.  In general, psychologists are required to make sure that there are no psychological factors that would interfere with the success the procedure. The psychologist is required to make sure that you understand those changes that you will need to make and there is a reasonable expectation that you will comply with those changes. The psychologist needs to make sure that you can provide informed consent by documenting that you understand the risks and benefits of the procedure. Psychologists are supposed to provide recommendations for treatment for those who may or may not yet be deemed a candidate for the medical procedure.


Some examples: 


If you are being referred for a pre-surgical clearance for bariatric surgery: All bariatric surgeries have different risk and benefit profiles, but ultimately they are tools to help the patient to lose weight and require that they comply with certain life-style changes.  Bariatric surgery will not, in itself, result in long-term weight loss success - it is not a magic bullet.  Success requires a significant permanent change in lifestyle and behavior patterns, and not only in regard to eating patterns.  There are often significant emotional and psychological stresses induced by changes in your self-perception and identity, as well as your social identity, as you learn how to 'be' different in the world.  For example, if you have had a tendency to use food for emotional reasons, you will likely struggle as you lose access to this significant emotional coping tool - you will have to learn how to regulate emotional needs in other, unfamiliar, ways.  Further, while often desired for health reasons, weight loss with bariatric surgery does not necessarily mean that you will resolve the health issues that the extra weight has caused.  Good health outcomes will require more than simple weight reduction.  These are the issues and concerns that a psychologist will want to address, both before and after the procedure.


If you are being referred for an evaluation regarding hormone therapy or sex reassignment surgery, your physician or endocrinologist will require this assessment as a standard of care.  This evaluation is not 'corrective' in nature or intent, and I fully honor and support an individual's right to pursue these options as they seek self-congruance.  The purpose of the evaluation is to ensure that each person has considered all the implications and ramifications of the change - physical, social, emotional, spiritual, financial - and is psychologically and emotionally prepared to successfully undertake this potentially difficult transition.  If the decision is made to proceed, I will continue to provide whatever support I can to support your journey. Note that I can provide referrals to others that I have worked with, both to ask questions about me and to provide additional support and direction. 


I occasionally receive referrals from pain management physicians and other specialists for psychological evaluations of patients suffering from chronic pain. These referrals are not meant to trivialize a person's pain condition as psychiatric in nature. Because chronic pain can cause depression and anxiety, that if severe enough, could adversely impact the effectiveness of pain treatments, then your doctor needs information about how you are coping with your pain in order to make informed decisions about your care. For this reason among others, your doctor may want to have you see a psychologist to determine for example if you are a reasonable candidate for certain types of medications (especially if you have had substance use concerns in the past), to see if you are a reasonable candidate for certain medical procedures, and to see if you may benefit from psychological approaches to pain management.