Clinical Test Publishing in the 21st Century

By Jeffrey Manson, MBA & David Herzberg, Ph.D.
May 15, 2014

Clinical test publishing in the 21st CenturyPsychology is about understanding a person’s unique strengths and challenges and how best to help individuals realize their potential. Psychologists rely on tests to inform their understanding–and in so doing, they rely on test publishers. A publisher’s responsibility is to develop innovative and accurate assessments, and to forge connections between test authors and clinicians, so that an author’s ideas can reach the widest audience and do the greatest good.

At Western Psychological Services (WPS), we publish titles for psychologists and other clinicians who work directly with children, adolescents, adults and families.

The popular press is full of news about the publishing industry’s difficult future, driven by the ascendency of electronic media and cultural changes in the way people consume information. Though not immune from these challenges, clinical publishing is a specialized, technical endeavor that differs in many ways from retail publishing. Mostly these differences accrue from our audience: Psychologists are highly educated and deeply passionate about their work, and they insist on assessments that meet the most stringent clinical and scientific standards. Their need for quality supports a healthy business environment for assessment publishers.

As in all aspects of publishing, the influence of technology looms large. Clinical publishers are in the midst of transforming a largely print-based industry into one that can deliver assessments through a variety of technology systems. Perhaps the most straightforward transition is enabling parents, teachers and other respondents to fill out electronic rating scales via an Internet browser. Some publishers are moving beyond this initial application, introducing platforms that allow the administration of one-on-one performance tests via a pair of tablet computers, one for the examiner and one for the client.

Psychologists evaluate new approaches carefully–they operate in cost-sensitive environments and they want to make sure that technology-based assessments do indeed deliver increased value over their printed counterparts. Publishers want to innovate, but not merely to claim ownership of the “latest and greatest” digital tests. The prudent course is to offer a choice in assessment approaches–introducing technology solutions for early adopters but continuing to support print-based assessment for the foreseeable future.

Pricing of assessment software can be a sticking point for school districts and other large organizations. Publishers favor a per-use pricing structure for software, one that parallels the situation in print assessment, where a test form is consumed in each assessment. Yet many schools face budgetary constraints that only allow purchase of unlimited-use software for a one-time fee.

Publishers and psychologists are concerned with the lack of standards around technology-based systems and user interfaces. In print delivery, the paper form is a standard interface that every clinician knows how to use. By contrast, in digital delivery, each publisher has its own platform, and often the only way a practitioner can compare the results of two online administrations is, ironically, to print the two reports!

Beyond technology, clinicians face a host of challenges to traditional methods of assessment practice. Obtaining appropriate reimbursement for psychological testing is certainly the most salient of these. As a publisher, we strive to support and educate our customers about their options in this area.

For example, psychologists need to understand and negotiate the Current Procedural Terminology (CPT) code system. CPT codes are used by third-party payers to determine rates of reimbursement for health care services. The system of codes itself is arcane, and it can obscure opportunities to obtain higher rates of reimbursement for the use of tests. Only close familiarity with the CPT system reveals the differing reimbursement rates for these modes of testing: computerized versus print-based, clinician versus technician administration and psychological versus neuropsychological test batteries.

The Affordable Care Act (ACA, also known as “Obamacare”) appears favorable for the practice of psychological assessment. For instance, the ACA includes funding to expand the network of health centers, community-based resources that place medical and psychological care on equal footing, within an integrated model of service delivery. These centers give psychologists the opportunity to reach a larger client base with assessment services.

The recent release of DSM-5 generated plenty of controversy in the academic world and made a big splash in the mainstream media. As a publisher, our responsibility is to ensure that all of our relevant titles are aligned with the DSM-5 diagnostic criteria. For existing tests, this may mean more quickly bringing the materials up to date.

A test publisher can only succeed by listening closely to the experts who use our tests in their daily work. We strive to connect with our customers through various levels of dialogue, including focus groups, advisory councils and survey-based market research. Clinicians ask for support in using test scores to develop measureable, effective intervention plans and in finding the best ways to convey assessment results to parents, teachers and other individuals involved in their clients’ care.

We respond to these needs by creating intervention materials tied directly to our assessments–down to item-by-item suggestions and strategies for treatment. In developing test forms and manuals, we work with our authors to write explanations of technical concepts (such as reliability and validity) that make sense to a nontechnical audience. Ours is a competitive industry–we know that for any referral question, psychologists can choose from a range of published instruments. As a publisher, one of our central aims is to provide practitioners with the information they need to select the best measures for their practice.

WPS is an independent, family-owned organization. Our industry includes other small publishers but also several larger corporate players. We believe the independent publisher can be more responsive, nimble and closely attuned to the needs of clinicians.

We are grateful for the efforts of our authors, whose scholarship and clinical wisdom are foundational to the assessment process. Many authors have tried to “self-publish” at some point in their careers, and they recognize the unique contributions of a test publisher. Developing professional assessments requires a range of capabilities, including research, design, presentation, logistics and good old-fashioned business acumen. At WPS, we see this skill set as shared among author, publisher and clinician: Each plays a vital role in the creation of tests that can really make a difference in the lives of individuals.

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Jeffrey Manson, MBA, is president and CEO of WPS and the third generation of his family to lead WPS. His email is David Herzberg, Ph.D., is vice president for research and development at WPS. He may be reached by email at

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