The Testing Psychologist Podcast

Would you rather read the transcript? Click here. Clinical intuition is often little more than a coin flip when it comes to detecting suboptimal effort. We like to think we can spot a client who isn’t giving their best, but the data suggests otherwise. In this episode, I dive into the necessity of using objective performance validity indicators rather than relying on gut feelings. I discuss the prevalence of failure rates in adult ADHD evaluations, the difference between malingering and a cry for help profile, and the technical balance between sensitivity and specificity in the tools we choose. I also share a practical framework for addressing poor effort in the moment using a three stage feedback sandwich to preserve the clinical alliance while ensuring the integrity of your data. Main Topics The limitations of clinical intuition in determining optimal effort Prevalence of validity failure rates in clinical ADHD evaluations Distinguishing between malingering and the cry for help profile Balancing sensitivity and specificity in validity measure selection The shift from legacy recognition tasks to multi stage symptom validity tests The two failure rule and the utility of the $0 embedded indicator Strategic scheduling and administration of PVIs throughout a battery The feedback sandwich: affirmation, calibration, and the reset Cool Things Mentioned The Testing Psychologist mastermind groups and business consulting Reverb: the premier AI-powered report-writing platform for testing psychologists Featured Resources TherapyNotes is the leading EHR system for mental health practitioners. I’ve used TherapyNotes for over 10 years, and it just keeps getting better. Use this link and the promo code “testing” to get two free months and try it for yourself! www.therapynotes.com/testing The Testing Psychologist podcast is approved for CEU’s! I’ve partnered with At Health to offer CE credits for podcast episodes! Visit this link to access current and past episodes available for CE credit. You can use code “TTP10” for a discount on ALL the course credits you purchase from At Health! About Dr. Jeremy Sharp I’m a licensed psychologist and Clinical Director at the Colorado Center for Assessment & Counseling, a private practice that I founded in 2009 and have grown to over 20 clinicians. I earned my undergraduate degree in Experimental Psychology from the University of South Carolina before getting my Master’s and PhD in Counseling Psychology from Colorado State University. These days, I specialize in psychological and neuropsychological evaluation with kids and adolescents. As the host of the Testing Psychologist Podcast, I provide private practice consulting for psychologists and other mental health professionals who want to start or grow psychological testing services in their practices. I live in Fort Collins, Colorado with my wife (also a therapist) and two young kids. Ready to grow your testing services? Click below to get on the waitlist! Join the Waitlist

Would you rather read the transcript? Click here. In this episode, I dive into the evolving understanding of Cognitive Disengagement Syndrome (CDS), formerly known as sluggish cognitive tempo. I explain why we are moving away from the older terminology toward a label that more accurately describes the internal mechanisms of the brain. We explore the neurobiological differences between CDS and traditional ADHD, specifically looking at the posterior attention system and the default mode network. I share how these differences manifest in clinical testing, such as the slow and accurate profile on processing speed tasks, and offer concrete tips for adjusting your assessment battery. We also touch on why traditional stimulant medications might not be the first line of defense for these individuals and what environmental primers might work better to wake up their attention systems. Main Topics Discussed 00:01 Introduction to the transition from sluggish cognitive tempo to Cognitive Disengagement Syndrome. 02:28 Defining CDS as a mental disengagement from the external environment. 04:54 Analyzing the 2022 Becker meta-analysis and the distinction between CDS and ADHD symptoms. 06:30 Neurobiology: Frontal-striatal circuits versus the posterior attention system and default mode network. 07:20 Differentiating CDS from predominantly inattentive and combined ADHD presentations. 08:45 The orienting network versus the executive control network in cognitive profiles. 09:38 Identifying the slow and accurate pattern in cognitive testing data. 11:15 Clinical recommendations: Rating scales, environmental primers, and medication considerations. Cool Things Mentioned The Testing Psychologist mastermind groups and business consulting Reverb: the premier AI-powered report-writing platform for testing psychologists Featured Resources TherapyNotes is the leading EHR system for mental health practitioners. I’ve used TherapyNotes for over 10 years, and it just keeps getting better. Use this link and the promo code “testing” to get two free months and try it for yourself! www.therapynotes.com/testing The Testing Psychologist podcast is approved for CEU’s! I’ve partnered with At Health to offer CE credits for podcast episodes! Visit this link to access current and past episodes available for CE credit. You can use code “TTP10” for a discount on ALL the course credits you purchase from At Health! About Dr. Jeremy Sharp I’m a licensed psychologist and Clinical Director at the Colorado Center for Assessment & Counseling, a private practice that I founded in 2009 and have grown to over 20 clinicians. I earned my undergraduate degree in Experimental Psychology from the University of South Carolina before getting my Master’s and PhD in Counseling Psychology from Colorado State University. These days, I specialize in psychological and neuropsychological evaluation with kids and adolescents. As the host of the Testing Psychologist Podcast, I provide private practice consulting for psychologists and other mental health professionals who want to start or grow psychological testing services in their practices. I live in Fort Collins, Colorado with my wife (also a therapist) and two young kids. Ready to grow your testing services? Click below to get on the waitlist! Join the Waitlist

Would you rather read the transcript? Click here. In this episode, I dive into the neurobiology of testing fatigue and why it is much more than just a simple lack of energy. We explore how high-demand cognitive tasks lead to a measurable buildup of glutamate in the prefrontal cortex, essentially creating metabolic debris that forces the brain into a self-preservation mode. I discuss the specific hierarchy of cognitive decline, noting why executive functioning and fluid reasoning are the first to fail while crystallized intelligence often remains deceptive and intact. To help you maintain the validity of your data during long assessment days, I share three concrete strategies: implementing a heavy-to-light task rotation, scheduling mandatory 90 minute movement resets, and utilizing proactive glycemic management through low-glycemic snacks. Main Topics 01:34: The neurobiology of cognitive fatigue and the role of the anterior cingulate cortex in cost-benefit analysis. 02:30: How intensive cognitive work leads to an accumulation of glutamate in the lateral prefrontal cortex. 03:45: Applying cognitive load theory and the “overflowing glass” metaphor to the six-hour assessment session. 04:54: Why executive functioning and fluid reasoning fail first while vocabulary and general knowledge remain resistant to fatigue. 06:15: The diagnostic trap of crystallized intelligence and how an articulate patient can mask underlying cognitive exhaustion. 07:45: Strategy 1—Heavy-to-light rotation and the importance of front-loading high-effort tasks. 09:10: Strategy 2—The 90-minute pivot and movement reset to clear adenosine and reset performance cycles. 10:15: Strategy 3—Glycemic management and using small, low-glycemic snacks to prevent the afternoon “food coma.” Cool Things Mentioned The Testing Psychologist mastermind groups and business consulting Reverb: the premier AI-powered report-writing platform for testing psychologists Featured Resources TherapyNotes is the leading EHR system for mental health practitioners. I’ve used TherapyNotes for over 10 years, and it just keeps getting better. Use this link and the promo code “testing” to get two free months and try it for yourself! www.therapynotes.com/testing The Testing Psychologist podcast is approved for CEU’s! I’ve partnered with At Health to offer CE credits for podcast episodes! Visit this link to access current and past episodes available for CE credit. You can use code “TTP10” for a discount on ALL the course credits you purchase from At Health! About Dr. Jeremy Sharp I’m a licensed psychologist and Clinical Director at the Colorado Center for Assessment & Counseling, a private practice that I founded in 2009 and have grown to over 20 clinicians. I earned my undergraduate degree in Experimental Psychology from the University of South Carolina before getting my Master’s and PhD in Counseling Psychology from Colorado State University. These days, I specialize in psychological and neuropsychological evaluation with kids and adolescents. As the host of the Testing Psychologist Podcast, I provide private practice consulting for psychologists and other mental health professionals who want to start or grow psychological testing services in their practices. I live in Fort Collins, Colorado with my wife (also a therapist) and two young kids. Ready to grow your testing services? Click below to get on the waitlist! Join the Waitlist

Would you rather read the transcript? Click here. In this episode, I sit down with Jennifer Taylor, an expert therapeutic educational consultant, to demystify the niche world of out-of-home placements and residential treatment. We explore the critical emotional journey parents face when realizing their child needs a higher level of care and how psychologists can play a foundational role in that transition. Jennifer shares her personal “why” as a parent of children who required intensive support, providing a deeply empathetic lens on the process of navigating wilderness programs, therapeutic boarding schools, and young adult transition services. We discuss the “safety quotient” and “anxiety quotient” for parents, the practicalities of how consultants vet programs through rigorous site visits, and why a high-quality neuropsychological evaluation is the essential roadmap for successful placement and treatment planning. Main Topics 00:01:36 – Introduction to Jennifer and the niche of therapeutic educational consulting. 00:04:02 – Jennifer’s personal story: Navigating the special education and residential world as a parent. 00:07:48 – Defining the role of a therapeutic educational consultant versus traditional consultants. 00:13:31 – Case study: The trajectory from suicidal ideation to University of Chicago admission. 00:20:52 – Determining when a higher level of care is necessary: Identifying school refusal and “pattern interrupts.” 00:25:20 – How psychologists can find and collaborate with reputable educational consultants. 00:36:07 – Managing parent ambivalence and the “safety and anxiety quotients” during transitions. 00:43:31 – The vetting process: Why visiting programs in person is non-negotiable for consultants. 00:52:15 – Best practices for collaboration between assessing clinicians and consultants. 01:02:42 – Final takeaways: Making psychological reports accessible and engaging for families and teens. Cool Things Mentioned The Testing Psychologist mastermind groups and business consulting Reverb AI-powered report-writing software Independent Educational Consultant Association (IECA): www.iecaonline.com Therapeutic Consulting Association (TCA): www.therapeuticconsulting.org JET Ed Consulting: www.jetedconsulting.com Featured Resources TherapyNotes is the leading EHR system for mental health practitioners. I’ve used TherapyNotes for over 10 years, and it just keeps getting better. Use this link and the promo code “testing” to get two free months and try it for yourself! www.therapynotes.com/testing The Testing Psychologist podcast is approved for CEU’s! I’ve partnered with At Health to offer CE credits for podcast episodes! Visit this link to access current and past episodes available for CE credit. You can use code “TTP10” for a discount on ALL the course credits you purchase from At Health! About Jennifer Taylor Jennifer Eve Taylor, JD, is the Founder of JET ED Consulting, and her practice specializes in supporting families and their children who are affected by mental health, emotional challenges, and learning differences. Jennifer is an expert in residential, therapeutic, and learning differences programs. Get in Touch & Resources: Website: www.jetedconsulting.com Email: jennifer@jetedconsulting.com About Dr. Jeremy Sharp I’m a licensed psychologist and Clinical Director at the Colorado Center for Assessment & Counseling, a private practice that I founded in 2009 and have grown to over 20 clinicians. I earned my undergraduate degree in Experimental Psychology from the University of South Carolina before getting my Master’s and PhD in Counseling Psychology from Colorado State University. These days, I specialize in psychological and neuropsychological evaluation with kids and adolescents. As the host of the Testing Psychologist Podcast, I provide private practice consulting for psychologists and other mental health professionals who want to start or grow psychological testing services in their practices. I live in Fort Collins, Colorado with my wife (also a therapist) and two young kids. Ready to grow your testing services? Click below to join our Waitlist! Join the Waitlist

Would you rather read the transcript? Click here. In this episode, Dr. Jeremy Sharp shares a personal and professional deep dive into the opaque world of InterQual and prior authorization. After experiencing a near-total rejection rate of clinical prior authorization requests within his own practice, Dr. Sharp investigates the history, logic, and evidence—or lack thereof—behind the criteria that dictate medical necessity for neuropsychological services. He breaks down the “checkbox” workflow used by utilization management reviewers, explains the origins of the controversial eight-hour testing benchmark, and highlights critical gaps in the system regarding clinical complexity and social determinants of health. Most importantly, the episode provides listeners with concrete, strategic language and documentation tips to help navigate these administrative hurdles and maximize the likelihood of securing the care their patients need. Main Topics Covered 00:01: The personal story of 100% denial rates and the motivation for investigating InterQual. 02:25: The history and objective of InterQual as a measurable indicator for standardizing care. 04:43: The massive scale of InterQual within the Optum and UnitedHealthcare ecosystem. 07:01: Decoding the “Black Box”: The decision-tree and checkbox software used by reviewers. 09:20: Why common referrals like ADHD and autism struggle to pass first-level screening. 11:43: Exploring the GRADE approach and the evidentiary standards used to build the criteria. 14:09: The eight-hour benchmark: Concept of testing fatigue vs. clinical complexity. 16:33: Critical gaps: Social determinants of health and the failure to account for environment. 18:57: The Appeals Paradox: Why the totality of the record wins when criteria fail. 21:18: “Playing the Game”: Specific keywords and strategies for successful prior authorizations. Cool Things Mentioned The Testing Psychologist mastermind groups and business consulting Reverb: the premier AI-powered report-writing platform for testing psychologists Featured Resources TherapyNotes is the leading EHR system for mental health practitioners. I’ve used TherapyNotes for over 10 years, and it just keeps getting better. Use this link and the promo code “testing” to get two free months and try it for yourself! www.therapynotes.com/testing The Testing Psychologist podcast is approved for CEU’s! I’ve partnered with At Health to offer CE credits for podcast episodes! Visit this link to access current and past episodes available for CE credit. You can use code “TTP10” for a discount on ALL the course credits you purchase from At Health!edit. You can use code “TTP10” for a discount on ALL the course credits you purchase from At Health! About Dr. Jeremy Sharp I’m a licensed psychologist and Clinical Director at the Colorado Center for Assessment & Counseling, a private practice that I founded in 2009 and have grown to over 20 clinicians. I earned my undergraduate degree in Experimental Psychology from the University of South Carolina before getting my Master’s and PhD in Counseling Psychology from Colorado State University. These days, I specialize in psychological and neuropsychological evaluation with kids and adolescents. As the host of the Testing Psychologist Podcast, I provide private practice consulting for psychologists and other mental health professionals who want to start or grow psychological testing services in their practices. I live in Fort Collins, Colorado with my wife (also a therapist) and two young kids. Ready to grow your testing services? Click below to get on the waitlist! Join the Waitlist

Would you rather read the transcript? Click here. In this episode, I sit down with Sara Woods to challenge the traditional, deficit-heavy lens of autism diagnostics and explore what it means to practice in a truly neurodiversity-affirming way. We discuss the shift from seeing autism as a collection of clinical “problems” to recognizing it as a natural variation of the human brain that brings unique strengths, such as integrity, systemizing, and deep focus. Sara shares her research-backed insights on why “repetitive behaviors” can be vital for regulation and how the “double empathy problem” reframes communication difficulties as a two-way street rather than an individual failure. We also dive into concrete tools for clinicians, including her Survey of Autistic Strengths, Skills, and Interests (SASSI), and practical tips for writing reports that validate a client’s struggles while celebrating their humanity and joy. Episode Topics 00:01-01:38 Why direct experience and neurodiversity matter beyond the textbook 01:39-05:00 Defining the neurodiversity paradigm and patient-led care 05:01-07:43 How differential diagnosis can be empowering rather than pathologizing 07:44-10:43 Reframing repetitive play as a foundation for cognitive development 10:44-12:52 Reconsidering eye contact through the lens of cultural difference 12:53-16:15 Integrity versus reputation management in autistic individuals 16:16-19:00 The functional purpose of stimming and sensory regulation 19:01-21:37 Navigating societal expectations and the choice to disclose 21:38-26:15 The double empathy problem and communication in mixed groups 26:16-31:06 Balancing the “superpower” narrative with authentic support 31:07-34:00 Frameworks for accommodations: Strengths, difficulties, and neutral differences 34:01-38:58 Introduction to the Survey of Autistic Strengths, Skills, and Interests (SASSI) 38:59-42:15 Specific interviewing strategies for eliciting joy and strengths 42:16-46:30 Adapting the assessment battery and the role of the ADOS 46:31-52:00 Writing affirming reports and the use of first-person language 52:01-56:30 Leveraging special interests in recommendations and school settings 56:31-01:01:20 Validating distress while maintaining a strengths-based perspective Cool Things Mentioned The Testing Psychologist mastermind groups and business consulting Reverb AI-powered report-writing software Sara’s upcoming talk: Autism or Something Else? Avoiding Misdiagnosis in Neurodiversity-Affirming Assessment Across the Lifespan – The Chicago School | Office of Continuing Education (Time-Limited Code for 15% OFF: TestingPsych2026) Neurodiversity-Affirming Observation Form Autistic Strengths Diagram Survey of Autistic Strengths Skills and Interests Suggested Autism Batteries across the lifespan Helpful Articles: Toward a More Comprehensive Autism Assessment: Article on the SASSI: Frontiers | Toward a more comprehensive autism assessment: the survey of autistic strengths, skills, and interests Neurodiversity 2.0 Article by Hari Srinivasan: Neurodiversity 2.0 – Harnessing cross-disciplinary disability insights – ScienceDirect The Neurodiversity Paradigm According to Nick Walker: NEURODIVERSITY: SOME BASIC TERMS & DEFINITIONS • NEUROQUEER Ideas for Identifying Autistic Strengths Using the ADOS-2: https://asha2024-asha.ipostersessions.com/?s=7F-36-58-FD-20-58-05-C5-E0-D3-C1-14-74-B4-C5-BE Girard et al. study on Autistic Play: Visual abilities and exploration behaviors as predictors of intelligence in autistic children from preschool to school age – Dominique Girard, Valérie Courchesne, Catherine Cimon-Paquet, Claudine Jacques, Isabelle Soulières, 2023 Granieri et al. study on Reduced eye contact being preferred among Autistic children: Atypical social communication is associated with positive initial impressions among peers with autism spectrum disorder – Jessica E Granieri, Morgan L McNair, Alan H Gerber, Rebecca F Reifler, Matthew D Lerner, 2020 Crompton et al. Telephone Study: Autistic peer-to-peer information transfer is highly effective – Catherine J Crompton, Danielle Ropar, Claire VM Evans-Williams, Emma G Flynn, Sue Fletcher-Watson, 2020 Hu et al. Reputation Study in which ethical consistency was framed as a problem: https://www.jneurosci.org/content/early/2020/11/02/JNEUROSCI.1237-20.2020?__cf_chl_tk=7KPu3hAVr6Rw_clfWWSLepcckNZdODcVgO_m94bHv6s-1770332980-1.0.1.1-.glkRotgLSe7lLFvTGYt5qjLBjaHIKk8XNOMroF3c_4 Kapp et al. Stimming Study: ‘People should be allowed to do what they like’: Autistic adults’ views and experiences of stimming – Steven K Kapp, Robyn Steward, Laura Crane, Daisy Elliott, Chris Elphick, Elizabeth Pellicano, Ginny Russell, 2019 Woods, Brook, & Angoff Neurodiversity-Affirming Collaborative Assessment Article: Principles of Neurodiversity-Affirming Collaborative Assessment – Sara Eileen O’Neil Woods, Amara Brook, Liz Angoff, 2025 Autism-Related Resources Thinking Person’s Guide to Autism: Strategies for Creating a Neurodiversity-Affirming Classroom: How to Create a Neurodiversity-Affirming Classroom — THINKING PERSON’S GUIDE TO AUTISM Subtle Signs of Autism: Could Your Child Be Autistic? Here Are Seven Subtle Signs. Talking to Your Child About Their Autism Diagnosis: 13 Tips for Talking to Your Child About Their Autism | ParentMap Outschool: Online classes for children that help them find other neurodivergent children and include classes with their special/foused interests: www.outschool.com Autistic Self-Advocacy Network: Autistic Self Advocacy Network Additional Neurodiversity Resources from the University of Washington Autism Center: Neurodiversity – UW Autism Featured Resources TherapyNotes is the leading EHR system for mental health practitioners. I’ve used TherapyNotes for over 10 years, and it just keeps getting better. Use this link and the promo code “testing” to get two free months and try it for yourself! www.therapynotes.com/testing The Testing Psychologist podcast is approved for CEU’s! I’ve partnered with At Health to offer CE credits for podcast episodes! Visit this link to access current and past episodes available for CE credit. You can use code “TTP10” for a discount on ALL the course credits you purchase from At Health! About Dr. Sara Woods Dr. Woods is a clinical psychologist who specializes in assessment across the lifespan at the University of Washington Autism Center and in private practice at Discover Psychology Services. She has been licensed as a psychologist for over 10 years. She offers continuing education training and consultation to other psychologists, providers, and graduate students to help them better understand how to complete evidence-based assessments in a neurodiversity-affirming and strengths-based ways. She is passionate about bringing communities together to better understand autism, ADHD, Bipolar, and other types of neurodivergence. Get in Touch & Resources: Website: www.laceypsychology.com Email: drsara@discoverpsychservices.com Website: https://depts.washington.edu/uwautism/about/clinical-staff/ About Dr. Jeremy Sharp I’m a licensed psychologist and Clinical Director at the Colorado Center for Assessment & Counseling, a private practice that I founded in 2009 and have grown to over 20 clinicians. I earned my undergraduate degree in Experimental Psychology from the University of South Carolina before getting my Master’s and PhD in Counseling Psychology from Colorado State University. These days, I specialize in psychological and neuropsychological evaluation with kids and adolescents. As the host of the Testing Psychologist Podcast, I provide private practice consulting for psychologists and other mental health professionals who want to start or grow psychological testing services in their practices. I live in Fort Collins, Colorado with my wife (also a therapist) and two young kids. Ready to grow your testing services? Click below to join our Waitlist! Join the Waitlist

Would you rather read the transcript? Click here. I have been a bit quiet lately, but for good reason, and I wanted to take a moment to reorient myself and check in with all of you. After taking two solid weeks off for a meaningful family Christmas in South Carolina (the first in almost 15 years!), I returned to a whirlwind January filled with major project launches. From opening the doors to our new membership community, Craft, to preparing for the upcoming Crafted Practice summer intensive and launching Reverb 2.0, it has been a season of intense “sprints.” In this episode, I share the personal reflections that came from that time away, the philosophy of why “later equals never,” and the exciting updates coming to the podcast, including the addition of a production and research assistant to help us bring even more high-quality content to your ears. Reconnecting with family and the importance of the present (01:10) The Later Equals Never philosophy for life and business (02:15) Reflecting on the benefits of a true two-week work hiatus (03:00) Launching the Craft membership community for accountability and action (04:15) Details and registration for the Crafted Practice summer in-person event (06:30) Hiring a new production and research assistant for the podcast (08:45) Updates on the Reverb 2.0 AI report writing platform launch (09:30) A call to action for listeners to engage and connect in 2026 (10:15) Cool Things Mentioned The Testing Psychologist mastermind groups and business consulting Reverb: the premier AI-powered report-writing platform for testing psychologists Craft: the only membership community just for testing psychologists Featured Resources TherapyNotes is the leading EHR system for mental health practitioners. I’ve used TherapyNotes for over 10 years, and it just keeps getting better. Use this link and the promo code “testing” to get two free months and try it for yourself! www.therapynotes.com/testing The Testing Psychologist podcast is approved for CEU’s! I’ve partnered with At Health to offer CE credits for podcast episodes! Visit this link to access current and past episodes available for CE credit. You can use code “TTP10” for a discount on ALL the course credits you purchase from At Health! About Dr. Jeremy Sharp I’m a licensed psychologist and Clinical Director at the Colorado Center for Assessment & Counseling, a private practice that I founded in 2009 and have grown to over 20 clinicians. I earned my undergraduate degree in Experimental Psychology from the University of South Carolina before getting my Master’s and PhD in Counseling Psychology from Colorado State University. These days, I specialize in psychological and neuropsychological evaluation with kids and adolescents. As the host of the Testing Psychologist Podcast, I provide private practice consulting for psychologists and other mental health professionals who want to start or grow psychological testing services in their practices. I live in Fort Collins, Colorado with my wife (also a therapist) and two young kids. Ready to grow your testing services? Click below to get on the waitlist! Join the Waitlist

Nicole McCance, retired psychologist turned business coach who scaled a private practice to 55 clinicians and sold it. She discusses practical lead generation beyond social media. Short, actionable takes on consult calls, email follow-up, hiring an admin early, physician referral playbooks, and a waitlist strategy to capture warm referrals.

Would you rather read the transcript? Click here. As this year winds down, I’ve been reflecting on how much of 2025 was about refinement rather than expansion. The Testing Psychologist stayed true to what it’s always been for me: a place for honest conversations about assessment, business, and the realities of this work. The podcast hit some meaningful milestones (500 episodes!), Crafted Practice was once again one of the highlights of my year and proved that small, close-knit spaces beat big, noisy ones any day, and the community around this work continued to grow in a way that felt grounded and sustainable. A lot of my energy this year also went into Reverb, which stretched me in ways I didn’t fully anticipate. Building something new alongside established businesses forces you to slow down and get very clear about what actually matters. There were plenty of decisions that didn’t make for exciting updates, but did make the product better. What feels solid now is the “why”: helping clinicians spend less time wrestling with reports and more time doing the parts of the job that actually require a human brain. That focus has guided every hard call along the way. Personally, 2025 pushed me to pay closer attention to my own limits. Heart surgery on January 3rd, 2025 forced me to slow down and be very intentional about my capabilities. I worked fewer hours, protected more unstructured time, and noticed how much better everything runs when I’m not operating at a constant low-grade sprint. I’m ending the year clearer, steadier, and more confident about what I want to carry forward (and what I don’t).  Before transitioning to the episode, I want to give shout outs to a few folks who are integral to the Testing Psychologist team. First, Facebook group moderators: Chris Mulchay, Laura Sanders, and Andres Chou. They keep the group on the rails so that we can continue to have a stable, safe place to talk about testing. I also have to thank my assistant, Laura, who does everything from podcast editing to researching spots for the next in-person retreat. I couldn’t do this without her. Speaking of which, I have to thank my sponsors as well. TherapyNotes and PAR continued to support the podcast this year, making all of this possible. While we’re saying goodbye to PAR for 2026, I’m excited to get some fresh sponsorship on the books. And of course, I have to thank all of you. If you’ve listened to the podcast, come to an event, sent a note, or just quietly followed along, thank you. I don’t take that support lightly, and I’m looking forward to what comes next.  Thanks for joining me one last time in 2025 to discuss the top five most downloaded podcast episodes! Cool Things Mentioned The Testing Psychologist mastermind groups and business consulting Reverb: the premier AI-powered report-writing platform for testing psychologists Craft interest list sign-up: www.thetestingpsychologist.com/craft 515: AI, Admin, and the Future of Private Practice w/ Uriah Guilford 521: Pathological Demand Avoidance w/ Dr. Donna Henderson 512: Better Feedback for Parents w/ Dr. Liz Angoff 509: “That” NYT Article on ADHD: Challenging Our Beliefs 497: ADI-R and ADOS-2 as the “Gold Standards” Featured Resources I am honored to partner with two AMAZING companies to help improve your testing practice! PAR is a long time supporter of the Testing Psychologist podcast, and I will continue to bring you featured items from their catalog! Listen to each episode for specific product recommendations and links. Learn more at www.parinc.com. TherapyNotes is the leading EHR system for mental health practitioners. I’ve used TherapyNotes for over 10 years, and it just keeps getting better. Use this link and the promo code “testing” to get two free months and try it for yourself! www.therapynotes.com/testing The Testing Psychologist podcast is approved for CEU’s! I’ve partnered with At Health to offer CE credits for podcast episodes! Visit this link to access current and past episodes available for CE credit. You can use code “TTP10” for a discount on ALL the course credits you purchase from At Health! About Dr. Jeremy Sharp I’m a licensed psychologist and Clinical Director at the Colorado Center for Assessment & Counseling, a private practice that I founded in 2009 and have grown to over 20 clinicians. I earned my undergraduate degree in Experimental Psychology from the University of South Carolina before getting my Master’s and PhD in Counseling Psychology from Colorado State University. These days, I specialize in psychological and neuropsychological evaluation with kids and adolescents. As the host of the Testing Psychologist Podcast, I provide private practice consulting for psychologists and other mental health professionals who want to start or grow psychological testing services in their practices. I live in Fort Collins, Colorado with my wife (also a therapist) and two young kids. Ready to grow your testing services? Click below to schedule a complimentary 30-minute pre-consulting call! Schedule Your Call

Would you rather read the transcript? Click here. In this episode, I break down what I believe are the most important business trends shaping assessment practices in 2026. Rather than focusing on vague predictions or generic AI hype, I zero in on the operational, regulatory, and payer-driven forces that are already creating friction for assessment-focused psychologists. My central argument is that 2026 will not be a “breakthrough” year. It will be a friction year, where practices succeed or struggle based on how clearly they can justify, document, and defend their work. I walk through how insurance pressures, prior authorization, AI governance, workforce scarcity, and shifting expectations around comprehensive batteries are converging, and what practical steps assessment clinicians can take now to stay viable, ethical, and sustainable. Main Topics Discussed Why 2026 is a “friction year,” not a breakthrough year (00:01) The unifying trend: auditability, justification, and traceability across systems (02:23) Efficiency adjustments and why integration work matters more than test administration (03:00) Auditing CPT code mix and aligning documentation with payer values (04:45) Prior authorization becomes more structured—and less forgiving (05:30) Building repeatable medical necessity language and pre-auth workflows (07:07) Payers tightening testing policies and eliminating “neutral” practice models (08:30) Choosing explicitly between insurance-first, hybrid, or cash-pay models (09:28) AI’s shift from convenience tool to governance and risk issue (10:30) Clinicians moving from “writer” to “editor” roles with AI-assisted workflows (11:38) State-level healthcare AI laws and the need for internal AI policies (12:30) Validity and defensibility becoming built-in, not optional (13:45) Rethinking over-testing and defining a minimum defensible data set (14:01) Hybrid assessment models and redesigning physical office space (15:00) Workforce scarcity and choosing between boutique vs scalable models (17:30) The controversial take: rethinking the default comprehensive battery (18:53) Why auditability—not tools—is the real work of 2026 (20:00) Cool Things Mentioned The Testing Psychologist mastermind groups and business consulting Reverb: the premier AI-powered report-writing platform for testing psychologists CMS Prior Authorization and Interoperability Rule overview: https://www.cms.gov/priorities/key-initiatives/burden-reduction/prior-authorization APA guidance on medical necessity and documentation: https://www.apaservices.org/practice/reimbursement/health-plans/medical-necessity APA resources on AI and ethics in practice: https://www.apa.org/monitor/2023/07/ai-psychology Episode on medical necessity: https://thetestingpsychologist.com/ttp-49-medical-necessity-pre-authorization-testing-services/ Featured Resources I am honored to partner with two AMAZING companies to help improve your testing practice! PAR is a long time supporter of the Testing Psychologist podcast, and I will continue to bring you featured items from their catalog! Listen to each episode for specific product recommendations and links. Learn more at www.parinc.com. TherapyNotes is the leading EHR system for mental health practitioners. I’ve used TherapyNotes for over 10 years, and it just keeps getting better. Use this link and the promo code “testing” to get two free months and try it for yourself! www.therapynotes.com/testing The Testing Psychologist podcast is approved for CEU’s! I’ve partnered with At Health to offer CE credits for podcast episodes! Visit this link to access current and past episodes available for CE credit. You can use code “TTP10” for a discount on ALL the course credits you purchase from At Health! About Dr. Jeremy Sharp I’m a licensed psychologist and Clinical Director at the Colorado Center for Assessment & Counseling, a private practice that I founded in 2009 and have grown to over 20 clinicians. I earned my undergraduate degree in Experimental Psychology from the University of South Carolina before getting my Master’s and PhD in Counseling Psychology from Colorado State University. These days, I specialize in psychological and neuropsychological evaluation with kids and adolescents. As the host of the Testing Psychologist Podcast, I provide private practice consulting for psychologists and other mental health professionals who want to start or grow psychological testing services in their practices. I live in Fort Collins, Colorado with my wife (also a therapist) and two young kids. Ready to grow your testing services? Click below to schedule a complimentary 30-minute pre-consulting call! Schedule Your Call