Services · Decision-Making Capacity Assessments
Decision-Making Capacity Assessments
A Decision-Making Capacity Assessment is a psychological assessment prepared for a legal or formal purpose, and it is different from therapy or a routine clinical assessment.
In these assessments, the psychologist has an independent role. Their task is to understand the questions they have been asked to address, review relevant information, complete an appropriate assessment or review and provide an impartial professional opinion.
The exact assessment depends on the referral questions and the purpose of the report.
Depending on the referral questions and the information available, an assessment may involve direct assessment of the person, a review of documentation only, or a combination of both.
Most assessments that involve direct contact begin with a 90-minute initial appointment, which forms part of the assessment itself. Where a documentation-only review is appropriate, no appointment is required.
Once the psychologist has clarified the referral questions and what the assessment will involve, a tailored quote can be provided.
What is a Decision-Making Capacity Assessment?
A Decision-Making Capacity Assessment considers a person’s capacity to make a particular decision, or particular type of decision, at a particular point in time.
Decision-making capacity is specific to the decision being considered. A person may have capacity to make some decisions and not others, and capacity may change over time or depending on the circumstances and support available.
The psychologist assesses the specific questions contained in the referral and provides an independent professional opinion based on the information available and the applicable assessment framework.
These assessments may be undertaken for a range of legal or formal purposes, including QCAT-related matters where appropriate.
Adults are generally presumed to have decision-making capacity unless there is evidence to the contrary. A capacity assessment therefore considers the person’s abilities in relation to the particular decision in question rather than assuming that a diagnosis, disability, cognitive difficulty or mental health condition means that the person lacks capacity.
Where relevant, the assessment also considers whether the person can make the decision with appropriate information, communication assistance or other support.
Who can refer?
Potential referrals may come from:
- solicitors
- barristers
- courts
- insurers
- government agencies
- other organisations
- individuals seeking an assessment for a legal or formal purpose, where appropriate
Where a professional or organisation is referring, we ask them to provide the referral questions and relevant documents as early as possible.
Independent and impartial assessment
The psychologist’s role is not to advocate for either party.
Their responsibility is to provide an independent professional opinion based on the information available, the assessment findings and relevant professional standards.
This means the findings may not necessarily support the position of the person or organisation that requested or funded the assessment.
A Decision-Making Capacity Assessment is not therapy
A Decision-Making Capacity Assessment is not a therapy service.
During therapy, the psychologist’s role is to support the person therapeutically. During a Decision-Making Capacity Assessment, the psychologist’s role is to gather and evaluate information for a particular legal or formal purpose.
Because of this:
- confidentiality works differently from therapy
- information relevant to the assessment may be included in the report
- information may be gathered from a number of sources where authorised
- the psychologist may need to comment on inconsistent or disputed information
- the report is written to address the referral questions
Where the psychologist is directly assessing a person, the psychologist will explain the purpose of the assessment, their role, the limits of confidentiality, how information may be used and who is expected to receive the report.
The way consent and authority are managed will depend on the circumstances of the referral, including the person’s ability to provide informed consent for the assessment and any applicable legal authority, court or tribunal order.
Reports and assessment information may be disclosed in accordance with the agreed instructions, applicable court or tribunal orders, legal requirements and the psychologist’s professional obligations.
What can a Decision-Making Capacity Assessment involve?
Depending on the referral, the assessment may include:
- detailed clinical interviews
- review of the referral questions
- review of court or solicitor documents
- review of previous psychological, psychiatric, medical or allied-health reports
- developmental, educational, occupational and psychosocial history
- collateral information where appropriate and authorised
- psychological or psychometric measures where relevant
- cognitive assessment
- assessment of neurodevelopmental conditions
- assessment of mental health
- assessment of everyday functioning
- formulation or differential diagnosis where relevant
- consideration of relevant risk or protective factors where this is within the referral scope
- a comprehensive written report addressing the referral questions
- court attendance or expert evidence where agreed
Additional assessment is included only where it is relevant to the referral questions, clinically indicated and within the psychologist’s area of competence.
A diagnosis or impairment does not, by itself, establish that a person lacks decision-making capacity. Psychological, cognitive, neurodevelopmental or functional information is considered in relation to the particular decision being assessed and the relevant referral questions.
Not every assessment will involve every component. What is included depends on the referral questions and the purpose of the report.
What happens during the assessment?
90-minute initial appointment
Most assessments that involve direct contact begin with a 90-minute initial appointment. This appointment is part of the assessment itself.
During this appointment, the psychologist begins gathering relevant history, explores the referral questions and considers what further information or assessment may be required.
Documentation-only reviews
In some matters, the psychologist may be asked to conduct an independent review of records without directly assessing the person. This is different from a direct Decision-Making Capacity Assessment. Any opinion provided from a documentation-only review will clearly identify the material relied upon, the absence of direct assessment and the limitations this places on the psychologist’s conclusions.
Review of documents
Relevant legal, clinical or other documents may be reviewed.
Further interviews or testing
Further interviews, collateral information or psychological testing may be required depending on the referral.
We do not use a fixed battery of tests. The assessment is tailored to the referral questions, and the psychologist may use interviews, documents, collateral information, observations or psychometric measures depending on what is actually required.
Report preparation
The psychologist prepares a report addressing the agreed referral questions.
In court-related matters a draft report is not provided for review. This differs from our other assessments, where a draft is issued so factual information can be checked. The psychologist will explain how the report will be finalised and released before the assessment proceeds.
Court attendance
Where required and agreed, the psychologist may attend court or provide expert evidence. This is quoted and charged separately.
QCAT-related matters
Where a matter is before the Queensland Civil and Administrative Tribunal (QCAT), a psychologist may be asked to provide an opinion about a person’s decision-making capacity in relation to a particular matter.
The psychologist’s role is to provide an independent professional opinion addressing the referral questions. A formal determination or declaration about a person’s capacity remains a matter for the relevant court or tribunal.
Making a referral
To make a referral for a legal psychological assessment, please provide:
- referral questions
- relevant court orders
- solicitor or barrister instructions
- relevant legal documents
- previous reports
- important deadlines or hearing dates
- details of who is commissioning the assessment
- details of who will receive the report
- funding and payment arrangements
Providing the referral questions and documents as early as possible helps the psychologist determine whether the assessment falls within their scope and what the assessment will need to involve.
Fees
Court-related psychological assessments are individually scoped, because the amount of interviewing, document review, testing and report preparation can vary considerably.
Where the assessment involves direct contact, it begins with a 90-minute initial appointment and the quote follows that appointment. Where the work is a review of documentation only, the quote is based on the referral questions and the volume and complexity of the documents.
Either way, a quote or estimate for the remaining work is provided once the psychologist has clarified what the assessment requires.
Court attendance, preparation for court and expert evidence are quoted separately.
General information about our fees is available on our fees and rebates page.
Frequently asked questions
Are your clinicians forensic psychologists?
We describe the clinician completing the assessment as the psychologist, the assessing psychologist, or the psychologist conducting the assessment.
The title forensic psychologist is used only where an individual clinician holds that endorsement. The psychologist will confirm their qualifications and the scope of what they are able to assess before the assessment proceeds.
Who can request a Decision-Making Capacity Assessment?
Referrals may come from solicitors, barristers, courts, insurers, government agencies and other organisations, and from individuals seeking an assessment for a legal or formal purpose, where appropriate.
Where a professional or organisation is referring, we ask for the referral questions and relevant documents as early as possible.
Will the report support the position of the person who requested it?
Not necessarily, and it should not be assumed.
The opinion is formed from the assessment findings, the information available and the relevant professional standards — not from the interests of whoever commissioned or funded the work. A report may well contain findings that are unhelpful to the party who requested it.
How much does a Decision-Making Capacity Assessment cost?
There is no fixed price, because the amount of interviewing, document review, testing and report preparation varies widely from one matter to the next.
Each matter is therefore scoped and quoted individually, once the psychologist knows what the referral requires. Attending court, and preparing to, is quoted on top of the assessment and report.
Related assessments and information
Where the referral questions call for it, a court-related assessment may draw on the same measures used in our other assessment services.
Discussing a Decision-Making Capacity Assessment
If you are a solicitor, barrister, insurer, agency or individual seeking a psychological assessment for a legal or formal purpose, the first step is to tell us what the report needs to address.
From there the psychologist will confirm what the assessment requires and provide a tailored quote before any work begins.
Assessments are available in person at our North Lakes clinic in North Brisbane and may also be available online across Australia where this is clinically, legally and professionally appropriate for the particular referral.
You can call us on 1300 366 614, or email info@thepsychologyhub.com.au with your referral questions and documents.
