Rethinking the “Rules”: Why Therapy and Assessment Don’t Need to Be Kept Apart

One of the things that has stayed with me after reading Decolonizing Therapy—and after years of developing my own therapeutic model—is how much of what we were taught in psychology training is treated as unquestionable truth. Not evidence-based truth. Not ethically inevitable truth. Just… inherited wisdom.

One of those ideas goes something like this:You should never conduct psychological testing with someone you’re already doing therapy with.

That rule is usually presented as self-evident. Of course you shouldn’t. Objectivity. Bias. Dual roles. End of discussion.

Except… is it?

Let’s slow that down.

Where Did This Rule Come From?

Like many “rules” in mental health, this one emerged from a medicalized, pathology-focused system that prioritizes distance, neutrality, and defensibility—often in service of institutions like insurance companies, courts, and other bureaucratic structures. Not necessarily in service of human understanding.

What’s striking is that this prohibition is rarely presented as evidence-based. It’s taught as risk management rather than as a conclusion drawn from outcome data. In fact, there is no empirical research demonstrating that having an existing therapeutic relationship inherently invalidates psychological assessment (Finn & Tonsager, 1997).

The assumption embedded in this rule is that assessment must be objective in a way that relationships inherently contaminate. That knowing someone too well somehow makes the data less valid. That emotional attunement is a liability.

But when we actually interrogate that assumption, it starts to wobble.

Assessment Doesn’t Exist Outside of Meaning

Psychological tests are not neutral truths handed down from the heavens. They are constructs. Cultural artifacts. Tools developed within specific historical, political, and economic contexts.

Even mainstream assessment literature acknowledges that interpretation is always contextual and theory-laden; meaning is constructed through the interaction between test data, clinician judgment, and client narrative rather than passively “discovered” in scores alone (Finn & Tonsager, 1997).

Most diagnostic labels exist largely because systems require them—insurance reimbursement, eligibility determination, categorization. That doesn’t mean they’re useless, but it does mean we should be honest about what they are and what they are not.

They are not identities.

They are not destinies.

And they are certainly not objective in the way we often pretend.

The Pressure to Pathologize

It’s also worth naming the systemic pressure that quietly shapes how assessment is taught and practiced. Much of psychological testing exists within a healthcare system that requires clinicians to justify care through diagnosis, impairment, and pathology. Insurance companies don’t reimburse for insight, relational growth, or increased self-understanding; they reimburse for disorders.

That reality incentivizes assessments that emphasize what’s “wrong” rather than what’s understandable, adaptive, or contextually shaped. Over time, this pressure becomes normalized and even internalized within our training, making it seem as though labeling and categorizing are synonymous with ethical practice.

But that equation serves systems of care more reliably than it serves the people seeking help.

Therapeutic Assessment Changes the Entire Equation

This is where research actually supports a different way forward. Stephen Finn’s model of Therapeutic Assessment reframes assessment as a collaborative, relational, and change-oriented process. Assessment is not something done to clients, but with them—with the explicit goal of insight, self-understanding, and growth (Finn & Tonsager, 1997).

A growing body of research supports this approach. A meta-analysis published in Psychological Assessment found that therapeutic assessment is associated with reductions in symptom distress, improvements in self-esteem, stronger therapeutic alliance, and increased treatment engagement (Durosini & Aschieri, 2021). In other words, assessment—when conducted collaboratively—can be therapeutic in its own right.

That finding alone fundamentally challenges the idea that emotional distance is required for ethical or effective assessment.

Do We Really Need “Objectivity”—or Do We Need Integrity?

The idea that a clinician who knows a client well is automatically less ethical or less accurate assumes that relational knowledge is a contaminant rather than a resource.

Yet clinical and assessment research suggest the opposite is often true. Contextual understanding—cultural, relational, developmental—frequently improves interpretation and reduces over-pathologizing (Finn & Tonsager, 1997).

A lack of relationship does not guarantee objectivity; it often increases the risk of misunderstanding. Importantly, the APA Ethics Code does not prohibit clinicians from conducting assessment with therapy clients. It cautions against multiple relationships only when they are reasonably expected to impair competence, objectivity, or effectiveness, or risk harm or exploitation (American Psychological Association, 2017). Transparency, informed consent, and client-centered intent are the ethical safeguards—not rigid role separation.

Decolonizing This Assumption

At its core, this “rule” reflects a colonial mindset: authority over collaboration, distance over relationship, classification over understanding.

Decolonizing therapy invites us to ask harder questions:

• Who benefits from this rule?

• Who does it protect?

• And who does it limit?

When assessment is used as a tool for insight rather than control—and when therapy is rooted in relationship rather than hierarchy—the wall between them starts to look less like an ethical necessity and more like an outdated artifact of a system designed to serve institutions over people.

The Invitation

I’m not suggesting recklessness. I’m suggesting reflection.

Maybe the better question isn’t, “Are we allowed to do assessment after therapy?”But rather: “What kind of assessment—and in whose service?”

If our goal is health, connection, and well-being—not just compliance with systems that were never designed with those goals at the center—then it may be time to rethink some of the rules we inherited.

Not because we’re dismissing ethics.But because we’re taking them seriously.

References

American Psychological Association. (2017). Ethical principles of psychologists and code of conduct.https://www.apa.org/ethics/code

Durosini, I., & Aschieri, F. (2021). Therapeutic assessment efficacy: A meta-analysis. Psychological Assessment, 33(10), 962–972.https://doi.org/10.1037/pas0001038

Finn, S. E., & Tonsager, M. E. (1997). Information-gathering and therapeutic models of assessment: Complementary paradigms. Psychological Assessment, 9(4), 374– 385.https://doi.org/10.1037/1040-3590.9.4.374