The Testing Psychologist Podcast

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In this episode, I sit down with Drs. Stephanie Nelson and Alison Wilkinson-Smith to address a persistent gap in the field of psychological assessment: the lack of a structured, evidence-based approach to supervision. We move beyond the traditional “osmosis” model of training to explore how supervisors can intentionally externalize their implicit expertise. Our conversation focuses on the SCOOP framework and the SWIRL model, providing a roadmap for navigating everything from case conceptualization to the emotional ruptures that occur when a supervisor and trainee reach a diagnostic stalemate. By integrating research on medical education and elite coaching with the core values of therapeutic assessment, Stephanie and Alison offer a comprehensive guide to becoming an attuned and effective supervisor.

Main Topics Discussed

01:37: The origin of the collaboration and the “mixed bag” of early career supervision.

08:17: The current state of supervision literature and the competency-based shift.

12:42: Navigating the transition from unconscious effectiveness to expert teaching.

15:53: Establishing emotional safety and the “nesting bowls” of clinical containment.

35:29: An overview of the SCOOP model for structuring supervision sessions.

40:50: Using the “First Crack” method to identify a trainee’s zone of proximal development.

54:22: Strategies for externalizing implicit clinical skills and avoiding the “master-apprentice” trap.

59:37: Resolving friction and diagnostic stalemates using the SWIRL framework.

Cool Things Mentioned

Craft: the premier membership community for testing psychologists

Crafted Practice: the only in-person business retreat for testing psychologists

Reverb: the premier AI-powered report-writing platform for testing psychologists

Stephanie & Alison’s upcoming workshop: https://www.level2psychconsult.com/supervision-and-mentorship-workshop

Level 2 Psych Consult: https://www.level2psychconsult.com

Essentials of Psychological Assessment Supervision (Jordan Wright): www.amazon.com/Essentials-Psychological-Assessment-Supervision-Essentials/dp/1119565507

Supervision in Neuropsychology (Bowden, Stuckey, and Bush): www.amazon.com/Supervision-Neuropsychology-Clinical-Neuropsychology-Practice/dp/0199837775

Therapeutic Assessment Institute: www.therapeuticassessment.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

NovoPsych brings 150+ standardized measures into one platform. If you’re interested in high quality measures for personality, disability, ADHD or Autism, try NovoPsych with a 15-day free trial via this link: https://novopsych.com/testingpsychologist

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. Stephanie Nelson

Dr. Stephanie Nelson is a pediatric neuropsychologist who specializes in complex differential diagnosis. She is board certified in both clinical neuropsychology and pediatric neuropsychology, and she is currently the president of the American Board of Pediatric Neuropsychology. She has a private practice in Seattle, WA. She also has a consultation practice called The Peer Consult, through which she provides consultation to psychologists and neuropsychologists who specialize in pediatric assessment.

Get in Touch

Website: www.thepeerconsult.com

About Dr. Alison Wilkinson-Smith

Dr. Wilkinson-Smith is board certified in Clinical Neuropsychology and has a sub specialty certification in Pediatric Neuropsychology by ABPP. She is also certified in Therapeutic Assessment of children by the TA institute. She is a Professor of Psychiatry and practices clinical neuropsychology in an academic medical setting and in private practice. She offers professional consultation on pediatric psychological and neuropsychological assessment, and she specializes in therapeutic and collaborative assessment techniques, pediatric functional neurological disorders, and assessment of children living with medical and psychosocial complexity.
Get in Touch

Website: level2psychconsult.com

Private Practice Website: Nextlevelneuropsychology.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 schedule a complimentary 30-minute pre-consulting call!

Schedule Your Call

Would you rather read the transcript? Click here.

In this episode, I examine the diagnostic paradox of autism masking and camouflaging, specifically focusing on how clinicians can identify autism when a client’s surface behavior appears neurotypical. I discuss the limitations of traditional observational tools like the ADOS-2 and explain how the DSM-5-TR provides a framework for recognizing compensation and historical symptoms. By looking at the cognitive mechanisms behind masking and the significant mental health toll it takes, I offer a perspective that re-conceptualizes autism as a neurobiological reality rather than a purely behavioral one. My goal is to help practitioners understand that the ability to camouflage is not a reason to rule out a diagnosis but is often evidence of the diagnosis itself.

Main Topics

00:01: Introduction to the diagnostic paradox of observable deficits versus effective camouflaging

02:20: Explicit recognition of compensation and the currently or by history clause in the DSM-5-TR

05:50: The cognitive shift from intuitive social cognition to rule-based learning and executive function

08:30: Why the need to camouflage confirms the presence of underlying social cognitive differences

13:50: Neuroimaging and the persistence of brain-based markers despite behavioral changes

18:00: Assessing functional impairment through the lens of exhaustion, burnout, and mental health burden

24:10: Re-conceptualizing autism as a neurobiological profile and the role of clinical consensus

27:30: Practical implications for clinicians and the risks of false negatives in adult evaluations

Cool Things Mentioned

Craft: the premier membership community for testing psychologists

Crafted Practice: the only in-person business retreat for testing psychologists

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

NovoPsych brings 150+ standardized measures into one platform. If you’re interested in high quality measures for personality, disability, ADHD or Autism, try NovoPsych with a 15-day free trial via this link: https://novopsych.com/testingpsychologist

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.

It’s great to be back with you all as we continue this deep dive into the world of autism and neurodivergence. Today, we are tackling a topic that has really taken the clinical world by storm over the last several years, and that is the concept of camouflaging and masking. Honestly, this is one of those areas where the research is moving so fast it can be hard to keep up, but it is also deeply personal for so many of the folks we see in our offices. I wanted to take some time to really look at the literature: what we actually know, what we think we know, and where the holes are. Because as much as we talk about “masking,” the science behind it is actually a lot more nuanced and a lot more complicated than it might seem on the surface.

Main Topics

00:01: Defining camouflaging as the conscious or unconscious strategies used to hide or compensate for autistic characteristics in social settings

01:45: The three core components of camouflaging: compensation, masking, and assimilation according to the Hull et al. (2019) framework

04:10: Methods for measuring camouflaging, including the CAT-Q self-report measure and the discrepancy method between cognitive ability and observed traits

06:45: The weak correlation between self-report and discrepancy measures and what that tells us about intention versus effectiveness

08:15: Prevalence of camouflaging in autistic versus non-autistic populations and its role as a broader form of impression management

10:20: Sex and gender differences in camouflaging and why females consistently report higher scores across studies

12:40: The significant mental health impact of camouflaging, including burnout, identity confusion, and suicidal ideation

15:15: Critical validity concerns regarding the CAT-Q and potential construct overlap with social anxiety

Cool Things Mentioned

Craft: the premier membership community for testing psychologists

Crafted Practice: the only in-person business retreat for testing psychologists

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

NovoPsych brings 150+ standardized measures into one platform. If you’re interested in high quality measures for personality, disability, ADHD or Autism, try NovoPsych with a 15-day free trial via this link: https://novopsych.com/testingpsychologist

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.

I’m back with the second part of our mini-series on autism. Today I’m really trying to parse out why we’re seeing such a gap in how often we diagnose males versus females. We’re also diving into the social communication paradox (how someone can look really skilled on the surface while still struggling with the same underlying neurological hurdles), and the way restricted interests look different when they’re focused on things like animals or art instead of train schedules. It’s a lot to wrestle with, especially when the DSM hasn’t quite caught up to what we’re seeing in our offices every day, but I’m hoping this helps clear up some of that diagnostic fog.

Main Topics

00:01: Discussion of the four-to-one male-to-female prevalence ratio and the evidence for under diagnosis in females

01:45: The timing of diagnosis and how delays in assessment compound over time for female patients

02:28: The intellectual disability paradox and how impairment levels influence diagnostic rates

03:20: Research on social communication differences and the distinction between observable skills and underlying understanding

04:55: Issues with measurement bias in the ADOS and the problem of diagnostic overshadowing with co-occurring conditions

07:10: Quantitative and qualitative differences in restricted interests and repetitive behaviors across sexes

10:21: Statistics on psychiatric comorbidities and why autistic females face higher rates of anxiety and depression

12:50: Developmental trajectories from early childhood through adulthood and the adolescence inflection point

14:30: A preliminary look at camouflaging and the CAT-Q subscales in the female phenotype

Cool Things Mentioned

Craft: the premier membership community for testing psychologists

Crafted Practice: the only in-person business retreat for testing psychologists

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/testingn use code “TTP10” for a discount on ALL the course credits you purchase from At Health!

NovoPsych brings 150+ standardized measures into one platform. If you’re interested in high quality measures for personality, disability, ADHD or Autism, try NovoPsych with a 15-day free trial via this link: https://novopsych.com/testingpsychologist

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.

I’m coming at this episode as much as a parent as I am a psychologist or the co-founder of an AI company. After my own son got flagged by a teacher for potentially using AI on a writing assignment, I had a pretty humbling realization: I hadn’t actually taught him what responsible AI use looks like. Most of our kids (about 70% of teens) are already using these tools, but they’re doing it in a vacuum without much guidance from schools or home. In this conversation, I wanted to move past the “cheating” panic and look at the real developmental stakes. We’re talking about how passive AI use might be replacing the “cognitive heavy lifting” kids need to build critical thinking and how we, as clinicians and parents, can start having the “AI Talk” early and often to turn these tools into structured thought partners rather than just answer generators.

Main Topics

00:01: The “Cop’s Kid” moment: How my son’s school assignment became a wake-up call about teaching responsible AI use.

03:05: Current statistics on teenage AI adoption and why school policies are struggling to keep pace with the technology.

05:40: Why the real concern isn’t just academic integrity, but the potential “atrophy” of critical thinking and analytical skills.

08:30: Comparing the “AI Talk” to the “Sex Talk”—why it needs to start early (age 8-10) and evolve over time.

11:20: Privacy red flags and why we need to monitor for “secrecy” or “humanizing” AI in our kids’ digital habits.

13:10: A framework for healthy AI use: Outsourcing the rote tasks while keeping the “human brain in the loop.”

14:50: Prompt Engineering as a metacognitive skill: Teaching kids to give context and identify where they are stuck.

18:20: Tailoring AI for neurodivergent kids: Specific strategies and prompts for ADHD, Dyslexia, and Autism.

24:30: Using the “Socratic Method” with AI to help teenagers navigate social conflict and perspective-taking.

Cool Things Mentioned

Craft: the premier membership community for testing psychologists

Crafted Practice: the only in-person business retreat for testing psychologists

Reverb: the premier AI-powered report-writing platform for testing psychologists

Simple prompt framework for kids document

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

NovoPsych brings 150+ standardized measures into one platform. If you’re interested in high quality measures for personality, disability, ADHD or Autism, try NovoPsych with a 15-day free trial via this link: https://novopsych.com/testingpsychologist

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