Adult ADHD Evaluation at Strive CLE Counseling

An adult ADHD evaluation at Strive CLE is a structured, team-based assessment that looks at attention, mood, medical factors, and daily life functioning, not just a checklist of symptoms.

The process combines questionnaires, a computerized attention test (T.O.V.A.), in-depth psychosocial interviewing, and a detailed psychiatric/medical review to reach a thoughtful, individualized diagnosis and plan.

The evaluation is completed over several appointments:

• 1. Step 1-Questionnaires and T.O.V.A. (up to 75 minutes): You complete ADHD and mental health questionnaires through the client portal, and a partner/parent/support person may complete collateral forms as well. Then you come to the Westlake office for the T.O.V.A., a brief computerized attention task that measures focus and impulse control, giving objective data to pair with your history and questionnaires.
• 2. Step 2- Psychosocial Evaluation with ADHD Specialist (up to 90 minutes): You’ll meet with our LPCC-S, ADHD-CCSP specialist for a thorough conversation about your life at home, school, and work. Together, you’ll identify which symptoms are affecting you the most right now and carefully look at other issues that can mimic or intensify ADHD, such as anxiety, depression, trauma, ongoing stress, or sleep difficulties.
• 3. Step 3-Medical & Psychiatric Review with PMHNP (up to 90 minutes): Our specialized PMHNP will review your medical history, current medications, and family mental health history, and screens for other conditions that can look like or occur alongside ADHD (mood, anxiety, learning issues, sleep, substance use).
• 4. Step 4-Feedback & Recommendations (up to 60 minutes): You receive a clear explanation of whether you meet criteria for ADHD, how that conclusion was reached, a review of your T.O.V.A. and questionnaire patterns, and personalized recommendations (medication options, therapy, coaching, accommodations, lifestyle changes, and follow-up plan).

The Test of Variables of Attention (T.O.V.A.) is a computerized task that measures sustained attention and impulse control over time. It is a well-studied and FDA approved attention measure that has shown high accuracy in distinguishing individuals with and without ADHD, and it provides objective, standardized data that is less influenced by language, education, or observer bias.

T.O.V.A. is always used as part of a comprehensive assessment-its results are combined with interviews, history, and rating scales and are not used as a stand-alone diagnostic test. It also helps guide treatment decisions over time by tracking response to medications or behavioral strategies, detecting subtle changes, and highlighting specific attention strengths and weaknesses.

You will typically meet with:

• An ADHD-CCSP, LPCC (Licensed Professional Clinical Counselor with specialized ADHD training) for the psychosocial evaluation, focusing on your lived experience and history.
• A PMHNP (psychiatric mental health nurse practitioner) for the detailed medical and psychiatric review and the feedback/recommendations appointment.

This team-based approach allows you to be evaluated from both a psychological and medical perspective, which improves diagnostic accuracy and treatment planning.

When you choose a self-pay ADHD evaluation at Strive CLE, you are choosing an approach that is guided first by clinical best practice and your safety-not by insurance rules or time limits. That means your providers have the space to listen carefully, think deeply about your history, and consider the full picture of your brain, body, and daily life.

Because Strive’s evaluation is self-pay, our team can:

• Take the time you really need: Sessions are scheduled for the length that makes clinical sense, not the length an insurance company decides is billable. This lets your clinicians slow down, ask careful follow-up questions, and double-check safety considerations instead of rushing to a diagnosis.
• Use the right tools for you, not just the covered ones: Your evaluation can include specialized options like T.O.V.A. and other assessments when they will genuinely add clarity, even if they are not typically reimbursed or are only partially covered by insurance.
• Involve a small, coordinated team of specialists: You are seen by both an ADHD-trained LPCC-S and a psychiatric mental health nurse practitioner, which means your emotional history, executive functioning, and medical safety are all considered together-not in separate silos or halfway due to coverage limits.
• Reduce wait times and confusion about bills: With self-pay, there is no waiting on prior authorizations, no chasing down “approved codes,” and no surprise statements months later because something applied to a deductible differently than expected. Many adults find that a focused, self-pay ADHD evaluation ends up costing less than a long, insurance-based process or a full neuropsychological battery that can run into the thousands.
• Avoid over-testing when it’s not necessary: Comprehensive neuropsychological assessments can be essential in complex cases, but they often cost three or more times as much and come with much longer waitlists. For many adults, a well-structured, clinically solid ADHD evaluation like the one at Strive CLE is the safest, most efficient first step-thorough enough to guide high-quality treatment, without putting you through more testing and cost than you need.

In short, self-pay lets your evaluation be driven by what is clinically safest and most helpful for you, instead of the narrowest definition of “medically necessary” in an insurance policy. The investment goes directly toward time, expertise, and support from a team whose only priority in those visits is to understand you clearly and assist you in finding a path forward.

Not everyone needs to wait for a full neuropsychological evaluation. Focused ADHD evaluations that include structured interviews, validated questionnaires, collateral information, and objective attention testing (like T.O.V.A.) are often sufficient when the main question is ADHD and there are no significant red flags for complex neurological or learning disorders.

A neuropsychological assessment may be recommended if there are concerns about broader cognitive difficulties (such as suspected learning disorders, brain injury, or major memory problems), high-stakes legal or academic questions, or very complicated diagnostic pictures. For many adults seeking clarity about attention, organization, and executive functioning to guide everyday treatment, the Strive CLE model is typically a faster, more affordable first step.

The evaluation is designed to look beyond ADHD. The team will assess for mood disorders, anxiety, trauma- and stress-related conditions, learning issues, sleep problems, substance use, and medical factors that can mimic or worsen attention difficulties.

T.O.V.A. Data, history, and clinical interviews together help distinguish when attention problems are more likely due to ADHD versus other conditions such as sleep disorders, traumatic brain injury, or other neurological and learning problems.

At the feedback appointment, you receive:

• A clear explanation of whether you meet criteria for ADHD and how that decision was made
• A walkthrough of your T.O.V.A. report and questionnaire patterns in understandable language
• Personalized recommendations, which may include medication, therapy, coaching, accommodations, lifestyle changes, and follow-up care options

The goal is for you to leave feeling informed, validated, and supported-walking away with an actionable plan, not just a diagnosis label.