Karin Celosse

I start with the assumption that the person in front of me is already doing something right. A strength-based approach is not a technique I apply after the clinical work is done — it is the foundation the clinical work is built on. Before I score a single subtest or write a single sentence in a report, I am already asking: what has allowed this person to navigate everything they have navigated? What are they doing well, even now, even in the middle of whatever brought them to this evaluation? That question shapes everything that follows. I approach assessment as a conversation, not an interrogation. Many of the people I work with have had difficult experiences with institutions, clinicians, and systems of evaluation. They have been poked, prodded, categorized, and sent away with a label but no real explanation. I work hard to make the evaluation process feel different from that. I take time at the outset to explain what we are doing and why, to answer questions, and to make clear that I am not here to find what is wrong with them — I am here to understand how they work. That distinction matters enormously, and people feel it. I hold the whole person, not just the referral question. Neuropsychological evaluation can become reductive if we let it — a collection of scores that describe deficits and stop there. I resist that. Every person who sits across from me has a history, a context, a set of life experiences that are inseparable from how they perform on any given day. Trauma, systemic disadvantage, language and cultural background, medical burden, medication effects, chronic stress — all of these shape the picture. An affirming approach means I account for those factors explicitly, both in how I interpret the data and in how I communicate findings. A score without context is not a fair representation of a person. I do not settle for that. I write reports that advocate, not just describe. A report that lists cognitive weaknesses without identifying strengths or recommending specific supports is not a useful document — it is just a record of what someone cannot do. My reports are written to be actionable. They identify what the person does well, what conditions allow them to perform at their best, and what specific accommodations, interventions, or approaches are likely to make a real difference. I write them so that a treatment team member, a family caregiver, or the individual themselves can read them and come away with more than a diagnosis — they come away with a path forward. I use my own neurodivergence as a clinical compass. Being on the autism spectrum and having ADHD means I have a lived, embodied understanding of what it is like to be evaluated through a deficit lens — to have your differences pathologised before anyone asks what they might also make possible. When I sit with someone who is neurodivergent, or struggling with cognitive changes, or behaving in ways that a system has deemed problematic, I bring that understanding with me. I am not just clinically trained to look for strengths. I am personally motivated to find them, because I know what it means when someone does. I name what I see, clearly and without shame. Affirming does not mean avoiding hard truths. It means delivering them in a way that preserves dignity and opens doors rather than closing them. When I share findings — whether with an individual, a family, or a care team — I am direct and honest, and I situate every challenge within the larger story of who this person is. Difficulty with memory does not erase decades of competence and wisdom. Impulsivity does not define a person’s character. Behavioral changes do not make someone less worthy of respectful, individualized care. I hold that frame consistently, and I expect the teams I work with to hold it too. I bring my whole background to bear — every time. My years as a medic taught me to read people quickly, stay calm under pressure, and never let the urgency of a situation override careful observation. My work in corrections, community mental health, and rehabilitation taught me that the most marginalized individuals are often the most misunderstood — and the most in need of someone who will take their presentation seriously rather than at face value. My training in psychopharmacology means I am always asking how medications may be shaping the cognitive and behavioral picture I am seeing. And my own neurodivergent identity means I never lose sight of the human being inside the clinical presentation. Together, these shape a practice that is rigorous, compassionate, and genuinely centered on the person — not just the referral. That is my how. It is not one tool or one framework — it is a way of being in the room, a set of commitments I bring to every case, and a refusal to reduce any person to their worst day or their lowest score.

I have spent most of my life being assessed, misread, and categorized by systems that were not built with people like me in mind. I am on the autism spectrum and have ADHD — combined type — and for a long time, I understood the world differently than the people around me seemed to, moved through it differently, and was often told, in subtle and not-so-subtle ways, that something about me did not quite fit. What I did not have, for far too long, was someone who could look at the full picture of who I was and say: I see you. I understand what is actually happening here. And here is what it means.That absence — of accurate understanding, of being truly seen — is the engine behind everything I do. Before I was a psychologist, I was a medic. I spent over a decade responding to people in their worst moments, reading situations fast, noticing what others sometimes missed, and learning that the most important thing you can do for someone in crisis is to actually see them — not the call, not the presenting complaint, not the stereotype. The person. That instinct has never left me. It just found a different form. I gravitated toward the populations that are most often misunderstood, mislabeled, or simply overlooked: people in jails and prisons, individuals experiencing homelessness, those in the grip of addiction, youth in the juvenile justice system, and older adults in long-term care whose cognitive changes are too often dismissed or mistaken for something else entirely. These are people who have frequently been assessed by systems designed to categorize them, not understand them. I know what that feels like. And I know how much it matters to get it right. Neuropsychological and psychological assessment, done well, is one of the most powerful tools we have. A thorough evaluation does not just produce a score or a diagnosis — it tells a story. It explains why someone struggles where they do, what their strengths actually are, and what kind of support would make a real difference. For someone who has spent years being told they are difficult, non-compliant, treatment-resistant, or simply not trying hard enough, an accurate evaluation can be genuinely life-changing. It can change how a treatment team approaches care. It can change how a family understands their loved one. It can change how a person understands themselves. My neurodivergence is not incidental to this work — it is central to it. This means I notice patterns, details, and inconsistencies that others sometimes overlook. It means I take seriously the experience of people who process the world differently, because I am one of them. This means I understand — viscerally, not theoretically — what it is like to have a brain that is capable and creative and also exhausting to inhabit, to be misjudged based on behavior that has a neurological explanation no one ever looked for. These are not weaknesses I have overcome. They are perspectives I bring into every evaluation room. My advanced training in psychopharmacology adds another layer to this work. Medications shape cognition, behavior, and mood in ways that can profoundly affect how someone presents in an evaluation — and in daily life. Understanding that intersection is not optional when you are working with individuals on complex medication regimens, or incarcerated individuals on psychotropic medications with limited monitoring, or anyone whose psychiatric and medical histories are deeply intertwined. I bring that lens to every case. At the end of the day, my why is straightforward, even if the work rarely is: I do this because being truly understood changes things. Because the right evaluation, with the right framework and the right human being on the other side of it, can give someone language for their experience, direction for their care, and dignity in a system that does not always offer it easily. I know what it means to need that. I know what it means to finally have it. And I want to be the person who provides it for others.