ch 13: Clinical assessment Flashcards
What is clinical assessment?
- a continuous process (not a single event)
- defined as a multifaceted process wherby counselors gather information from, and about, a client to make informed decisions related to diagnosis, treatment planning, and documenting therapeutic efficacy
What is the primary purpose of clinical assessment?
to help counselors assess for the potential presence of a mental disorder
a mental disorder is generally defined as a condition in which what 3 elements are present:
- clinically significant disturbance in cognition, emotion regulation, behavior tat results in a dysfunction
- significant distress or disability in social, job, other activities
- disorder is not a result of social deviance or conflicts with society
What two decision-making models are used in clinical assessment?
- clinical judgement model
2. statistical decision-making model
what is the clinical judgement model?
counselor integrates information gathered through observation and subjective and objective data to reach conclusion on diagnosis
what are three drawbacks of clinical judgement model?
- viewed are largely individual in nature
- Subjective, poor reliability
- counselor bias is a known deficit of the model
What is the statistical decision-making model?
counselor uses analytic techniques (statistical inference, probability, sampling) to move from hypothesis to conclusion
what are two strengths of statistical decision-making model?
- uses instruments (tests) to objectively assess
2. diagnoses made are more reliable and valid
what is the primary classification system counselors use
DSM 5 - diagnostic and statistical manual of mental disorders
what recent changes were made to this version of the DSM
- now uses arabic, not roman numerals, for the editions - allows for future updates (5.1,…) and
- reorganized chapters on relatedness of disorders to one another.
- now organized based on developmental and lifespan considerations (childhood to adult)
- more dimensional approach - overlap among disorders
- removed the “not otherwise specified” diagnosis. now uses “other specified” and “unspecified”
what are four diagnostic interviewing strategies?
- intake interview
- clinical interviews
- mental status examination
- suicide assessment
What is an intake interview?
an assessment technique that provides counselors with information about client’s past functioning and how it relates to their current situation and the problems they are facing
what 8 core areas are addressed in intake interview?
- demographic information
- referral reasons
- current situations
- previous counseling experience
- birth and developmental history
- family history
- medical history
- education and/or vocational background
what is a clinical interview?
interview used to assess and provide treatment for the symptoms the client is experiencing
what are three types of clinical interviews?
- structured
- semi-structured
- unstructured
define structured interviews and advantages and disadvantages
it defines what a counselor should ask, how it should be asked, and the ordered sequence questions should be asked.
advantages: uses direct questions, standardized format for all clients, info gathered serves as foundation for further exploration
disadvantages: time-consuming, quality of response is a direct result of quality of questions asked, challenging to use with less verbal or apprehensive clients
what is a semi-structured interview?
a less formal interviewing technique that allows leeway in shaping the content and direction of the interview. freedom to tailor to specific client.
what is an unstructured interview?
has no established form or structure; often starts with broad, open-ended question followed by questions based on client’s responses
most common used; conversational tone
What is the Mental Status Exam?
a structured interview designed to objectively assess the emotional, behavioral, and cognitive functioning or mental state of a client at the time of the interview
The MSE is organized into what 6 categories?
- appearance, attitude and activity
- mood and affect
- speech and language
- thought process, thought content and perception
- cognition
- insight and judgment
What techniques can be used for suicide assessment?
can be formal (assessments, questionnaire) and informal (questions), often combo of both
what 3 components are in a sound suicide risk assessment?
- gather info on risk factors, protective factors and warning signs of suicide
- collect info related to client’s current suicidal ideation, planning, behaviors, desire and intent - level of severity and intent
- make clinical formulation of risk based on info obtained
what is forensic assessment?
evaluation of cognition, mood, personality, or behavior conducted for the purpose of assisting attorneys or the court in legal matters
What’s the objective of forensic assessment
clarify possible psychopathology, needs, risks of reoffending, possibilities of treatment
How is it different from a traditional assessment?
- goal is to collect factual info that can be used by the court.
- not interested in helping address problems - only how existence of problems may factor into case
- little attention given to building therapeutic relationship
forensic assessment activities gather info to make decisions in what three main areas?
- competency to stand trial
- mental status at time of defense
- prediction of an individual’s likelihood of being danger to self/others and risk for future offending
what are two parts of a competency to stand trial evaluation?
- basic competence - ability to understand the charges brought against them and work with defense counsel
- decisional competence - quality of defendant’s reasoning abilities
what is sanity? (it’s a legal term))
refers to soundness of a person’s mind and if they are able to think rationally and function as member of society.
