Lecture 3 Flashcards
What is assessment?
Is a dynamic, collaborative oricess in order to gain an understanding of the client by exploring his presenting difficulties, symptoms and his experience on these difficulties
Why is assessment important?
Is essential in order to make a tentative formulation of how and why this person is experiencing these particular difficulties in this particular way at this particular time
What assessment involves?
A delicate balance between providing an opportunity for the client to tell his story in a way that has meaning and the therapist’s agenda to obtain necessary info in order to make a formulation and progress to thenext stage of the theraoeutic process
Is assessment a joint exploration?
YES. It is a joint exploration ofthe client’s material and his “unexplored territory” with the therapist who encourages the client to explo aspects of hid experience in a new or different ways
Assessment is NOT
just sth you do before tou start theraoy, but is an inseparable part of the whole theraputic process
What may happen within assessment?
Within any assessment session some info will be factual (demographics) but any assessment should go beyond the client merely giving information and telling “his story”
How does the assessment enables the client to feel understood?
Allowing the client to tell “his story” will only have meaning if the client feel that the therapist really attending to and striving o understand his expience
How does the assessment provides an opportunity for the client to assess the therapist?
“Can I trust you?” “Can you help me?” “Are you good enough for me?”
How does the assessment helps to begin to identify transference and counter-transference?
The therapist may also remind the clint of some other person or relationship in his life. This can lead the client to have feelings towards or to attribute characteristics to the therapist which belong elsewhere
E.g. therapist might be seen as an “authoritaarian figure”, “abusive teacher” or “perfect carer”.
Similarly the therpist’s perception of the client would be shaed by therapist’s life experiences and/or relationships
What are th sources of assessment?
Referral letters
Liaising with other professionals
Pre-therapy quesstionnaires or other psychometrics
Therapis’s observations
How does a therapist decides which areas to explore further?
It depends on cues picked up by the therapist from the client (from what the client says, the way in which it said, client’s non-verbal behavior
What are some things to consider for assesment?
Therapist’s primary theoretical orientation
Client’s osychological mindedness, openness emotional state, cognitive style
The protocol and policy of the service you work
What are the areas of assessment?
Backgroound history
Demographics
Risk (history)
Substance use
Medication (dose, type)
Preseting difficulties
Current situation
Triggers to current difficulties
Previous psychological difficulties
Suitability for the sevice
What are the client’s presenting issues and difficulties?
It is whatever led them to seek or agree to psychological therapy
Clients demographic info
Age
Status
Sexuality
Client’s current situation info
Family
Work
Support
Interests
What do we mean by triggers?
Triggers to current difficulties
What do we want to know about previous psychological difficulties?
Coping strategies and risk
What do we want to know about previous therapeutic help or intervention?
Type of therapy
Duration
What do we want to know about medication?
Name and dose of medication
Client’s beliefs and experience with medication
What do we need to know about a client’s background?
Birth order and the effect o his role in the family as a child
Family expectations in terms of behavior e.g. be good
Family relationships (parents, siblings, grandparents)
The client as a child (“what sort of girl/boy was?”, personality, temperament, relationship with parents, coping with changes etc)
Cultural context: ethnicity, religion, socio-economic background
Schooling: friends, academic ability and performance, experiences
Adolescence: development of adult identity, relationships
Young adulthood-current time: work, social, emotional development and issues
Adverse life events: traumatic experiences
What are the basic skills involved in assessment?
Managing the assessment interview
Open-ended questions
Reflective statements
In basic skills involved in assessment, what do we mean by “managing the assessment interview”?
Creating a balance between providing a facilitative and safe environment for the clien to give an account of, and to explore client’s presenting difficulties, background and allowing the opportunity for the therapist to gain an overview of the client’s situation
In basic skills involved in assessment, what do we mean by “open-ended questions”?
Questions which leave it open for the respondent to answer as they wish
In basic skills involved in assessment, what do we mean by “reflective statements”?
The therapist’s understanding of client’s contect, emotional state
Therapist’s hypothesis and formulations
What is formulation?
A conceptual map of the psychological terrain that you and your client wil be navigating during the course of your work together
The therapist’s psychological understanding of the difficulties and concerns the client is experiencing
Synthesis of information from multiple and varied sources including the client’s story and implicit formulation, your observations of the client in the session, the results of psychometric tests or self-report inventories
How do we define a “good formulation”?
It convey an integration of clinical material and psychologiacl theory
What are some questions for formulation?
What are some of the factors that might have made this particular client vulnerable to developing this type of problem? e.g. strong family history of the same prob, early trauma and other sig developmental experiences, social or economic deprivations, previous medical and mental health history
Why did the prob begin at this particular time and way?
How has teh prob developed over time?
What is maintaining the prob now?
How is the client coping?
5 P’s - Key elements for formulation
Presenting prob
Predisosing factors
Precipitating factors
Perpetuating/Maintaining factors
Protective factors
What are the predisposing factors?
Factors in the client’s history that make the client inclined toward presenting with “these symptoms” in this current situation
What are the precipitating factors?
Are the immediate factors or events that have caused te client to present with or experience symptoms now.
Depending on their backgrounds, life experiences, support system, coping strategies and current circumstances, we might expect or even predict that two different people would react differently to the same (precipitating) event
What are the perpetuating/maintaining factors?
Are the factors that are causing the client’s symptoms to continue or progressivelt worsen
What are the protective factors?
What can i rely on?