Lecture 3

Question 1

What is assessment?

Answer 1

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

Question 2

Why is assessment important?

Answer 2

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

Question 3

What assessment involves?

Answer 3

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

Question 4

Is assessment a joint exploration?

Answer 4

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

Question 5

Assessment is NOT

Answer 5

just sth you do before tou start theraoy, but is an inseparable part of the whole theraputic process

Question 6

What may happen within assessment?

Answer 6

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”

Question 7

How does the assessment enables the client to feel understood?

Answer 7

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

Question 8

How does the assessment provides an opportunity for the client to assess the therapist?

Answer 8

“Can I trust you?” “Can you help me?” “Are you good enough for me?”

Question 9

How does the assessment helps to begin to identify transference and counter-transference?

Answer 9

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

Question 10

What are th sources of assessment?

Answer 10

Referral letters
Liaising with other professionals
Pre-therapy quesstionnaires or other psychometrics
Therapis’s observations

Question 11

How does a therapist decides which areas to explore further?

Answer 11

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

Question 12

What are some things to consider for assesment?

Answer 12

Therapist’s primary theoretical orientation
Client’s osychological mindedness, openness emotional state, cognitive style
The protocol and policy of the service you work

Question 13

What are the areas of assessment?

Answer 13

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

Question 14

What are the client’s presenting issues and difficulties?

Answer 14

It is whatever led them to seek or agree to psychological therapy

Question 15

Clients demographic info

Answer 15

Age
Status
Sexuality

Question 16

Client’s current situation info

Answer 16

Family
Work
Support
Interests

Question 17

What do we mean by triggers?

Answer 17

Triggers to current difficulties

Question 18

What do we want to know about previous psychological difficulties?

Answer 18

Coping strategies and risk

Question 19

What do we want to know about previous therapeutic help or intervention?

Answer 19

Type of therapy
Duration

Question 20

What do we want to know about medication?

Answer 20

Name and dose of medication
Client’s beliefs and experience with medication

Question 21

What do we need to know about a client’s background?

Answer 21

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

Question 22

What are the basic skills involved in assessment?

Answer 22

Managing the assessment interview
Open-ended questions
Reflective statements

Question 23

In basic skills involved in assessment, what do we mean by “managing the assessment interview”?

Answer 23

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

Question 24

In basic skills involved in assessment, what do we mean by “open-ended questions”?

Answer 24

Questions which leave it open for the respondent to answer as they wish

Question 25

In basic skills involved in assessment, what do we mean by “reflective statements”?

Answer 25

The therapist’s understanding of client’s contect, emotional state
Therapist’s hypothesis and formulations

Question 26

What is formulation?

Answer 26

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

Question 27

How do we define a “good formulation”?

Answer 27

It convey an integration of clinical material and psychologiacl theory

Question 28

What are some questions for formulation?

Answer 28

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?

Question 29

5 P’s - Key elements for formulation

Answer 29

Presenting prob
Predisosing factors
Precipitating factors
Perpetuating/Maintaining factors
Protective factors

Question 30

What are the predisposing factors?

Answer 30

Factors in the client’s history that make the client inclined toward presenting with “these symptoms” in this current situation

Question 31

What are the precipitating factors?

Answer 31

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

Question 32

What are the perpetuating/maintaining factors?

Answer 32

Are the factors that are causing the client’s symptoms to continue or progressivelt worsen

Question 33

What are the protective factors?

Answer 33

What can i rely on?