Module 5 Assessment and Intake

Question 1

conduct a comprehensive intake or assessment interview

Answer 1

SECTIONS OF AN ASSESSMENT/INTAKE FORM;
1. Personal data;name,address, sex, relationship,parental situation for minors etc.
2. Presenting problems (primary and secondary) eg nature of problem, frequency, duration, behaviours associated with, any identified patterns, reason for current counselling, impact of problem on everyday functioning,
3. Current ;
background and context for everyday functioning, usual weekly routine,participation in social, religious, culture, sport, educational, vocational, weekly demands/obligations, etc
4. Family;mother/father job,temperament,relationship, family mental illness, family domestic violence, drinking, etc.
5. Personal history; life milestones, relationships, medical, military,sexual relationships, alcohol and drug use, previous counselling
6. Description of client during interview-appearance, difficulties of speech/movement/hearing/sight, logical thought, speech patterns, how well seemed to relate to counselor,
7. Summary and recommendations; to what extent is the client a rational fit for your services or which counsellor/service to match with, suspected duration/type of counselling required.

Question 2

outline the four Ps of case formulation

Answer 2

PREDISPOSING FACTORS ;
Formative factors that increase vulnerability—often historical, family, early life experiences. Often lay dormant until triggered.
PRECIPITATING FACTORS;
More recent triggers: for example, job loss, relationship breakup, exam mark.
PERPETUATING FACTORS;
Keep the problem going or make it a bit worse. For example, loss of sleep, avoidance, drinking.
PROTECTIVE FACTORS;
Personal/environmental strengths that help one cope: good coping skills, good communication skills, good support.

Question 3

explain process goals and outcome goals

Answer 3

PROCESS GOALS;
The factors (therapeutic condition) necessary for counselling to lead to client change. Are the counselor’s responsibility. eg; establish rapport, create a non threatening environment, communicate empathy and positive regard.
OUTCOME GOALS;
Combination of what client wants to achieve, and what counselor thinks important for their client. is a mutual responsibility. They should be SMART (Specific, Measurable, Achievable, Realistic, and Timely).

Question 4

explain why we collect assessment information such as formulation, treatment, process, suitability, and readiness for therapy.

Answer 4

Need to determine what problem is, what client’s desires are, what therapy would be suitable, and how to make it happen.

Question 5

Family Genogram

Answer 5

Diagram illustrating which family members have mental health issues/good relations/bad relations, drug/alcohol problems, other health issues etc.May also consider other factors such as world views, cultural memberships, religions etc.
Figure 5.1 The Family Genogram
https://plus.pearson.com/eps/pearson-reader/api/item/37bb74a7-75d2-4d9f-ad63-257f4f8c869f/1/file/9780134165776_Hackney_Profession_8_v1/OPS/images/fg05_00100.png

Question 6

Tips

Answer 6

1. Follow the PROCESS not the PLOT. ie Stick more with the client’s feelings, how was affected, is there a pattern. Make sure to fully explore the client’s life circumstances.
2. CONCEPTUAL FORECLOSURE= prematurely designing a therapeutic plan without having fully understood/explored ALL factors. Whilst might occasionally be successful, far more likely to end in failure as not all aspects have been considered and taken into account.
3. The assessment process itself can be REACTIVE, ie the process of trying to obtain info re the problem, can change the problem too.
4. If the client is in crisis during this first interview, a typical intake is not conducted; rather, an assessment of the crisis is conducted and the goal is to establish physical and psychological safety for the client until a regular intake can be conducted.
5. Do NOT use diagnostic language (eg Depressed) UNLESS are actually making a diagnosis (in which case should be using diagnostic tools also).
6. Recognise that problems occur within environments. Are there factors there which can be ameliorated?

Question 7

Linking statement

Answer 7

These are hypothetical explorations. They allow the client to explore connections between events, thoughts, feelings and circumstances. By proposing links, it is hoped the client may have a “lightbulb” moment of understanding, They are not the same as interpretations.

Question 8

Possible client reactions to assessment

Answer 8

POSITIVES;
1.Understanding: “I believe someone finally understands how terrible these last few months have been for me.”
2.Relief: “Well, it does feel good to get that off my chest.”
3.Hopefulness: “Now maybe something can be done to help me feel better and get a handle on things.”
4.Motivation: “Now that I have someone to talk to, I feel like I can stick with a plan.”
NEGATIVES;
1.Anxious: “Am I really that bad off? This is a lot to deal with all at once. Can I do this and still keep up with everything else?”
2.Defensive: “Boy, do I feel on the spot. There are so many questions being thrown at me. Some of them are so personal, too.”
3.Vulnerable: “How do I know if I can trust her with this? Can she handle it? She seems awfully young. Will she keep what I say to herself?”
4.Evaluated: “I wonder if she thinks I’m really messed up? Crazy? Stupid? Maybe something really is wrong with me?”

Question 9

Crisis Assessment

Answer 9

Whilst Crisis Assessment is a specialised field, it is encountered in regular practice. Where crisis point is, is very much an individual point, as is what constitutes a crisis. A person is in crisis however when they have used the psychological resources and coping strategies that they typically use when a problem occurs, and yet the situation doesn’t seem to get any better. This can be frightening and results in the person feeling out of control.
Councilor must (a) seek to understand the nature of the client’s perception of the crisis event, (b) determine the needs and strengths of the individual in crisis, and (c) determine the strengths and deficits of the client’s recovery environment. It is important to assess whether the client is in emotional or physical jeopardy. In addition, issues such as goal setting and intervention planning take on a much shorter-term focus.