Assessment Process

Introduction
Obtaining a complete initial assessment is the foundation of treatment planning and problem solving in a solution-oriented approach to counseling. Case management, assessment, and interview skills are essential to counseling families, couples, and individuals, as is competence in the proper implementation of systemic interventions. In addition, if assessing a youth, you must determine specific strategies to implement in order to meet goals and objectives in the school system. The initial assessment also directs what further tests are indicated.
The assessment process usually includes a variety of techniques. The interview can include discussions with family members and significant others. The purpose of the interview is to elicit information in the following areas: demographic data, reason for referral, presenting problem, medical and psychological history, family history, suicide risk assessment, substance abuse assessment, trauma history and assessment, and current concerns. While the interview is being conducted, the counselor makes extensive observations of behavior, thought processes, affect, and mood.
The suicide risk assessment is essential and required in all clinical settings and is becoming part of sound clinical treatment. Talking about suicidal thoughts helps to validate the client’s perception and experience and helps build rapport as well as gain insight into moods and behaviors. Hood and Johnson (2007) discuss six significant sets of factors essential to suicide risk assessment. They are self-reported risk, suicide plan, suicide history, psychological symptoms, environmental stress, and available resources. Clients at risk for suicide may need psychiatric evaluation and follow-up treatment for a medication evaluation and safety plan.
The guidelines for communication of test results will be reviewed, as well as ways to make certain that information is understandable for the client or person receiving the information.
Reference
Hood, A. B. & Johnson, R. W. (2007). Assessment in counseling: A guide to the use of psychological assessment instruments (3rd ed.). Alexandria, VA: American Counseling Association.
Objectives
To successfully complete this learning unit, you will be expected to:
1. Examine legal and ethical issues in the application of assessment instruments.
2. Analyze factors involved in the communication of assessment results.
3. Synthesize the use of standardized and non-standardized assessment techniques in a professional setting.

• Learning Activities unit 5 Study 1
Assessment Process
Required Readings
Use Principles and Applications of Assessment in Counseling to complete the following:
• Read Chapter 7, “Selecting, Administering, Scoring, and Communicating Assessment Results,” pages 119–139.
• Read Chapter 8, “Initial Assessment in Counseling,” pages 140–167.
Use the Capella University Library to complete the following:
• Read Lester, McSwain, and Gunn’s 2011 article, “A Test of the Validity of the IS PATH WARM Warning Signs for Suicide,” in Psychological Reports, volume 108, issue 2, pages 402–404.
• Read Forbes et al.’s 2011 article, “Psychological First Aid Following Trauma: Implementation and Evaluation Framework for High-Risk Organizations,” in Psychiatry: Interpersonal & Biological Processes, volume 74, issue 3, pages 224–239.
Use the Internet to complete the following:
• Read “Psychological First Aid: How You Can Support Well-Being in Disaster Victims” from the Center for the Study of Traumatic Stress.
• Read the section about the IS PATH WARM acronym in SAMSHA’s brochure, What to Do If You Think a Person Is Having Suicidal Thoughts.

Optional Reading
If you choose, read:
• Jones’ 2010 article, “The Unstructured Clinical Interview,” in Journal of Counseling & Development, Issue 88, pages 220–222.
• Ruzek, Brymer, Jacobs, Layne, Vernberg, and Watson’s 2007 article, “Psychological First Aid,” in Journal of Mental Health Counseling, volume 29, issue 1, pages 17–49.
• Simon’s 2009 article, “Suicide Risk Assessment Forms: Form Over Substance?” in The Journal of the American Academy of Psychiatry and the Law, Volume 37, Issue 3, pages 290–293.

Discussion 1: 1 page needed with minimum of 250 words and 2 references.
Goldilocks and the Three Assessment Scenarios
If you have not already done so, watch the Goldilocks and the Three Assessment Scenarios video. Choose either the “too warm” or “too cool” scenario and compare how the counselor in the “just right” scenario manages the assessment process differently. Applying professional ethics and unit studies as a guide, describe appropriate administration, interpretation, and communication of results in psychological testing.
Transcript of Goldilocks and the Three Assessment Scenarios Below
Goldilocks and the Three Assessments
________________________________________
Counselor Is Too Warm
Counselor (C): Hi. My name is Dr. Nelson. How are you today?
Client (CL): Ummm. Fine.
C: We are going to be doing some assessments together. I hope that will be OK. This assessment is very important to help us get to know you better, and I want to help you make a great impression!
Cl: Uhh. OK.
C: Great! Let us get started C: Ok. Here is the first test you’ll be completing. If you have any questions, just let me know. I will be right here.
Cl: Thanks. I think I am good here. C: Oh good.
Cl: (stops writing) I will be fine if you have other work to do…
C: Oh it is fine. It is important that I am here to observe. C: You may want to take another look at #4 there…
Cl: Gee. Thanks.
C: No problem. I am here to help! C: Oh great. I will score this real quick and give you the results. C: Ok. You did just fine. This is a brief assessment of your intelligence and you are a very intelligent person!
Cl: Really? I cannot wait to tell that to my dad. He never thought much of me in the brains’ department.
C: That is terrible! Everyone has their own type of intelligence and yours is just …less conventional. Cl: Less conventional? What the heck is that supposed to mean?
C: Oh..You are your own kind of smart.
Cl: What? I have no idea what you are saying. Can you just give me a straight answer, instead of this “less conventional” garbage?
Counselor Is Too Cold
C: Hi. I am Dr. Nelson. We will be doing some tests today. It is important that you do your best because the results are very important to your future.
Cl: Oh, OK.
C: Let us get started. Here. (Slides the paper to the client). Follow the directions at the top. I will be back in a few. (walks out)
C: Are you done yet?
Cl. Yeah, I just finished the last question. ..Here. (Slides papers back)
C: OK. Hang on. I will score this real quick. (jots notes)
C: Well, it seems you’ve scored below average. Do not take this wrong, but I do not think this is going to look good for you.
Cl: Say what?! What does that supposed to mean?
C: It is just that most folks do better. That is all.
Cl: Yeah, I get what below average means! What did you mean that it would not look good?
C: Oh. Well, this is a brief intelligence test and it means that you’re just not that smart. It is OK. I mean, it is not THAT bad.
Counselor Is Just Right
C: Hello. I am Dr. Nelson. (
Cl: Hi. I am ___. (Shakes hand)
C: Did you have any trouble finding our office?
Cl: No. Your directions were just fine.
C: Oh good.
Cl: What is this all for anyway?
C: Your employer has a contract with my agency to complete assessments as part of the Employee Assistance Program. Are you familiar with how the program works?
Cl: I think so. Based on the tests I take here today, you are going to decide if I can return to work.
C: Well, not exactly. I will be writing a report based upon the work we do here today, but it is not up to me whether you return to work. You have the right to review the report and ask questions about the results.
Cl: Oh. That makes more sense. I guess my supervisor would have to decide whether I am ready.
C: That is right. My report is just one piece of information to help determine if your recovery is far enough along to make it safe for you to return to a job where safety is very important.
C: We are going to be doing several different assessments today. This first is a brief intelligence test. The purpose is to get a general idea of how your problem-solving skills are progressing.
Cl: Yeah. My doctor said that would take some time to get better.
C: The directions are here at the top. It is important that you only mark one answer for each item. Do you have any questions?
Cl: Seems pretty straight forward. Is it timed?
C: No. You may take as much time as you need to complete it.
90 minutes later….
C: OK. We are all done. Thank you.
Cl: When do I find out the results?
C: I was able to score a couple of the assessments while you were completing others, but I do not have all the results at this point. I will be able to put a report together for you later this week and we can discuss your score at that time.
C: Can you tell me anything?
C: Yes. Compared to others who do your type of work, you seem to still be struggling a little. I remember that you said your doctor predicted that your full recovery would take some time.
Cl: Yeah. I know. I am just so anxious to get back to work. I wonder if I did this too soon. Maybe I should have waited another week…
C: Some of these tests can be repeated. That may be a recommendation for me to consider. A reassessment might be in your interest depending upon the results.
Cl: Oh? Can retry some right now? I know I would do better!
C: I am sorry. The tests are only valid if they are repeated far enough apart. Some would need to be substituted as they cannot be given again so soon.
Cl: I guess that makes sense. So, I should just wait for the results?
C: I understand how important these results are for you. Why do we not set an appointment up for later this week to review the results together? At that point, I will share my recommendations with you, but you certainly have input into what information is shared with your employer.
Cl. I would like that.
Discussion 2: 1 page needed with minimum of 250 words and 2 references.
IS PATH WARM
Consider the case example of Mary, a client who discusses suicidal ideation with a counselor, which is presented in Chapter 8 of the text on pages 156–157 of a client who discusses suicidal ideation with a counselor.
1. Discuss which aspects of “Psychological First Aid: How You Can Support Well-Being in Disaster Victims” from the Center for the Study of Traumatic Stress. Which aspects would you use to calm Mary, establish rapport, and obtain more information?
2. Apply the mnemonic IS PATH WARM, recommended by SAMHSA, to this scenario. How would you assess each of the criteria for the case of Mary? What other assessment tool(s) could be used to help assess Mary’s level of suicidal ideation? Present a rationale for using (or not using) that tool with Mary.

 

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