How to Draw Assessment Ideas in Counseling

Drawing assessment ideas about a client in counseling can be an overwhelming experience that requires a lot of patience, awareness and knowledge. A therapist must rely on a variety of tools and techniques to draw out relevant information, including empathy, instinct, research, tests and behavioral observations. While drawing out these ideas may prove only moderately difficult, considering them all simultaneously in an effort to reach a conclusion is the truly difficult component in psychological assessment.

Things You'll Need

• Mental status exam
• Diagnostic and Statistical Manual, Fourth Edition, Text Revised
• Client's notes and records
• Psychological assessment tests

Show More

Instructions

• 1

  Conduct the intake interview with your new client in a way that allows you to complete a Mental Status Exam after the session. Pay attention to its basic components, including physical appearance, behavior, thought process, perception and mood. Note any abnormalities within these areas that may provide clues to the client's condition. For example, you may list "trembling hands" under appearance and "anxious" or "euphoric" under mood. Trembling hands and an anxious mood could point to drug use or an anxiety disorder, while trembling hands and euphoria could indicate a manic state. Use these notes as a starting point.

• 2

  Get to know your client over the next several sessions. Pay attention to whether you experience him in the same way from session to session or whether he shifts subtly or dramatically from one session to the next. Gather information about your client by asking him about his history if he seems willing to talk about it. Try to get a sense for how long his current symptoms have been bothering him (weeks, months or years), find out if there are periods when he is unaffected, and at what age they first began. Many diagnoses are highly dependent on the time parameters of symptoms.

• 3

  Administer one or more psychological assessment or personality tests to get another side of the story. The MMPI-2 is one of the most popular assessment tools used by psychologists, and consists of several different scales, including Depression, Hysteria, Paranoia, Hypomania and Social Introversion scales. Study the results and pay attention to the combination of different scores and scales, which can be helpful for determining psychopathology. Pay special attention to scores that surprise you.

• 4

  Use the scores or results of the assessment tests to guide your future approaches while interviewing the client. Ask key questions that may provide you with further insight into particular aspects of your client. For example, if a client usually seems moderately anxious in sessions and rates extremely high on Social Introversion, it may be helpful to explore his feelings regarding social settings. What may have previously seemed like Generalized Anxiety Disorder may actually prove to be Social Phobia.

• 5

  Pay attention to any cultural components of your client that could affect the assessment. Many behaviors that may be considered psychopathology according to Western psychology may actually be considered normal in other cultures. For example, Asian cultures are often more collectivistic than individualistic, placing greater emphasis on the group needs instead of the individual's desires. A recent immigrant from China who seems overly dependent on her parents' approval should not be given a diagnosis of Dependent Personality Disorder unless her behavior is out of proportion with her culture's norm.