Topic 5: Initial Assessment in Counseling {by 6/26}

Based on the text readings and lecture recordings due this week consider the following discussion points: (1) Share why it is important to get an accurate understanding of the client’s problems early in therapy (i.e., intake/early sessions). (2) Understandably, especially as a beginning therapist, the thought of assessing suicide can be anxiety provoking. Share a few of your initial concerns when (not if) you are confronted with a suicidal client. (Keep in mind, you will learn a lot more about responding to suicidal clients in future classes and on your practicum/internship.) (3) Assessment has a broader role beyond just determining diagnosis. What are some ways assessments can help therapists understand how presenting problems are affecting clients?

***Prepare for Class (do not blog): You will notice on my website (Class Lectures & Recordings) a short video “Assessment Review Introduction,” “Assessment Review Reflection Questions” template, and multiple assessments (under the two chapter topics). Please review these questions and the assessments before class. You do not have to complete these assessments before class. In class, we will discuss expectations for completing assessments, including the reflection questions.

Your original post should be posted by 6/26. Post your two replies no later than 6/28. *Please remember to click the “reply” button when posting a reply. This makes it easier for the reader to follow the blog postings.

17 Comments (+add yours?)

Sydney Corfey
Jun 25, 2025 @ 12:23:42
1. It’s important to get an understanding of the client’s problems early on in therapy like in intake sessions or early sessions because it would help form a proper treatment plan. Getting to know the client’s past and if they tried seeking help beforehand is important. We learn what worked and didn’t work for them and we also get an understanding of their major struggles. Previous diagnosis is important to know in the beginning so as counselors, we can assess properly and form the best treatment plant for that specific client. It’s also important to know the severity of symptoms and how the problems have an impact in the client’s daily functioning. Every client has different needs, so understanding the problems, severity, frequency, and past problems would benefit with making a proper treatment plan and assist them in reaching their goals.
2. A couple concerns would be keeping my body language under control and knowing what to say. I have known at least three different people I went to school with or friends of my sister that have committed suicide. When a client is suicidal, I will need to control my body language and facial expressions. If my uncomfortable facial expressions and body language are conveyed to the client, they may not feel safe anymore and keep things to themselves. As counselors, it’s our job to be there for the client. If we show facial expressions and body language that show our level of discomfort, it could ruin rapport and prevent the client from sharing more which would alter the treatment planning. Knowing what to say would be my other concern. It’s normal to be uncomfortable regarding suicide, but knowing what to say can be challenging. We want to make the client feel safe and supported, so knowing what to say is crucial.
3. Assessments could help therapists understand the presenting problems because it gives us specific information about the client that would help with treatment planning. Assessments give us information like symptoms, the most present symptoms, suicidal risk, substance usage, triggers for the client, severity of diagnosis/symptoms, risk of self-injury, and help us determine the level of help needed for the client. Assessments give counselors specific information that helps us determine the level of help needed for that client and their risk of specific factors.
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- Alexis Culver
  Jun 25, 2025 @ 12:44:44
  
  Hi Sydney,
  
  I agree with your answer to question three about why assessments are so important. I also said something similar. I also agree with your statement for question one, I did not think about the point of them trying to seek help before but that is extremely important. Good Job!
  
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- Nick Cedeno
  Jun 25, 2025 @ 14:37:09
  
  Hi Syd!
  
  I thought that it was important to mention the complete picture that you can form from gaining a clear understanding of the client early on. The more insight you gain, the better the relationship between the client and therapist. I noticed that you mentioned the “past” history of the client and this would be particularly helpful in forming an accurate diagnosis. I had the same thought about gaining a whole picture of the client to optimize the therapists approach.
  
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- Kiera Mills
  Jun 28, 2025 @ 16:47:23
  
  Hi Syd,
  
  I definitely agree that watching non verbals is important with suicidal clients. Especially if they mention it unexpectedly, as I would be very taken aback if I did not anticipate it before hand. I also liked how you mentioned that it would harm rapport and make the session more difficult
  
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- Kiera Mills
  Jun 28, 2025 @ 16:47:25
  
  Hi Syd,
  
  I definitely agree that watching non verbals is important with suicidal clients. Especially if they mention it unexpectedly, as I would be very taken aback if I did not anticipate it before hand. I also liked how you mentioned that it would harm rapport and make the session more difficult
  
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Alexis Culver
Jun 25, 2025 @ 12:42:09

It is important to get an accurate understanding of the client’s problems during early sessions because this is when you learn pertinent details about the current situation. What could be the reason it is happening as well as back ground information as to what could be the reason this happened. This is also when you start to build your therapeutic relationship. In the early sessions you also start hearing about the clients background and everything you hear in the beginning influences what treatment you try to use in the future with that client.

A few concerns that I have would be that the client is not willing to admit that they have had suicidal ideation even if running an assessment on them. Also, watching my body language and trying to stay calm in a situation where suicide is indicated. It is important to keep calm because you are their to support the client they are not there to support you. Also if the person does have a plan and it has to be reported that they will lose all trust that may have been built.

Assessments can help determine what the underlying cause of the presenting problem is. Also, it is useful when treating a client because you can give them an assessment at the beginning and then at the end to see of their score has changed. This would allow you to know if the treatment you are using is effective.

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- Nick Cedeno
  Jun 25, 2025 @ 14:31:14
  
  Hi Alexis!
  
  I like how you mentioned the potential resistance of a client who has communicated suicidal ideations. I hadn’t thought of that, because I assumed that somebody would want help in this situation, but dealing with the hopeless feelings and pessimism of somebody with these intense thoughts is a really good consideration.
  
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- Sydney Corfey
  Jun 26, 2025 @ 21:27:43
  
  Hi Alexis,
  
  It’s good that you mentioned the change with the clients’ scores regarding assessments. If we see changes in a positive direction, then we know the treatment plan is working. If there is no change or it goes in a negative direction, then we know the treatment plans needs to be altered and changed for the clients best interest. It’s good that you mentioned that for future clients and giving assessments for the proper treatment plan for them.
  
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Nick Cedeno
Jun 25, 2025 @ 14:25:50
1. It is important to get an accurate understanding of the client’s issues early on in the process of therapy because we want to have confidence in how we are approaching treatment for this individual. If we were to blanket diagnose people who present the same without doing our due diligence of asking the right questions to build a more whole understanding of the individual, we may be missing some essential details that could completely change the approach to treatment. It is also important to get an accurate understanding of the individual to build a strong therapeutic relationship. If the client feels understood, they might be more likely to be more forthcoming and honest in their communication with you. This allows for a better therapeutic relationship and may lead to better outcomes.
2. I would be concerned about saying the wrong thing. In a situation where I feel like I need to particularly thoughtful, I may be so careful that it ends up being counterproductive. I might feel responsible for saying the perfect thing and in the process of trying to formulate the perfect advice, I am worried that I may say something that isn’t helpful and ends up adding more stress than alleviating it. I want to communicate that I am non-judgmental and supportive, but I don’t want those efforts to seem forced. Because of the sensitivity of the topic, I would also be concerned about my own emotions. I would not want to put the burden on the client of having to emotionally console their therapist. I would also be mindful of reporting it to the proper channels. I’m not positive on the protocol, so informing myself on how to handle the required reporting would also make me feel more confident in this context. Being aware of these issues going into situations necessitating an extra consideration of suicidal ideations would be my main concern.
3. Assessments in counseling has a broad application of uses. Not only could it help you determine a proper diagnosis, but it could help you gain surrounding information this is helpful for better defining an individual treatment plan. Assessments could determine the intensity of a particular issue, as well as the projected performance that a client may have in their designed treatment plan. We would also be able to compare a client’s current performance alongside their peers of a similar demographic using assessments. Using the insight gained with these assessments allows us to form a detailed an individualized understanding of how to optimally approach therapy with a client.
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- Alexis Culver
  Jun 25, 2025 @ 14:40:42
  
  Hi Nick,
  
  I agree with your response to question one because if the client feels more understood then they may be more willing to open up. I also agree with your response to question two, I also feel I may say the wrong thing at a time where it is especially pertinent that you say the correct thing.
  
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- Madelyn Messier
  Jun 27, 2025 @ 12:57:53
  
  Hi Nick,
  I agree with your response on number 3. Assessments really do play a critical role in helping us gather a fuller picture of what a client is experiencing. I like how you pointed out that they not only help with diagnosis but also with treatment planning and tracking progress over time. Being able to compare a client’s functioning to others in similar demographics can provide helpful context, and overall, assessments help ensure that the care we provide is truly individualized and effective.
  
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Kiera Mills
Jun 25, 2025 @ 22:26:07
1. I believe it’s important to get an accurate understanding of the client’s problems early on because if you continue to later sessions while still misunderstanding the clients issues you would be attempting to treat the wrong disorder. If someone had symptoms of depression but you thought they presented for anxiety, then all the counseling after would be anxiety focused and ineffective for the actual problems. This would cause a lot of backtracking on treatment later on when it proves ineffective, and could ruin rapport with the client.
2. I think my biggest concern as a new therapist with assessing suicide is having issues with boundaries between work and personal life that could lead to me missing something important. I have a fear that someone will be suicidal and reach out to me after work when I’m not checking my phone. I just think I would be too hypervigilant if I knew I had an actively suicidal client. I’m also afraid of missing signs of suicidal behavior when assessing a new client and potentially not being able to prevent an event.
3. I think assessments can be a good way of gaging a client’s emotions outside of just diagnosis symptoms. A lot of people aren’t able to accurately name or describe how they feel, but when asked specific questions like those in assessments it’s easier to see if they are stressed or angry or frustrated. They’re also good conversation starters because assessment questions can make people remember things they wouldn’t normally think to bring up in session.
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- Sydney Corfey
  Jun 26, 2025 @ 21:31:09
  
  Hi Kiera,
  
  I also have that concern with giving therapy with an active suicidal client. It’s easier said than done to shut off the work life and not let it into your personal life. It will be difficult for the future when we have a client who is actively suicidal. This is where self care comes into play and we must learn what helps us focus on our personal life and not let work life intertwine with it. I also like how you mentioned assessments showing changes within the client and if the treatment plan is working. It gives both the client and clinician a better picture of what’s going on and giving the client the proper treatment plan.
  
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- Madelyn Messier
  Jun 27, 2025 @ 12:55:26
  
  Hi Kiera,
  I completely agree with you. The fear of missing warning signs or not being available when a client is in crisis is something I also worry about. It’s hard not to feel responsible for a client’s safety at all times, especially when working with someone who is actively suicidal. It’s comforting to know that others share this concern, and I think ongoing supervision and training will help us feel more prepared and confident over time.
  
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Madelyn Messier
Jun 26, 2025 @ 13:39:25

1. Why it’s important to get an accurate understanding of the client’s problems early in therapy

I think it’s really important to fully understand a client’s problems early on in therapy. If we don’t fully understand what the client is going through, we might miss important issues or focus on the wrong things. The intake and early sessions help build a full picture of the client’s mental health, life situation, and any risks they may be facing. It also helps build trust and shows the client that we’re listening and care about what they’re experiencing.

2. Understandably, especially as a beginning therapist, the thought of assessing suicide can be anxiety provoking. Share a few of your initial concerns when (not if) you are confronted with a suicidal client.

The idea of talking with a client about suicide does make me nervous. I worry about saying the wrong thing or making the client feel worse. I also worry about missing the warning signs or not knowing what steps to take to keep the client safe. It feels like a big responsibility. But I also know that asking about suicide can help save someone’s life, and that with more training and support, I’ll feel more confident handling these situations.

3. How assessments help therapists beyond just making a diagnosis:

Assessments do more than just help figure out a diagnosis. They help the therapist understand how the client’s problems are affecting different parts of their life, like work, school, family, and social relationships. Assessments can also help track progress over time and show if the client is getting better or if the treatment needs to change. They give both the therapist and the client a clearer picture of what’s going on and how to move forward.

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- Kiera Mills
  Jun 28, 2025 @ 17:00:53
  
  Hi Maddie,
  
  I definitely agree with your answer to question 1. I liked how you mentioned that if you misunderstand the issue you could focus on the wrong details. I also think this makes assessments very useful in early sessions.
  
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Xhesika Halili
Jun 28, 2025 @ 23:44:09
Hello everyone,
1. The initial interview often provides crucial information that influences the treatment phase of counseling and clinical decision-making. Key areas addressed during this phase include identifying the client’s major issues, evaluating the potential effectiveness of counseling for the individual, and determining the most appropriate treatment approach. Intake, interviews usually gather information about the range and scope of the concerns, pertinent details about the current situation, and background information relevant to the current problems.
2. My biggest worry is that I will not have power to prevent the action of suicide. Assessing suicide risk is one of the most difficult parts of counseling. Each client is different, but there are common warning signs to watch for. Even if a client says their suicidal thoughts are minor, counselors should always follow up with a more in depth assessment. Clients may use vague language or euphemisms, but it’s important for counselors to respond clearly and directly, any mention of suicide is a serious signal.
3. Assessment helps therapists understand more than just a diagnosis. It shows how the client’s problems affect daily life, relationships, and functioning. It also helps identify patterns, triggers, and coping strategies, and provides a baseline to track progress. Assessment also strengthens the therapeutic relationship. It shows clients that the therapist is listening, this builds trust and encourages openness early in the counseling process.
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Dr. Adam M Volungis