Topic 6: Using Assessment in Counseling {by 10/21}

Based on the text reading and lecture recording due this week consider the following two discussion points: (1) Assessment has a broader role beyond just determining diagnosis.  What are some ways assessments can help therapists understand how presenting problems are affecting clients?   (2) What is the difference between formative assessment and summative assessment?  What are the benefits of formative assessment?

 

(Prepare for Class [do not blog]) – You will notice the following assessments for this class: (1) Beck Depression Inventory – II (BDI-II), (2) Automatic Thoughts Questionnaire, (3) PHQ-9, and (4) Outcome Questionnaire (OQ-45.2).  Please review these assessments before class.  You do not have to complete these assessments before class, but you can if you want.  In class, we will complete these assessments and discuss them based on the Assessment Review Reflection Questions.

 

Your original post should be posted by 10/21.  Post your two replies no later than 10/23.  *Please remember to click the “reply” button when posting a reply.  This makes it easier for the reader to follow the blog postings.

40 Comments (+add yours?)

  1. Victoria Cestodio
    Oct 18, 2021 @ 11:48:01

    Assessment is definitely not just used to determine a diagnosis for the client. There are many other reasons we use assessments. Looking more into the problems this assessment is showing it is important to look at how these are affecting their daily life. This could be your job, friends, significant other, etc. These all can lead us to understand the clients problems much better. Analyzing their relationship with their significant other for example can show us possibly that maybe the relationship is actually contributing to their problems significantly, or that their problems are worsening their relationship with their significant other. Also, assessments can show possible environmental and social factors contributing to their problems. Like Dr. V said, not a lot of assessments are this detailed, but when they are it can be really beneficial.

    Formative and summative assessments are extremely opposed. The difference between these two is that formative assessment is a continuous process of giving evaluations to clients. It is not just focused at the end point of therapy. Formative really wants to examine the process. As you could assume, summative is completely opposite. Summative is more cumulative on the end point, or a final evaluation. This wants to just focus on how the client assesses at the end of therapy, which we know is not that useful. There are many benefits of formative assessment. One being that it gives you more up to date knowledge of where the client really is, and if they are going in a more positive direction or negative. Second being (which I think is one of the biggest benefits) is it enhances your relationship with your client. The more you use formative assessments the more feedback you can give to your client, it can lead to clients feeling as though they are improving and lead to more trust and rapport within the therapeutic relationship.

    Reply

    • Bekah Riley
      Oct 19, 2021 @ 14:56:57

      Hi Victoria,

      I thought your post was great this week!
      I really liked how you went into more depth about how a specific relationship in a client’s life could have an impact on their progress. As you mentioned, while the client’s specific symptoms may have an impact their relationship with a significant other for example, the relationship itself may also be making those symptoms worse. There are many client factors that come into play when interpreting a client’s symptoms and how to treat them.

      When considering Formative Assessments, I really liked how you described this assessment as one that looks at the direction in which the client is going. This is so important because whether the client is improving on their goals or not may show the therapist that the treatment is either right for that client or not.

      Reply

    • Madelyn Haas
      Oct 19, 2021 @ 23:33:43

      Hi Victoria,
      I enjoyed reading your response and think you made some wonderful points. In your first paragraph, I think your example about assessing problems with their significant other is a great way to explain how important assessments can be outside of diagnoses. If someone is in a bad relationship, they will not get a diagnosis for that, but said relationship could be contributing heavily to their preexisting depression, for example. For that reason, it is extremely important to continuously assess your client throughout therapy.

      Also, your definition of formative vs summative evaluations is spot on! Both have their places, but summative will not benefit your client as it is after the completion of therapy Formative evaluation, however, is essential for counseling because it allows you and you client to work together to adjust the treatment plan.

      Reply

  2. Kristin Blair
    Oct 18, 2021 @ 14:07:20

    Assessments can help therapists with a multifaceted approach to learning and understanding their clients’ needs. Making decisions for the good of someone else’s mental health really needs multiple sources of information to make sure the correct decision is being made. A big red flag here is assessing suicide risk. Depression is extremely common and has a big link to suicide. Therefore, it is especially important to make sure that a risk of suicide is not overlooked in a patient that may be simply saying “they’re feeling a little depressed.” It may also be important to not assume the opposite and confirm suicidality when it is in fact not present. Doing so could harm the rapport between the therapist and the client. Due to reasons like this, it is greatly beneficial to use a combination of various appropriate assessments, as well as interviewing and counseling. It is also important to understand the difference between warning signs and potential risk factors. Risk factors are having several signs and the general situation indicates that the individual may be at an increased risk for attempting suicide; whereas warning signs mean that there is an impending or pressing danger that implies that the individual should be assessed for possible intervention. It can also be beneficial to do assessments throughout the time you work with a client to monitor changes and how well therapy practices are working or not working.

    Formative assessment is a continuous or intermediate evaluation typically performed to examine the process. Summative assessment is more cumulative and is more of a final evaluation. The biggest difference between the two is that formative assessment focuses on the process, whereas summative assessment focuses on the product.

    Formative assessment provides ongoing feedback to clients about their progress and how it relates to their goals. That can lead to more/different resources and suggestions to delve deeper into, as well as prompting and opening opportunities for questions that will only help speed up treatment and get them closer to their goals. It also gives the therapist an idea as to how well the chosen therapeutic practices are working and if any changes need to be made.

    Reply

    • Vanessa Nichols
      Oct 19, 2021 @ 12:29:29

      Hi Kristin,
      I really liked your response and thought it created a better understanding of what assessments can offer a clinician, especially regarding suicidality. Assessments can also provide information regarding treatment planning, monitoring treatment or symptoms, and evaluating counseling as a whole. Assessments open the door for conversation between the client and the counselor. It allows the counselor to give feedback to the client about their opinions on this assessment while considering all the other information and session. It will enable the client to provide input regarding what’s important to them, what this means for them, and where they want to go from here. Due to conversations like this, assessments also improve the therapeutic relationship.
      I think you did a great job explaining the formative and summative assessment, and it increased my understanding of the two terms. I agree with you that formative provides feedback to clients. It also provides the clinician with information regarding progress and treatment.

      Reply

    • Will Roche
      Oct 20, 2021 @ 11:17:11

      Kristin,
      It seems like you have a great understanding of why assessments are so important on a clinical level. The example using depression and suicidality are two prevalent issues in counseling I’m sure, so it’s important to put these textbook definitions of importance of assessment into real life scenarios. Using assessments intermittently is a great way to understand improvement rather than just assume that a client is better because they told you so. This is a great example of why assessments are so important to be used regularly and how this can impact your client if you fail to do so.

      Reply

  3. Mary Altomare
    Oct 18, 2021 @ 18:45:32

    Assessments play a critical role for not only determining a client’s diagnosis, but also for treatment planning, tracking the client’s progress, building a strong therapeutic relationship, and evaluating counseling. In order to provide meaningful treatment, utilizing assessments on a continuous basis allows for the clinician to understand the magnitude in which a specific problem(s) is impacting the client’s daily functioning/ quality of life. For instance, an assessment can provide a clinician with useful information on a client that is diagnosed with social phobia, specifically the ways in which it impacting their quality of their interpersonal relationships, school and work. Through assessments, the clinician is able to see if the interventions that they are utilizing is reducing the clients social phobia, and if it isn’t the clinician is able to make the necessary changes to meet the client’s needs. Therefore, assessments are a great tool for the clinician to provide feedback and for the client to express their own opinion about how therapy is going for them. If used continuously and correctly, assessments are an awesome way for clinicians to build and maintain a strong therapeutic relationship with their client.

    The main difference between formative assessment and summative assessment is that formative assessment is given on a continuous basis, whereas summative assessment is given at the end to evaluate treatment. Formative assessments are beneficial because the clinician is able to track the clients functioning on a continuous basis. This approach allows for the clinician to meet their client where they are at, and gives the clinician to modify the treatment plan to better suit the client’s needs. More importantly, formative assessments offers a more thorough and accurate understanding of the clients challenges versus relaying solely on the clinicians perception. The clinician is able to closely track and be aware of any new factors that may be a barrier for the client to overcome any challenge(s).

    Reply

    • Vanessa Nichols
      Oct 19, 2021 @ 12:12:55

      Hi Mary,
      I like your response. I agree with you entirely that assessment is beneficial for planning, monitoring, evaluating counseling. I think overall, it is vital in just basic understanding of where the client is currently at. I think you illustrated this excellently through your example of social phobia. Conducting the assessments created an understanding of what is working and what isn’t working. Reviewing the assessment as a team creates the opportunity for some feedback from the client and the counselor. I really like how you tie this all back to maintaining a strong therapeutic relationship because that is the key to good counseling.
      I like your explanation of formative assessment and summative assessment. I believe summative assessment relies too heavily on the clinician’s judgment and opinion.

      Reply

    • Bekah Riley
      Oct 19, 2021 @ 14:46:41

      Hi Mary,

      I really enjoyed reading your post this week!
      First of all, I liked how you used an example of a specific mental disorder when describing how assessments help therapists understand the presenting problems of a client. When a client is diagnosed with social phobia, it can have a huge affect on the client’s daily life including their relationships and preferred occupations. An assessment may be essential in providing the therapist with information about the clients symptoms, the duration of their symptoms, and overall how these symptoms affect the client’s life. With this knowledge, the therapist will be able to implement a treatment plan that may help the client reach their goals and have motivation to do so.

      Reply

    • Victoria Cestodio
      Oct 19, 2021 @ 18:23:23

      Hi Mary,
      I loved your example in this post on social phobia! I think this shows how important assessments are and that they aren’t just for a diagnosis. Once the clinician examines the assessment we can get a better look at specific aspects of the clients life we can help, which then in return also builds the therapeutic relationship.

      Your explanation of formative and summative assessment is great. I think an important point you noted was “meeting the client where they are at”, because that is so true. That then helps us develop a better treatment plan like you mentioned.

      Great post!
      Victoria

      Reply

    • Lauren Pereira
      Oct 20, 2021 @ 11:22:11

      Mary,
      I like that you mentioned that assessments help track the client’s progress and evaluate the counseling as well. Assessments have more benefits than we may realize. I also like the example you added in because I feel like it does a great job presenting something that could really happen within therapy. If the right changes can not be managed in therapy, it will be hard to see progress and change within the client.
      I also agree that formative assessments can give more accuracy within therapy, as it tracks functioning. I find it important to have that continuous aspect so that things can be modified if needed. It is also a good way to assess how things are going early on because of adjustments that might need to be made in order to find more of a positive outcome. Another thing I like that you mentioned was how formative assessment comes off as more thorough than summative assessments, which I do agree with.

      Reply

  4. Vanessa Nichols
    Oct 19, 2021 @ 11:53:57

    As we have learned all semester, assessment is essential for determining diagnosis, but this chapter shows us that assessment is also helpful for treatment planning, monitoring treatment progress, and evaluating counseling. I believe a continuous array of assessments throughout the counseling process allows the clinician a continual view of the progression or degression of a disorder. Assessments can be beneficial for treatment planning because every client is different, and for therapy to work, the treatment should match the client. Assessments are a fantastic way to gather information on the client that can be useful when designing a treatment plan. Conducting assessment gives the counselor a better understanding of things like impairment; that way, counselors do not overestimate or underestimate impairment. One example that comes to mind is the Readiness to change questionnaire. By conducting this assessment, you gain an understanding of the client’s Readiness or motivation to change. Suppose the client is in precontemplation or contemplation; you know not to design too heavy of a treatment plan. On the other hand, if you have a client in the action stage (highly motivated), you know to give them a more independent treatment plan.
    Assessments also help clinicians monitor treatment; this allows the counselors to understand the current problems regarding frequency and severity of symptoms. By having an ongoing understanding of treatment, the clinician can decide if that client benefits from this course of treatment. Without continuous monitoring and assessment of treatment, you could think that the client is improving while they are actually having a hard time. It’s important to understand what is working for a client and what is not working for a client. Although you can and should ask them, sometimes it is easier to give assessments you have already given so you can compare results from before treatment to now.
    The difference between formative and summative assessment is when you give the assessment. Formative assessments mean that you provide assessments continually; so throughout the entire counseling relationship. In contrast, a Summative assessment approach is only offered at the end of the counseling relationship. While I understand why some people may take a summative approach, I believe it lessens the counselor’s understanding of the client and the client’s problem. The formative approach is beneficial because it provides the counselor with an abundance of information about the client that the counselor can use when making a diagnosis, planning, and monitoring treatment. The summative assessment can only evaluate the counseling. I believe the formative approach is beneficial because it gives an understanding of where the problem is currently at throughout treatment, not just at the end when it’s too late, and therapy is over.

    Reply

    • Victoria Cestodio
      Oct 19, 2021 @ 18:28:08

      Vanessa,
      I couldn’t agree with you more! I think having an array of continuous assessment gives the clinician a better look into the client that can further their own progress in therapy. Giving the example of the readiness to change questionnaire was an amazing incorporation to this post. This assessment does not just give us a “yes or no” answer, it gives us so much more like you said. Whether they are at pre contemplation or contemplation, which then gives us as clinicians insight on how to further treatment.
      Awesome post!!

      Victoria

      Reply

    • Will Roche
      Oct 20, 2021 @ 11:11:05

      Vanessa,

      This is a great discussion about the importance of assessment. There are a multitude of reasons why continuous assessment has many benefits, and it’s important for the therapist and client to use these assessments throughout the treatment plan. Your example of Readiness to Change Questionnaire seems like a great example. Perhaps at the beginning their readiness to change is low, so you know not to go to heavy of the treatment plan, but if you give this assessment again weeks down the line, and they are more motivated to change, this might give great insight on what the next steps might be to improve their condition. You may then want to give them a heavier treatment workload per se, which might improve their condition faster than before when they were not as ready to change. Great example.

      Reply

    • Tom Mandozzi
      Oct 20, 2021 @ 15:48:22

      Hi Vanessa,

      I liked your points about how assessment is important for not only assessing clinical presentation of mental health issues, but also for establishing a sense of how ready the client is to work toward change. As we have discussed in class, it is important that the client wants to make changes and implementing assessment can help us determine if the client feels motivated and capable of making these changes and how their level of readiness might inform treatment planning. I also liked your point about how continually implementing assessment in treatment can help the clinician compare results and responses to past assessments and thus monitor progress and make adjustments in treatment planning accordingly. Great post!

      Reply

  5. Bekah Riley
    Oct 19, 2021 @ 14:37:44

    Assessments are essential in counseling and have many important roles in addition to giving a diagnosis. In giving a client an assessment, the therapist is able to receive and interpret information on how presenting problems may be affecting clients. For example, the therapist is not only able to see what symptoms may be present, but the duration of these symptoms and how they affect the daily functioning of the client. In addition, each client may have different occupations and relationships that are important to them in everyday life. This could be their job, school, a relationship with a significant other, a friendship and much more. In understanding the client’s symptoms and how much they have an affect on the client’s daily life, the therapist is able to treat the client more effectively.

    In monitoring the treatment progress of the client, there are two major types of evaluations or assessments. These are known as Formative and Summative Assessments. A Formative Assessment is a continuous or intermediate evaluation of the client’s progress. This assessment is performed mainly to examine the process of the client’s treatment progress, rather than just the initial intake and endpoint. This form of assessment may be very beneficial to both the client and the therapist. The therapist is able to see whether or not the treatment is effective in that it helps the client improve upon their goals while the client may be more inclined to be motivated to reach their goals if they see continuous improvement.

    On the other hand, Summative Assessments are more cumulative and focus on the final evaluation. While this form of assessment is beneficial in the sense that it evaluates the counseling overall, it does not provide the client with information on their progress while in therapy. Formative Assessments may be more beneficial to the client in that they do provide the client with information about their progress while they are still in therapy and able to work with their therapist on continuing their progress and reaching their goals.

    Reply

    • Madelyn Haas
      Oct 19, 2021 @ 23:40:36

      Hi Bekah,
      Great response! I think your first paragraph is a great summarization of why assessments are so essential. A therapist can never see what a client is going through in their lives outside of therapy, so assessments serve to bridge the gap and give the therapist an idea of what the client is going through. So many things can contribute to a client’s problems, and it is essential to find out what things are contributing to them so that the therapist can come up with the best possible treatment plan. Your definitions for formative and summative assessments are good too. Good job overall!

      Reply

    • Tressa Novack
      Oct 20, 2021 @ 21:10:52

      Hi Bekah,
      You make a really good point about how therapists also need to take a look at a client’s significant relationships and other areas of their life, such as work. This type of information provides therapists with a more complete picture of the client and just how pervasive a client’s problems are. I agree with you that formative assessments are more beneficial to the client and therapist. Formative assessments allow the client and therapist to track progress, and this is necessary so that the therapist can ensure that the client’s needs are being met. Seeing progress can also keep a client motivated to continue with their treatment.
      Tressa

      Reply

  6. Madelyn Haas
    Oct 19, 2021 @ 23:26:34

    Although people may consider assessments only pertinent for diagnoses, they can be used in multiple ways. They can be used for planning treatments, monitoring progress, and for evaluating treatment efficacy. When initially getting to know a client, assessments can help with planning their treatment. Treatment for someone with severe depression will look pretty different than treatment for someone with mild anxiety, for example. Throughout the treatment process, a client filling out the Beck Depression Inventory II can give their therapist an idea of how the treatment is going. The therapist can use programs and statistics to determine if the client is “on track” or if they need to make changes to their treatment plan to best benefit the client. Finally, assessments can be used during and after the fact to evaluate how effective the treatment was. Insurance providers may want to see data to support the fact the treatment is working, or you may want to show your clients that your treatment plans have worked in the past. Assessments can and should be used throughout the entirety of the counseling process. There are many types of assessments that can give a therapist an idea about their client and their problems. There are assessments about symptoms, about relationships with others, about therapy readiness, and many more. All of these give therapists an idea about how to best treat their client and their presenting problems.

    Evaluation or accountability information is information that shows that treatment has been effective. Evaluation information is wanted by insurance companies and organizations that fund counseling clinics. There are two types of evaluation: formative evaluation and summative evaluation. The main difference between the two is when they are conducted. Formative evaluations are done throughout the treatment process while summative evaluations are at the end. For example, a teacher may give pop quizzes to see if students are understanding concepts during the semester which would be a formative evaluation. In this scenario, a final exam would be a summative evaluation. Both types of evaluation serve an important function. Formative evaluations can be especially important for mental health counseling. Benefits of formative evaluations include getting feedback about how the treatment plan is going, allowing the therapist to adjust the plan if it is not going well, and letting the client and therapist have an open dialogue about how the treatment is going. Overall, formative evaluations can be incredibly important in the treatment process and give the client a voice in the matter.

    Reply

    • Lauren Pereira
      Oct 20, 2021 @ 10:58:10

      Madelyn,
      I agree that assessments should be used throughout the entirety of the counseling process. I believe that it does help the therapist in giving them better ideas and understanding of their client and what they may be dealing with. It is important not to miss any big reasonings for a client’s struggle in order to get a positive outcome in therapy. This is the best way to treat each client.

      You also have great definitions of formative and summative assessments. After learning more about each one, it is very distinct at how different they are. You also provide a great example within these two assessments that can help to better visualize the two different types of evaluations. I like that a benefit you portrayed was that in formative assessments, it gives the therapist time to adjust their plan if they do not see much improvements. This is something that can not be done within summative assessments which is why it is so important to have brought it up.

      Reply

    • Tom Mandozzi
      Oct 20, 2021 @ 15:42:34

      Hi Madelyn,

      I appreciated your point about a clinician using statistics and results of assessment to determine whether the client is “on track” based on the current treatment plan. This can inform whether changes or revisions need to be made in the treatment plan to best support progress for the client. I think we often think of assessments as only used to monitor symptoms of mental health disorders, but I appreciated that you pointed out assessments can be used to gather information about relationships, readiness and other aspects of the client. I also resonated with your example of formative assessments as pop quizzes and summative assessments as a final exam. This really helped me comprehend the concepts and apply them to the context of the therapeutic process and counseling.

      Reply

    • Mary Altomare
      Oct 22, 2021 @ 09:12:08

      Hi Madelyn,

      I really enjoyed your explanation of assessments and they clinicians can utilize various assessments throughout treatment. As you explained, assessments are an awesome way for a clinician to track and monitor a clients progress, and if a client is struggling in a certain area, the clinician is able to make the necessary changes to their treatment plan. Additionally, assessments can be utilized to measure how effect treatment was for the client, which provides great feedback for the clinician as well.

      Reply

  7. Lauren Pereira
    Oct 20, 2021 @ 10:39:56

    Assessments are important, not only for determining diagnosis, but also to help therapists get a better understanding of their clients. Throughout assessments, it gives therapists the ability to interpret the information that has been presented to them so they can determine what may be affecting their client. The therapist will be able to analyze this information in a better and more understanding way. These types of assessments can lead to bigger factors that may contribute to a client’s struggle. For example, there may be more to the cause of anxiety than your job, alone. A client may also be feeling anxious because of a tough relationship with a loved one that has been weighing down on them. There can be completely different factors that contribute to these feelings. Assessments will help therapists determine what the hidden constructs may be, which is super beneficial in therapy.

    Formative assessments and summative assessments are portrayed very differently. Summative assessments are cumulative where there focus is on the end result. The evaluation is only at the end and it is based on the counseling as a whole. Formative assessments are continuous evaluations that can track the client’s progress throughout therapy instead of just assessing the final result. Formative assessments seem to be more beneficial for both the client and therapist. Being able to track the client’s treatment throughout the process rather than just at the end can help therapists find more effective treatment. If they see good progress, then it shows that it is positively effecting the client. This will show the client that they are capable of reaching their end goals and they will keep seeing improvements. The formative assessments are more beneficial than summative assessments because you are able to track progression and will be more likely to reach a positive outcome this way.

    Reply

    • Mary Altomare
      Oct 22, 2021 @ 09:08:01

      Hi Lauren,

      I liked the way you explained assessments and the pivotal role these instruments play with a clients treatment. As you explained, there may be several reasons that a client is feelings anxious, and utilizing assessments, a clinician is able to explore more of those reasons. I believe that assessments is a useful way for clinicians to build a strong rapport with their client, because the client can see that the clinician is trying to understand them.

      Reply

  8. Will Roche
    Oct 20, 2021 @ 11:03:53

    Assessments can play a much larger role in the treatment of a client than just being able to diagnose them. Assessments can be used for building a therapeutic alliance, evaluating the process, noting progress within the client, and further direction for future sessions. I think all of these aspects of assessments are very important. It is crucial to build rapport with the client, so using assessments to build rapport can be very beneficial. Walking through assessments and interpreting results to a client can be very comforting in a time where they may feel uneasy. Furthermore, using continuous evaluation of the client’s problems/diagnosis can help the client and therapist get a better understanding of how the treatment is going, and what they need to do in the future. If the client is not improving with the current direction of treatment, it may be time to switch to another approach. If the treatment plan is currently working, and assessments are being used intermittently that show improvement, it is likely that continuing the current treatment plan might be best for the client. That is why it is very important to make sure that assessments are used intermittently, and are not just evaluations at intake and at the end of treatment.

    The two major types of evaluation are formative and summative evaluation. Formative evaluation is more of a continued type of evaluation throughout the client’s time with the therapist. Used to examine the process of how well the treatment is going for their issue (anxiety, depression, suicidality), these evaluations are used more intermittently to determine if the treatment is going well rather than assessing the severity of the issue at the beginning of treatment and then only using this assessment again at the end of treatment. Summative evaluation is focused on the beginning and end of treatment, as previously mentioned. Summative evaluation seeks to look at the treatment process as a whole, rather than intermittently. It looks to see if there is a significant difference between initial intake of treatment and the final outcome. Typically, formative assessments are more helpful to both the therapist and client.

    Reply

    • Tressa Novack
      Oct 20, 2021 @ 21:04:06

      Hi Will, I agree with everything you had to say in your post. Assessments are really important for building the therapeutic relationship. They allow the client to see that the therapist is taking the time to understand them and their problems. I like how you point out that assessments should be used continually and allow the client and therapist to track progress. This is so important because therapists need to make sure that the client’s needs are being met. If a therapist underestimates a client’s problem a client can end up feeling worse than when they began therapy.
      Tressa

      Reply

    • Kristin Blair
      Oct 22, 2021 @ 10:51:58

      Hi Will,

      I really liked your post and agree with all of your points. I really liked your words, “therapeutic alliance” here, such a great description! I also liked how you pointed out specifically that formative assessments are most beneficial for both parties, the therapist and the client. It’s a simple statement but speaks volumes about the importance of this assessment.

      -Kristin

      Reply

  9. Tom Mandozzi
    Oct 20, 2021 @ 15:05:55

    Assessment is important in assessing a client’s needs and reaching an appropriate diagnosis. However, assessment is important beyond reaching this diagnosis and informs treatment planning and identifying presenting problems and concerns for the client. The assessment process continues throughout the duration of meeting with clients and does not stop after a diagnosis is made. As we have discussed in previous chapters, assessment is a pivotal part of the therapeutic process and integral to counseling beyond the intake stage of treatment. Assessment can be helpful in tracking and quantifying progress made with clients and whether symptoms are being better and there is improvement made. Assessment can help a clinician determine a client’s strengths, to what degree the presenting problems are significantly impacting daily functioning, cultural aspects for presenting concerns and determining a prognosis for treatment and future planning. I think assessment can be important for determining readiness for change and how motivated the client is to engage in treatment.

    Formative assessment is a continuous evaluation typically performed to examine the therapeutic process, while summative assessment is more cumulative and focused on a final evaluation. Formative assessment is more focused on the therapeutic process, which is an extremely important aspect of the therapeutic outcome, whereas summative assessment focuses more on just the outcome of treatment without continuous assessment throughout therapy. Formative assessment is beneficial because better therapeutic outcomes result when clinicians receive feedback about progress and observations made throughout the therapeutic process. As Dr. V mentioned in the lecture recording, if assessment and feedback is only implemented at the start and end of therapy, the clinician may find out in the final session that the client is still depressed and there is not an adequate understanding of how much progress has been made in services. However, if a formative assessment approach is taken, the client will be assessed throughout the therapeutic journey and relationship and will receive more feedback about progress to inform a better understanding of how far they have come and where additional treatment is still needed.

    The idea of formative assessment reminds me a lot of my current job. At the agency I work at, the in-home therapy team is encouraged to administer a “progress indictor tool” to the youth and parents we are working with to assess progress and any feedback on treatment goals and interventions being implemented. We discuss the concept of closing services at the time of intake and inform families that we will be having them fill out this assessment-like progress indicator tool (which is a likert scale ranging from 1-10) every three months to better inform treatment and plan for closing when appropriate. If we complete intake assessments and gather information at the start of services and then don’t assess the client until discharge of services, we might not have a clear or comprehensive picture of what progress has been made and what potential needs have not yet been met in treatment. By not implementing regular assessment and feedback throughout services, the client may also not feel prepared for closing services and the termination might feel too abrupt without proper feedback.

    Reply

    • Kristin Blair
      Oct 22, 2021 @ 10:58:50

      Hi Tom,

      I really like how you presented your summary on the topics in your post. I especially liked that you mentioned the cultural component when describing things that assessments can offer more information on, I feel like that topic may be overlooked often. Your point referencing Dr. V’s lecture about not using formative assessment is a big one here. Summarizing at the end and then realizing that your client may still be depressed is really “dropping the ball” so to speak and something that is extremely important not to miss. It’s a great example to point out the importance of the formative assessment approach!

      Kristin

      Reply

  10. Tressa Novack
    Oct 20, 2021 @ 20:58:06

    There are a few ways that assessments can help therapists understand how problems are affecting clients. Assessments can provide therapists with information on the severity of the problem. For example, the Beck Hopelessness scale and Beck Scale for Suicide Ideation can tell a therapist if a depressed client is experiencing suicidality and the severity of it. Other assessments can provide information on the duration of the problem that the client is dealing with or the types of thoughts a client may be experiencing. These are just a few examples of the information assessments provide, and all of this information is critical when a therapist is forming a treatment plan. Assessments can also provide therapists with information about a client’s strengths and weaknesses, cultural factors that may be affecting the client, and environmental and social factors that may have an effect on the client. Using all of this information a therapist can come up with a treatment plan that best suits the client and avoid underestimating the client’s problem as that could lead to the client getting worse if their needs are not being met.

    The difference between formative assessment and summative assessment is that formative assessment is continuous while summative assessment is cumulative. Formative assessments may be given every two to three sessions while a summative assessment is given at the end. The benefits of a formative assessment are that the client and clinician are receiving feedback continuously throughout treatment. This allows the client and therapist to track the client’s progress. This is important because it allows the pair to make changes if progress is not being made. If progress is being made, it makes the client aware of the progress when they might not otherwise realize it, and this can help keep the client motivated to keep working hard.

    Reply

  11. Kelsey McGinness
    Oct 20, 2021 @ 21:26:50

    Assessments hold a broader role beyond solely determining a diagnosis for an individual. Assessments are also used to determine how the client’s daily life is being impacted through sleep, work, social life, etc. By gaining a better understanding of how various areas of the client’s life is being impacted by the presenting problems can help a therapist direct specific conversations and create specific examples of how to change and work on the client’s life. For example, if a client is battling depression and their social drive is being impacted to where they are no longer seeing people, stay in bed all day, avoiding social and work responsibilities, then their therapist can dive deeper into those situations to better understand and develop triggers.
    Formative assessment is when a therapist continuously provides a client evaluations to routinely check in on how they are doing, how they are feeling, and what is being impacted in his/her/their life. This is beneficial because it allows a therapist to navigate the path of therapy to help a client from get to their start point to their end point of healing. This can also help a client see their own progress which provides a sense of satisfaction and pride. Summative assessment is a cumulative and final assessment which assess how the client is solely at the end of therapy. This does not show how a client got to where they end up. This focuses mainly on the final product of a client’s therapy. The difference between the two is that one aka formative assessment focuses on a client’s progress from start to finish, while summative focuses on the end of therapy and where the client is at that point in time.

    Reply

    • Alexis Grey
      Oct 21, 2021 @ 16:16:31

      Hi Kelsey

      I like how you talk about specific factors to be interested in as therapists like sleep, work, eating etc, because it is so true that the more information, we have the better, and I think the more clues or puzzle pieces we have the better more accurate conclusions we can make and the more effective treatment will be for the client. I agree too that adding specific layers to the conversations we are having with the client is a great point, if we can make ourselves and them more aware of patterns or areas of concern then the collaboration will be stronger in therapy also. Knowing as much as possible about the specifics in a persons life makes our decisions about treatment more informed and hopefully create a better more tailored / individualized experience for clients.

      Reply

  12. Olgena
    Oct 20, 2021 @ 23:01:52

    This chapter, and lecture recordings were a great lesson to learn, train, and educate ourselves more about the importance of assessment not only as a tool that serves to diagnose clients, but also as indicator of their; problem identifications, cases formulation, future goals and interventions. Working as a behavior therapist, I can truly relate my experience with many points Dr. V made. First I could not agree more when he explains that the judgment of a clinician should not stop and be limited after those first intakes. I have been present where many treatment plans need constant improvement within time, based on client continuity. Second, there are a lot of socio- economic factors that could play important role toward an individual mental issues ( positive and negative). Third, cultural factors play a very important role that should carefully be considered by a clinician. For example, I have worked with clients from different countries and diverse cultural backgrounds, whose families expectations about their child could be more specific toward their focusing points and future outcomes. It is important for a therapist, clinician, to find the best adopting links between these requests and a productive treatment plan.

    To continue, formative assessment refers to continuous evaluation of your client and helps to examine better their outgoing during therapeutic progress. Summative assessment, refers to cumulative evaluation that is made in the end of the therapeutic process, in contrast to the formative assessment which takes place in several sessions. Moreover, formative assessment also allows the clinician to modify their treatment plans, and serves as a tool to support future feedbacks that are important to explain to your clients their progression. Furthermore, this type of assessment also contributes in acknowledging better their strengths, feelings and helps improving client-therapist relationship.

    Reply

    • Alexis Grey
      Oct 21, 2021 @ 16:10:59

      Hi Olgena

      I agree with you and Dr. V that it is so important to remember not to make the mistake of placing too too much weight in the assessments done at intake as the end all be all – we need to always remember that results of assessments are tentative rather than absolute just as we learned in the last chapters when discussing reporting results to clients, Therapy is a process and each client is an individual, we need to have eyes and ears open and remember that assessment is a helpful tool to guide decisions, but should not be viewed as the absolute unchangeable truth of a client. People are so much more complex than that.

      Reply

  13. Emily Barefield
    Oct 20, 2021 @ 23:12:05

    The use of assessment in counseling is most beneficial when it is used throughout the entirety of the counseling process. While assessment is certainly useful in determining diagnoses, it has much more value when integrated throughout treatment. At the beginning of treatment, an assessment can be used to determine to what degree the presenting problem is affecting the daily life of the client in addition to determining if the problem meets criteria for a diagnosis of a mental illness. An assessment may measure how much environmental and social factors are contributing to the distress the client is experiencing. Assessment is useful in gaining a more complete picture of the experience of the client. Assessment can also be useful for determining a client’s strengths. This is potentially useful because these strengths can be utilized in the development of the client’s treatment plan and should be kept in mind when collaborating with the client on their treatment goals. Throughout the course of treatment, assessment is a useful indication of progress or lack thereof. Assessment can be used to show improvement overtime, and if improvement is not occurring, the therapist is able to modify their approach to benefit the client. It can also be used to measure changes in a client’s behaviors, environment, or social relationships, which have the potential to affect their treatment outcomes.

    Summative assessments are concerned with the endpoint and are a final evaluation. The focus of summative assessment is on the product. Summative assessments are certainly useful. They provide an indication of the effectiveness of a treatment and of the clinician’s effectiveness in implementing the treatment. Formative assessments are continuous or intermediate evaluations that allow for the examination of the therapeutic process. Formative assessments focus on evaluating the process and are beneficial because they provide the clinician with feedback on the treatment plan as it is occurring. This gives the clinician the opportunity to adjust the treatment plan while they are still working with the client. Formative assessments have the potential to make clinicians of a disconnect between the client’s experience and the clinician’s interpretation of that experience.

    Reply

  14. Alexis Grey
    Oct 21, 2021 @ 16:04:15

    Psychological assessments are used for more than strictly creating an accurate diagnosis, they are also helpful tools in planning treatment, describing or categorizing the severity of patient symptoms, track progress or changes in the clients’ symptoms or behaviors overtime, and predicting future behaviors. In treatment planning, various assessments can be used to better understand individual nuances of the client so that treatment can be more effectively tailored to their unique needs and personality. Counselors should evaluate to what extent the problems or symptoms are affecting the client and what that client has in terms of strengths and weaknesses which can be used to benefit, or which may hinder the therapeutic process. Understanding the client better in terms of level of impairment, level of distress, and their subjective experiences allows for better treatment matching, and thus better outcomes. Different clients may report dealing with their distress in very different ways, mental health affects us all differently and.] in addition we tend to communicate very differently. Some clients may be very aware and vocal about the level of distress they are experiencing and how it is affecting them, while others may be less aware or less forthcoming about the severity of their struggles. This is why assessment is important beyond diagnosis to monitor client levels and progress or decline over time.
    Monitoring progress or changes in symptoms and behaviors over time also gives the counselor the ability to judge if the therapeutic approach is effective or not. If not, then the counselor / therapist is able to make adjustments to the approach.

    For example, if we measure someone’s level of depression and see it getting worse, we can bring that up in therapy and it gives us a clue to something going on in the person’s life, or it can be a sign that we need to make adjustments in our efforts to help that individual. If we make adjustments and then see a client’s depression getting better, we can be encouraged that the new approach is working better. Continuous assessment means we have better insight and a better ability to make therapy effective for each individual. Formative assessments are continuous and designed to evaluate the therapeutic process or the effectiveness of the counseling services someone is receiving. The benefit of formative assessment is that it is done as a way to judge the quality of the services while there is still opportunity to improve, change or adjust the service approach. In other words, it allows us to intervene when things aren’t going as well as they could be. Summative assessments are given at the conclusion of the therapeutic process and offer a “summary” of the effectiveness of the services as a whole.

    Reply

  15. Monika
    Oct 21, 2021 @ 17:02:16

    Even though assessments are mainly used for case formulation and creating treatment plans, like Dr. V said assessment is a continuous process. A good assessment can help us determine the degree to which the problems are affecting the clients. (e.g. the frequency, the intensity of the issues). Assessments can also help better understand a person’s strengths and weaknesses, identify potential problems with cognition, emotional reactivity, and then make recommendations for treatment/remediation. Everyone has strengths and weaknesses relative to their own abilities; it is helpful to inform individuals from testing of what their strengths are and how to use these to compensate for any documented weaknesses they may have. The information helps empower people to develop and grow, and results obtained from the psychological assessment can help people be more informed. The assessment also fosters rapport-building with clients in the form of a joint understanding and decisions on interventions or treatments. The test process engages and empowers, it communicates genuine respect for the client and has them as an integral part of the process rather than just the ‘subject’ of an assessment.
    Formative assessment is a type of continuous or intermediate evaluation used to assess a process. For example, the formative assessment allows a teacher to keep an eye on the learning of the student as they get feedback that they can use to improve their teaching methods. This technique allows students to gain insight into their strengths and weaknesses to work on target areas that are to be improved. Formative evaluation is an ongoing process and is often referred to as an internal method of evaluation. The endpoint or ultimate evaluation is the focus of summative evaluation, which is more cumulative than formative evaluation. The focus in summative assessment is on the outcome which is why it is called an external evaluation technique. For example, it is used to check if students have achieved what the goal of the training program is. Teachers get the help of the benchmark to assess the achievements of students. The discrepancy between the two is sometimes explained by the fact that formative assessment focuses on the process, whereas summative evaluation focuses on the product. The aim of formative evaluation is to improve upon what has been learned whereas the aim of summative evaluation is to prove the amount of learning that has taken place. The main intention of formative evaluation is that it helps in the development of knowledge and skills for the learners. The individual’s hindrances and difficulties are found out by this method and appropriate remedies are applied to overcome them.

    Reply

  16. Sandra Karic
    Oct 21, 2021 @ 17:14:07

    While determining diagnosis may be what comes to mind when most people think about mental health assessments, there are many other ways assessments can be useful during the counseling process. Assessments can be used to measure a variety of important factors that contribute to treatment outcome. For example, assessments can be used to analyze environmental factors like social support, or factors like coping styles. Researchers have found that making the distinction between clients who are prone to externalizing and internalizing can impact treatment and give the counselor more information on how clients cope with distress. Furthermore, assessments may be used to identify client strengths. Client strengths are not only good information for the client to know but can be used to choose which interventions to use for a particular client in order to maximize benefit. A client’s optimism level and attachment style may also be relevant to treatment.

    Formative evaluations are given to clients continuously throughout the course of treatment. Their purpose is to assess the process of counseling. Conversely, summative evaluations are administered at the end of treatment and their purpose is to measure the product of counseling. Formative assessments have many benefits and give the counselor more information during the course of treatment. This information can be in regards to how a client is responding to a particular treatment or whether they are even responding at all. Results of formative assessments allow the counselor to modify or adjust treatment plans if needed depending on the assessment results. Finally, conducting formative assessments may strengthen the therapeutic relationship

    Reply

  17. Moises Chauca
    Oct 21, 2021 @ 19:32:51

    Psychological assessment provides a therapist with more information than only a diagnosis. A good assessment provides enough information that can be used to find a good treatment plan. In addition, it can provide a scope of the in what degree is the problem affecting the client, the client strengths and the developmental track of a client diagnosis. Assessment help therapist understand their client better and influence the treatment plan. Furthermore, assessment helps a therapist see the frequency, intensity, duration, and the impact of the client symptoms on their daily lives. An assessment shows a client strength by high scores in a specific domain in the test. Lastly, an assessment can provide the progression of the mental health issue with or without treatment and help a therapist apply this to their treatment.

    Formative assessment are is a type of evaluation that is continuous or intermediate that evaluate the process. Summative assessment is a type of evaluation that is cumulative and focuses on the final product. Good assessment are usually continuous that evaluate the progress of a mental health illness. Formative assessment provides the therapist the ability to track the client progress and modify treatment if there are new influential factors. Formative assessment influences the treatment result outcome and enhances the therapeutic relationship between client and therapist when collaborating to interpret the results.

    Reply

  18. jeremy
    Oct 21, 2021 @ 22:01:12

    Assessment can help a therapist discover how an illness is affecting the clients life, how severe the diagnosis is, used properly assessments can be used to track progress. Additionally Assemsenmts can be used therapeutically going though question by question can proveid convervstaion statters, allow clients to refect on emotions, and perhaps come to terms with how their mental health is affecting them.
    Formative assessments are used throughout the therapeutic relationship, as such they are better suited or tracking growth, progress, and wellbeing. Summative assessments are a summary of the patient’s time in therapy. These are more common in larger systems.

    Reply

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Adam M. Volungis, PhD, LMHC

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