Topic 6: Using Assessment in Counseling {by 10/8}

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]) – Like you did for last week, complete the following assessments and then take some notes using the “Assessment Review Reflection Questions”: (1) Beck Depression Inventory – II (BDI-II), (2) Automatic Thoughts Questionnaire, and (3) Outcome Questionnaire (OQ-45.2).

 

Your original post should be posted by 10/8.  Post your two replies no later than 10/10.  *Please remember to click the “reply” button when posting a reply.  This makes it easier for the reader to follow the blog postings.

68 Comments (+add yours?)

  1. Tayler Weathers
    Oct 06, 2020 @ 12:37:12

    1. Assessment can help therapists understand how problems are affecting clients by getting at their relationships and elements of client functioning the client may not be aware of. For example, maybe the client never thought about how their depression was affecting their energy – they just felt tired and attributed it to something else. Issues like social relationships or interpersonal functioning (for example, avoidance of friends or feeling less connected) might be understandably more difficult to analyze for someone going through a problem. Assessments can detect those smaller things a client might forget to or not know to say, and a counselor might run out of time to ask. In addition, thinking through assessments might bring to light an issue (maybe tangential to the assessment question) that the client is experiencing.
    2. Formative assessment is assessment conducted repeatedly throughout the process, whereas summative assessment is typically at the end. Formative assessment looks at the actual process of therapy, not just the end result. The main benefits of formative assessment are that it allows the therapist to correct if the client doesn’t like or isn’t benefitting from a technique (for example, maybe they hate how many questions the therapist asks, and it’s making them angry), and that it allows the therapist to actually discuss feedback with the client. When feedback is only at the end, the therapist both can’t fix the problem and can’t discuss it with the client, as they may have already terminated. Feedback also builds the therapeutic relationship, which is crucial during the therapeutic process, rather than after termination.

    Reply

    • Bibi
      Oct 06, 2020 @ 14:53:29

      Hey Tayler,
      I like how you talked about how you can learn a lot about client relationships from the assessment process. I feel like those are often a really important part of the prognosis that help to explain a lot about the client problem. I love the strengths aspect too, that is what I focused on in my discussion!

      Reply

    • Connor Belland
      Oct 07, 2020 @ 12:45:35

      Hi Tayler, I think its important how you talked about assessments being able to show both the client and the therapist a problem or behavior that maybe neither one of them were aware of. Not all of a clients problems they are aware of and often times may not present in therapy so its hard for a therapist to know about them without the help of assessment. A complete and accurate understanding of a client is crucial to the therapeutic relationship.

      Reply

    • Abby Robinson
      Oct 07, 2020 @ 14:52:04

      Hi Tayler!
      Your point about a client having trouble bringing to light some of their problems, but assessments can help bring them about really stuck out to me! I think this is a great way to show how assessment can really detect the severity of the client problems which can then let the therapist make an appropriate goals and treatment plans. It is also helpful that assessments detect the severity of the client problems because when the assessment is given throughout the therapeutic process, the therapist can monitor the severity of these problems and then adjust the treatment if necessary.

      Reply

    • Destria Dawkins
      Oct 08, 2020 @ 20:40:21

      Hi Tayler! I like that you pointed out the fact that assessments can help professionals to understand how presenting problems are affecting clients by getting at the different elements that clients may not be aware of. It is true that a client might not even be aware of how their presenting problems are affecting their daily lives and assessments can help to bring in some insight. I also agree that feedback builds the therapeutic relationship because once a client feels that they can trust their therapist with certain information about them and can rely on the therapist to gain a better understanding of their issues, they will begin to open up a whole lot more. When there is feedback within the therapeutic sessions, there are better outcomes.

      Reply

  2. Bibi
    Oct 06, 2020 @ 14:51:55

    1. Assessments can focus on the strengths of the client problem as well as point to a prognosis. Something that isn’t often emphasized in assessments is looking for client strengths. I feel like we spend so much time talking about how we can look for client problems as well as determine weaknesses, but we can spend a lot of time looking into the strengths of the client as well. You can find out how they have been managing the problem as well as places which you can use their strengths to better help them manage their problems.
    2. A formative assessment is a continuous or intermediate evaluation that is used to examine the process of therapy. You would use this type of assessment throughout the counseling process to measure how the client is doing and how they are progressing in their treatment. A summative assessment is more cumulative that concerns an endpoint or final evaluation. You would use this type of evaluation at the conclusion of therapy. A formative assessment has more benefits that include allowing the counselor to track how the client is progressing in therapy. The counselor can then use this information to update or change the treatment plan.

    Reply

    • Connor Belland
      Oct 07, 2020 @ 12:56:26

      Hi Bibi, I like how you mentioned how assessments also highlight the strengths of a client and not just their weaknesses. So often therapists just focus on the negatives or fixing a client’s problems when really they should not only be doing that but also highlighting the clients positives or strengths. This can be an effective and beneficial part of therapy for the client that is often overlooked by therapists, but assessments help us see it more.

      Reply

    • Tayler Weathers
      Oct 07, 2020 @ 16:13:04

      Bibi, I think your point about client strengths is so important. I like that there are assessments that actually look for strengths – because not only does that make it easier for the counselor to remember to do it, but it also helps the client not get so bogged down in their problems. A reminder of strengths, and of good things, is not a bad thing! Plus, I think that a client will feel way more heard if you ask about strengths too.

      Reply

    • Maya Lopez
      Oct 08, 2020 @ 17:33:19

      Hey bibi,
      I really loved the point you made in your last sentence for question 1. Not only do assessments help us see clients’ strengths but it also allows insight for us to help them use their strengths in a better way. I also liked how you mentioned assessments can help us see how the client has been trying to manage their issues thus far, what has worked and what hasn’t. Lastly, I agree that formative assessments are better for tracking client progress and using that new info to reassess the treatment plan.

      Reply

    • Nicole Giannetto
      Oct 11, 2020 @ 11:09:08

      Hi Bibi! I agree with you that strengths aren’t always focused on as much as they should in therapy. With assessments, both weaknesses and strengths can be identified in the client’s answers. For example, if a client answers on the BID that they have experience a loss of interest in activities they typically enjoy nearly everyday, but they also answer that they do have hope for the future, then the clinician can find ways to incorporate the hopefulness about the future into therapy. By highlighting this positive aspect, it can get the client to start thinking about the strengths they do possess despite their problems that they experience.

      Reply

  3. Elias Pinto-Hernandez
    Oct 06, 2020 @ 18:14:21

    (1) Assessment has a broader role beyond just determining a diagnosis. What are some ways assessments can help therapists understand how presenting problems are affecting clients?

    The assessment process (test and interview) can provide the clinician with vital information about the clients’ difficulties, facilitating the client and therapist’s exploration of the best methods to deal with them. Assessments are necessary not only at the begging for intake but also for case conceptualization, treatment planning, and to monitor treatment progress. In addition, at the end of the treatment process, to detect whether there is any symptom remaining. Therapists can benefit from assessment in terms of understanding how presenting problems are affecting clients if feedback is received. Research shows that clients have a better therapeutic outcome when the provider receives feedback. A study demonstrated that therapists could only identify one out of forty clients whose mental health deteriorated during therapy. The return information can be obtained with a short assessment at the beginning and end of every session. Evaluations can serve as a compass to the practitioner.
    In short, studies demonstrated that clinicians are often biased in their clinical judgment, and I believe that looking to specific items besides the total score in formal and informal assessments is necessary to identify problems affecting the client.

    (2) What is the difference between formative assessment and summative assessment? What are the benefits of formative assessment?

    I understand the formative assessment as an instrument that allows the clinician to search empirically for the ongoing progress of the therapeutic process during treatment intervention—a mechanism to receive feedback from the client. Alternatively, a tool to measure the therapeutic process as it goes (on the process). On the other hand, summative assessment is an evaluation to gather cumulative data and is usually administered at the end of the therapeutic process.
    As we notice, the formative assessment and summative assessment are used to record the counseling effectiveness; yet, there is a massive difference between them. The two processes evaluate the counseling services mainly for accountability reasons. However, the clinician must consider that if no therapeutic progress is detected after scoring a summative test, there is little to be done; oppositely, with a formative examination, the provider would be able to monitor treatment progress, could predict potential obstacles and take corrective actions that can lead to a positive outcome.

    Reply

    • Beth Martin
      Oct 07, 2020 @ 18:57:59

      Hi Elias!

      I really liked the term “mechanism to receive feedback” that you used for describing formative assessment! It’s a really great summary of what the non-client facing side of assessment. It’s incredibly important that a therapist has information at their disposal to evaluate their own performances too; as you said, getting feedback has been linked to better therapeutic outcomes for the client, and being able to assess oneself without having to ask a client for feedback directly is a great way to boost those odds. I’d imagine it’s especially useful for newer therapists, as I know I definitely will be more hesitant about directly asking “how am I doing?” the first few months I’m working! You get information that’s vital to the therapeutic process and your own development as a therapist, without that layer of vulnerability/awkwardness in those early days.

      Thanks for posting!

      Reply

    • Nicole Giannetto
      Oct 11, 2020 @ 11:14:54

      Hi Elias! I like how you elaborated on the various uses of assessments in counseling. I agree that they have so much more use than just for an intake session. Using assessments throughout the therapeutic process is helpful for both client and clinician because it can monitor and track progress and can highlight specific issues or symptoms that may need to be focused on more. Formative assessments have the ability to do just this, which gives them greater utility in therapy.

      Reply

  4. Abby Robinson
    Oct 07, 2020 @ 12:08:23

    Assessments can help therapists understand how presenting problems are affecting their client because it can show the client’s level of functioning. The assessment can help figure out how much the client’s presenting problems affect the client and how strongly it is affecting them. Assessments can show how greatly the problems are effecting important parts of their clients lives, like their personal relationships, their job and also how well they are functioning in every day life. This is important because then these factors can contribute to the therapist’s goals and treatment plans and case formulation. This leads to the therapist being able to determine the most appropriate way to address the problems and meeting their client’s needs by giving assessments throughout their therapeutic process. Assessments can also be an important factor that contributes to the development in their therapeutic relationship.
    Formative assessments are evaluations that are given throughout the therapeutic process, i.e. multiple times. This helps examine the process. Summative assessments are evaluations are cumulative in that the focus is the end of the process. The benefit to formative assessments is that it gives the therapist opportunity to modify the interventions and helps them conceptualize the client’s problems. That way, each time the assessment is given, you can evaluate how well the intervention plan is going and then adjust according to the assessment results. Giving the assessment many times throughout the therapeutic process also helps build therapeutic relationship because this allows collaboration between the therapist and client when the goals and intervention plans are set and/or adjusted. This should help keep the client motivated to work towards their goals.

    Reply

    • Bibi
      Oct 07, 2020 @ 12:15:38

      Hey Abby
      I really liked how you added how assessment can build the therapeutic relationship. I feel like the book talks a lot about how beginning counselors are afraid to use assessment because they don’t want to hurt the relationship and I feel like it is often overlooked how beneficial assessment can really be. You can also use them to change or modify your treatment plans which is huge!

      Reply

    • Tayler Weathers
      Oct 07, 2020 @ 16:13:19

      Abby, I think you’re so right that formative assessments help client motivation! One of the crucial pieces of the therapy process, at least in my experience, was understanding how what we were doing fit into the whole picture, and why we were doing stuff. If a therapist forgets to explain, and a client feels like something is pointless, then a formative assessment will allow the therapist to correct it. That way the client doesn’t dread therapy later on, or decide it just isn’t working or interesting anymore! I do wonder what is the most important stuff to

      Reply

    • Beth Martin
      Oct 07, 2020 @ 18:50:13

      Hi Abby,

      You make a great point on how assessments look into how things are going in day-to-day life. I think it’s easy, when you’re in the midst of a depressive episode, for example, to not really be able to see the wood from the trees, and how things are genuinely affecting your life. Assessments are great in that regard, as they can link things to presenting issues that an individual may not have even considered. I think somatic symptoms are a great example of this; I know a lot of people, anecdotally, that don’t realise hypertension, jaw pain, headaches, muscle aches etc. can be a symptom of depression. When they’ve sat down with therapists who’ve explained that to them, I think it’s been a bit of a relief to them – they don’t have some mystery illness that’s plaguing them, and it allows them to focus better on what their presenting problems affect in their lives.
      Thanks for posting!

      Reply

    • Anne Marie Lemieux
      Oct 10, 2020 @ 13:05:44

      Hi Abby, I thought your point about assessments being able to better assess a clients level of functioning is a good one. I think assessments may assist in bringing awareness to areas of need that a client may not even be aware of as an issue. For example, as we discussed in class people with substance abuse issues may be in denial about the level in which it is impacting other aspects of their lives. Assessments can definitely give clarity and focus to appropriate treatment and in turn enhance the therapeutic relationship. Thank you for your insight.

      Reply

  5. Connor Belland
    Oct 07, 2020 @ 12:36:14

    Assessments have many uses during therapy that isn’t just getting diagnoses. One way assessments can help is that they really help a client learn more about themselves and just get a better overall understanding of their situation. Self-awareness is an important aspect of therapy for a client so it helps when an assessment can help a client see a new perspective of themselves and their presenting problems it can help them a great deal to progress more efficiently in therapy. Assessments also help the therapist get a deeper understanding of a client which is also beneficial for a therapeutic relationship. An assessment might highlight an issue with the client that might not always come out naturally in a conversation with the client which is helpful because we want to be able to help the client with whatever is bothering them even if they don’t explicitly tell us about something. Then towards the end of treatment you can assess them again to see if any of these problems are still sowing up in the client, which makes assessments are great measure of progress of a client.
    A therapist can choose to use either formative or summative assessment in therapy and each has their differences. Summative assessments are more cumulative and are typically given right at the start of therapy and then again at the endpoint. They mainly focus on a final evaluation at the end of therapy. A formative assessment focuses more on progress. They test clients more continuously and intermediately to get a better understanding of clients on a more current basis. Formative tests are better because they give us a close more current understanding of the client. You get to see if therapy is making good progress in the client instead of waiting until the end to see if your treatment plan is working. You also don’t want to wait until therapy is over with a summative test just to learn that the client still is dealing with some problems.

    Reply

    • Abby Robinson
      Oct 07, 2020 @ 14:43:06

      Hi Connor!
      I’m glad you brought up the importance of self awareness when explaining how assessments can be helpful to therapists. I think this draws light to client’s problems in ways that they never thought of. This is important to keep up the motivation for the client because if they aren’t aware of the problems and all the components that come with them, they may not be apt to change. If they are more motivated to change then outcome will most likely be positive.This is a great way assessments can help therapists when determining the severity of the problems the client is presenting.

      Reply

    • Destria Dawkins
      Oct 07, 2020 @ 21:41:29

      Hi Connor! Yes, I like that you pointed out the fact that assessments are used to help create self-awareness in an individual in order for them to have a better understanding of their presenting issues. This shows just how important assessments are because they can help to build trust within the therapeutic relationship, between helper and client. Once the helper and client get into deeper discussions and work together to fix the presenting problems, the client will begin to feel comfortable enough to open up more.

      Reply

  6. Pawel Zawistowski
    Oct 07, 2020 @ 18:12:39

    1. Other than making a diagnosis, assessments can also help determine how much certain problems are affecting a client. They can give you small details and indicator of what the therapist can go over in the next therapy session. They can help a therapist get a better idea of the intensity, duration, and frequency of each symptom. It gives the therapist insight of how much certain problems may be affecting the functionality and daily life of the client. It can also give details about social aspects of the client’s life such as personal relationships (friends, significant others, family, occupational relationships, etc.) as well as how things are at work or school. It does not only give information about the problems of a client, but they can also be used to identify the client’s strengths. Assessments can give us an idea what the progression may look like, as treatment continues and the effectiveness of interventions.

    One example of how assessments are useful, say a client reports that are very likely to experience severe anxiety when eating in public restaurants, but not as severely in other situations. Such information is useful to determine how intense the anxiety is (severe) and when it occurs (eating out in public places). This information can also be compared to other situations that induce anxiety to get a better overall understanding how anxiety impacts the client’s life. Such information can be very useful in developing a treatment plan as it tells us where the problem lies and how we may go about prioritizing certain problems over others and how interventions will be used.

    2. A formative assessment is a continuous or intermediate evaluation and is used to evaluate how the client is doing. It allows the therapist to understand the progress or where the client stands as the therapy sessions continue week by week. A therapist does not need to give an assessment every therapy session, however it is encouraged to do every other or every third session. It is especially important because it provides the opportunity to modify treatment and adjust things as time goes on. It allows the therapist to determine what is working and is not working, and can help them weed out certain strategies that do not work and replace them with new ones. Summative is usually used at the end to sum up the overall progress the client has made and is used to measure the effectiveness of treatment as sort of a final product.

    Reply

    • Tanya Nair
      Oct 07, 2020 @ 20:49:16

      Hi Pawel, thank you for your post. I really enjoyed the example that you used to explain how assessments are useful. A good point you bring up that I did not think about is highlighting areas which the client is competent in. I feel like this contributes towards making sure the client is aware of things that are positive which may help treatment. Oftentimes, we think of only the negatives and ways to solve the negative things without giving any praise or reward to the positives. I liked how you touched base on a variety of things that show how certain problems are affecting a client. I think it is also important that you mentioned how formative assessments allow the therapist to understand what strategies are working and not working. I think that not only are these assessments important to the therapist but to the client as well. This is because if the client understands what is working and what is not, they will also be able to play an active role making sure they are seeking out helpful strategies and communicating their needs with the therapist.

      Reply

    • Lina Boothby-Zapata
      Oct 10, 2020 @ 15:43:53

      Hi Pawl,

      This was a nice clinical example about “a client having anxiety when is eating in public places.” I thought about claustrophobias and how important it is to analyze these symptoms. As future counselors, we need to assess how severe the symptoms are, what is the intensity and frequency, where these symptoms happen, and what type of situations trigger the phobia, in this case. I agree with you that the counselor should be looking at how the symptoms impact the client’s life; how functional the client can be in his daily life, such as work, family, and any other settings the client is linked. If the counselor answers these questions related to the client’s problems, then he/she will have the clinical content to present a treatment plan and goals to the client, and type of interventions. Furthermore, a better understanding of the client’s problems will enhance therapeutic rapport.

      Reply

  7. Beth Martin
    Oct 07, 2020 @ 18:46:15

    Assessments can highlight how a problem is affecting their client in multiple ways. Although a therapist may have an inkling that a client may have depression, for example, an assessment will help identify how it is affecting them. An example of this can be seen in the OQ-45; it asks questions about somatic symptoms that a client may not have linked with their presenting problems. There are many aspects of mental illness that individuals do not associate with the illness itself, such as having trouble maintaining relationships or being more argumentative. Therefore, the assessment allows therapists to explore problems that a client may not be aware of, or able to communicate. Additionally, assessments also highlight which areas a client is competent in, or not having issues affect them. A client may not be experiencing issues at work in relation to their presenting problems, and this information from the assessment allows therapists to better understand the overall nature of their client’s issues. There is also the aspect of bias that assessments help counteract. Newer therapists will often underestimate how severely problems are affecting their clients, which in turns leads to negative outcomes. However, using a series of assessments shows a more empirical view of severity, suggesting to the therapist that their initial beliefs were not accurate.

    Formative assessment is continuous evaluation that is used to examine how therapy is going. Good assessments are formative, in that they are given multiple times throughout therapy to consistently assess how a client is progressing, and ideally getting better. It gives a therapist more information to work with throughout therapy, and it allows a therapist to alter their goals/methods for the needs of a client on a more regular basis than if they were not constantly assessing. Summative care, on the other end, is a final assessment that is used to evaluate how well therapy has worked for the client. As mentioned previously, formative assessment allows a therapist to know how their client is progressing session-to-session, and change their tactics to get the best possible outcome for the client. It also helps build the therapeutic relationship, as a client knows that their therapist is motivated and engaged into seeing how they are progressing and changing on a regular basis, not leaving them to go through the process without checking in on them.

    Reply

    • Tanya Nair
      Oct 07, 2020 @ 20:39:09

      Hi Beth! Good job using examples to help explain and get your point across. I feel like all the examples you used contributed directly to helping me understand the concepts fully and the ideas surrounding assessments. A good point you bring up that I did not think about is highlighting areas which the client is competent in. I feel like this contributes towards making sure the client is aware of things that are positive which may help treatment. Oftentimes, we think of only the negatives and ways to solve the negative things without giving any praise or reward to the positives.

      Reply

      • Elias Pinto-Hernandez
        Oct 10, 2020 @ 15:50:43

        Hi Tanya, I also believe that Beth has a remarkable way to present her comments on every week’s topic. An assessment (in black and white) can help client to “see” or identify if there is a behavior or problem that there are not aware of. In addition, the client and therapist can identify the client’s strength, which could helpful for therapy.

        Reply

  8. Lilly Brochu
    Oct 07, 2020 @ 19:28:26

    Assessments have a broader role other than determining one’s diagnosis. Assessments can determine the impact of a client’s problems and how they are negatively affecting their everyday functioning. Furthermore, it can provide the clinician with more information about other parts of the clients life that may not be shared face to face (e.g., family or work life). Clients may be unaware that a specific problem in their life could be causing their unhappiness and distress. Assessments can help the client recognize any problems that they may have not acknowledged or identified for themselves. The results of the assessments provide the clinician with the information needed to provide the proper treatment plan or interventions. Furthermore, assessments should be used to not only show the client’s weaknesses, but also their strengths. By noting the strengths and weaknesses of the client, this can help to create a more positive outlook for the client of themselves, their problems, and experiences going forward in the therapeutic process.

    There are two major types of evaluations: formative assessment and summative assessment. Formative assessment is a continuous evaluation that takes place multiple times throughout the therapeutic process. Formative assessments are used throughout therapy (between every 1-3 sessions) to gather information about the client’s progress. By assessing multiple times throughout the duration of the relationship, it allows the clinician to have more opportunities to help or change their treatment plan to match or fit the client and their needs. Overall, formative assessment is the best option and has better outcomes because the clinician is consistently assessing their own abilities, the progress of the client, and what the clinician could do better or improve on in their relationship. On the contrary, summative assessment takes place at the end of the therapeutic relationship that examines the client’s progress overall and how their experience in therapy has/has not helped them. Summative assessment does not provide us with the feedback we need (especially as beginner therapists) to help our clients in the ways that they need us to and are not as beneficial or useful for both parties involved.

    Reply

    • Pawel Zawistowski
      Oct 08, 2020 @ 17:41:34

      Hi Lilly, I think it’s very important you mention that the client can be unaware of certain problems in their life. Assessments can not only help identify the problems but also get the client thinking about them in a therapeutic way. Also, I do like that you mention that it is not to only focus on the problems the client is facing and the negative aspects of their life, and that assessments can also be used to identify strengths. I also think that, assessments can be used to measure and compare severity of certain symptoms which is a useful tool for a therapist.

      Reply

    • Christina DeMalia
      Oct 10, 2020 @ 13:40:54

      Hi Lilly,

      I really like how you pointed out what assessments can do for the client’s themselves. Although in many ways assessments are used for the therapist to gain a better understanding of the clients presenting problems and the role they play, they could also be used to inform the client. Someone may have become adjusted to feeling depressed all the time, and it is only when they take an assessment, see their answers on papers, and hear their score that they are able to recognize the significance of the problem. I think that when assessments are presented as something that can help both the client and the therapist and lead to better treatment, it becomes easier to get the client to engage in the process collaboratively.

      Reply

  9. Anne Marie Lemieux
    Oct 07, 2020 @ 19:44:14

    Assessments are multifaceted. They can help therapists in many ways but specifically how depends on the assessment that is chosen to be used. It can be used initially to better understand a client’s vague concerns and narrow in on the presenting issues. In using assessments as part of the assessment process it may not only help to clarify specific issues but help to build rapport. They may give the sense that you and the client are working towards the same goal. Assessments can help lead you to better understand the direction of interventions and treatment. They may give a therapist insight into client habits and coping strategies. More specifically it could indicate if substance abuse issues are a contributing factor. It can also indicate what protective factors the client may have so that they can be built upon.

    Formative assessments are used to monitor the progress of an individual. It can provide feedback about their growth and next steps needed to move forward towards their goal. It is a self-reflective process that can be a powerful tool in gauging change. Summative assessments are exactly what they sound like, a summary. They summarize the development at a specific time. They are not used on a continuous basis but rather as an assessment of learning. However, formative assessments are used to to learn from.

    Reply

    • Zoe DiPinto
      Oct 08, 2020 @ 13:22:40

      Hey Anne! I hadn’t thought about your point of using an assessment to narrow in on one issue. I think it would be very useful! I’m sure therapists encounter many people who have generalized fear and sadness who may have trouble focusing on one aspect of their life that may be causing them stress. I enjoy the thought of using an assessment to make the issue more clear in testing whether they have a support system, worry about productivity, have existential fears, or etc. I’m sure that would save some time and prevent the client from spiraling when used correctly.

      Reply

    • Elizabeth Baker
      Oct 10, 2020 @ 14:12:15

      Hello Anne Marie,
      I love how you started your post by defining the multipurpose of assessments. I feel that when I first heard about assessments, I had a narrow view of them; that they were just used to assess client’s severity of symptoms. Now that I’ve been continuously educated on the multiple uses of assessments, I can truly understand how vital they are during the therapeutic relationship. These assessments are used to help clients understand the true impact their symptoms have on their lives, and can help them view their daily actions and thoughts with a more serious mentality. Assessments can not only be used for that, but can help the client become more introspective, or at least that’s one of the hidden hopes behind assessments.

      Reply

    • Elias Pinto-Hernandez
      Oct 10, 2020 @ 15:47:46

      Hi Anne,
      I agree with your remark on this week’s topic. Assessment can assist the clinician in many ways, especially if the therapist integrates the questionnaire as part of the therapeutic process. Another strong point you present is the rapport building. I believe that the counselor should seek that positive relationship in every encounter with the client.

      Reply

  10. Tanya Nair
    Oct 07, 2020 @ 20:22:28

    After watching the lecture, I now have a broad sense of other ways assessments can help therapists understand how presenting problems are affecting clients, other than determining a diagnosis. Assessments are also important towards determining things such as how the client lives their day to day life, how work is going, and how they are impacted socially. One of the things I think is important to grasp from assessments is the client’s readiness and motivation to change. According to the assessment, a therapist can understand where the client’s head is at in order to create a unique plan going forward. Assessments seem to also bring out an important aspect that client’s may not always feel comfortable talking about. This is a good way to determine other problems and speak more about them, which can bring more awareness. I think according to this, a therapist can better see how a client’s motivation or lack thereof is affecting them. Determining not just the diagnosis but a treatment plan through looking at the various ways that assessments can help therapists is important towards successful treatment.

    Formative and summative assessments are techniques used by clinicians to evaluate how much information one has learned. Formative assessments are assessments given throughout the session, whereas summative assessments are solely at the end of a session. Summative assessments is used more at the end of a session by looking at the final result of where the client has come. It is sort of the sum of the sessions or kind of “final exam.” Formative assessments are beneficial to both clients and therapists because they allow them to understand where an individual is and the progress made. It also allows the therapist to see which strategies have worked well and ones that have not worked well and create goals from the progress (formative) assessments.

    Reply

    • Lilly Brochu
      Oct 08, 2020 @ 12:32:41

      Hi Tanya,

      Assessments prove to be helpful in so many ways. Prior to this, I assumed that assessments were only used to ultimately get a diagnosis of the client. However, assessments give the clinicians more information about the client through the answers they provide. You mention readiness, motivation, and self-awareness of the client in being indicators that the client is welcoming to change and progress. I think these are all important signs to look out for while administering assessments and examining the overall results of the client’s progress. As for my own understanding of formative and summative assessments, formative assessments prove to have the better therapeutic outcomes because of how consistent the therapist is “checking in” with the client and their progress. It makes more sense to take this approach rather than a summative approach because the client is given positive (or negative) feedback and the therapist can change or adjust the client’s treatment plans or goals accordingly.

      Reply

    • Anne Marie Lemieux
      Oct 10, 2020 @ 13:12:39

      Tanya, I think your point about assessments being a tool to help gage a clients motivation level is one I hadn’t thought of. Using assessments to better understand a clients readiness and motivation to change is essential in treatment planning. It will allow a therapist to appropriately encourage, support and empower clients based on their need level. As noted in class, just saying “they weren’t ready to change” can be an excuse for a therapist. If you know at the beginning that motivation is problematic you can address it early.

      Reply

  11. Destria Dawkins
    Oct 07, 2020 @ 21:29:21

    1. Assessments can be helpful in bringing in insight. They can help bring clarity of focus for both patients and professionals. Assessments help to keep a clear focus on the issues that are being worked on and why. They can help professionals to keep a common set of goals with patients. Assessments are used to provide valuable insights into a patient’s skills, behavior, thoughts, and personality.
    2. Summative assessments are fixed assessments that come at the end of lessons or courses. Summative assessments are based upon a formal process that is highly structured and normalizes scores for comparison against a standard. Summative assessments produce a grade and evaluate the end result, not the process. Formative assessments are ongoing and flexible. They are incorporated into the lesson and they are based upon an informal process. Formative assessments focus on patient performance and provide feedback. Formative assessments are beneficial because they help to open up communication and focus on growth. Because formative assessments include setting learning goals and measuring the process towards those goals, this type of assessment helps to increase motivation.

    Reply

  12. Cassie Miller
    Oct 07, 2020 @ 21:48:10

    Assessment is very important in the counseling process and extends past simply providing a diagnosis. It must first be understood that assessment is continuous, meaning it should be provided throughout the entire therapeutic process. This will allow for the possible revision of treatment plans, as well as, providing the client and therapist with feedback on treatment progress. This feedback, or benchmark of progress, may not only motivate clients to continue incorporating these skills into their lives, but also increase the likelihood of a positive long-term treatment outcome for them. In addition, assessment helps the clinician: figure out the degree to which the problems are effecting the client, identify the clients strengths and weaknesses, and help develop a prognosis for them. Sometimes assessment can also point out cultural issues that should be considered, as well as, important social/environmental variables that can impact a clients prognosis. All in all, assessment is able to keep both the client and clinician informed and accountable.
    The main difference between a formative assessment and a summative assessment really has to do with what is being evaluated. A formative assessment is an ongoing or intermediate evaluation that is mainly conducted to examine the therapeutic process. These assessments are much more flexible and are often viewed as more informal. Thus, we are receiving a more continuous evaluation when using this assessment. A summative assessment is more formal and structured. It is a more cumulative measure that focuses mainly on the final outcome or endpoint of the therapeutic process. This is often used to measure how much total progress has been made, thus keeping the client accountable. The benefits of using a formative assessment are mainly that it can be used continuously and that it is less formal. This allows the client and therapist to evaluate treatment progress routinely and make adjustments as needed. It is a benchmark of progress and is a good talking point, due to its informal nature. This assessment is able to catch issues and successes in the client process early on, so that the clients goals and skills for achieving them can be adjusted sooner rather than later.

    Reply

    • Zoe DiPinto
      Oct 08, 2020 @ 13:14:19

      Hey Cassie! I really enjoyed your point about being able to revise a treatment plan with the acquiring of new knowledge from an assessment. I can see how a therapist may be pressured to stick to an original treatment plan that was formulated at intake. In reality, people’s situations are constantly changing and therapists need to be responsive to that. A treatment plan must be adjusted as needed. I imagine it is also important to communicate this to your client! A changing treatment plan is normal and shouldn’t take either the client or the therapist by surprise.

      Reply

    • Viviana
      Oct 09, 2020 @ 10:50:59

      As you mentioned above the benefits of formative assessments and the importance of an early identification of the issues makes a significant difference in mental health field. Reiterating your comment, client goals of intervention should be continuously assessed during sessions to allow the therapist not only formally but informally to assess the client level of progress. When counselors offer the opportunity to clients of participating in the process, not only the client is held accountable but also the counselor would use this to ask oneself if the therapeutic intervention that is being utilized matches the client’s problems. I really liked how you commented in formative assessment of how due to its informal nature it allows the client and therapist to have informal discussions and use the responses as talking point. That being said, counselors should not only diagnose based on a score and ignore the client’s self-reported information.

      Reply

  13. Viviana
    Oct 08, 2020 @ 00:13:55

    Assessments in counseling are not use solely for a diagnosis as it’s an ongoing process throughout the therapeutic sessions. Assessments play a role beyond of just stablishing a diagnosis to address the client’s problems and it is in fact one of the many pieces of information to form a diagnosis. The textbook explains an approach call treatment matching that has been in the field of mental health for a while but gained a strong citation in 2000 by Beutler and colleagues. Treatment matching is when the client’s specific characteristics aligned with appropriate treatment and consequently creates a positive therapeutic relationship. When a therapist has a sound understanding of these characteristics, therapeutic interventions are more effective as the therapist would have a more clear understanding of how problems are affecting the client. Through assessments a therapist would be able to understand to what degree the problems are affecting the client and the daily functioning. The degree is not only referring to the symptoms but the intensity and the duration of those symptoms and the effects on the client’s relationship within the community, personal, job and family environment. A client’s strengths is another characteristic a therapist can gather through assessments. These strengths are capacities that enhances the wellbeing of the client through thoughts, feelings, and behaviors that should be given appropriate identification during therapy. Positive psychology, as indicated by Seligman, focus on the person’s strengths and growth as a human being while taking also in consideration the individual’s weaknesses. Another way assessment can help a therapist understand how the client is getting affected by the presenting problems is to gain knowledge to certain extend about the cultural issues about the client. As Dr. V expressed during the lecture certain assessment might help to gather some information about culture of the client but not to the fullest and that’s why is important to include both formal and informal assessment measurements as it can provide helpful information to determine ways to learn how culture is impacting the client’s present issues and consequently prepare a treatment plan including cultural considerations. Additionally, assessments serve as tool to indicate environmental and social variables which should be included in therapy for a more accurate prognosis. Overall, in one way or another, assessments allow both the clinician and the client to hold each other accountable.
    Formative and summative assessments are two main types of evaluations. What differentiates formative and summative assessments is the type of results a counselor is looking for. Assessments that are formative are ongoing or intermediate evaluations typically use to evaluate the therapeutic process. These type of assessments are flexible and should take place during the counseling process which allows the clinician to have a more up to date notion of where the client is standing. Formative assessments are also informal as it gives the opportunity to the counselor to modify the therapeutic interventions throughout the sessions and hence the conceptualization of the presenting problems. A summative assessment is formal and structured. These assessments are cumulative and focused mainly on an endpoint and not during the therapeutic sessions as formative assessments do. Summative assessments measure the end product and look only for a result at the end of the process. Clients are held accountable in these type of evaluations whereas formative assessments, the counselor is continuously cognizant of the progress and would match the client’s characteristics and enhances the therapeutic relationship. The benefits of formative assessments lies in the fact that they happen during the process of the therapy and not just one time, but several times. In that way the therapist is able to monitor progress and adjust treatment plans accordingly. Counselors also would be able to give meaningful feedback to the client allowing as mentioned above, a positive therapeutic relationship.

    Reply

    • Lina Boothby-Zapata
      Oct 10, 2020 @ 14:32:03

      Hi Vivi,
      I found the matching two very interesting. I am glad you are referring to getting a better understanding of the client’s problems, the quality of the client’s therapeutic relationship can improve. As you said, this information will help us to improve the therapeutic relationship. Furthermore, to formulate the treatment plan, goals, and make clinical decisions such as; what type of intervention can I do with this client. I want to add that Dr.V highlights in the lecture another point is that about the client resistance. He invites us not just to assume that the client is not ready to do insights and learn about how to resolve these problems. Contrary, Dr. V states that counselors need to examine ourselves and answer questions such as; what can I do to improve the client’s relationship?. If the client struggles to identify what automatic thoughts are, ask, what can I do as a counselor to help the client identify? I thought this point is interesting because it allows us to think about the quality of our interventions and what we offer to the client.

      Reply

  14. Elizabeth Baker
    Oct 08, 2020 @ 10:23:58

    Assessments are used to determine future or current diagnosis, but it also allows the clinician to understand how the client is being affected. When going through the therapeutic process with a client, clinicians may not understand the true impact the situation or symptoms are affecting their lives. Clients may go to therapy willingly to get help, but they may feel ashamed or anxious to tell their clinicians the whole truth. Even with clients who give as much information as they can, clinicians may not get the whole truth of the situation. Clinicians never know everything about the client, and the client may not know everything about themselves. That’s why it’s important to give assessments to help the clinician understand the severity of symptoms that the client is experiencing. Assessments may also allow the client to understand the severity of their own situation. Some clients may be in denial of how their situation is affecting their lives, so an assessment may give the client more insight on how severe their situation truly is.

    My understanding about formative assessments and summative assessments is that, formative assessments are continuous through the therapeutic experience and helps understand the progression of the individual’s conceptualization of the topic; summative assessments are focused on the endpoint, it can help understand how much the individual has cumulatively understood the topic, and can help compare performance/scores with other assessment takers. Formative assessments are more flexible and can help understand the individual’s improvement in blocks throughout the therapeutic session, instead of just gaining the pre and post understanding. This assessment can be altered to fit the unique needs of the client, and can help the clinician understand how the client is progressing.

    Reply

    • Lilly Brochu
      Oct 08, 2020 @ 12:44:12

      Hi Elizabeth,

      When clients first begin therapy, there may be a sense of anxiety, shame, or guilt in the way they are feeling or thinking. Assessments are helpful because they can fill in some of the “gaps” of what they have been going through without physically verbalizing it to the clinician. The assessment is an essential tool in helping both involved in the therapeutic relationship by addressing these thoughts and feelings and gathering as much information as possible about the client while making them feel (hopefully) more comfortable and transparent in their answers. Furthermore, formative assessments are more consistent and can assist both the client and the therapist in understanding themselves/the client better. Summative assessments are done at the end of the therapeutic relationship, and this may not be helpful in furthering the progress of the client nor does the clinician get any criticism about their techniques or abilities throughout the relationship until the end of it.

      Reply

    • Pawel Zawistowski
      Oct 08, 2020 @ 17:50:13

      Hello Elizabeth, I like your reasoning for why assessments are important other than making a diagnosis. I think there are a few more things that a therapist can draw from an assessment other than severity of symptoms. Assessments can also tell us things about the frequency, for example how frequently does the client experience anxiety attacks. Or how frequently the client may drink alcohol. They can also tell us about the duration of certain problems. For example, how long has the client been experience hopelessness. Or how long has a client been having suicidal thoughts. Such information can be very useful in the therapeutic process.

      Reply

  15. Zoe DiPinto
    Oct 08, 2020 @ 13:09:42

    1. Assessments are used for reasons beyond determining if a client qualifies to be diagnosed with a mental disorder. They are also used to assess the degree and severity of their suffering, duration of symptoms, and sometimes can detect environmental or contextual factors that may be influencing the client’s behaviors. Assessments do not exclusively test client’s weaknesses– often an assessment will show what the individual has strengths in. Finally, a good assessment may show the therapist what the progression of the situation may look like with or without treatment. This is very important to consider when making a treatment plan.
    2. Formative assessment is assessment that occurs continuously or intermittently throughout a therapeutic relationship. Summative evaluation is used to make cumulative judgements and is often focused on an endpoint/ goal. Summative evaluation refers to assessment styles that are focused at the beginnings and endings of therapy. Although assessing clients at intake and termination is important, it is also important to take a formative assessment approach. A formative approach allows the client to continuously receive input on their well-being. This allows for consistent feedback through whatever ups and downs the client experiences through treatment. This helps build a relationship between the therapist and client through an exchange of information and helps the client understand their position of well-being compared to other points in their life.

    Reply

    • Maya Lopez
      Oct 08, 2020 @ 17:25:13

      Hey Zoe,
      I liked how you also mentioned how assessments do not exclusively test weaknesses because that could be an important aspect to relay to the client when explaining the results of their assessment. It would be very tough to hear all the weaknesses and not hear any hope or strengths. You also brought up another good point with formative assessments that not only is the therapist getting more assessment data but the client is also getting more consistent and continuous feedback on how things are going. And I agree that it would help build the therapeutic relationship more with the client feeling the therapist is competent in their knowledge of helping and assessing them.

      Reply

  16. Anna Lindgren
    Oct 08, 2020 @ 14:34:43

    Assessment tools can be utilized not just at intake and termination of therapy, but throughout the course of treatment. While the clinician may get a good sense of how the client is doing through the counseling sessions, it is also beneficial to track progress through formal or informal assessments throughout treatment. This can be as simple as asking the client at the beginning of the session to rate how depressed they are feeling on a scale of 1-10. Over the course of treatment, that number should go down. If it is maintaining or increasing, then the counselor may decide to use a formal assessment like the BDI-II so that they can see which specific symptoms are worsening and address those in therapy. These assessments help the counselor see where their client is at and if they are “on track”. If they’re not, they can use that information to adjust the treatment plan accordingly.

    Formative assessment is what I described above: assessing periodically throughout treatment to examine the therapeutic process. Summative assessment is cumulative and measures the outcome at the endpoint of therapy. Formative assessment has been shown to produce better therapeutic outcomes because counselors and clients receive consistent feedback on how the treatment is progressing and can change course if needed. Additionally, counselors may be asked to show documentation that their interventions are effective, and continuous assessment can provide this.

    Reply

    • Tim Cody
      Oct 10, 2020 @ 23:09:28

      Well put Anna,
      I appreciated when you mentioned how formative assessment can provide new counselors with information on the progress of the client’s mental health condition. This is helpful to pass along information from one counselor to another, especially if the patient is not receiving treatment well and is not showing improvement overtime. I would even add that the counselor’s role in the assessment is not only to find solutions to the client’s problems, but also to help them focus on their strengths as well. Furthermore, the therapist can use the client’s strengths and achievements to progress their mental issues into a healthy state.

      Reply

  17. Cailee Norton
    Oct 08, 2020 @ 14:48:40

    1. Assessments provide a slew of information. Not only can they provide a diagnosis for which a clinician can move forward with treatment options, but it can provide insight to various topics that perhaps the client has not mentioned or the helper has not yet further explored. When looking at specifically the Outcome Questionnaire (OQ-45) for example, we see several items that look at substance abuse, others that look at interpersonal relationships, items that examine the social role in which a client may feel the difficulties experienced in social settings, and even items that examine how a client is feeling on a physical level. This range of topics allows the clinician to assess various areas of a clients life that may need more examining, rather than being able to provide a diagnosis for that client. When a client is answering this type of questionnaire, they may become aware of these as being persisting problems that need to have attention drawn to them. A therapist may also be able to reevaluate a clients status after a number of sessions and see that perhaps the client isn’t doing too well in their interpersonal relationships over the past two weeks and this can guide them to change their course of action with that client. In this way assessments are a tool of checking in as well as narrowing down topics that need attention with a client.

    2. A formative assessment or evaluation is the continuous or even intermediate evaluation that is performed during the examine process. The focus of a formative assessment is the process, whereas this is not the case for a summative assessment. A summative evaluation or assessment is a cumulative measure that is concerned by the endpoint or final result. So while the formative assessment focuses on the process, summative assessments focus on the product. The major benefits of a formative evaluation is that through a formative evaluation adjustments can be made to better accommodate the client based on their unique needs. Formative evaluations can be performed multiple times because the focus is not on the end result, and through these multiple applications a great amount of information can be gathered about your client at that moment. Perhaps a client isn’t reacting well to the techniques and skills you’re implementing. Through using a formative assessment rather than a summative assessment, you can change course to correct this and provide better care to your client.

    Reply

    • Lina Boothby-Zapata
      Oct 08, 2020 @ 15:05:30

      POST

      Dr. Whiston clearly stated that a narrow view of Assessment is when counselors only utilize Assessment as selecting, administrating, and interpreting the results, during the intake and the end of the therapy process. Dr. Whiston stated that Assessment has a significant role and an active role during the therapeutic process. These are some of the contributions that brought my attention;

      First, my understanding of how Assessment plays a role in the treatment plan phase is that results have to be obtained with objectivity rather than solely the counselor’s subjectivity. Dr. Whiston states “what is important is to gather quality information and evaluate it with a scientific approach.” Then, the content/results obtained during the instrument’s administration are incorporated in the case formulation, treatment plan, interventions, and clinical decisions. During the assessment/treatment planning, Dr. Whiston states that Counselors need to answer the following questions; in what degree are the problems affecting the client? What environmental or social factors are contributing to the client’s issues? What are the client’s strengths? are there cultural issues that need to be considered? What is the prognosis? In his lecture, Dr. V. highlights that answering these questions will allow counselors to better understand how the client’s presenting problems affect the client. In summary, Assessment has a fundamental role during the intake stage. Suppose the counselor has the capacity of doing an accurate evaluation. In that case, this assessment’s information and results will be incorporated in the clinical case with more objective and precise information that answers “what are the client’s needs and presentation problems instead of the counselor’s subjectivity and assumptions.

      Second, Dr. Volunguis has expressed on different occasions about the matching two. My first surprise about that matching two is that “Counseling is not a process in which the client gets the same service”. My traditional view was that the client had the responsibility of looking for the best fit. There are several offers and the client decides which one to take if they can fit better in cognitive/behavioral therapy, humanism/existentialism therapy, or psychoanalysis/psychodynamic therapy. The downside of this view is that clients can spend years trying to figure out the appropriate type of therapy and never address their problems effectively. Contrary, Dr. V states the counselor needs to understand the client’s presenting problems, needs, a better understanding of who the client is, where is your client coming from, and then decide what type of therapy strategies will use. In the past post, I made the analogy of a therapeutic toolbox that the counselor can utilize during the therapy. In other words, the treatment looks at the toolbox and decide what tool to use at the moment. However, matching is more complicated. Dr. V stated that matching two is the counselor’s ability to be malleable and flexible to meet at the client level. Dr. Whiston states that you do this when you can do an assessment of your client answering the following questions; Functional impairment, Subjective distress, Problem complexity, Readiness for change Reactant/resistance tendencies, Social support, Coping style, and Attachment style. Doing is Assessment will allow the counselor to select a type of intervention, strategies, coping skills, and how to approach your client to build rapport.

      Third, Dr. Whiston stated that another way to incorporate Assessment in the clinical practice is for Evaluation and Accountability, and there are two types; Formative Assessment and Summative Assessment. The Formative Evaluation is the continuous or intermediate performance to assess the process. Simultaneously, The Summative Evaluation is the accumulation of the process being evaluated at the end. The difference between Formative and Accumulative Evaluation is that formative evaluation is made during the process and a summative evaluation at the end. In our role as a counselor, the Formative Assessment is what ideally counselors need to be doing. Dr. V recommends assessing the therapy on a regular basis meaning every three days. This is related to the client’s symptoms that need to be monitored because it is our concern and because instruments like BDI-II, Suicidal Ideation, Hopelessness Scales, SMAST, or DAST 10 the time frame assessment is between one or two weeks of the client. As a consequence, the results lost their weight or importance at that time. This is why the counselor needs to monitor the “items” in the instrument concerned in the test past administration. An example of that is “suicidal ideation” presenting at the moment. In summary, the Formative Assessment is the best type of assessment that needs to be implemented in our clinical practice.

      Reply

      • Viviana
        Oct 09, 2020 @ 11:31:45

        I agree with you Lina, formative assessments should be practice often by mental health counselors as it offers a more informal way to assess the client’s progress. I find often in the field of human services that many clients or individuals when asked about treatment goals they barely know how to respond. While I believe clients could have different reasons why they are now aware of these or probably don’t want to share that information, counselors have the responsibility to have a continuously discussion about the therapeutic goals and interventions. These discussions, of course, would include statistical methods and informal assessments. As mentioned in the class lecture, solid statistical methods are better predictors than clinician judgement but also the methods should be used for more than determining a diagnosis or creating treatment goals and take into consideration cultural, environmental, and social factors, among others. You commented about the Beck Scale for Suicide Ideation and how it’s important to measure mental health states in an “emergency” basis. For example, that is an evaluation with face validity that could quickly measure suicide ideation probably within the first five items given the opportunity to the counselor to create interventions at the moment and continuously assessing the client’s level of suicide ideations.

        Reply

  18. Brianna Walls
    Oct 08, 2020 @ 15:22:52

    1. Other than providing a diagnosis assessments can be useful for additional information. One being that assessments can provide the therapist with a better understanding of their client. This in return has a direct influence on the effectiveness of the treatment. In addition, statistical methods are much better predictors than a beginning therapist’s judgement, and it is critical for the therapist to not underestimate the severity of their client’s problems. Another way assessments can help therapists understand how presenting problems are affecting the client is by identifying the degree to which the problem is affecting them. For example, are the clients’ problems affecting their relationships with family and friends? In addition, it is also important to identify what environmental or social factors are contributing to the client’s issues. One last point I would like to make is that assessments are not only good for identifying the client’s problems but they are also good for identifying the client’s strengths. Identifying client’s strengths are just as important as identifying their weaknesses. This is because it provides the therapist information on how you have been coping with your issues/problems and in return may help the therapist and client come up with additional ways to help the client cope with future problems.
    2. Formative assessment is a continuous or intermediate evaluation typically performed to examine the process. A summative assessment is a more cumulative and focused on endpoint or final evaluation. In other words the difference between the two can be determined by the distinction that the focus of a formative assessment is on the process of therapy and a summative assessment focuses on the product.
    There are benefits of a formative assessment, one being that it allows the therapist to have a more up to date notion of where your client is at. A formative assessment gives the therapist the opportunity to modify interventions and conceptualizations of the problem. By providing formative assessments this could also enhance the therapeutic relationship. By giving multiple other rounds of assessments it provides the client and therapist an idea of where the client is heading. Either they are improving, staying the same, or declining. Formative assessments are also good because they show numbers that indicate improvement.

    Reply

    • Timothy Cody
      Oct 10, 2020 @ 23:16:55

      Hi Brianna,
      One’s mental health can not only affect oneself but those around them as well. I think you did a good job describing how a person’s problems can both be the cause of and be effected by social and environmental factors. Family members and friends play a large role in one’s internal mental awareness, and if our own mental health is not in check, then it could potentially affect those in close contact with us. it is important for the therapist to assess how one’s mental health is affecting their social life so that peace and stability can not only be brought to the client, but hopefully to their family and friends as well.

      Reply

  19. Carly Moris
    Oct 08, 2020 @ 16:17:54

    Assessments can be used to help therapists understand how a clients presenting problems are affecting them. One important way assessments do this is by assessing the degree to which the problem is affecting the client in their daily life. How it is impacting their job or school, and their interpersonal relationships. This information can help a clinician determine a clients level of impairment. It is important to accurately asses a clients functional impairment because research shows that clients whose therapist underestimate their level of impairment have worse treatment outcomes. Some assessments can help assess environmental and social factors that are contributing to a clients issues. This can be important information for clients presenting with substance use disorders. If an individual with a substance use disorder indicates a strong social component to their substance use it may be appropriate to recommend them for inpatient treatment, or help set them up with social support when leaving an inpatient program. Assessments can also be used to help assess a client’s strengths. Counselors tend to have a biases for looking at a client’s problems, but we also need to look at a clients strengths and see how they can be incorporated into the therapeutic process. Assessments can also assess a clients readiness for change. It is important to understand where clients are in the process of changing for each of their presenting problems. This understanding will give clinicians an idea how much they need to help motivate the client for change and how far they can “push” in the processes of changing these presenting problems.

    It is also important for clinicians to use assessments to evaluate the effectiveness of their own treatments, and to provide accountability information to insurance companies and agencies they may be receiving funding from. This information can also be used to make sure each individual client is receiving effective treatment, and let you know to alter your treatment if they are not. There are two types of evaluations for these purposes, formative evaluation and summarative evaluation. Formative evaluations are continuous or intermediate evaluation typically preformed to examine the process. Meaning these evaluations are done throughout the counseling process as a way to track progress and look for patterns that may emerge. This is helpful because it allows to see if the patient is improving and if they are not to adjust their treatment plans. These type of evaluations are also helpful to share with patients throughout the counseling process. The can help keep clients engaged in the process or work as a talking point if clients aren’t seeing improvements. Summarative evaluations are more communities than formative evaluations and are more concerned with the endpoint or final evaluation. These evaluations are good for providing accountability information.

    Reply

  20. Maya Lopez
    Oct 08, 2020 @ 17:10:24

    Assessments can be helpful for many different reasons. As stated in lecture, assessments can help to measure the severity of a clients issues, they can also determine how long a client has suffered with certain symptoms. Assessments can give more quality information on the basis of symptoms, details, and external factors. This can help therapists to understand their client better and construct a better case formulation. Formative Assessments are done continuously to evaluate the process of one’s thinking throughout therapy and the therapetutic relationship. It is best to assess and evaluate the client continuously instead of just once in the beginning or end. The benefit to using it can be to gather a more whole-concept view of the client by assessing them more often. Whereas, summative assessment is more focused on assessing the end product of therapy. (How much has the client grown, how well can they self reflect etc.)

    Reply

  21. Tim Cody
    Oct 08, 2020 @ 17:57:23

    When making an assessment, a therapist is not only looking to find the problem and determine its diagnosis, but also determining the degree to which the client is being affected. They may find that the problem is causing them to be dismissive and challenging of others, or they may find that they have more of a handle on their mental health. It is important for a therapist to know the severity of the mental illness being evaluated in order to determine the best treatment match for the client. Assessment also can help determine if the problem is simply mental or if it is caused by environmental or social factors as well. It is also important for the therapist and the client to be aware of the client’s strengths as well as their weaknesses. One should not ultimately focus their time and energy on one’s problems, but also use their strengths in order to bring about a solution. Lastly, mental health not only varies differently from person to person, but it also varies across cultures as well. It is important for therapists to determine during the assessment period if there are any cultural discrepancies behind a mental disorder, and how culture is affecting the mental health of the patient.

    Formative assessment deals with the continuous or intermediate evaluation, while summative assessment is more cumulative and focused on the overall endpoint or final evaluation. Formative evaluation is usual done to examine the whole therapeutic assessment process, while summative assessment is focused on the product, or how the client develops towards the end of the therapeutic relationship. A benefit to the formative assessment is that it is done throughout the process, so if a method is not successful or if a treatment needs to be readjusted, it can be done well before the end of the therapeutic relationship. This also allows for frequent feedback from the client themselves throughout the counseling services instead of feedback on at the end of the sessions.

    Reply

    • Christina DeMalia
      Oct 10, 2020 @ 13:50:09

      Hi Tim,

      A lot of us touched on the fact that assessments can also be used to identify strengths. However, I really like that you took it one step further to explain that those strengths can be used to identify solutions. If a person is only told they are severely depressed, they might internalize that and believe that their depression is a large part of who they are. In a way, this can sometimes make people feel worse about their prognosis. On the other hand, if someone were told those results but were also told that they scored high on something like creative expression, the therapist may be able to suggest creative outlets that allow the client to express their emotions in a positive way and make meaningful progress in their treatment.

      Reply

    • Brianna Walls
      Oct 10, 2020 @ 15:18:57

      Hi Tim! I think it was important that you touched on how important it is to focus on not only the client’s weaknesses but their strengths as well. By doing this the therapist and client will be able to use their strengths to come up with coping methods based off of what has worked for the client in the past or what hasn’t worked in the past. I also thought it was important how you brought up culture. It is important to consider the client’s culture during therapy because it will help the therapist better understand their client and also it will help the therapist determine if the client’s culture is causing their mental health problems.

      Reply

  22. Christina DeMalia
    Oct 08, 2020 @ 18:51:19

    (1) Assessments on their own will likely not be used to determine someone’s diagnosis. Instead many factors will be taken in to account, that could include results from several assessments, to determine a diagnosis. However, assessments play an important role in therapy settings beyond just contributing to diagnosis. Assessments can tell the therapist many things about the client, as well as helping the client to better understand the issues they are facing themselves. Assessments can also determine to what degree the problems are effecting the client, possible contributing factors, and strengths of the clients. Assessments allow therapists to have a measurable aspect of the work they are doing with their client. In order to show if treatment is working and if the client is improving, assessments create data that can be compared from the start of therapy to the completion, or periodically throughout the process.

    (2) Summative assessments are those that are cumulative, and focus on the end result or are a final evaluation. Formative assessment, on the other hand, is a continuous evaluation process throughout therapy. Evaluation is done either continuously or intermittently to assess the client at various stages and monitor the progress being made. Formative assessments are more beneficial because they show how effective treatment is. By monitoring symptoms throughout the therapeutic process, you can tell how well the client is responding to treatment, and if a different method should be used. If only summative assessments were used, symptoms could be maintaining or even worsening over the course of sessions, without the clinician or therapist being fully aware. It is better to keep track of how the client is feeling through regular assessments so that changes can be made as needed.

    Reply

  23. Karlena Henry
    Oct 08, 2020 @ 18:58:15

    Assessments have an important role to play in the therapeutic process as a tool for determining diagnosis (as you mentioned) but also to have a more accurate picture into the patients thought processes. Taking an assessment during intake can be useful to have a baseline for treatment, and then retaking it later to see what progress has been made. This can be useful for both the clinician and the client. For the clinician to measure growth during treatment, and for the client, introspection on the changes they are seeing. For instance, when I was completing the BDI II for this class, I realized I had taken it before during an intake for therapy. As I was going through the questions, I recognized how I had answered previously, and compared it to my current condition, and I was surprised at how much healthier I am now.
    A formative assessment is used to measure a client’s progress throughout therapy, and a summative assessment is designed with more detail to get more specific information. The way I understand it, a formative assessment is like these blog posts we write. It gives a snapshot of our understanding of the material, whereas a summative is like our midterm and final. Each play an important role in gauging how we grasp the information, but the formal evaluations are more specific in diagnosis, or in my example, our final grade in this course.

    Reply

    • Elizabeth Baker
      Oct 10, 2020 @ 14:20:23

      Hello Karlena,
      I enjoyed reading your post! I like how you explained that assessments are useful for not only the client’s, but the clinician. Yes, clinicians use assessments to understand how much the client’s symptoms are affecting their lives, but it can also be used to understand the thought process of the client’s. Do they think their habits aren’t causing any significant changes in their lives? Do they think their habits are only affecting themselves rather than those around them? Etc. There are so many questions that can be potentially answered when assessing clients. That’s why I think it’s important to use formative assessments rather than summative assessments; clinicians are able to see the progress of their client’s thought processes on how their actions are impacting their daily lives.

      Reply

    • Cassie Miller
      Oct 12, 2020 @ 14:26:29

      I really liked how you discussed the importance of a baseline measure in your response. Assessment is vital to monitoring a client’s progress or lack thereof and it is important to make sure that you are being as effective as you can be. A baseline measure makes it possible to start the individuals treatment plan and to set up goals for them to work towards. You also wrote about how the client should be privy to these results because it has an influential effect on their awareness of their own progress and can increase their motivation. This is such a good point because the client should be kept in the loop and updated on what areas of treatment are working well for them, as well as, what areas need to be tweaked. If they feel as though they are accomplishing their goals and that a difference is being made, it will have a positive effect on their mental health and increase the likelihood of them being able to maintain these lifestyle changes. Like you said, I also noticed my own progress when completing the BDI II and it actually made me feel better about the point that I am at in my life currently. Sometimes just taking an assessment can highlight certain areas in your life that you are succeeding at, as well as, help you see that certain areas could be worse (which in its own way feels reassuring).

      Reply

  24. Laura Wheeler
    Oct 08, 2020 @ 18:58:57

    (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?

    1. Assessment is never solely for the purpose of determining a diagnosis, but rather it is one piece of a much larger puzzle. Assessment allows the clinician a great deal of insight into how the presenting problems are affecting the client in day to day life, within their family and home life, at work, in their relationships, in their general functioning, etc. Assessment also helps to identify (and should consider during which) if/how/to what extent social and environmental factors are contributing to the clients problems. For example, an assessment that touches on a clients ability to maintain their hygiene, attend work daily and on time, maintain personal relationships, care for children, etc. will provide a great deal of insight into the degree in which the clients life and functioning is impacted by their problems.
    2. Formative assessment is continuous or intermediate evaluation typically performed to examine the process. Summative assessment is more cumulative and focused on endpoint or final evaluation. A formative assessment is beneficial for a number of reasons; most importantly, formative assessments allow you to establish a baseline, or starting point, and then improvement or worsening of a condition. Formative assessment is particularly popular (and needed) because managed care organizations will not approve counseling services unless clinicians can show they are effective with clients. Performing regular assessment with clients provides concrete data to illustrate the work that is being done in sessions.

    Reply

    • Brianna Walls
      Oct 10, 2020 @ 15:30:05

      Hi Laura! I think it was important that you mentioned how formative assessments are useful during therapy for a number of reasons. But, the one that stood out to me was how they are helpful in determining if therapy is improving the client’s problems. For instance if the therapist needed to provide evidence that therapy is working to the client’s insurance company in order for the client to continue with therapy, formative assessments would be an ideal way to show this. This is because formative assessments are given to the client consistently during therapy and therefore the client’s results will provide proof either that treatment is working or it is not working for the client.

      Reply

  25. Nicole Giannetto
    Oct 08, 2020 @ 21:05:05

    1. Assessments can help therapists identify where the client is in regards to where they ideally should be, which allows them to focus on the track of the therapeutic outcome. Additionally, assessments are helpful for the therapist to understand the client’s specific symptoms, and what ones are more severe and less severe. Assessments can also foster an awareness in clients of their own problems which can push them to give feedback to their counselors regarding their therapeutic relationship, readiness for change and social support. Assessment results can additionally inform the therapist of both the descriptive and numerical data related to their client’s performance on the assessment, and the combination of the data can be useful when informing the client of their results.

    2. Formative assessment is the continuous or intermediate evaluation during the therapeutic process. For example, a clinician will give an assessment at the beginning of sessions, and will continue to do that either every week or every couple of weeks. Summative assessment is more cumulative than formation evaluation, and concerns the endpoint or final evaluation of a client. The benefit of formative assessment is that it can track the change in behavior whether it is negative or positive. This way the clinician can be routinely updated on how their client is reacting to treatment. Additionally, formative assessments are good because they can show how effective different assessments are.

    Reply

  26. Cassie Miller
    Oct 12, 2020 @ 13:39:39

    Hi Nicole,
    I really like how you discussed assessments not only being important for identifying specific symptoms for the client, but also for providing an indication of symptom severity. You have such limited time during a counseling session which makes it important to be able to hone in on the more severe client symptoms or concerns. From personal experience I know that it is very easy to enter a counseling session and try to get everything off your chest that has been weighing on your mind. Thus, it is important to remember that the client is also aware of their limited time to receive the counselors support, so they may be including details that are not as relevant to the main problems they are facing. The assessments are thus able to keep the counselor focused on the more pressing concerns for the client, as well as, to continuously update the clinician as to what problems are more pressing during that given period of time (since things are often subject to change and shift).

    Reply

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Adam M. Volungis, PhD, LMHC

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