Topics 5 & 6: Initial Assessment in Counseling & Using Assessment in Counseling {by 6/21}

Based on the text readings and lecture recordings due this week consider the following discussion points: (1) Share your understanding on why it is important to get an accurate understanding of the client’s problems early in therapy (i.e., intake/early sessions).  (2) Understandably, especially as a beginning therapist, the thought of assessing suicide can be anxiety provoking.  Share a few of your initial concerns when (not if) you are confronted with a suicidal client.  (Keep in mind, you will learn a lot more about responding to suicidal clients in future classes and on your practicum/internship.)  (3) Assessment has a broader role beyond just determining diagnosis.  What are some ways assessments can help therapists understand how presenting problems are affecting clients?   (4) What is the difference between formative assessment and summative assessment?  What are the benefits of formative assessment?

39 Comments (+add yours?)

  1. Morgan Rafferty
    Jun 16, 2021 @ 21:17:44

    1.) It is important to get an accurate understanding of the client’s problems early in therapy. Research has shown that the quality of the therapeutic relationship is established during intake and the first session or two. Most clients do not return beyond the intake or first session. Factors that can increase the likelihood of a client returning beyond that initial point are: doing a good job gathering information about the client so that the client feels heard and understood. It is important that the client feels connected to the therapist. If the therapist does not achieve the goal of gaining a good understanding of the client’s problems, he/she is less likely to feel engaged and less likely to continue therapy sessions.

    2.) Concerns that come to mind when assessing a suicidal client are that I might offend the client by inquiring if they have thoughts of killing themself. I fear that asking that questions might offend some clients and create a distance between the client-therapist relationship. I know it is crucial to ask this question when the signs are all there. I am concerned, however, that at times it might come across the wrong way and will not be well-received. I also fear struggling with not trusting the answer a client provides. It must be hard to simply take their word for it.

    3.) Using assessments involves collecting information in order to identify, analyze, evaluate and address problems a client has. Assessments help therapists decide what problems to address with their clients, as well as what interventions to utilize. Assessments provide a broader window into how a client’s problems might be hindering their growth and development. They can also highlight strengths that the client might possess.

    4.) Formative assessment includes continuous evaluations typically performed to examine the process (ie., in-class discussions; quizzes throughout the semester). Summative assessment includes a cumulative evaluation (ie., like a final exam). A benefit of formative assessments is that a therapist is able to gauge a client’s progress across the span of ongoing therapy sessions. Formative assessments also allow for changes/alterations/adapting on the part of the therapist to take place along the way.

    Reply

    • Lindsay O'Meara
      Jun 19, 2021 @ 17:42:40

      Hi Morgan!

      Making a client feel understood and heard from the start is definitely an effective goal for every counselor to strive for. It makes sense that a client would not want to meet with a counselor again if the entire first and second session they felt misunderstood.

      Suicide can definitely be a scary subject. However, I think it is really important to come out and ask a client if they are feeling suicidal. I know that sounds intense, but in crisis counseling we come right out and say it. If you have spent the time to build rapport with the client, and it is truly something that they are struggling with, they will probably want to talk about it. Those feelings are so heavy for clients so it is probably really relieving to share them with someone they trust.

      Thanks,
      Lindsay

      Reply

      • Morgan Rafferty
        Jun 21, 2021 @ 11:40:28

        Hi Lindsay! Thanks for your feedback. It is really helpful to hear your stance on working with suicidal clients being that you have experience with the Crisis Suicide Text hotline. It must be very interesting and rewarding for you. To be there and provide support for individuals in crisis seems to me to be the work of very strong and good-hearted people; like yourself!
        What you are saying makes sense to me. I am sure the more experience each of us gain as we possibly encounter suicidal clients, the more comfortable each of us will feel in asking if the client is indeed suicidal and proceeding from there.

        Reply

    • Frayah Wilkey
      Jun 21, 2021 @ 11:51:58

      Morgan,
      I liked reading your thoughts about Q1. I didn’t realize how many people do not return after the first session, especially due to the role that client expectations play. I think that you brought up the key points of why understanding the presenting problems is so important. I know you have a lot of experience so you’ve probably seen these issues come up before. The chapter definitely highlights how important initial sessions really are, especially the first one.

      Reply

    • Kaitlyn Tonkin
      Jun 21, 2021 @ 15:03:14

      Hi Morgan,

      I really liked your examples for question 4. Thinking about formative and summative assessment in terms of quizzes and final exams is really helpful and a nice analogy. I think that sometimes it is easier for me to understand things better with an example that is not in the same context as the definition. So, I really appreciated your examples, thank you!

      Your response to question 2 made me think more about my fears of dealing with suicidal clients. I had never thought about the possibility of offending someone by inquiring if they are suicidal, I just thought it was part of the therapy/intake process. However, after thinking some more, I think there are definitely some scenarios where that could be a possibility. However, I would much rather offend a client than not have a conversation with them and have them commit suicide.

      Best,
      Kaitlyn

      Reply

      • Morgan Rafferty
        Jun 22, 2021 @ 08:50:35

        Thanks so much Kaitlyn! I appreciate your feedback. Yes! I also do well when examples are given that stretch outside of the specific topic area. This is probably because we have been students for so long and are used to random examples being thrown into the mix while learning about various subjects.

        You are so right — it definitely is worth the risk of offending a client to potentially save a life! I just envision me putting that question out there and getting some irate response like, “No way! Thanks alot! Do I really seem to be in that bad of shape?!” But, if that’s the case, so be it. As therapists, and in life in general, having thick skin is a major asset. If the client is angered, I would move on to expressing relief that they are not suicidal.

        Reply

    • Angie Petrella
      Jun 22, 2021 @ 10:42:44

      Hey Morgan!

      I completely agree with your answer to the first question in regards to gathering information so that the client feels heard and understood! I wonder if it is a tricky balance of making sure to obtain the important information, while also trying to build rapport and make the client feel comfortable, especially in that first session considering the statistic for returning is so low.

      I also wanted to point out your concerns with assessing a suicidal client, as they are in alignments to my own concerns! I definitely worry that asking questions regarding suicide will offend my client and create an awkward tension between us during therapy. It is such a vulnerable topic, so I just want to make sure that my client feels comfortable talking about it, especially if I am using an assessment and directly asking them about it. I also agree with what you said about “taking their word for it”, I can imagine myself having a session with a client and believing what they said, but then also have that fear in the back of my mind later on that maybe they weren’t being totally honest, or maybe there was more I should have said or done.

      Reply

  2. Jennifer Vear
    Jun 17, 2021 @ 14:42:05

    1. It is important to get an accurate understanding of a client’s problems early in therapy in order to facilitate the best goals and interventions for their treatment. If the clinician is able to get an idea of the presenting problems of their client, they can center the therapy around various techniques that will help the treatment processes. Treatment is different for each client and each client has their own problems. For example, the treatment process for an individual with agoraphobia is going to be much different from the treatment process for an individual with bipolar disorder. Aside from the diagnosis, the treatment process for an individual that is coping with sexual abuse is going to be different from someone who is dealing with a difficult transition from high school to college. So, by the clinician understanding the presenting problem(s) early on in therapy, they can gear the treatment and intervention process toward what is best for the client.

    2. I am very nervous about how to help someone who is suicidal. The main concern I have is trying everything that I learned to help them, but then wondering if I have done everything in my power to make them not want to kill themselves. I am terrified to think about one of my clients actually committing suicide. Sometimes depressed individuals can hide things very well. I hope that with the training that I will receive, I will be able to actually make a difference in a person’s life that will help them to realize their true value in life and want to actually live it.

    3. Assessments are more than just diagnosis. Assessments can help a clinician find out what their client’s presenting problem(s) is or are and how that affects their life. Assessments help clinicians determine the degree to which the problems are affecting the client as well as the environmental and social factors that come into play. For example, a client could come in with a presenting problem of dealing with a divorce. As a result of the divorce, they also have a substance abuse problem. Then they are also dealing with issues with their kids and their job and their home life, etc. Various types of assessments could tap into different aspects of a client’s life. It is the clinician’s job to pick these out and then take them into account during treatment. Another important factor for treatment is not just assessing the weaknesses a client has, but also their strengths. This is ‘positive psychology’ because it helps increase optimism for their future getting better because they do contain strengths. Then finally, with this information gathered, the clinician can figure out the best form of treatment for the client that is symbiotic to their goals.

    4. Formative assessment is a continuous or intermediate evaluation that examines the therapeutic process. An example would be a clinician giving an assessment to their client every 2-3 sessions. A summative assessment is focused on the endpoint or final evaluation. An example of a summative assessment would be a clinician giving an assessment at the very beginning and then only again for the final session. Formative assessment is the best type of assessment process because this continuous process and assessment can show the effectiveness, or lack thereof, of treatment. If a therapy session is really working for the client, and they take an assessment every 3 sessions and their symptoms are getting better, the assessment will show this improvement. On the other hand, if a clinician is not fully focused on working with their client toward intervention and getting better, an assessment every 3 sessions could show no change in symptoms or the worsening of symptoms. This will show the clinician that they need to try something different to better help their client. Also, when clinicians are receiving feedback about their client’s progress during therapy, they can then share it with the client. This will better their relationship and help the therapeutic process when both the client and the clinician see the improvements.

    Reply

    • Katie O'Brien
      Jun 21, 2021 @ 12:22:17

      Hi Jenn!
      I like that you mentioned each client is different and each client has their own problems. In PSY 600, we saw how many symptoms there are for depression alone – I bet it’d be hard to find two patients with identically presenting depression. What works for one patient may not work for another and seeing the nuances in what symptoms / issues each client is dealing with. Assessments can help with that, especially when it comes to thinks like what coping mechanisms or other strengths certain clients have. From there, the clinician is better able to find a treatment best suited to their particular needs.

      Reply

    • Lisa Andrianopoulos
      Jun 21, 2021 @ 14:37:27

      Hi Jennifer,
      I liked your comments about confronting a suicidal client, mainly because I’m terrified too!! I want more than anything to get it right, and I find myself overwhelmed with knowing exactly what to do. I already started memorizing the acronym “Is Path Warm.” I liked what you said too about not everyone showing their depression. The chapter talked about “masked depression” and that the signs can be subtle. I find all of this to be an awesome responsibility.
      Lisa

      Reply

    • Sergio Rodriguez
      Jun 22, 2021 @ 18:51:22

      Hi Jennifer,

      I think reading your example helped me to clarify the relevance of the frequency of assessment in therapy. It is widespread that therapists just use a verbal or checking with the patient to measure their change along with the therapy. Since I’ve worked in the field, I try to recall myself how important it is to measure constantly so patient and therapist can have a better idea (more objective) of the therapy progress and the multiple options and changes that can be made to work towards the treatment goals set up previously.

      Reply

  3. Lindsay O'Meara
    Jun 19, 2021 @ 17:37:07

    1. It is important to get an accurate understanding of the client’s problems early in therapy because significantly better results in counseling stem from a quality relationship with the client. There is a lot of background information necessary to gain insight into what the client is feeling and dealing with. Some of this information is when the problem started, whether the client believes it is possible to change or combat the problem that they are having, how they have coped with this problem, and how it can affect the clients’ daily functioning. Understanding the clients’ problem is also important because it will define their treatment moving forward and can help to define future goals for the client. By downplaying or misunderstanding the problems of the client, there is a possibility that there will be a negative outcome in therapy.

    2. It is a little anxiety provoking to meet with a suicidal client. I volunteer for Crisis Text Line, and I have worked with suicidal texters in that situation. At first it was uncomfortable, because you just want to be sure that you are providing the best help that you possibly can while speaking to someone who is suicidal. Suicidal ideation is clearly prevalent in counseling, I am concerned about having the best tools and skills possible to try and help this (and all) population(s).

    3. There are many ways to use assessments, one of them is to gauge how presenting problems are affecting clients. Some of the assessments that you can use at the beginning of treatment are, the Outcome Questionnaire, Symptom Checklist-90-Revised, and the Brief Symptom Inventory. Characteristics to consider when treatment matching are functional impairment, subjective distress, problem complexity, readiness for change, reactant/resistance tendencies, social support, coping style and attachment style.

    4. Formative assessment is continuous or intermediate evaluation typically performed to examine the process. Whereas summative assessment is more cumulative and focused on endpoint or final evaluation. Formative assessment requires that you assess outcome throughout treatment and not just at the end of treatment. This is important because it gives the client feedback throughout therapy about their progress.

    Reply

    • Frayah Wilkey
      Jun 21, 2021 @ 11:48:19

      Lindsay,
      It’s great experience that you’re getting from volunteering at a crisis center. As you mentioned, I’m sure that there’s a lot of pressure and I would be anxious knowing that my words/help could have a huge impact on whether or not someone commits suicide. I’m sure you’ve been able to let go of some of those thoughts and anxieties through training at your job though, which is definitely an important part of being a therapist.

      Reply

    • Jennifer Vear
      Jun 21, 2021 @ 14:06:43

      Hi Lindsay,

      First of all, I like how you mentioned the fact that you work for a suicide hotline and would get nervous, wanting to make sure that you provided all the information you could to help them. That is my main concern as well. When I encounter someone who is suicidal, I hope that I can provide everything I can to help them.
      Second, I also like how you mentioned in question 1 about downplaying or misunderstanding a problem for a client. This is incredibly important because if they believe that we do not think it is a problem, then what is going to motivate them to come back to fix it? And if they do continue to attend sessions, then we could think that it was not an important topic to address and they would not get the proper help. This could also increase the negative stigma around therapists and prevent someone from going back to therapy if they believe that others think their problems are not real. Great job!

      Reply

    • Angie Petrella
      Jun 22, 2021 @ 10:33:56

      Hey Lindsey!

      I wanted to ask you what your experience has been like working at a Crisis Text Line. I have considered doing something like this to get more comfortable working with suicidal clients, as I a have a lot of anxieties about this currently, and I think it would be good to have some exposure to get a little more comfortable. I also wanted to acknowledge your answer to question 1 because I like how you mentioned how detrimental it can be to downplay or misunderstand the problems the client is dealing with. It is so important to obtain accurate information so that the interventions put in place are actually going to help the client!

      Reply

  4. Lindsay O'Meara
    Jun 19, 2021 @ 17:47:04

    Hi Jennifer!

    I feel the same way about the need to have the skills and tools to properly assess and help clients who are feeling suicidal. I’m sure that this program, and our experiences afterwards, will give us the insight and knowledge to feel comfortable helping a suicidal client. The fear of not being able to do enough is there for me as well. We care a lot, that’s why we’re here! So, I’m sure we will be successful in interventions with these clients.

    With formative assessment, I can definitely see the strength in being able to give feedback to our clients continuously. Just like in any situation, it feels really great to know whether you’re making the progress that you are striving for or not.

    Thanks,
    Lindsay

    Reply

  5. Kaitlyn Tonkin
    Jun 19, 2021 @ 18:17:38

    1. Research has shown the importance of getting an accurate understanding of the client’s problems early on, particularly through an intake session and interviewing. This is important because it is best to gain an understanding quickly so that as a therapist, you are able to help the client. Some clients may be high risk and need counseling or need to be taught skills sooner rather than later. So, figuring out what those problems are early on is important to devising a treatment plan and getting an understanding of the client’s diagnosis. Research has also shown that the way a counselor begins the counseling process is crucial to the effectiveness of the counseling process. Furthermore, the quality of the therapeutic relationship early on predicts long-term positive results. This shows that it is important to have a successful intake, where the therapist and client can connect and build rapport, but it is also important for them to discuss the presenting problems and develop a treatment plan to best help the client.

    2. The main concern that I have when I am presented with a suicidal client is that I won’t be able to help them enough to prevent them from committing suicide. The book mentions that 28% of the 71% of counselors who had worked with suicidal clients had clients who died by suicide. That was a striking number to read, and I fear that I would become part of that statistic. I would want to do anything I could to make sure my client was safe without needing to hospitalize them since that could hinder the therapeutic relationship, but I also want to make sure that my client is still alive. I worry that no matter what I do to help a client, they could still make the decision to commit suicide. I also worry that despite the training I will have received and the number of assessments I could give, that a client might not tell the truth about being suicidal and end up attempting or committing suicide. I know that this is a likely possibility, but also that with the training I receive, I will be able to notice the signs that outwardly present themselves.

    3. Assessment is not just useful at the beginning of therapy to determine presenting problems and a diagnosis but can be used throughout the entire process of therapy. Assessment can be useful as a way to determine if the current therapy is helpful or detrimental for clients. For example, the same assessment that was given during intake could be given months later to see if the results are different. The therapist can interpret the results to determine whether or not the interventions they have implemented are helpful or not. If the interventions are not helpful, the therapist can use the results of this assessment to alter the treatment plan. During the therapy process, assessment can be useful if a client begins presenting symptoms of another disorder since there are tests that can be administered to see if there is a comorbid disorder along with the current one. Assessments can also be useful if an intervention does not seem to be working as well as it had been and can help the therapist develop new intervention ideas or alter the treatment plan. Assessments can also be used to measure the client’s prognosis. For example, a client might express interest in terminating therapy, so a counselor could administer an assessment to figure out if that’s a good idea or not.

    4. Formative assessments are a continuous evaluation which is performed to examine the process. An example would be a counselor administering the same test every few weeks to check on the severity of symptoms or to gauge how a client is (or is not) progressing. On the other hand, summative assessments are a more cumulative evaluation that concerns an endpoint or final evaluation. Summative assessments are concerned more with the final product rather than the process. These are more common in education; an example is a final exam that assesses all of the acquired knowledge from that semester. Formative assessments are more beneficial, especially in psychology because they allow the counselor to see how things are progressing. This also allows the counselor to make changes to the therapeutic plan if necessary. If the counselor were to just administer an assessment at the end of therapy, it would be difficult to measure progress. Furthermore, it would be difficult for the counselor to effectively help their client because they would not be able to measure the progress and determine if the interventions were working. Overall, formative assessments allow the counselor to assess how interventions are working since these types of assessments are administered continuously.

    Reply

    • Lisa Andrianopoulos
      Jun 21, 2021 @ 14:45:34

      Hi Kaitlyn

      I liked what you said about it being difficult for the counselor to effectively help their client without being able to measure progress and determine if the interventions are working. It takes the guesswork out of it. I think we (us humans) tend to rely too much on our own judgments and perspectives, which sometimes clouds our interpretations. Also, I think it’s just as important for the counselor as it is for the client to get that ongoing feedback. Not only does it help the client in terms of informing progress and treatment, but I think it also helps the counselor grow professionally. This is especially important for beginning counselor and makes for great talking points in supervision!

      Lisa

      Reply

    • Francesca Bellizzi
      Jun 22, 2021 @ 16:20:33

      Hi Kaitlyn!

      I think we’d all be lying if we were to say an anxiety that comes with being presented with a suicide patient is actually being able to help them – so you aren’t alone in that. Suicide is certainly an uneasy subject for many, and know that there are many factors that come into play outside of counseling sessions. Remembering to treat the client in a humane, empathetic way certainly makes the individual more cooperative and helps to build a trusting relationship between the two of you. I agree with you on hospitalization being a potential rapport “ruiner”; however, those steps are sometimes necessary to ensure that their safety is not jeopardized.

      Don’t worry – you’ll receive a lot of training with verbal and nonverbal cues (and of course assessments).

      All the best,
      Francesca

      Reply

  6. Katie O'Brien
    Jun 21, 2021 @ 10:58:53

    1.) As most clients do not even return to counseling for a second session, it is important to get an accurate understanding of their problems early on, even during the initial intake session if possible. Research has shown that client expectations based on the initial sessions have a strong influence on the outcome of treatment and that they must feel like their clinician can help them with their specific issues, much like people may not return to a physician if they feel the doctor is not adequately addressing their concerns. Assessments can help identify areas of concern. Research has also found that the quality of the therapeutic relationship during the early stages of treatment has more influence on outcomes than the quality of the relationship later down the line in counseling. In order for a clinician to get the most out of their intake session, the client has to feel like the clinician is trustworthy and will listen to them, so building the therapeutic relationship quickly is very important. Administering both formal and informal assessments and going over the results with clients can help build that relationship and give clinicians a good idea of the clients problems, while also helping to make sure the clinician does not underestimate the issues. If the client does not feel the therapeutic bond or feel like their concerns were addressed during an intake session, they may not return or get much out of the counseling.

    2.) As the book notes, predicting suicide can be difficult as moods can vary so greatly day to day, or even hour to hour. My most pressing concern would be deeming a client at minimal risk for suicide and then have them attempt suicide after the session. The biggest concern is missing a risk factor or warning sign that could have somehow predicted the change in their behavior. At the same time, I would not want to risk the therapeutic relationship by being the therapist who always calls for hospitalization when it is not truly warranted, either. Of course I would rather that than finding out a client’s attempt was successful, so the concern is finding the right balance and knowing what to look out for.

    3.) Besides diagnosing clients, assessments can also be helpful in treatment planning, monitoring client change, and evaluating the effectiveness of counseling. During treatment planning, assessments help clinicians understand client characteristics like environmental and social factors impacting their issues, cultural factors impacting issues, and the clients strengths, which can be used to select appropriate treatment methods. It is also important to monitor clients progress throughout the treatment, to see if the client is making positive gains, has become “stuck,” and to see what is working and what is not working. Research shows that feedback during treatment has a positive impact on treatment outcomes, as it allows the clinicians to adjust their techniques if necessary. Assessments can also be helpful in providing accountability data to parents, schools, insurance, and other institutions, that treatment is working by showing measurable progress in the client.

    4.) Formative assessment is the continuous or intermediate evaluation typically performed to examine the process and summative assessment is more cumulative, concerning an endpoint or final evaluation. Formative assessment tends to involve the process where summative assessment involves the product. Formative assessment is useful in seeing clients progress throughout treatment, but also which factors or approaches are contributing to the outcome. For example, if a client presenting with depression is formatively assessed, the clinician might notice trends between lower depression ratings corresponding to specific treatment methods used during that specific time period with lower depression ratings, and determine that those methods work well with this client. Similarly, they might notice higher depression ratings relating to methods that are not working so well, or other factors that the counselor may not have noticed initially, allowing them to explore that factor more deeply and how it relates to the higher depression scores.

    Reply

    • Jennifer Vear
      Jun 21, 2021 @ 14:22:31

      Hi Katie!

      I like how you mentioned in question 3 how it is important to consider environment, social, and cultural factors in assessments. You want to make sure that the assessment will be accurate for the correct population. Also, you are right that it is important to measure progress. This could determine if the clinician is the right fit for the client, if the clinician needs to change something or try another CBT technique, or if they are progressing great and the treatment process is working. Great points!

      Reply

  7. Francesca Bellizzi
    Jun 21, 2021 @ 11:18:07

    1) When gathering information about a client’s problems, it is important to get an accurate understanding early in therapy because this formulation drives the therapeutic process and, in turn, predicts the long term outcome of treatment. Since defining the client’s problem and developing a solid formulation is a driving force of treatment goals, underestimating the severity of the problem and symptoms can result in a negative outcome upon completion of counseling. Similarly, if the client’s problems are not well defined and understood there may be other problems that become overlooked and therefore, untreated.

    2) The main concerns that come to mind when I am presented with a suicidal client is making sure that I do nothing that would come off as offensive or insincere. These concerns, for me, are the foundation of turning the client away with the thoughts that “nobody cares, nobody wants to help”. Through the work that I have already experienced, this has been a big presenting problem as these thoughts may cause an influx in suicidal ideation, hopelessness and overall feelings of depression. Similarly, the biggest concern I would have is safety. As counselors it is our job to make sure that the individual is safe and to do the best that we can to make sure they do no harm to themselves. With the concept of safety, follows the concept of higher level of care (hospitalization, residential facilities, etc.) which can tear are the rapport built with the client – hindering the therapeutic relationship and possibly causing mistrust. Lastly, there is the overall concern of being no help and the client making an attempt to commit suicide or worse – take their own life.

    3) Assessments are certainly crucial when beginning the counseling process as they determine a diagnosis and help the counselor understand the client’s presenting problem. However, assessments can be used throughout the counseling process in order to determine client progress and even how their presenting problems are impacting their daily living. In considering the client’s progress throughout treatment a positive outcome is desired. By using assessments to determine progress it helps the counselor reflect upon the effectiveness of the interventions that they are using and alter the treatment plan accordingly. Likewise, these assessments are useful in determining how the client’s presenting problems are impacting their daily life. For example, if a client comes in and presents with a problem of depression there may also be substance use problems. By being able to identify two comorbid problems, it helps the counselor better “tailor” the treatment to treat the individual and not just the diagnosis. Most importantly, assessments can be used to determine a client’s strengths. These strengths are important to identify as they are considered to be resiliency factors that keep the individual going, and may help the individual in understanding that there is more to them than their illness.

    4) There are two major types of assessment, formative and summative. Formative assessments are evaluations that are given throughout the counseling process in order to examine the effectiveness of the treatment. For example, a therapist might administer the Beck Scale for Suicidal Ideation once every two sessions to check on the severity of the clients suicidality and determine if progress has been made, and if not – to change up the therapeutic interventions being used. Summative assessments, on the other hand, focus on the endpoint and final outcome (i.e. the initial client assessment and then assessing the client at the conclusion of treatment). Formative assessments are highly beneficial in counseling because it allows the treatment team to determine whether their plan is effective for this particular individual and their presenting problems. This process not only helps the clinician deliver proper treatment, but it also helps the client as they can reflect on the progress that they have made – only strengthening the rapport and giving them some level of hope that things can change. For many, the main part of treatment is progress and allowing them to see their progress strengthens their determination.

    Reply

    • Kaitlyn Tonkin
      Jun 21, 2021 @ 14:55:34

      Hi Francesca,
      I liked that you mention how assessments can also examine a client’s strengths. I feel like as psychology students, we often think about the presenting problems (and underlying issues) and we don’t look at the other side of that. I think it’s important to measure a client’s strengths as well because it can help the counselor understand their client better and could influence how the counselor structures treatment plans. I also liked that you mentioned how determining a client’s strengths can help the client with their diagnosis and understanding they are not just their disorder.

      Thanks for the insight!

      Best,
      Kaitlyn

      Reply

  8. Frayah Wilkey
    Jun 21, 2021 @ 11:44:10

    (1) Early therapy sessions should include gathering an accurate understanding of the client’s problems. According to the text, expectations that the clients build during
    initial sessions have a huge influence on the outcome of therapy and can encourage them to return, rather than quit after one or two sessions. These expectations will be positive if the therapist is able to accurately assess the clients concerns. If the client does not feel like the therapist is understanding their needs and ‘where they’re coming from’, it can cast a negative light on the client’s views of the therapist and their expectations, and they may not feel comfortable returning. Goals for treatment should also be established early on because most therapies are not infinite. The therapist should be able to identify the problems and set therapeutic goals during the initial stages so that sessions can be as effective as possible. Overall, the therapist should explore each problem using different perspectives and gather as much information as possible about major presenting problems so that the therapy is effect and the client feels heard.

    (2) I think that the biggest concern for assessing a suicide is getting a false negative like we talked about in class. I would be worried about not giving someone enough support when they really need it because my assessment was inaccurate. The issue of false negative for suicide could lead to extremely harmful consequences. I would also be concerned with what interventions are too much vs. too little. Inpatient settings aren’t a cure-all and can sometimes cause more damage as we’ve talked about in PSY 600, so it is a fine line in deciding what risk level the client is. It can be really difficult to be a deciding factor in whether or not someone gets put in the hospital or gets to go home, and even more stressful when you feel like you play a role in reducing their suicidality.

    (3) Assessments can go beyond the scope of determining diagnosis for a client. They may be useful in informing the therapist to the degree that certain issues effect the clients daily living and what issues are most important to the client. Knowing what specific issues have the greatest effect on the client will guide the treatment plan and allow the therapist to have sessions that are client specific because not everyone with X diagnosis will benefit from the same treatment outline. Also, subcategories in some assessments can help with this by showing the therapist certain areas that may effect clients more than others within the same diagnosis.

    (4) Formative assessments refer to the continuous or intermediate evaluation. This is usually performed to examine the process. Summative assessments refer to the evaluation of an endpoint or a final evaluation. These are more cumulative than formative assessment and are focused on the complete evaluation of the product. Both can help play a role in evaluating services provided to the client, they are just focused on different areas of information.

    Reply

    • Katie O'Brien
      Jun 21, 2021 @ 12:34:37

      Frayah,
      I agree, the false negative for a suicide attempt is what I am most concerned with as well. On the one hand, I see how the “better safe than sorry” approach might win out in some cases, whereas in others, the risk of further harm of hospitalization might be the worse option. Likely a lot of factors go into it, like the client themselves, how they’re presenting, and your relationship with them, but I do wonder how often it is that clinicians feel 100% confident in their decision and its consequences. I’d rather a client alive and angry with me for having them hospitalized than have successfully committed suicide, but at the same time don’t want to increase risk unnecessarily. It seems like a fine line to walk in most cases.

      Reply

    • Valerie Graveline
      Jun 21, 2021 @ 12:37:10

      Hi Frayah,

      I thought your point about deciding what interventions might be too much versus too little was really important. I agree with the idea that inpatient programs could potentially make matters worse and aren’t the best option for everyone. I think I’d also be concerned about the therapeutic relationship while deciding methods of treatment in these instances, because I wouldn’t want the client to stop trusting me if something like inpatient might be the best course of action for their circumstances, despite them not wanting to go. I think it’s really important to address the concerns we have when being confronted with suicidal patients, and I’m glad you brought up these points because it made me think further about the different courses of action.

      Reply

  9. Angie Petrella
    Jun 21, 2021 @ 12:04:55

    1. It is important to get an accurate understanding of the client’s problems early on, as this has been proven to help foster positive therapeutic expectations. Research indicates that the expectations that clients build during the initial therapy sessions, including the intake, can have a significant influence on their overall outcome. With that being said, making sure to build rapport and gather important information about the clients problems can help them feel better about the therapeutic process overall, and even lead to better outcomes in the long run. It is also important to get an accurate understanding of the clients problems early in therapy because it can help clinicians decide what assessments will be helpful to use so they can begin the treatment planning process.

    2. My biggest concern that I have about working with a suicidal client is not being able to help them enough to prevent them from committing suicide. If that were to happen, I worry that I would constantly wonder if there was more I could have done to help the or if there was something else I could have tried and if I did, maybe they wouldn’t have gone through with it.

    3. Aside from determining diagnosis, assessments can and should be used in various ways for therapists to understand how presenting problems are affecting clients. First and foremost, assessments should be used to help clinicians come up with a treatment plan which includes both the goals of treatment as well at the interventions that will help the client achieve said goals. With that being said, assessments play a big role in gathering quality information that is useful to enhance the evocativeness of treatment. Assessments used throughout therapy can also provide great feedback for the client and clinician to monitor progress.

    4. Formative assessment is a continuous evaluation used to examine the process whereas summative assessment is focused more on the endpoint or final evaluation of treatment. One major benefit of formative assessment is that is allows the clinician to have up-to-date information on how the client is responding to treatment. This will then allow the clinician to know if they need to modify any interventions that are in place to ensure the client makes progress towards their end goal. Additionally, research has revealed that the more frequent a client is assessed, the better their treatment outcomes will be considering it allows clients and clinicians to provide feedback to one another. Ultimately, this will also enhance the therapeutic relationship, which as stated above, can also significantly influence a clients outcome.

    Reply

    • Giana Faia
      Jun 21, 2021 @ 20:02:39

      Hi Angie,

      Your concern about working with a suicidal client is a very valid one that I’m sure many people can relate to. For me, thinking of all the tools and protocols that we are going to learn in the years to come helps minimize the worry about facing a suicidal client in the future, for me. The worry might still always be there, but at least we will be well prepared when the time comes.

      Reply

  10. Valerie Graveline
    Jun 21, 2021 @ 12:29:56

    1) It is important to get an accurate understanding of a client’s problems in the intake and early sessions because what is addressed early on in these initial sessions heavily influences the paths of treatment. It was said in the reading that counselors select interventions based on where the client is in the change process, so for the treatment to be effective, the client’s positioning in the process must be understood. Not only this, but it is crucial to get an accurate understanding of the client’s problems because if the severity of their problems are overlooked, then the counseling is more likely to result in a negative outcome. On the other hand, it was mentioned in our reading by Beutler et al. (2004) that the quality of the therapeutic relationship in early sessions has been shown to be a predictor of positive, long term results in comparison to the relationship later in the process. Intake sessions are especially important because clients often don’t return after the first session, so the therapeutic relationship and rapport should be established right from the beginning.

    2) Some of my initial concerns when being confronted with a suicidal client includes if I cannot prevent them from committing suicide. I feel as though I would feel very guilty if I could not prevent someone from committing suicide, and am fearful that it would deeply bother me. I think this also comes from the fact I have had personal experience with friends who have been suicidal. I know a relationship between friends is much different than a relationship between clinician and client, but I feel as though that’s where this fear of feeling-too-deeply might come from. In the reading, it mentioned that the discussion of suicide in a clinical setting does not actually increase the likelihood of committing suicide, which was one of my concerns prior to reading this as I would be concerned about triggering someone and therefore, would feel hesitant to address it. However, I understand the importance of addressing suicidality in clients since it is so prevalent and I hope to work through with these initial concerns that I have.

    3) Assessments have far more uses in the therapeutic process than just determining diagnoses. For instance, assessments play a role in treatment planning, monitoring client change, and evaluating the effectiveness of interventions throughout the process of counseling. With this in mind, assessments can also help clinicians understand how presenting problems are affecting their clients. There are assessments that address client’s coping styles, attachment styles, their reactant/resistant tendencies, etc. These factors are crucial in a clinician’s understanding of a client’s presenting problems because with coping styles, clients may tend to respond to distress by internalizing the problem, or they may externalize the problem. With attachment styles, the client’s style may contribute to their current issues and may also impact the therapeutic relationship, so it is important a clinician is aware of this potential variability in their clients. Reactant and resistant tendencies can be addressed with the Therapeutic Reactance Scale, which predicts a client’s resistance to the counseling process. These factors are important in understanding client’s because there is so much variability in how client’s may receive different interventions or how they may interact with the process of counseling itself. Clinicians need to have a holistic understanding of their clients as each client will be unique, and assessments can greatly help in this understanding.

    4) In the realm of counseling, a formative assessment is a continuous evaluation that is used to examine the counseling process itself, and a summative assessment is an evaluation that examines an endpoint or final goal of counseling. The main difference between a formative and summative assessment is that a formative assessment focuses on the process, whereas a summative assessment focuses on the product. When I was in highschool, my school actually used the terms “formative” and “summative” assessments in regards to quizzes and tests, with a formative assessment being a quiz and a summative assessment being a test. I think imagining a formative assessment to be a quiz is helpful, since in a school setting it is considered to be a tool to check in on a student’s current progress and retention of the information being taught. In the therapeutic process, a formative assessment can be seen as checking in on a client’s progress in order to see if the current interventions are working. Imagining a summative assessment to be a test, since in a school setting they are used to see if a student had an overall understanding of a certain domain, helps me understand the idea that summative assessments examine the “end goal” of treatment in counseling. In the therapeutic process, a summative assessment can be seen to measure a client’s overall outcomes of therapy.
    Benefits of formative assessments might include that the clinician can ensure whether or not their interventions are helping, or whether the client’s presenting problems are getting better or worse. It allows the clinician to better tailor their paths of treatment and interventions to better suit the clients needs. Not only this, but it allows the clinician to ensure they are properly understanding the client’s problems, and that they are continuously addressing what needs to be addressed.

    Reply

    • Yoana Catano
      Jun 21, 2021 @ 13:02:03

      Hi Valerie,
      Thanks for your example in “formative” and “summative” assessments in regards to quizzes and tests, I like the idea that a formative assessment is like checking in on a client’s progress in order to see if the current interventions are working. I think is a good way to understand the process in counseling and the importance of assessment to obtain and provide accurate information. Sometimes in real practice checklists and scales are used only at intake and not during the process, leaving the progress to client of therapist perception, which is also important, but it is better to monitor the service with a validated instrument.

      Reply

    • Giana Faia
      Jun 21, 2021 @ 20:12:58

      Hi Valerie,

      I liked how you highlighted the point that if the clients problem is overlooked, then counseling could result in a negative outcome. In order to make sure their problems are not overlooked, we must address each major problem that they are faced with. We must then take the steps to address the degree in which these problems are affecting them. By understanding and being aware of the range of problems at hand during the early sessions in therapy, then we can properly assess and formulate treatment plans.

      Reply

  11. Yoana Catano
    Jun 21, 2021 @ 12:54:31

    1. As a clinician, it is imperative to understand client’s problems to better facilitate change or provide help. Definition of the problem comes with the client and they are the best to explain what is happening, we will clarify in a collaborative way, a solvable problem or prioritize them. Time is important in the process, and it has been shown in therapies like The brief therapy model, understanding the problem even in the referral, will facilitate strategic conversations leading to change. It is important to know the symptoms, the real problem, motivation to change and also the individual strengths to change. Accurate information will prepare client to transition to different stages in therapy, design or match a treatment, set goals and select appropriate instruments. Mohr (1995) mentioned that underestimate the severity of client’s problems can result in negative outcome, this shows that our role as clinicians is investigate what are the client’s needs to provide the best treatment possible in a timely manner.
    2. It is not a problem for me to practice the QPR in suicide prevention. Question a person about suicide – Persuade someone to get help – Refer someone to the appropriate resource. And in a basic way, this training helps communities to recognize potential suicidal ideation and facilitate help. However, not all clients will show symptoms related or will disclose suicidal ideation. Some could mask their symptoms. Having a good treatment team will facilitate to consult with other clinicians or psychiatrist any potential risk or other ways to assess suicide.
    My main concern related to assessing Suicide has been the legal responsibility that this brings in case of suicide in a current client. According to the Centers for Disease Control, each year in the United States, approximately 30,000 individuals die by their own hand. This is the equivalent of one person every 18 minutes, or 80 each day. We all probably know someone that has died due to suicide and we know the guilt that is associated to not being able to provide help to prevent it. As clinicians, the responsibility is higher and probably the guilt in case this happens. I am certainly waiting for some other training to facilitate this process.
    3. In the initial assessment is important to provide an accurate diagnosis of the client or situation and using the right instruments or techniques will determine the overall success of the treatment. But assessment should be permanent during the counselling process, formal and informal in monitoring client progress, to see changes in the severity of the problem or lack of improvement, sometimes other problematic behaviors could appear or the initial diagnosis could change, quality assessment information facilitates the clinical decision-making process, to modify treatment, set new goals or refer to other specialties. Assessment is also important to evaluate the service provided and research in therapy effectiveness.
    4. According to Whiston (2013) the difference between Formative assessment and Summative assessment is explained by the distinction that the focus of formative evaluation is on the process, whereas the focus of summative evaluation is on the product. This fall in the idea of providing accountable data to payors like insurance or parents of the client or client themselves who are paying for a therapeutic process, this will be a formative assessment. Formative assessment also will provide important information to the clinician about the process and modifications that need to be made and to the client in the sense of insight within the process.
    On the other hand, research about effectiveness in a therapy could be related to a summative assessment, providing important information for individuals, school or science in general. Both evaluations could be similar and according to Hill and Lambert (2004) should include: 1. Clearly specify what is being evaluated 2. Measuring from multiple perspectives (client, counselor and outside observer) 3. Using diverse types of assessments (rating scales, checklists, etc.) 4. Using symptom-based and a-theoretical measures 5. Examining as much as possible patterns of change over time (prediction).

    References
    Hill, C. E. & Lambert, M. J. (2004) Methodological issues in studying psychotherapy processes and outcome In: Whiston, S. C. (2013). Principles and applications of assessment in counseling (4th ed.) Brooks/Cole.
    Mohr, D. C. (1995) Negative outcome in psychotherapy: a critical review. In: Whiston, S. C. (2013). Principles and applications of assessment in counseling (4th ed.) Brooks/Cole.
    Whiston, S. C. (2013). Principles and applications of assessment in counseling (4th ed.) Brooks/Cole.

    Reply

    • Francesca Bellizzi
      Jun 22, 2021 @ 16:10:44

      Hi Yoana!

      I love that you’ve received training in regards to facilitating the assessment process for suicidality, and I really enjoy hearing your perspective as you have already been working with clients due to your previous education. I also really appreciate that you shed some light on the prevalence and frequency of suicide, as it reinforces that it is a very common issue that many of us will come across in our future practices.

      All the best,
      Francesca

      Reply

  12. Lisa Andrianopoulos
    Jun 21, 2021 @ 14:30:42

    It is important to get an accurate understanding of the client’s problems early in therapy because it has implications for building the therapeutic relationship, treatment planning, and outcomes of counseling. In the initial sessions, you are getting to know your client, and your client is getting to know you. Accurately understanding (and communicating that understanding) of your client’s problems is important to forming a positive bond between the client and counselor. According to the readings, clients build expectations early. How a client perceives your ability to help them not only relates to whether they come back for subsequent sessions, but also influences their perceptions that positive outcomes are possible. It also increases the degree to which they feel heard and understood by you, which is essential to a strong therapeutic relationship. Additionally, one must have an accurate understanding of what the problem is in order to know how to treat it. Thus, accurate understanding is critical to choosing appropriate treatments. Chapter 6 discusses “problem assessment” and states that one of the major reasons for negative outcomes in counseling is underestimating the severity of the problem. Another is not recognizing and prioritizing the range of issues that are present. There is also a significant amount of research that indicates a strong relationship between the quality of initial sessions and counseling outcomes.

    As a beginning therapist, my initial concern about confronting a suicidal client is getting it right! It is extremely important to make an accurate assessment of suicide risk because someone’s life is at stake. As stated in the chapter, the ramifications of a misdiagnosis are potentially serious. Lethal or serious harm may occur that could have been avoided. Thus it will be very important, especially as a beginning therapist, to err on the side of caution, meaning it’s better to “over explore” rather than miss something. My only worry would be coming off as over the top and/or “turning off” the client; though that is the risk you must take. The chapter also talks about a strong connection between depression and suicide risk. Morrison’s (2007) advice to assess depression with every client resonated with me. I think that this is a practice I will use moving forward.

    Assessments can help therapists understand how presenting problems are affecting clients because they help inform the therapist about client progress, provide information important for treatment planning and help evaluate the counseling provided. Case conceptualization for example, is an ongoing process. In order to comprehensively assess the client’s problem, you need to have a clear understanding of it at each stage of the process. According to Whiston (2013), inherent in the first step of case conceptualization, “…the focus is on the client’s problems and the processes that lead to the problematic outcomes.” There is considerable research to support that, when the counselor is informed of the client’s progress or lack there of, the counselor can adjust, modify or adapt the counseling process and treatments, which then leads to better outcomes. Formalized assessments, in conjuction with other information gathering is important because research shows that such statistical and acturarial assessments are better predictors or client outcomes than clinical judgement alone. In effect, the counselor uses assessment throughout the counseling process not to just understand the initial problem, but to gage progress and change (for better or worse) along the way, with the ultimate goal of leading to positive client outcomes.

    A formative assessment is used when one is interested in evaluating the process. It is a continuous or intermediate evaluation. An example of a formative assessment is the ongoing assessment of a client’s problem as discussed above. By continuously assessing a client’s problem you are also assessing the counseling process through monitoring progress and outcomes. The advantage of this is that it allows you to modify, adjust and change according to the needs of the client at each stage of the process. Alternatively, a summative evaluation refers to evaluating the “endpoint;” meaning that it is a final evaluation. These types of assessments are important for assessing final outcomes and are often used to provide evidence of accountability. For example, an institution or agency might be interested in examining the quality of a particular service, or an insurance company may want validation for paying for a particular treatment.

    Reply

    • Valerie Graveline
      Jun 21, 2021 @ 17:59:22

      Hi Lisa,

      I enjoyed your point about erring on the side of caution with clients and “over exploring” instead of potentially underestimating suicidality. I think that’s really important to think about how “over exploring” a problem most likely wouldn’t cause harm to a client but could provide them with more insight, whereas underestimating the problem could have detrimental impacts. I would hope that if our clients know we truly care about them and are genuine within the therapeutic relationship that is built, then they will hopefully not feel as though our exploration with them in any problem is “over the top”. I definitely agree with you that it’s better to take that risk in over-exploring than to not.

      Reply

    • Sergio Rodriguez Pineda
      Jun 22, 2021 @ 18:41:41

      Hi Lisa,

      I really agree with the point that you mentioned regarding the “side of caution”. I consider it’s way better to make a mistake because I did something extra than missed something. Suicide is a really concerning topic, any mistake not considering a situation with the importance it is supposed to be can be a life or death matter. Also, assessing is an important element related to clients, and I would like to add to your point that it is important to consider that a client who is not depressed often could have the intention or impulse to do it, as it happens with BPD patients.

      Reply

  13. Giana Faia
    Jun 21, 2021 @ 14:51:35

    (1) Getting an accurate understanding of the client’s problems is crucial early in therapy. Intake interviews are used to help us gain information on the client’s concerns, current problems, and background information. In order for the insight and action stages to occur, we must first identify what the client is struggling with. If we do not clearly understand the client’s problems and downplay them, it could result in a negative outcome in therapy. We need to ensure that the range of problems the client faces are addressed completely. Once that is done, we need to gather specific information on each problem, then assess the intensity of each, assess how much the client thinks the problems can be changeable, and discuss what methods have been used to change these problems in the past. By identifying and understanding the client’s problems, it lays the foundation for the rest of the therapy and treatment.

    (2) An initial concern of mine when confronted with a suicidal client is just discussing if they are suicidal. For a while I thought that by asking they would get offended or sit would give them ideas. However, in chapter 6 is clearly states how this is not the reality of it. By talking about suicide, it does not increase the risk of it. Another concern is not being able to change their mind if they are seriously considering suicide. Just the idea of someone’s life in jeopardy at all is nerve wracking to most people, so these are things to think about when faced with a suicidal client.

    (3) Assessments help us understand how presenting problems are affecting clients by gathering information in many different areas of the clients life and using that to assess the problems at hand. Information such as demographic, client background, medical, client’s presenting problem, and other relevant information helps us to understand how the problems affect their daily life. Within assessments, there can be checklists, specifically standardized checklists such as The Symptom Checklist-90-Revised or Brief Symptoms Inventory. There are also rating scales used to measure the degree of the problem. These assessments are useful for gauging how much the presenting problems are impacting the client.

    (4) Formative assessment is the continuous or intermediate evaluation usually performed to examine the process. Summative evaluation is more cumulative and concerns an endpoint or final evaluation. For the formative assessment, it is focused more on the process, whereas summative focuses on the product. Formative assessment is beneficial for being able to track the client’s progress throughout therapy. With this assessment, it is helpful for making changes to treatment plans and altering them to better fit the client’s progress.

    Reply

    • Yoana Catano
      Jun 23, 2021 @ 23:07:48

      Hi Giana,

      I understand that suicide is difficult to talk about, but I have learnt from the QPR training “ask a question, save a life”, which brings the idea that talking or making it real in a conversation will help people to reconsider or seek help. Research has shown the majority of those who attempt suicide give some warning signs, verbal or behavioral, of their intent to kill themselves, so we will have an opportunity to help someone just asking. I also learnt in this class that suicidal thoughts are common but suicidal acts, threats and attempts are less common, but much more frequent than most people realize. I hope we can get more training in helping with a suicide emergency.

      Reply

  14. Sergio Rodriguez
    Jun 21, 2021 @ 22:44:28

    (1) Share your understanding on why it is important to get an accurate understanding of the client’s problems early in therapy (i.e., intake/early sessions).

    Several factors should be analyzed to identify the importance of understanding the client’s problems in the early sessions. The first element to analyze is the reason for consultation. Many patients come to the consultation with a reason for such as: “I do not feel good,” “my partner broke up with me,” I do not feel comfortable with my body.” which seems within the expectations. However, on many occasions, those consultation reasons could be more severe. Once the therapist digs into the clients’ behavior, thoughts, and emotions, the therapist can find that the client’s life could be at imminent risk.

    In situations where the person is at latent risk and needs immediate and practical help, if the therapist does not identify the problem in the first sessions, it may be too late for the patient to stay alive by the time of the intervention. The other reason why I think it is important is that, like many other things, therapy is still a product or service, and the client must want to consume it and feel that their needs are or will be met as the sessions progress. In this sense, a correct diagnosis and identification of the problem will allow a greater therapeutic engagement and patient commitment to the therapy.

    (2) Understandably, especially as a beginning therapist, the thought of assessing suicide can be anxiety-provoking. Share a few of your initial concerns when (not if) you are confronted with a suicidal client. (Keep in mind, you will learn a lot more about responding to suicidal clients in future classes and on your practicum/internship.)

    As a therapist, it is very challenging to address any topic related to suicide, probably because suicide is the closest construct to death that a clinician usually has to address. Suicide means latent risk, so every word, interpretation, assessment, or decision made by the clinician is seen as a life-or-death decision. In my experience, I have been confronted on many occasions with situations where the patient (adolescent) has presented suicide attempts, suicidal ideation, or some suicidal behavior. The first experiences were of great anxiety and fear related to not knowing how to address the severity of the behavior. What allowed me to have more peace of mind when dealing with a suicidal client was learning and better understanding suicidal behavior and assessing it. The evaluation is fundamental because it is the starting point for any subsequent procedure to be performed with the patient. Likewise, therapies such as Dialectical Behavioral Therapy (DBT) are essential because they have cognitive and behavioral strategies ready for the clients based on their current situation. I hope to learn more about suicidal assessment to feel more confident when a patient with suicidal behavior comes to me.

    (3) 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?
    Psychological assessment is based on the scientific method, and the application of psychological instruments represents a significant part of it. In other words, the psychological assessment process may include different measurement procedures, identifying specific dimensions of the subject, his or her environment, and the relationship between them. The clinical assessment facilitates the choice of the most appropriate therapeutic strategy. The findings obtained through the implemented assessment will allow the practitioner to make future estimates around four aspects:

    a) The length of the treatment: this means that the therapist and the patient can have a better idea of how long the therapy will go for and, even though, considering flexibility. b) the format of the therapy, i.e., how it can be carried out, if it is more feasible to do it in person or by video or teleconference, as well as the duration and frequency of therapy, such as measurements or evaluations throughout the therapy, among other logistical aspects. c) the resources that can be applied (including the techniques to be used) imply the intervention model to be used and the strategies to be used at any given time based on evidence-based intention.

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

    Formative assessments are evaluations that are given throughout the counseling process to assess the therapeutic process. A summative assessment is focused on the endpoint or final evaluation. In other words, this type of assessment is concerned more with the final product rather than the process. The benefits of formative assessment are that when you get the chance to have a continuous evaluation throughout the process, that will provide a better understanding of how effective the treatment is being. Also, the feedback for the client will give them a sense of how much progress they are having and what type of specific work has to be made to pursue the goals. Likewise, it will facilitate for the therapist to make arrangements for the therapeutic process and evaluate himself and adjust the treatment interventions.

    Reply

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Adam M. Volungis, PhD, LMHC

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