Client Assessment in Psychotherapy
In this client assessment example paper we will analyse what is assessment in psychotherapy and how it can be used with clients. Assessment in psychotherapy is the collection of information, which is sometimes raw data in order to identify, analyse, evaluate and arrive at a solution or address the problem, an issue or circumstances. An assessment can include numerous components such as norm-referenced psychological tests, informal tests and surveys, interview information, school or medical records, medical evaluation and observational data.
In the academic world, assessment and testing are sometimes used interchangeably but according to Cohen & Swerdlik, 2002; Gladding, 2009, “assessment is gathering information while testing is the measurement of psychological constructs through instruments or specific procedures” Psychological testing and assessment in psychotherapy are quite similar to medical testing. In the same way that a medical practitioner would order testing, which would include X-rays and blood test to ascertain the cause of the symptoms, is the same way a psychological evaluation is used to understand what cause the symptoms of the person with psychological issues. Psychological tests are a part of psychological assessments and are administered for a variety of reasons such as, but are not limited to, testing the aptitude of children who experience unexplainable low grades. Dexterity, reaction time and memory skills to diagnose neuropsychological conditions such as brain injuries or dementia.
Assessments are used to plan interventions, for diagnosing clients. Therapist, however, have to be careful how patients are labelled in their diagnoses because this could have far-reaching implications for the clients’ future as it relates to their jobs and personal relationships with their families and significant others. Assessment plays an integral role in all aspects of counselling and helps to make and measure progress in the counselling environment. It is impossible for a counsellor to function without the understanding of the processes of assessment in psychotherapy. Assessing a client, aids the therapist in determining the client’s strength, interests, expectations and very importantly; identifying the nature and extent of the concerns or problems. Garnering all this information will allow the therapist to construct a strengths list on which to base interventions during the planning stage. Identifying the client’s expectations will assist the therapist in determining treatment or rehabilitation goals. Assessment, however is nothing new, as it began in the 19th Century among biologists, Charles Darwin and his cousin Sir Francis Galton. According to Cohen & Swerdlik.
Although, by modern standards, Galton’s work seems to be irrelevant in terms of assessment, he investigated the relationship between physical characteristics and mental capacities. For example, he examined physical characteristics such as height, weight, arm span, head length, finger length and compared them to mental and behavioural characteristics such as auditory and visual acuity, grip strength and reaction time. Galton set up a lab and charged persons a small fee to take these tests.
Galton found out, based on his assessments, that individuals with severe retardation were indifferent to sensory perception such as hot, cold, or pain, which led to the investigation of how physical characteristics may be related to discerning sensory information tests (Anastasi & Urbina, 1997). Out of Galton’s assessments, it is worthy to note that he believed anything could be tested which led counsellors today to measure processes and constructs such as interests and emotions.
Ways in Which Assessment is Important in Ensuring Successful Outcomes in Therapy
People seek or engage in counselling because there are issues that need to be addressed and these issues usually affect their daily living. These issues might or might not be severe but essential enough for the individual to want to address them. It is therefore the task of the therapist to, as much as is possible, assist the client in arriving at a solution and this can be done by beginning with assessing the client.
Assessment uncovers the mystery of the client’s presenting issues and usually reveals the underlying problems. It is a skill within itself because the therapist has to ask the right questions to ascertain how these problems fit into the comprehensive picture of the client’s way of functioning and how the problem influences the individual’s experience dealing with the problem.
The therapist also has to take into consideration the client’s interpersonal style, thought processes, emotions and existential outlook during the assessment in order to plan a therapeutic approach. One of the pros of assessment is the ability to place clients in the right intervention programs. Assessing, recording and tracking outcomes in therapeutic sessions, ensure that neither the client nor the therapist work is futile. It is therefore, imperative that there is absolute certainty, that if the same assessment were administered to the same client at another short period of time, it would prove to be reliable. According to Austin and Crawford. A sound assessment also identiﬁes the client’s health status, needs, and strengths.
According to Palmer and McMahon “Diagnosis involves matching signs and symptoms of the client with a known cluster of symptoms (a syndrome). The purpose of making a diagnosis is to allow the counsellor to intervene in the most effective way possible. However, change is only possible within the limitations set by the system or systems of which the person is a part and with the resources at the person’s disposal”.
Poorly done assessment, results in vague and misleading results that will pose several problems and does not show the client’s need for the programme; in addition, the therapist would have to make up a program without having accurate, systematic date or results and this ultimately would not generate successful outcomes.
This is like a domino-effect. Poor assessment leads to inaccurate results, which leads to mistakes and inaccurate approach which does not meet the client’s needs and ultimately resulting in not achieving client outcomes.
The Role of the Therapist in Using Assessment Instruments
One of the therapist’s major role in using assessment instruments, is to perform deductive reasoning. In other words, the therapist should garner facts from the client and develop a hypothesis which is based only on the facts obtained and not on pre-existing assumptions.
A quote from Sherlock Holmes “The Adventure of the Cardboard Box”, a classic series, written by A. C. Doyle, comes to mind: “It is a capital mistake to theorize before you have all the evidence. It biases the judgment. Let me run over the principal steps. We approached the case, you remember, with an absolutely blank mind, which is always an advantage. We had formed no theories. We were simply there to observe and to draw inferences from our observations.”
Another role of the therapist is to engage the client and helping the individual through difficult or distressing issues, whether perceived or real. Apart from asking open-ended questions, the therapist should have in-depth knowledge of the assessment tools he or she will use for the given situation and should be able to check and re-check his or her own diagnoses for accuracy. Using the aforementioned method, the therapist is able to identify those clients who present in some counselling sessions as being in control of their behaviour or situation but are really not or those who are manipulators. When deciding on an assessment tool, the therapist should take into consideration the age, cultural background and any specific medical problem or disabilities the client may have. In the assessments, the therapist may also include interviewing persons who are close to the client, such as teachers, co-workers or family members. Interviews of this nature, however, would only be performed with written consent from the client.
Psychological assessment plays an integral role in therapy. It is one of the core functions which determines a favourable outcome. A competent therapist who carries out a thorough assessment, is more likely to plan an effective course of therapy as oppose to the therapist who does not use assessment tools or isn’t competent in this area.
Assessment should not be used as a quick method to provide a label in diagnosis but as a meaningful method in arriving at a helpful and full understanding of the issues that the client faces and in so doing, plans an effective therapeutic approach.