Friday, September 14, 2012
Assessment in Counseling
Assessment in counseling provides the counselor with information to understand clients, and may be therapeutic in clients' self understanding. People are complex, and assessments can provide the counselor with an broader and more accurate perspective of the client (Laureate Education, Inc., 2010). Utilizing a broad range of formal assessment instruments and informal information gathering techniques in a variety of counseling circumstances assures the counselor of having the appropriate information necessary for case conceptualization, treatment planning, ongoing therapy, and tracking progress (Juhnke, 1995; Whiston, 2009).
The Role and Importance of Assessment in Counseling Practice
Whiston (2008) described assessment as integral to counseling. Formal and informal assessments help counselors more accurately assess client issues, create case conceptualizations, select effective empirically proven therapies, and evaluate ongoing progress (Whiston, 2008). Wall (2004) suggested formal assessments provide information for initial and ongoing evaluation with minimal personal bias as well as the data necessary for effective interventions. Assessments help counselors judge their own effectiveness and how the intervention affects the client (Wall, 2004). Furthermore, assessments can be therapeutic, offering objective information for the client's self-discovery and may engage the client in self-reflection, which can be valuable in maintaining psychological health (Whiston, 2008). Without utilizing appropriate assessments, counselors may limit the quality of care they provide to clients.
Two Situations for Using Formal Assessment in Counseling
Initial Assessment of Client's Self-Reported Symptoms
During the initial interaction in counseling, clients report one or more challenges or symptoms with which they are presently struggling. Prior to creating a case conceptualization or diagnosis, addressing the severity and complexity of symptoms is critical to the counseling process. For example, if the client presents with apparent depressive symptoms but does not mention depression as a present concern, determining the extent and severity of the symptoms is an important part of how the counselor will proceed with the client. Furthermore, using formal assessments during initial stages of therapy will help the counselor determine the level of care necessary and any integrative therapies the client may need (Whiston, 2008).
Ongoing Case Conceptualization
Similar to assessing client symptoms, case conceptualization supports counselors' ongoing and deepening understanding of the client's needs and challenges (Whiston, 2008). For example, if a client initially presents with some depressive symptoms, but over the course of the first four sessions, reports an increase in the symptoms, the counselor must re-evaluate and reprioritize the client's needs. In effect, the counselor must reassess the direction of therapy for effectiveness in light of the newly developed or exacerbated symptoms. Formal assessments accurately evaluate symptoms, supporting the counselor's ability to continue to conceptualize the client's case appropriately and therapeutically. Ongoing case conceptualization is critical for accurately determining the client's evolving needs and contributes to the client's progress and an effective process (Hiebert, 1996; Whiston, 2008).
Two Situations for Using Informal Assessments in Counseling
Initial Intake and Information Gathering
According to Juhnke (1995) formal assessments should be used as one source of information about clients, although information gathering by informal methods and other alternative sources is critical for initial information gathering and ongoing success in counseling. Meyer & Melchert (2011) described intake assessment as one of the critical stages of counseling. The quality of information gathered during the first meeting with the client has a direct effect on diagnosis, case conceptualization, and the intervention chosen by the counselor. Furthermore, Whiston (2008) found initial assessment critical because of unique client contexts that require an equally unique approach to therapy.
Continuous Client Assessment
Juhnke (1995) described client circumstances as dynamic, and as these change, the goals of therapy must evolve as well. Informal and continuous assessment keeps the counselor aware of the changing concerns of the client, which may be critical when the client develops urgent needs. Without assessment, these needs cannot be readily identified or addressed. Whiston (2008) determined informal assessment is therapeutic in its ability to nurture the counseling relationship and increase communication between the client and counselor. Toller (1999) suggested counseling is based on empathetic understanding and simply being heard has therapeutic value. For example, during informal assessments, the counselor can show authentic care and concern by asking basic questions regarding the client's health and general experiences. This alone may be as therapeutic as any one part of the counseling process (Wampold, 2001).
Accurate and sound assessments in counseling are vital components of effective therapy (Whiston, 2008). When choosing or utilizing any assessment, the counselor must "consider the whole person and understand that people are complex; hence, assessment procedures must be comprehensive" (Whiston, 2008, p. xi). Effective counselors must learn the skill of assessing clients, a skill that must precede effective case conceptualization, treatment planning, and ongoing, effective therapy.
Hiebert, B. (1996). Using informal methods to assess client change. Guidance & Counseling, 11(4), 3–13.
Juhnke, G. A. (1995). Mental health counseling assessment: Broadening one's understanding of the client and the clients presenting concerns. ERIC Digest, 1–6.
Laureate Education, Inc. (Executive Producer). (n.d.). Introduction to Assessment. Baltimore, MD: Executive Producer.
Meyer, L., & Melchert, T. P. (2011). Examining the content of mental health intake assessments from a biopsychosocial perspective. Journal of Psychotherapy Integration, 21(1), 70-89. doi: 10.1037/a0022907
Toller, P. (1999). Chapter 3: Learning to listen, learning to hear: A training approach. In P. Millner & B. Carolin (Eds.). Time to listen to children: Personal and professional communication (pp. 48-61). New York: Routledge.
Wall, J. E. (2004). Why counselors shouldn’t let testing leave them behind. In Vistas: Perspectives on counseling, 2004 (pp. 69-77). Alexandria, VA: American Counseling Association.
Wampold, B. E. ( 2001). The great psychotherapy debate: Models, methods, and findings. Mahwah, NJ: Erlbaum.
Whiston, S. C. (2009). Principles and applications of assessment in counseling (3rd ed.). Belmont, CA: Brooks/Cole, Cengage Learning