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assessment_cont._and_goal_setting.pptxAssessment
Activity 2: To Share or Not to Share
Clients have right to ask for their diagnoses & a copy of contents of their clinical file
Debate about whether to share a DSM diagnosis with the client.
Share your opinion: How do you think sharing a client’s diagnosis with a client can be helpful? How might it be harmful?
Assessment Skills
Assessment Filling in the client’s story with other details
Review: Areas of Assessment
Demographic information
Presenting problem
Strengths and resources
Background
Biopsychosocial stressors
Psychological functioning
Health and biological factors
Test results
Diagnosis
Activity 1B: What do you need to know revisited?
Revisit this story and re-answer the questions based on what you now know about assessment:
Lars is a 45 year old man who calls your office and sets up a counseling appointment. When he shows up for his appointment he appears to be anxious and he looks exhausted. After some brief introductions you ask how you can be of help and he says “My life is a mess. My wife has filed for divorce, she wants to move to California to be near her family but that means I won’t get to see my kids. On top of all this, they just announced at work they are getting ready to do a bunch of layoffs and I think my job may be cut.”
What else do you need to know about Lars to develop a plan for change?
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Structured vs. semi-structured interviews
Predetermined set of questions
Interviewer sticks to the questions
Questions usually follow a particular order
Predetermined areas to ask about
Follow-up probes are possible
Interviewer may vary order as long as all areas are addressed
Assessment Interview
Filling in the presenting problem
Learning about strengths
Exploring background (family history, significant events, etc.)
Learning about stressors and health
Start with demo with me as therapist, student as client
Offer EC for student participation
Prime student – Student presenting with depressive symptoms; above are the things I’ll ask about
Begin with a preface, setting the context for the assessment
Group exercise
Number off
Working independently, each person identify 3-5 questions you could ask a client to learn more about this area
Brainstorm these as a class – let them know they will be interviewing one of the members of their group for four minutes on this area
As a group, identify a client. They will take turns playing this client in a role play
Interview in a round robin manner
Process afterwards
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Goal Setting
Change Process
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Client’s
Story
Getting the story
Assess & Evaluate
Setting Goals
Implement
Change
Goal Setting Activity
Close your eyes
Reflect on your life as is right now
Think ambitiously
Reflect on 2 things, either personal and/or professional, you would like to achieve or experience one day
Open your eyes and write these 2 things down
Setting Goals
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Some people’s idea of a goal….
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But is this (or another) realistic?
SMART principle for goal setting
Specific
Significant, stretching, &/or simple
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Measure
Meaningful, motivational, &/or manageable
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Attainable
Agreed action plan between clients & clinicians
Small
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Relevant
Person-specific, interesting, &/or focused
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Time-Bound
Time-oriented, &/or time-specific
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Goal Setting Activity Re-Visited
Review the 2 goals you set for yourself at the beginning of the presentation
Assess these 2 goals using the SMART principle for goal setting
Pair up and share with your peer the strengths and limitations you noticed about your 2 goals as you checked them using the SMART principle
Important keys to goal setting
Do at the beginning, not the ending
Moving from general to specific
Funnel effect
Partializing
Prioritizing multiple goals
Easy to hard: Working on easier goals builds momentum for change
Sequencing: Focusing on one goal first may make it easier to reach later goals
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Change Process
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Client’s
Story
Getting the story
Assess & Evaluate
Setting Goals
Implement
Change
Role of Research in Practice
Research informs clinical assessment & practice. Consider:
…do you want to take medication that has no research to support its use?
…..do you want a surgeon to operate on you without research to support the procedure?
We want therapies that are supported by research
Evidenced-Based Practice
“Evidence-based practice” (EBP) – sometimes referred to as “empirically supported therapy” (EST) – describes models that demonstrate research-based efficacy, effectiveness, & efficiency
Sometimes, clinicians use EBPs that follow treatment manual with step-by-step instructions and techniques to resolve a particular set of problems
EBP techniques may not be generalizable to all clients or may not be a culturally-sensitive treatment (CST)
Some therapies might not meet full criteria for EBP, but may meet criteria for a lesser tiered research-informed therapy
Hierarchy of Best Practices
Example of EBP: Motivational Interviewing
5 stages of change:
Precontemplation
Contemplation
Preparation
Action
Maintenance (recurrence and eventual permanent exit)
