ERIC Identifier: ED388883
Publication Date: 1995-00-00
Author: Juhnke, Gerald A.
Source: ERIC Clearinghouse on
Counseling and Student Services Greensboro NC.
Mental Health Counseling Assessment: Broadening One's
Understanding of the Client and the Clients Presenting Concerns. ERIC Digest.
Assessment has experienced a resurgence in recent years both in the United
States and abroad (Piotrowski & Keller, 1992; Watkins, 1994). Some continue
to use the terms assessment and testing interchangeably. Both are vitally
important to the counseling process (Lambert, Ogles, & Masters, 1992). Yet,
assessment is broader in scope than testing. Typically, assessment includes
gathering and integrating information about a client in a manner that promotes
effective treatment (Cohen, Swerdlik, & Smith, 1992). This can be
accomplished by using testing in conjunction with other methods, such as
qualitative techniques, behavioral assessments and review of past client
records. Testing should not be used as the only source of information about a
client (Anastasi, 1992).
Corroborating data from a number of sources helps create a more thorough
understanding of the client and his or her presenting concerns. The counselor
can then interpret these data and formulate hypotheses related to the client's
strengths and weaknesses. Data gathered and the hypotheses formed, thereby,
contribute to the creation of an effective counseling strategy. This digest
discusses how counselors can use assessment as a continuous process throughout
treatment. It also reviews three common forms of assessment techniques which can
be used in conjunction with testing.
Vacc (1982) notes, "Assessment in
counseling should be viewed not as a one-time prediction activity but rather as
continuous throughout the counseling process..." (p.40). Continuous assessment
influences the direction of treatment in two ways. First, presenting concerns
and client circumstances are not static. Goals identified by the client during
the initial assessment often must be modified or re-ordered to meet new and
urgent client needs. Continuous assessment apprises the counselor of possible
new and urgent needs which have arisen since the initial assessment. These needs
can then be addressed through the counseling process. Second, assessment can aid
in evaluating the efficacy of treatment. Upon entering treatment, an initial
assessment establishes the client's baseline of functioning. Continuous
assessment allows comparisons between this initial base-line and the client's
current functioning. Improvements suggest treatment efficacy and the benefit of
continuing the current treatment course. Reduction in functioning or a lack of
improvement, however, suggests a need to alter treatment. Continuous assessment,
therefore, is important, because it keeps the counselor apprised of the client's
ever changing needs and indicates treatment efficacy.
Qualitative assessment techniques
are compatible with the belief that "...assessment activities should not stand
outside the change process; rather, they should blend into treatment strategies
to guide self-discovery and to inform clients" (Drum, 1992, p. 622). Unlike
standardized tests, qualitative assessments often consist of games or simulation
exercises that are flexible, open-ended, holistic, and nonstatistical (Goldman,
1992). Typically a debriefing follows the qualitative assessment experience.
Clients can process what they learned from the experience immediately within the
One commonly used qualitative assessment experience is called, "The Life
Line" (Goldman, 1992). The intent of this experience is to help clients reflect
upon significant past events which have influenced them. Clients draw a
horizontal timeline on a blank sheet of paper. They are then asked to recall
past significant experiences, relationships, events or wishes which have
influenced their lives, and to plot these along the timeline. The result gives
the counselor detailed information about significant events in the client's
Similarly, role plays can serve as a qualitative assessment experience. For
example, a mental health counselor may ask a client to role play a recent
anxiety provoking experience (e.g., an argument with a supervisor, receiving a
speeding ticket, etc.). The role play provides the mental health counselor with
a sample of the client's behaviors. As the role play is being demonstrated the
counselor can query the client regarding possible negative self-talk (e.g., I'm
so stupid, he'll never listen to me, etc.). Understanding the self-talk used by
a client can help the counselor generate effective intervention ideas. Clients
can also practice new counselor-directed behaviors or self-talk (e.g., I'm
intelligent, he'll want to listen to me) within the counseling session through
Another qualitative assessment technique that can provide valuable
information is a photograph safari. Depending upon the presenting concerns, the
counselor may request that the client bring to the session photographs of the
client's family-of-origin or childhood. The counselor and client can jointly
review these photographs. Particular attention should be paid to: (a) those
present in the photographs; (b) those consistently absent from the photographs
(e.g., Are the client's siblings always included in the photographs but the
client absent?); (c) common themes of the photographs (e.g., Are all the
pictures taken on the family farm? Are pictures only taken during certain
holidays?); (d) proximity to significant others posing in the photographs (e.g.,
Is the client consistently posed beside the client's father? Is the client
consistently standing apart from other family members?); and (e) emotions
displayed on family member faces (e.g., Does the client consistently pout or
appear angry in photographs?). Such qualitative assessment techniques can
promote insight for the client and therapeutic direction for the counselor.
Counselors using behavioral
assessments are most interested in recording manifest behaviors. Emphasis is
placed upon identifying antecedents to problem behaviors and consequences that
reduce their frequency or eliminate them (Galassi & Perot, 1992). Both
indirect and direct methods are used for behavioral assessments. Indirect
methods of behavioral assessment might include the counselor interviewing the
client or talking to significant others about the reported problem behavior.
Indirect behavioral assessment provides important information about the client
and the client's presenting concerns, but the information obtained may be
contaminated by misperceptions or biases about the client or the client's
behaviors. More direct methods reduce the probability of misperceptions or
biases, and might include counselor observation of the client or client
self-monitoring. A behavioral problem checklist or procedures especially
designed to record the client's concerns directly (e.g., recording the
frequency, duration and intensity of marital arguments) can be used to help
clarify possible antecedents to behavioral problems and record what subsequent
interactions result in their discontinuance.
Reviewing previous client records (e.g.,
counseling, school, police, medical, military, etc.) help the mental health
counselor identify important patterns which the client may be unaware of or
disinclined to discuss readily (e.g., problems with authority figures,
self-injurious behaviors occurring after the ending of significant
relationships, etc.). These records can be a vital source of information. Often
a review of previous counseling records will indicate what types of treatment
were attempted. Previously ineffective treatments can be ruled out, and
treatment regimes found helpful re-implemented.
Concomitantly, past records link the client's history to the presenting
concern. A counselor can gain increased clarity of the immediate concern based
upon an improved understanding of previous stressors or transitions leading to
the client's current condition. The Counselor can then address the cause(s) of
the symptoms rather than the symptoms, themselves.
Assessment provides direction for treatment and
aids in the evaluation process. Although many methods can be employed to promote
a thorough assessment, no one method should be used by itself. Ultimately, it is
the counselor's responsibility to gain sufficient information regarding the
client and the client's presenting concerns to establish an effective treatment
strategy. Using a combination of assessment techniques increases the likelihood
of positive interventions and promotes successful treatment.
Anastasi, A. (1992). What counselors should know
about the use and interpretation of psychological tests. Journal of Counseling & Development, 70(5), 610-615.
Cohen, R. J., Swerdlik, M. E., & Smith, D. K. (1992). Psychological
testing and assessment: An introduction to tests and measurements. Mountain
View, CA: Mayfield Publishing Company.
Drum, D. J. (1992). A review of Leo Goldman's article "Qualitative
assessment: An approach for Counselors." Journal of Counseling &
Development, 70(5), 622-623.
Galassi, J. P. & Perot, A. R. (1992). What you should know about
behavioral assessment. Journal of Counseling & Development, 70(5), 624-631.
Goldman, L. (1992). Qualitative assessment: An approach for counselors.
Journal of Counseling & Development, 70(5), 616-621.
Lambert, M. J., Ogles, B. M., & Masters, K. S. (1992). Choosing outcome
assessment devices: An organizational and conceptual scheme. Journal of
Counseling & Development, 70(4), 527-532.
Piotrowski, C., & Keller, J. W. (1992). Projective techniques: An
international perspective. (ED 355 273).
Vacc, N. A. (1982). A conceptual framework for continuous assessment of
clients. Measurement and Evaluation in Guidance, 15 (1), 40-47.
Watkins, C. E., (1994). Thinking about "Tests and Assessment" and the career
beliefs inventory. Journal of Counseling & Development, 72(4), 421-423.