MCC 670 – Data Gathering

Ingram (2012) describes the intake interview as an assessment phase that typically occurs in 1-3 sessions. Oftentimes employers set specific requirements including a timeline for completion along with a predetermined format. However, Ingram (2012) states that the degree of structure and limitations on flexibility affect the client’s ability to engage in a storytelling process. Ingram (2012) defines problem solving as ideally involving minimal influence in order to gather information and identify the goals and problems. Testing a potential hypothesis exists as the initial stage of solution formulation in this process.

​According to Ingram (2012) the Intake Interview occurs in three phases. During the phase one, the client is allowed to tell their story as the counselor remains attentive and expresses understanding. In the second phase of the intake interview process, the counselor directs the clients toward key topic areas in an effort to complete this initial assessment (Ingram, 2012). Two key goals during this stage include determining of a crisis intervention is needed, and testing clinical hypotheses (Ingram, 2012). During the final phase, taking time to summarize progress thus far is important alongside a discussion and overview of the counseling process.This can help the client understand what to expect from therapy.

Ingram (2012) begins by describing the counseling as a problem-solving process that occurs in stages as follows:

  1. STEP ONE – Gather data —>

  2. STEP TWO – Identifying problem–>

  3. STEP THREE – Decide on goals—>

  4. STEP FOUR – Test hypothesis—>

  5. STEP FIVE – Move toward solution—>

Ingram (2012) encourages us to minimizing our influence over the problem solving process in the early data-gathering stage.

Ingram (2012) cautions that predefined approaches shape and restrict the client’s storytelling process and content that is provided – be flexible.  My biggest problem – thus far has been learning to balance a need for note taking with the development of a rapport.  Additionally it is important to be aware of how the process of social exchange can further influence the outcome of the data gathering process.  Ingram (2012) provides the following examples of how our level of influence can vary during the intake interview:

  1. Minimal influence – “allow silence, follow-up questions, encouragers, paraphrasing, reflection of feeling.” (Ingram, 2012).

  2. Mild influence- selective summary, probing topic chosen by the therapist, offer a bunch, reassurance

  3. Moderate influence – challenging questions, give suggestions, confrontation if inconsistence

  4. Maximal influence- interpret, teach, set limits, direct.

Ingram (2012) describes the intake interview as a process that occurs in three stages.

Phase One

Invite clients to tell stories in their own way unobstructed while you track this story and express understanding.  The primary goals are as follows:

  1.  During first session goals
  2. Gather cultural data
  3. Create good rapport & establish credibility
  4. Be sensitive and ask questions rather than rely on assumptions

Phase Two

This is the exploration phase (Ingram, 2012). It involves directing client toward topics of your choosing so you can complete the intake process.  The goals during this phase include   (1) testing the emergency hypothesis, to rule out need for crisis intervention, and (2) testing clinical hypotheses with questions, in order to assess your understanding of the problem.  What follows is a list of tips to minimize your influence during the data gathering portion of the intake interview (Ingram, 2012).

  1. Leading client to areas that you think are important, by blending listening with questioning.
  2. Do not bombard with questions.  Create bridge between client discuss and u r ?’s
  3. No agenda setting at this point.  The focus is on data gathering…
  4. Be aware that some exploratory questions carry advice
  5. Keep in mind, some questions encourage the client to think differently

Phase Three

Closing involves keeping track of time without being distracting and summarizes session. Psychoeducation important along with helping client understanding what to expect, (i.e. informed consent, & intake paperwork).

Data Gathering & The Therapeutic Relationship

Finally, Ingram, (2012), provides a few important suggestions for attending to the establishment of a therapeutic relationship during this phase.

  1. Empathetic listening and nonjudgmental acceptance are critical during this phase since this can impact what the client shares…
  2. Self-Awareness is vital and should be part of your training.  In addition to understanding. how other people perceive and respond to you, be mindful of the impact values, emotional reactions, cognitive filters and defensive tendencies, or cultural biases might have.
  3. Cultural Competence – Counseling doesn’t occur in a vacuum in the sense that we bring to the tables our sociocultural perspective as the filter through which we view life. An understanding of diverse cultures other than your own is especially critical.

Finally, Ingram, (2012) provides a quick overview of a few essential data gathering tools frequently utilizing during the intake process.

  1. ADDRESSING (Age, development, disability, religion, ethnicity, socioeconomic status, sexual orientation, indigenous status, national origin, gender.)
  2. GENOGRAM(Family Tree Diagram) – Includes  three generations using symbols to represent nature of relationships, gender, marriages, Etc
  3. FOUR (problem, outcome, obstacles, and resources)
    1. PROBLEM – what is wrong? Since when? How:
      1. Describe problem
      2. Discuss onset and developmental course.
      3. Progressive deterioration and history….
      4. Past attempts to solve
    2. OUTCOME – What do you want to happen?
      1. Your vision of the future?
      2. Where do you want to be?
    3. OBSTACLESBarriers to what you want?
      1. Internal barrier?
      2. Environmental obstacles
      3. Cultural / Social Issues
    4. RESOURCE & SUPPORT –what would help you get what you want?
      1. Environmental changes
      2. Applying new habits and skills. Etc…
    5. BASIC SID(Behavior, affect, sensation, imagery, cognition)
    6. Check out this description of Multimodal questions…
  4. OTHERS
    1. Evidence-based self-Reporting Instruments – Beck Depression Inventory, etc….
    2. Behavioral Observation Rating – Child-Symptom-Inventory 4
    3. Self-Monitoring Charts – antecendents/consequence/Trauma….

References

Ingram, B.L. (2012). Clinical Case Formulations: Matching the Integrative Treatment
​Plan to the Client. (2nd ed.). Hoboken, NJ: Wiley.

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