NCE Study – Assessment Section (basic skills)

(((FYI))) – This information is taken from notes for a class. I’m re-reading it for the NCE Exam

ASSIGNMENT QUESTION:  What are the five basic steps in the problem solving model:

“Because performing an assessment is similar to engaging in problem solving, the five steps in a problem solving model can be used to describe a psychological assessment model.” (Page 6).

  1. Problem Orientation: stimulate counselors and clients to consider various examples….
    1. Instruments promoting self-awareness & self-exploration
    2. Group survey’s used to identify problems/concerns
  2. Problem Identification: Clarify the nature of a problem or issue
    1. Screening inventories or problem checklists assess the type and extent of client concerns
    2. Personal diaries and logs identify situations in which problems occur.
  3. Generation of Alternatives: Suggest alternative solutions for a client’s problems, and help them view problem differently….
    1. Assessment interview used to determine what techniques have worked in the past to solve a problem…
    2. Checklists or inventories can also yield data that can be used to generate alternatives….
  4. Decision Making: Determine appropriate treatment for the client…
    1. Expectancy tables can show success rate of people with different types of scores or characteristics…
    2. Balance sheets or decision making grids enable clients to compare the desirability and feasibility of various alternatives
  5. Verification: evaluate the effectiveness of a particular solution:
      1. Readministration of tests
      2. Satisfaction survey

  6. ASSIGNMENT QUESTION – The definition of an assessment procedure:

    THE PURPOSE OF AN ASSESSMENT – “serve diagnostic purposes, help evaluate client progress and are useful in promoting awareness” (page 6) LIST OF USES…

    1. Classification (program placement, screening and certification)
    2. Diagnosis and Treatment Planning
    3. Client self-knowledge
    4. Program evaluation
    5. Research to guide theory and technique development

    DEFINITION OF ASSESSMENT: “Assessment is an umbrella term for the evaluation methods counselors use to better understand characteristics of people, places, and things….”(Morrison, page 4)

ASSIGNMENT QUESTION:  List Some Core Assessment Skills

Assessment is defined as a  “systematic method of obtaining information…to draw inferences and characteristics of people” (Hays, 2013, p4).   The assessment process consists of five steps: (1) test selection, (2) test administration, (3) interpretation, (4) communication of findings, and (5) outcome assessment (Hays, 2013).   Our textbook provides a review of four core skills that are vital when conducting mental health assessments.  These are discussed below:

Problem Solving

In Chapter one Hays, (2013), provides an introduction to the concept of assessment by describing it as a problem-solving process (p6).  The initial steps in this process involve identification of the problem.   With a clear understanding of issues at hand, the next step involves the consideration of alternatives.   Choosing amongst these alternatives and evaluating results conclude the process.   While discussed just briefly, this concept appears critical to the process of mental health assessment.  Therefore, I’ve included it as a core assessment skill.

Basic Counseling Skills

Chapter two provides an overview of assessment by reviewing counseling skills critical to the process (Hays, 2013).  The assessment process involves “engaging and collaborating with clients throughout the counseling relationship” (Hays 2013, p40).  In order to begin, the therapist must first assess a client’s level of readiness to change (Hays, 2013).  This can provide guidance for use of motivational skills and psychoeducation to initiate the assessment process.  Working closely with the clients when selecting and administering tests encourages active participation.  Contextualizing results and communicating findings allows the client make use of this information.

Statistical Measures

Chapters five and six review basic statistical measures as they pertain to mental health assessment (Hays, 2013).  Raw scores are meaningless by themselves.  In order to understand these findings, therapists need to utilize basic statistical measures interpret these raw scores (Hays, 2013).  An understanding of basic measurement concepts such as reliability, variability and scales of measurement is critical to mental health assessment (Hays, 2013).   Knowledge of basic statistical concepts such as measures of central tendency and variability, are also important (Hays, 2013).

Initial Assessment Process

“The initial phases of counseling require several types of assessment to evaluate overall function and plan interventions” (Hays, 2013, p138).  To do this, counselors need to understand the intake interview process, mental status exams, suicide risk assessments and DSM-5 diagnosis (Hays, 2013).  Understanding these components of an initial assessment is the final core skill reviewed in our textbook (Hays, 2013).

ASSIGNMENT QUESTION:  Utilize the case example in your textbook.  Then discuss information needed and assessments you would utilize to obtain it.

“Jeffery is a 16-year-old White male in 11th grade.  He lives with his father James (age 49), his mother Linda (age 48), an older brother Keith (age 18), and a younger brother Max (age 14).  His parents are both teachers in the same high school as Jeffery.  Jeffery’s parents made the appointment with you, a professional school counselor at the same school as Jeffery and his parents.  Jeffery is currently in danger of failing 11th grade, with his grades mostly D’s and F’s, except for a B in computer class.  His parents are frustrated because they do not know how to motivate him.  In addition, a teacher found a notebook with written song lyrics with references to guns and dying.  Asked for an explanation, Jeffery just shrugged and said he was bored in class.  Jeffrey previously saw a counselor during elementary school after he seemed to be having trouble fitting socially in class” (Hays, 2013, p37).

Information Needed –

The first essential bit of information, is Jeffery’s level of readiness for change.  Since he already displays low motivation and is only here at his parent’s request, this is an initial concern (Hays, 2013).  Another consideration would include reviewing his past academic history, to determine if he has experienced drops in performance like this before.  Additionally, since he has had trouble fitting in elementary school, this might be something to look into.  Finally, I would also assess for depression as a potential cause for his low motivation.

Recommended Assessments

An unstructured motivational interview may be a good place to start to assess Jeffery’s level of readiness for change.   Biographical measures, defined in our textbook as client reports and/or historical records, can be another useful source of information (Hays, 2013).  These historical records can include Jeffery’s past academic history and any previous assessments (Hays, 2013).  Behavioral observations from teachers, his parents, and other staff may also provide a useful perspective.   Finally, if depression appears to be an underlying issue, it may be important to refer him to a private therapist for further evaluation.

“Charlotte, a 19-year-old female, presents to a college counseling center to seek help for increased anxiety she has had since attending college.  She states she is having difficulty understanding the course materials and is failing her courses.  Charlotte reports that she seldom finishes class assignments or tests, as she ‘runs out of time.’  She notes that she has no previous history or academic problems” (Hays, 2013, p53).

 Information Needed

This scenario provides a realistic picture of how client’s can present their problems to a therapist.  In order to assist Charlotte, it would be important to better understand her anxiety and any associated life stressors.  Other information needed includes a review of her academic history, study habits, as well as any previous aptitude tests.

Recommended Assessments

A primary goal in Charlotte’s case includes an assessment of her anxiety and clarification of underlying issues.  It will also be important to understand how this relates to her academic performance.   Based on the case scenario description, Charlotte does not to appear to have a great deal of insight.  In order to address this, chapter one discusses several problem-solving steps that can be helpful (Hays, 2013).  Problem orientation is described as processes of self-exploration in which assessments can allow the client recognize and accept underlying issues (Hays, 2013).  Problem identification can utilize screening inventories to further clarify issues (Hays, 2013).  These steps can provide a good starting point that can help establish a rapport and mutual understanding of underlying problems.

Alongside these efforts, a review of biographical data can also be helpful.  This can start with an informal interview that can assess for any recent life stressors, underlying her anxiety.  Formal assessments, such as the Beck Anxiety Inventory or Multidimensional Anxiety Questionnaire, should be discussed (Hays, 2013).

In order to address the issue of her recent academic performance a review of her academic background could be helpful alongside an array of study habit inventories mentioned in our text (Hays, 2013).

“Nicolas is a 41-year-old African American male presenting to counseling at the request of his neighbor.  The neighbor reports to you that Nicholas has mentioned he has been depressed since he lost his job six months ago and ended a long term relationship four months ago.  Nicholas reports that he has increased his drinking to help him escape and states he doesn’t want to be here anymore….’” (Hays, 2013, p135).

Information Needed

As a mandatory reporter a thorough suicide risk assessment would be critical.   It will be important to thoroughly review Nicolas’s psychiatric history and assess for a past history of attempts (Hays, 2013).  Since Nicolas acknowledges his suicidal ideation, a therapist should assess for any plan and intent (Hays, 2013).  Other information needed includes an assessment of substance use, depression history, and related environmental stressors.

Throughout this process it would be important to contextualize findings in terms of Nicolas’s culture and backstory.  A person’s backstory includes the context within which recent observed symptoms are occurring.   In other words, how can observations and findings be contextualized in terms of recent life events and cultural background?

Recommended Assessments

Key assessments critical in Nicolas’s case include a thorough risk assessment and mental status exam.  Additionally, the therapist should review his psychiatric history and assess for any recent life stressors.  Other tests that should be considered include an assessment of alcohol abuse, depression inventory.

ASSESSMENT REPORT OUTLINE 

Name:

Date of Birth:

 Age:

 ]Date of Report:

Assessment conducted by:

Client Description:

Reason for referral: what question needs to be answered, background information that is relevant such as marital status, health information, developmental information=

Background Information:

Evaluation Procedures:

Behavioral Observations:  describe behaviors during the test, response to test situation, physical description if relevant, anything unusual that happened during the testing, location/testing environment

Findings:  start by reporting each score for each test given and explain what the score means, include examples of questions to illustrate, integrate scores with background and observations, connect all of information-as a whole what do they mean.

Recommendations:  Brief summary of findings and answer the referral question.  Provide specific recommendations for services, treatment, etc.

References

 Hays, D.G. (2013). Assessment in counseling a guide to the use of psychological assessment procedures (5th Ed.). Belmont, CA:  Brooks/Cole, Sengage Learning.

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