In counselling, this can be a controversial topic for some and so it is always up for discussion. However, have you ever wondered or questioned your practices and the role of assessments? Sure, as counsellors, we are not able to diagnose. But that doesn’t mean that we throw the assessment process out the window. We would have all developed our own unique practices in this particular space. Something that I come back to time and time again is what is the purpose of the assessment?
Well, what is it? Ask yourself each and every time you choose to do a formalised assessment. Why am I doing this? Do I have a specific reason? And the question that should always, always be asked, will this benefit my client?
Assessments come in many shapes, forms and sizes! They also have different purposes and meet different needs.
Let’s talk about scaling questions for a minute. I love a good scaling question because it encourages an opportunity for an in-depth conversation if you open up that floor. Scaling questions can be a powerful tool in initial assessments because it allows for less formalised questioning, and it gives you a chance to ask your clients what their definition of a 4 is. Because trust me, there are many different definitions of a 4. And for you and the relationship that you have with your client the thing that matters most of all if you are using scaling questions is their definition. So, stop yourself and ask, “Well what does a 4 look like for you?”
Some of you may or may not be a fan of Solution-Focused Brief Therapy (SFBT). This blog is not here to reconcile opinions on this therapeutic practice, but like all practices it has its place in the world of therapy and rightfully so. Something that is worth checking out if you are looking for ways for formulate your scaling questions so that they instil both, hope, future-forward thinking and organic goal formulations- SFBT has some brilliant strategies and ways to really delve deep into scaling questions. More often than not, most clients won’t put themselves at 0. And here lies your opportunity, say your client says “I am a 2” you get them to describe in depth what a ‘2’ is. Then you take a moment to get them to describe what a ‘1’ is. This gives you a place to reference with both the client realising that they are not a ‘1’ and ‘2’ is a bit better and they have defined what it would feel like if it was 1. During your practice if a client tells you they are a ‘1’ you and they will already know what that looks like. But the most beautiful thing you can do here is ask them what a ‘3’ looks like. You aren’t asking for the world all at once, you are simply asking ‘what would one step up look like?’ suddenly, because it is only one step up, the client has made something achievable for themselves. Something that actually doesn’t feel so far out of reach.
Sure, we have so many scaling questions but do any of us ever think or practice the art of asking more? Because their definition of where they are is the definition of you putting the process of scaling questions in a place of benefit for your client. So, what about those murky waters of formalised assessments and how do you do these well? The purpose of formalised assessments can be highly valuable as long as they are used in the correct context. Firstly, they can give a baseline. They can be highly motivating for both you and the client when it comes to re-assessing – it can be like a bird finding its wings. But if we don’t approach formalised assessments with that core question ‘how will this benefit my client’ and if we instead approach it with ‘this is for me because I want to see if I can get them to improve’ then we have taken something away from the client. We have taken away the part where the process of counselling is purely for them and instead made it about you.
And if we approach it from the lens of ourselves, then too often, we can end up throwing a battery of assessments at a client when maybe, just maybe, one or two were all that were relevant. Please remind yourself- not all formalised assessments suit every situation so whether you learn about your client in the intake form and feel confident that say a PCL-5 is going to be more relevant than a GAD-7 or maybe you know that childhood trauma is prevalent and you decide to do a ACE-Q. Give it some thought. And maybe, just maybe, you need to wait until your second session to take your baseline because that will be better than navigating in the dark or picking an irrelevant assessment in your first session.
Then review it and analyse it don’t just do it to tick a box, make sure you get something out of it, that you find an insight, because this will bring you back to that all important question—how does this benefit my client? Formalised assessments can be awkward things. The questioning can seem so rigid but if you preface it and explain to the client why you are doing this and how you hope for it to be useful and maybe start it from the start of the session so it doesn’t then interrupt the flow- you can even say ‘I am doing this as part of your intake so I can gather a little more information about you. I am going to ask you some very specific questions and there is also a way that I would like you to think about and answer them. There is no correct or incorrect answer the purpose of this is so I can better understand you.’ – keep it real, keep it in a space that ensures that it matters.
Maybe some of us are in specialised practice areas where we know that there are particular assessments that should be or could be useful for our clients, because the practice we are in specialises in a particular area, and in that instance, our formalised assessment process is less complicated. But even if you belong in this camp, why not remind yourself before you start any assessment- ‘how is this useful?’ Maybe this frame of thinking will help us do assessments well.
So how do you do yours?