Chapter 13Using Assessment in Counseling

Facts

Making a treatment decision is a form of diagnosis

Formal Diagnosis expected by:EmployersLicensing boards Insurance companies

Informal diagnosisReferral

Examples of Diagnosis

Community counselorWhen determine issue is developmental not

pathological equals a diagnosisSchool Counselor

Recommend student be tested by psychologist equals a diagnosis

Career CounselorsDetermines client is “vocationally immature”

equals a diagnosis

Instruments Designed to Provide Diagnosis

Interview Composite International Diagnostic Interview

Schedule: Authorized Core Version 1.0 (CIDI-Core) Assesses Axis I disorders and is approproate for those 18 and

older Takes between ½ hour and 1½ to complete Can be administered by clinicians or trained lay interviewers

Diagnositic Interview Schedule (DIS) Designed to diagnosis on all axes Does not require clinical judgment Must be administered exactly as given Trainer must have participated in training program Takes one hour to complete

Both of these instruments have good interrater reliability

Semi-Structured Interview

Psychiatric Research Interview for Substance and Mental Disorders (PRISM) Assesses Axis I disorders, borderline, antisocial

disorders Trained clinicians Amount of time varies with psychopathology

Structured Clinical Interviews for Axix I DSM-IV Disorders (SCID-I) Assesses Axis I disorders Only administered by clinicians Takes about 1½ hours to administer

Good to excellent interrater reliability

Interviews for Children

Diagnostic Interview for Children (DISC-IV)Assesses Axis I disorders

Diagnostic Interview for Children and Adolescents (DICA)Assesses wide range of child and

adolescent psychopathology

Both can be adminstered by clinician and lay technician

Treatment Planning Client Characteristics

Client demographics Functional impairment – work, love, play,

spiritSubjective distress – work, love, play, spiritCoping Style - strengthsResistance – blind spotsProblem Complexity – theorySocial Support – work, love, play, spirit

Treatment Planning

Problems – Goals

1. What are the goals

2. How to recognize when accomplished

3. How to conceptualize getting there

4. Alternative conceptualizations

5. How to focus on all aspects

6. How to evaluate effectiveness