1. Chapter 13 Clinical Assessment Robert J. Drummond and Karyn Dayle Jones Assessment Procedures for Counselors and Helping Professionals, 6 th edition Copyright ©2006 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

2. Clinical Assessment To determine which DSM–IV-TR classification is appropriate To see whether neurological impairment exists To help decide which type of treatment, counseling, or therapy would be most appropriate To prescribe the proper instructional strategies To identify the client’s assets, achievement, aptitude, or personality to guide in rehabilitative, therapeutic, or educational planning To determine whether an inmate should be considered for a release program To evaluate the effectiveness of treatment, counseling interventions, and group sessions Robert J. Drummond and Karyn Dayle Jones Assessment Procedures for Counselors and Helping Professionals, 6 th edition Copyright ©2006 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

3. Behavioral Assessment Behavioral assessment centers on the circumstances of behavior rather than the reasons for it. Robert J. Drummond and Karyn Dayle Jones Assessment Procedures for Counselors and Helping Professionals, 6 th edition Copyright ©2006 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

4. Behavioral observation Observation, normally of a specific, observable set of behaviors. Observation might describe or identify the following components: 1.Purpose and object of the observation 2.Physical environment 3.Acts or events that have taken place 4.Time dimensions 5.Actors or people observed 6.Goals of the persons observed 7.Feelings of the observer Robert J. Drummond and Karyn Dayle Jones Assessment Procedures for Counselors and Helping Professionals, 6 th edition Copyright ©2006 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

5. Behavioral Observation Form Behavior ❒ Withdrawn, isolated ❒ Erratic, inconsistent ❒ Mood swings ❒ Inappropriate laughter ❒ Class clown ❒ Drowsy, sleeping in class ❒ Obscene language, gestures ❒ Rebellious, argumentative ❒ Talks about drugs, "partying" Academic ❒ Sudden decline in grades ❒ Short attention span, easily distracted ❒ Daydreams, "spaces out" ❒ Hyperactive ❒ Lacks motivation, apathetic Attendance ❒ Frequent absences or lateness ❒ Frequent requests to go to the restroom ❒ Found hanging around inside or outside school Instructions: Think of a particular student you feel concerned about and check off any items that apply to the student's recent behavior. Robert J. Drummond and Karyn Dayle Jones Assessment Procedures for Counselors and Helping Professionals, 6 th edition Copyright ©2006 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

6. Self-monitoring The client focuses on targeted behavior. Give explicit definitions and examples of the targeted events and explain their possible relevance to the problem at hand. Give explicit monitoring instructions on how to record the behavior. Illustrate the use of the form or recording device and provide practice exercises. Ask the client to repeat the target definitions and self-monitoring instructions. Test client understanding of the assignment. Check with the client during the period specified for any questions or problems. Robert J. Drummond and Karyn Dayle Jones Assessment Procedures for Counselors and Helping Professionals, 6 th edition Copyright ©2006 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

7. Robert J. Drummond and Karyn Dayle Jones Assessment Procedures for Counselors and Helping Professionals, 6 th edition Copyright ©2006 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

8. Personality Assessment Specific Domain –Depression –Anxiety –Eating disorders –Childhood disorders –Other “Axis I” disorders Comprehensive –Personality disorders Robert J. Drummond and Karyn Dayle Jones Assessment Procedures for Counselors and Helping Professionals, 6 th edition Copyright ©2006 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

9. Interviews Structured Unstructured Robert J. Drummond and Karyn Dayle Jones Assessment Procedures for Counselors and Helping Professionals, 6 th edition Copyright ©2006 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

10. Structured Interviews Interviewer asks each interviewee exactly the same questions in the same manner. A specific set of questions is usually read to the client. Ensures that specific information will be collected from all clients, and does not require as much training because all interviewers have a list of questions in a prescribed order. Robert J. Drummond and Karyn Dayle Jones Assessment Procedures for Counselors and Helping Professionals, 6 th edition Copyright ©2006 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

11. Unstructured Interviews Psychosocial Psychiatric interview Intake interview Robert J. Drummond and Karyn Dayle Jones Assessment Procedures for Counselors and Helping Professionals, 6 th edition Copyright ©2006 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

12. Unstructured Interviews Counselor-made questions with “client responses” and “counselor observations” recorded by the counselor. No standardization of (a) questions or (b) recording of client responses. Allows client a chance to determine what is important to talk about; it allows the counselor to pursue important but unanticipated topics; and it provides an opportunity to judge the client’s behavior in an unstructured situation. Counselors may follow a general interview format. Robert J. Drummond and Karyn Dayle Jones Assessment Procedures for Counselors and Helping Professionals, 6 th edition Copyright ©2006 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

13. The Unstructured Interview Format 1.Identifying Information 2.Presenting Problem 3.History of Presenting Problem 4.Family History 5.Relationship History 6.Developmental History 7.Education/Employment History 8.Medical History 9.Substance Use 10.Previous Counseling Robert J. Drummond and Karyn Dayle Jones Assessment Procedures for Counselors and Helping Professionals, 6 th edition Copyright ©2006 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

14. Interview Checklists There are a wide variety of interview checklists available to help clinicians organize the information gained in the interview and help structure the interview. Some examples follow: The Mental Status Checklist—provides a comprehensive examination of the mental status of the client. The Personal History Checklist—facilitates recording personal history during intake sessions for children, adolescents, and adults. The Personal Problems Checklist—provides a list of common problems for each age group. Robert J. Drummond and Karyn Dayle Jones Assessment Procedures for Counselors and Helping Professionals, 6 th edition Copyright ©2006 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

15. Mental Status Exam Appearance: well-groomed, disheveled, unkempt, cooperative, unruly Mood: depressed, sad, angry, euphoric, worried, anxious Affect: labile, appropriate, flat, constricted Thought Content: hallucinations, delusions, obsessive thoughts Thought Process: linear, tangential, flight of ideas, incoherent, racing thoughts Speech (rate, volume): normal, pressured, rapid, slow, soft, loud Psychomotor (physical movement): agitated, restless, normal, rapid, slow Orientation: X3 Robert J. Drummond and Karyn Dayle Jones Assessment Procedures for Counselors and Helping Professionals, 6 th edition Copyright ©2006 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

16. Suicide Risk Assessment Suicidal ideation A plan High lethality Few inhibitors Low self-control (especially drinking or using drugs) Previous attempts Gender—men try more lethal means; women try more often Recent stressful event Robert J. Drummond and Karyn Dayle Jones Assessment Procedures for Counselors and Helping Professionals, 6 th edition Copyright ©2006 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

17. Neuropsychological Assessment A neuropsychological assessment typically evaluates multiple areas of functioning. Used to assess the following: Learning disabilities Attention deficit disorders Neuropsychiatric disorders (e.g., pervasive development disorders, Tourette syndrome, anxiety and depression) Closed head injury (e.g., concussion, as opposed to “penetrating” head injury) Seizure disorders Brain tumors Strokes Effects of toxic substances (e.g., lead poisoning) Genetic disorders (e.g., Turner syndrome, Williams syndrome) Robert J. Drummond and Karyn Dayle Jones Assessment Procedures for Counselors and Helping Professionals, 6 th edition Copyright ©2006 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

18. Cognitive Impairments Memory (retrieval/encoding) Processing speed (the speed with which you can perform cognitive activities such as recognizing simple stimuli (+++, ***), identifying letters or words, or naming successive numbers printed on a page) Learning Attention Decision-making Language Judgment Orientation in time and space Problem-solving Verbal communication Robert J. Drummond and Karyn Dayle Jones Assessment Procedures for Counselors and Helping Professionals, 6 th edition Copyright ©2006 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

19. Behavioral Impairments Eating, dressing, toileting (e.g., unable to dress without help; becomes incontinent) Interests (e.g., abandons hobbies) Routine activities (e.g., unable to perform household tasks) Personality (e.g., inappropriate responses, lack of emotional control) Robert J. Drummond and Karyn Dayle Jones Assessment Procedures for Counselors and Helping Professionals, 6 th edition Copyright ©2006 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

20. A typical neuropsychological examination will evaluate: Orientation General intellectual functioning Memory: ability to learn and remember new information Attentional capacity and concentration Language Visuoperception –Visuoperception is the ability of the brain to understand what it is seeing. Patients with visuoperception problems may have difficulty in such areas as reading and recognizing faces or common objects. Sensorimotor functioning –psychomotor speed (ability to rapidly process and produce oral and written information), fine-motor control and dexterity, and visual acuity Ability to self-monitor and correct one's behavior Academic achievement Personality functioning Robert J. Drummond and Karyn Dayle Jones Assessment Procedures for Counselors and Helping Professionals, 6 th edition Copyright ©2006 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

21. What does a neuropsychological examination find out? Learning disabilities Attention deficit disorders Neuropsychiatric disorders (e.g., pervasive development disorders, Tourette syndrome, anxiety and depression) Head injury Seizure disorders Brain tumors Strokes Effects of toxic substances (e.g., lead poisoning) Genetic disorders (e.g., Huntington's disease, Williams syndrome) Robert J. Drummond and Karyn Dayle Jones Assessment Procedures for Counselors and Helping Professionals, 6 th edition Copyright ©2006 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.

22. Instruments for Neurological Assessment Halstead-Reitan Neuropsychological Test Battery Lauria-Nebraska Neuropsychological Battery Kaufman Short Neuropsychological Assessment Procedure Quick Neurological Screening Test Robert J. Drummond and Karyn Dayle Jones Assessment Procedures for Counselors and Helping Professionals, 6 th edition Copyright ©2006 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved.