Life Stages in Client Assessment
Hey, guys! Welcome to this Mometrix video over life stages in client assessment.
There are five major stages that we will look at today:
Stage 2: In-depth exploration
Stage 3: Commitment to action
Stage 4: Counseling intervention
Stage 5: Evaluation, termination, or referral
Let’s look at what each of those means.
Stage 1: Initial Disclosure
In this stage, the main focus is relationship building. When I say relationship building, in this setting, I mean establishing rapport with the client that is based on trust, respect, and care. When there is a good relationship between you and your client, the likelihood of the sessions being more productive is greater. In this stage, you want to practice all the basic counselor skills that we discussed in the Basic Counselor Skills video, such as empathy, genuineness, unconditional positive regard, etc.
Here are some practical tips for helping to build a relationship with your client:
- Introduce yourself. Be personable and inviting.
- Be hospitable. Invite the client to sit down. Ask them if they would like water, coffee, etc. Make sure they are comfortable.
- Address the client by name. This is a big step in helping your client feel known.
- Be inviting of social conversation to help reduce any anxiety they may be feeling. Remember, recognizing that they need and want help working through things can be a really big step.
- Allow your client to talk about his or her reason for coming in to talk.
- Indicate that you are interested in them and what they are going through.
Remember, your client may talk about all their experiences, from earliest childhood to the present, and the way that you respond can either help them to trust you or lend to them feeling a betrayal of trust.
One of the greatest obstacles in the relationship-building stage is the tendency to move at too quick of a pace. Be patient with your client, be sensitive, and give them room to move at a natural pace. As trust begins to build between counselor and client, they are more inclined to respond in a positive way as you encourage them to move towards change.
Stage 2: In-Depth Exploration
In this stage, you will hone in on problem assessment. One of the major reasons a client goes to talk with a counselor is to have help resolving problems or concerns that interfere with their daily lives, or are causing them major heartache. The counselor should have the expectation to be an effective tool to help them move towards change. Assessment refers to anything the counselor does to gather information and draw conclusions about the concerns of the client. This stage should not feel like an interrogation to the client, but, rather, they should feel that someone desires to know who they are, the things that have shaped how they think, how they feel, and their concerns. Psychologist Martin Seligman suggests the following reasons for assessing a client:
- Allow for counselors to make an accurate diagnosis
- Discern whether or not a person is suitable for a certain treatment plan
- Help counselors to develop a treatment plan
- Help the counselor to have better clarification in setting goals, and makes the achievement of goals more measurable
- Helps the counselor to better facilitate the generation of options and alternatives
So, now, let’s talk about the different things that you will want to explore or assess.
Identifying data such as the client’s name, address, phone number, email, age, gender, marital status, occupation, etc. This enables the counselor to be able to contact the client, but it also gives insight into living conditions and background about marital status.
Client’s current lifestyle. What does the client’s typical day look like? What social, religious, or recreational activities are the client involved in? What is the client’s education status? What are some special characteristics about the client, like age, physicalities, cultural characteristics, etc.
Family History. You want to gather information about both the father and the mother; things like age, occupation, personality, roles, and the client’s relationship with each of them. Does the client have siblings? How many? How old are they? What is their relationship with each of their siblings? What was the stability of the family like when growing up? Jobs held? Family moves, and the reason for the move.
Personal history. What is their medical history like? What about their educational history- like academic performance, extracurricular activities, hobbies and interests, relationships with peers. What about their career? What jobs have they had? What was their relationship like with their colleagues and bosses? What personal goals does the client have?
Description of the client during the interview. What was their physical appearance like? Things like posture, dress, gestures, facial expression. How did the client relate to you (the counselor) during the session? Client’s warmth, willingness, motivation, passivity, etc. Were the client’s remarks logical? Did they flow, or were they all over the place?
Summary and recommendations. Were there any connections between problems that the client stated and any other information gathered? In your opinion, does the client need to be assigned to any other counselor? Were the goals for counseling, stated by the client, practical and realistic? How much counseling, if you had to suggest, might be required?
Stage 3: Commitment to action or goal-setting
Just like with anything in life, counseling needs to have a focus. The client’s focus is going to be on the problem, but the counselor needs to be focused on the problem, the client, the counseling process, and the overall goal. Goals help to give direction during each session. In goal setting, the client identifies, with the help of the counselor, specific ways to move towards change and the best course of action to help make that happen. Clear goals can help to motivate your client to take the steps necessary in achieving those goals. It helps them to structure their lives in a way that makes reaching those goals more practical. Setting goals helps to eliminate sideways energy, as the client and counselor set forth on the same page about what the goal is.
In some cases, the client may be hesitant to set goals. It is possible that a person who resists setting goals could be protecting the very behavior that is in need of modification, because that behavior is also serving some desirable behavior. For example, someone begins to recognize the negative consequences of an unhealthy, abusive dating relationship, yet they cling to it claiming that the person makes them happy.
Here are some helpful guidelines for selecting and defining goals:
- Goals should be connected to the desired end that the client is looking for
- Goals should always be laid out in explicit and measurable terms
- Goals should be attainable
- Goals should not be outside of the knowledge and skill set of the counselor
- Goals should always be focused on positive growth
Stage 4: Counseling Intervention
There are 3 steps within the counseling intervention stage:
Step 2: Identify a strategy
Step 3: Select and implement intervention
Step 1: Summarize the problem
Summarize the problem using the four-dimensional analysis, which includes four different components: affective, behavioral, cognitive, and interpersonal/systemic component.
How do the problems make the client feel? How do these feelings affect the client’s desire to change? How are the client’s feelings sustaining the problem? What feelings could change the client’s problem?
The behavioral component. What does the client do in the midst of the problem? How do these behaviors support or sustain the problem? What behaviors could the client change to help reduce the effects of the problem?
The cognitive component. What thoughts are going through the client’s mind? What is the client saying to himself? How are these messages part of, or adding to, the problem? What cultural or personal beliefs or assumptions are part of the client’s self-talk? How can these statements be filtered through truth to help the client recognize, identify, and weed out any false thoughts.
The interpersonal or systemic component. What do the client’s personal relationships look like? What are their interactions like with the opposite sex? How does the client interact with their primary support person or group? Do the client’s relationships with family members affect the problem? How?
Step 2: Identify a strategy
The counselor must be equipped to carry out the strategy that is chosen. The strategy should simulate the character of the client’s problem. For instance, if the client experiences the problem mostly in emotive or affective terms or states, then the strategy should engage them in that same way and be more relatable to them. The strategies should be decided on with the previous goals stated in mind. Everything should be directed towards the goal. The client’s level of functioning should be considered when selecting an intervention strategy. Before the intervention strategy is implemented, the counselor should review it with the client.
Step 3: Implement the intervention strategy
Now, remember, we talked about choosing a strategy that relates to how the client experiences the problem. They may experience it more cognitively or more effectively. The goals of affective intervention strategies are to help the client express feelings or feeling states, manage feelings or feeling states, identify or discern between feelings or feeling states. Some feeling states may be so consuming for a patient that they need to be managed to function effectively. The client must express and recognize the feeling state.
The goals of cognitive intervention are to reduce emotional distress and corresponding behaviors by correcting errors in thought, perception, and beliefs. Cognitive interventions are meant to alter a patient’s way of thinking about a particular event, person, self, or life. Cognitive interventions are based on the assumption that clients have the ultimate responsibility for the way that they think about something.
Stage 5: Evaluation, Termination, or Referral
It may seem odd for someone beginning counseling to think of terminating a patient. But, termination is something that you want to move towards. Ideally, termination happens when the goals that are mutually agreed on by the counselor and client have been achieved, or the problem has become more manageable or resolved.
Researchers at Syracuse University say that “Termination should be one of the first topics the counselor and client discuss. The counselor is ethically bound to discuss how long they are able to meet with the client, the timeline of their relationship, and to make helpful referral or recommendations at the conclusion of the counselor/patient relationship.”
Here are some helpful tips to appropriately move your client towards termination, when ready:
- Remind your patient when the ending is coming up. Do this at least 2-3 sessions prior to the final one.
- If you and the client are not constrained by a specific number of sessions, then it may be helpful to space out your last couple of sessions. This can help to sort of wean your patients off of any sort of emotional dependency on you (the counselor) and help them begin to feel more confident. This may be more helpful than an abrupt end.
- Go back over the progress that has been made with the client. It’s very common for the patient to lose sight of the progress that has been made. Ask your client what they learned, what they found helpful about the sessions, and how they felt about their cooperation in the process.
- Allow the clients to articulate what they are feeling in terms of termination. It’s normal for them to have lots of emotions that need to be worked through. So, time should be allocated to acknowledging and processing them.
- It’s also important to be aware of your own feelings in terms of the patient’s termination. It’s a good thing to grow to care for the well-being of the patient. That is a really important part of counseling. Just remember that your aim is to be used to help get them to a place where they are not fully dependent on you. So, termination can oftentimes be seen as a great, and hopeful thing.
Those were the five stages in client assessment.
I hope this video was helpful! See you next time!
Frequently Asked Questions
Q
What are the five stages of the client-counselor relationship?
A
The five stages of the client-counselor relationship include initial disclosure, problem assessment, goal setting, intervention, and evaluation/termination/referral.
Q
What is the first stage of the client-counselor relationship?
A
The first stage of the client-counselor relationship is initial disclosure. The goal of this stage is to build rapport and trust in the client-counselor relationship. This stage is conversational and includes basic introductions in an open and friendly manner, allowing the client to talk about the reason he or she is seeking counsel, and indicating interest and empathy towards the client’s needs.
Q
What is the second stage of the client-counselor relationship?
A
The second stage of the client-counselor relationship is an in-depth exploration of the client’s primary problem, or a problem assessment. Information can be gathered through tools, interviews, casual conversation, and an assessment of the client’s nonverbal communication in order to make an accurate diagnosis and determine the client’s suitability for specific treatment plans.
Q
What are the elements of a problem assessment in the client-counselor relationship?
A
The components of a problem assessment include (but are not limited to) the impact of the problem on the client’s life, the client’s current lifestyle, family history, personal history, and an assessment of the client’s physical presentation during the interview. From this assessment, the counselor can create a summary of the primary problem in terms of how it relates to secondary problems.
Q
What is the third stage of the client-counselor relationship?
A
The third stage of the client-counselor relationship involves committing to action and goal setting. Goals should be related to the client’s desired outcome, measurable in nature, attainable, and focused on positive growth. The goals should also be within the knowledge and skill set of the counselor.
Q
What is the fourth stage of the client-counselor relationship?
A
The fourth stage of the client-counselor relationship involves counseling intervention. It involves summarizing the problem, identifying a strategy, and finally, selecting and implementing the appropriate intervention. The problem should be summarized and addressed through four dimensions: affective, behavioral, cognitive, and interpersonal.
Q
What is the fifth stage of the client-counselor relationship?
A
The fifth stage of the client-counselor relationship involves evaluation and subsequent termination or referral. Termination should be discussed throughout the counselor relationship as a reminder to the client that the goal is to end the counseling relationship once the client has returned to a comfortable level of functioning. Termination is conducted after a thorough evaluation of client progress. If progress has not been made or new problems have been identified, referral may be indicated.
