Chapter 22: Assessment in routine clinical and counselling settings

AUTHORS:  C. Young, D. Edwards

ABSTRACT: This chapter examines the principles of assessment applied to clinical and counselling settings in which clients seek help for such problems as depression, anxiety, eating disorders, or other problems related to trauma, relationship conflict, or difficulties with self control or substance use. The aim of assessment is to obtain an understanding of the client’s difficulties and the context in which they arise sufficient to form the basis of a management or treatment plan. In adults, the main method of assessment is an interview structured to elicit information about the presenting problem, its time course and context, factors that might have precipitated it, case history relevant to understanding the client’s vulnerabilities.  In addition, information is gathered on which to base a diagnosis and an evaluation of risk that the client may harm self or others. Other methods of assessment, particularly with children, include interviews with family members or other significant individuals (for example school teachers, employers) as well as observation (for example of classroom behaviour) or self-monitoring. For children observation of play or interaction between caretaker and child in a playroom may be valuable.  This chapter examines the application of clinical assessment in South African conditions based on case examples and published case studies and discusses the problems and challenges that practitioners face due to time constraints, shortage of resources or cultural and contextual factors.

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