Assessment Methods and Techniques

1.Methods of assessing risk of harm to self and others

• Ask about suicide directly and plainly; asking does not plant the idea or raise risk. Assess ideation, plan, intent, access to means, timing, past attempts (the strongest predictor), current stressors and protective factors.
• Structured tools support judgment: the Columbia Suicide Severity Rating Scale, item 9 of the PHQ-9, and the ASQ for youth; they never replace a clinical interview.
• When risk is elevated, build a collaborative safety plan (Stanley-Brown: warning signs, coping, people and places, professionals, crisis lines such as 988 in the US and Canada, and making the environment safe) and counsel on lethal means, especially firearms and medications.
• Imminent risk (a plan, intent and means) calls for immediate action: do not leave the person alone, involve emergency services or arrange an emergency evaluation, and inform the supervisor afterward.
• Violence risk: past violence is the best predictor; consider threats, substance use, access to weapons and recent losses; structured professional judgment tools such as the HCR-20 are used in specialized settings.
• Intimate partner homicide risk rises with prior strangulation, access to a gun, threats to kill, extreme jealousy and recent separation (Campbell’s Danger Assessment).

In practice: A client says she has been saving her pills and plans to take them this weekend when her children are away. The worker stays with her, asks about the pills’ location, contacts the crisis team for an emergency evaluation and does not end the session until she is safe.

Clinical items expect detailed risk formulation and safety planning; Bachelors items expect direct questions, staying with the client and getting help.

2.Principles and techniques of interviewing (e.g., supporting, clarifying, confronting, validating, feedback, reflecting, language differences, use of interpreters)

• Open questions (what, how, tell me about) invite the story; closed questions confirm facts. Avoid why questions, which sound blaming, and avoid stacking several questions at once.
• Core skills: minimal encouragers, paraphrasing content, reflecting feelings, clarifying, summarizing, validating the person’s experience, and purposeful silence.
• Confrontation means pointing out a discrepancy between words and actions or between goals and behavior, respectfully and after rapport is built, not attacking.
• Feedback is specific, descriptive and timely, and focuses on behavior the client can change.
• With an interpreter: brief them first, sit so you face the client, speak to the client in the first person, use short segments and ask for word-for-word interpretation; never use children or, for sensitive topics, family members.
• Interview in the client’s preferred language when possible, and attend to cultural norms about eye contact, directness and who speaks for the family.

In practice: A client says, I’m fine with my son moving out, while tearing up. The worker reflects, You say you’re fine, and I notice tears as you talk about it, and waits.

3.Methods of involving clients/client systems in problem identification, problem solving, and intervention planning

• Start where the client is: let the client define the problem in their own words and agree on which concern to address first.
• Partialize large problems into manageable parts, set priorities together, and generate options jointly before choosing.
• Shared decision-making means presenting options with their pros and cons and the client’s values deciding; the worker contributes expertise, not the final choice.
• With involuntary clients, find a goal they do want (for example, ending court supervision) and build the plan around it.
• With families, groups and communities, use participatory methods such as family meetings, community forums, focus groups and nominal group technique so those affected shape the plan.

In practice: A mandated client insists the only problem is the probation officer. The worker agrees to work on getting probation completed and, together, they list what the court requires and how to meet it.

4.Methods, techniques, and instruments for assessing client/client system strengths, resources, needs, and challenges

• The strengths perspective (Saleebey) assumes every person, family and community has strengths and resources; assess them as carefully as problems.
• Mapping tools: the genogram (family history and patterns), ecomap (links to outside systems and their quality) and culturagram (Congress: immigration, language, beliefs, values and family culture).
• Standardized scales measure specific problems: PHQ-9 for depression, GAD-7 for anxiety, AUDIT for alcohol; check that a tool is reliable, valid and normed for the client’s population and language.
• Functional assessments rate activities of daily living (bathing, dressing, eating) and instrumental activities (managing money, medications, shopping) to plan care for older adults and people with disabilities.
• At the community level, use needs assessments and asset mapping (asset-based community development); at the agency level, a SWOT analysis (strengths, weaknesses, opportunities, threats).

In practice: A newcomer family seems isolated. The worker completes an ecomap and culturagram with them, discovering strong ties to a faith community that can provide childcare and translation help.

5.Methods for obtaining sensitive and/or confidential information (e.g., substance use, sexual abuse)

• Build rapport and explain the limits of confidentiality before asking about sensitive topics, so the client can decide what to share.
• Normalize and ask directly: many people who go through this use alcohol to cope; how much do you drink in a typical week? Use specific, behavioral questions and the client’s own words.
• Move from less to more sensitive questions, and offer written or self-administered screening, which can increase honest disclosure.
• Ask about partner abuse only when the client is alone, never in front of a partner or a family member who could be the abuser.
• When a child discloses abuse, listen calmly, use open non-leading questions, do not probe for details or promise secrecy, document the child’s words and report; detailed forensic interviews belong to trained interviewers, often at child advocacy centres, to avoid repeated questioning.

In practice: During a routine visit, a worker asks a woman’s husband to step out before asking whether anyone at home has hurt or frightened her.

6.Methods for assessing resilience and coping abilities

• Resilience is a process of adapting well to adversity, not a fixed trait; Werner’s Kauai study and Masten’s ordinary magic show most people draw on ordinary protective factors.
• Protective factors: at least one caring, stable relationship, problem-solving and self-regulation skills, a sense of purpose or faith, and supportive schools and communities.
• Lazarus and Folkman’s stress and coping model: primary appraisal (is this a threat?) and secondary appraisal (can I cope?); coping is problem-focused (changing the situation) or emotion-focused (managing feelings), and both are useful.
• Ask how the client has survived past difficulties, what helped, and when the problem is less severe (exceptions); this assesses coping and builds hope.
• Instruments include the Connor-Davidson Resilience Scale and the Brief COPE; avoidant coping (denial, substance use) predicts poorer outcomes.

In practice: A man who lost his job feels hopeless. The worker asks how he got through a previous layoff; he recalls calling old colleagues and keeping a routine, and they build those steps into his plan.

7.Indicators of and methods of assessing motivation, barriers, and readiness for change

• The transtheoretical model (Prochaska and DiClemente) describes stages of change: precontemplation (not considering change), contemplation (ambivalent), preparation (planning), action and maintenance; relapse is common and is a return to an earlier stage, not failure.
• Assess readiness with a readiness ruler (0 to 10: how important, how confident), a decisional balance of pros and cons, and by listening for change talk (desire, ability, reasons, need, commitment, steps).
• Match the intervention to the stage: raise awareness and doubt in precontemplation, explore ambivalence in contemplation, plan in preparation, support skills in action, prevent relapse in maintenance.
• Barriers can be practical (transport, childcare, cost, hours), personal (fear, low confidence), cultural or systemic (waitlists, discrimination); remove them before labeling a client unmotivated.
• Resistance is best seen as a signal about the interaction: when a client argues, the worker changes approach rather than pushing harder.

In practice: A client says, I know smoking is bad, but it’s the only thing that calms me. The worker identifies contemplation and explores both sides of her ambivalence instead of handing her a quit plan.

8.Components and function of the mental status examination

• The mental status examination is a structured snapshot of a person’s mental functioning at the time of the interview, not a diagnosis.
• Components: appearance; behavior and psychomotor activity; attitude toward the interviewer; speech (rate, volume, flow); mood (the client’s words) and affect (what you observe: range, intensity, congruence, such as flat, blunted or labile).
• Thought process (how thoughts connect: logical, circumstantial, tangential, flight of ideas, loose associations) and thought content (delusions, obsessions, suicidal or homicidal ideation).
• Perception (hallucinations, illusions), cognition (orientation to person, place and time, attention, memory), insight and judgment.
• Brief cognitive screens such as the Mini-Mental State Examination and the Montreal Cognitive Assessment (scored out of 30) support, but do not replace, a full evaluation.

In practice: A client answers each question with long, detailed detours but eventually reaches the point. The worker records the thought process as circumstantial, which differs from tangential speech that never returns to the question.

Clinical items expect precise MSE terms; Bachelors items expect knowing what the MSE covers and when to refer.

9.Methods of assessing clients’/client systems’ communication skills

• Assess receptive language (understanding) and expressive language (speaking, writing), literacy, hearing and vision, and the client’s preferred language.
• Cognitive or neurological conditions change communication: expressive (Broca’s) aphasia makes speaking hard while understanding is intact; receptive (Wernicke’s) aphasia produces fluent but meaningless speech with poor understanding.
• Children communicate through play, drawing and behavior; match language to developmental level.
• Culture shapes communication style: high-context cultures rely more on nonverbal cues and relationships, low-context cultures on explicit words.
• Satir described family communication stances (placating, blaming, super-reasonable, irrelevant) contrasted with congruent communication; augmentative and alternative communication devices support people with limited speech.

In practice: After a stroke, a client nods to every question but cannot answer open questions. The worker uses yes or no questions, pictures and writing, and requests a speech-language assessment.

10.Methods of incorporating information from records and evaluations (e.g., employment, medical, psychological, school)

• Obtain written consent before requesting or sharing records; a valid release names what information, from whom, to whom, for what purpose and until when.
• Review records critically: note the date, source, purpose and possible bias, and do not simply carry forward an old diagnosis or label.
• Integrate school records and evaluations (in the US, protected by FERPA; individualized education programs), psychological testing, medical records and employment history with the client’s own account.
• When records and the client’s account conflict, explore the discrepancy with the client rather than assuming either is wrong.
• Collateral contacts (family, teachers, other providers) add perspective, with consent except where the law allows otherwise, such as in child protection investigations.

In practice: A youth’s file from five years ago says conduct disorder. The worker reviews the date and context, notes a later trauma history, and completes a current assessment rather than repeating the label.