Using formal and informal observations

“Use formal (e.g., assessment results) and informal (e.g., body language) observations” (NBCC, 2027 task 2B.8)

Assessment draws on formal data, such as test scores and structured instruments, and informal observations, such as body language, tone and how the client relates in the room. Skilled counselors combine both and notice when they agree or conflict. The exam tests the value and limits of each kind of data.

Key points

Formal observations come from standardized instruments, rating scales, structured interviews and records; they have known reliability and validity.
Informal observations include posture, eye contact, facial expression, tone of voice, hygiene, psychomotor activity and interaction style.
Interpret nonverbal behavior within cultural context; eye contact and personal space norms differ across cultures.
Discrepancies matter: a client who reports feeling fine while tearful, or who scores low on a depression scale while appearing withdrawn, warrants exploration.
Observations should be described objectively in records, separating what was seen from what the counselor infers.
Avoid overreliance on any single data point; assessment conclusions should rest on converging evidence.
Reflecting observations back to the client (I notice your hands are clenched) can deepen the conversation.

In practice

A client's anxiety scale score has dropped, but in session he fidgets and avoids topics he used to discuss. The counselor names the difference gently and learns he underreported because he did not want to disappoint her.

A counselor notes that a client from a culture where direct eye contact with authority figures is considered disrespectful keeps her gaze lowered. The counselor avoids reading this as depression and asks about her mood directly.

Check yourself

Give an example of a formal and an informal observation.

A score on a standardized depression inventory is formal, and a client's slumped posture and flat tone are informal.

What should a counselor do when test results and observed behavior disagree?

Explore the discrepancy with the client, since it may reveal underreporting, context or a measurement issue.

Why must nonverbal behavior be interpreted within cultural context?

Norms for eye contact, expression and space vary across cultures, so behavior can be misread as a symptom.

NBCC's knowledge and skills for 2B. Assessment

Knowledge of: Foundational knowledge of statistics; Diagnostic criteria - DSM-5-TR; Diagnostic Criteria - ICD-11; Symptoms of trauma; Medical diagnoses and symptoms that can contribute to mental health symptoms; Differential diagnoses, co-occurring diagnoses, and comorbidities; Risk assessment and risk factors or symptoms; Cultural idioms of distress; Cultural implications of diagnosis.

Skill in: Conducting a diagnostic assessment and evaluation; Conducting and interpreting assessments; Conducting formal assessments; Conducting informal assessments; Conducting lethal means restriction.

A study guide written by ExamDragon from NBCC's published task; not NBCC material and not part of the exam.