Clinical and Counseling

1. Clinical and
Counseling
Assessment
CHAPTER 11

2. Learning Menu
KEY CONCEPTS IN
DIAGNOSING MENTAL
DISORDERS
METHODS OF CLINICAL AND
COUNSELING ASSESSMENT
SPECIFIC SITUATIONS IN
CLINICAL AND COUNSELING
ASSESSMENT

3. An Overview
Does this client have a mental disorder? If so, what is the diagnosis?
What is this person’s current level and premorbid level of functioning?
What type of treatment shall this patient be offered?
How can this person’s personality best be described?
Which treatment approach would be most effective for this client?

4. The Diagnosis of Mental Disorders
Reference: DSM-5 by the American Psychiatric Association or the ICD-11 of the World
Health Organization
Incidence rate: the rate of new occurrences of a particular disorder or condition in a
particular population for a given timeline
Prevalence rate: the proportion of individuals in a given population at a given point in time
who have been diagnosed or otherwise labeled with a particular condition or disorder
Diagnosis has to be weighed between its advantages and disadvatanges

5. Biopsychosocial
Assessment
A multidisciplinary approach to assessment
that includes exploration of relevant
biological, psychological, social, and cultural
and environmental variables for the purpose
of evaluating how such variables contribute
to the development and maintenance of
problems

6. The Interview in Clinical Assessment
Therapeutic contract: part of the interview where an agreement is reached between the
client and the counselor setting the goals, expectations, and mutual obligations in the
therapy
Clinical interviews vary by content, structure, and tone
Stress interview, hypnotic interview, cognitive interview, collaborative interview, mental
status exam

7. Case History Data
Biographical and or
related data about an
assessee may be obtained
by interviewing the
assessee and or significant
others in the person’s life.
Other sources of
information could be
historical records like
from the hospital, school,
employment, military, and
related documents

8. Psychological Tests
Test battery: a group of tests administered together to gather
information about a client from a variety of instruments
Standard battery: an intelligence test, a personality test, and a
neurological deficit screening test

9. Broad Screening Tests
These tests attempt to screen the existence of possible mental disorders in
the client
Administered before specific diagnostic tests to inform clinician about the
possibility of other disorders [comorbidity or differentials]
DSM-5 Level 1 Cross-cutting Symptom Measure (Adult, Children, and
Informant)
Symptom Checklist-90 Revised

10. Culturally Informed Psychological Assessment
In objective psychological tests, the clinician must be aware of the impact of the
culture on the pattern of responding of the client
DSM-5 recommends the Cultural Formulation Interview as a way of
contextualizing the mental disorder experience of the client within their culture
ADDRESSING: age, disability, religion, ethnicity, social status, sexual
orientation, indigenous heritage, national origin, and gender

11. Specific Applications of Clinical Measures

12. ASSESSMENT OF
ADDICTION
AND SUBSTANCE
USE

13. Forensic Psychological Assessment
The theory and application of
psychological evaluation and
measurement in a legal context
Lethality assessment: one’s
dangerousness to oneself or
others
Competency assessment:
sufficient present ability to
consult with his lawyer with a
reasonable degree or rational
and factual understanding of the
proceedings against him/her.
Criminal responsibility:
determining level of guilt in a
criminal case in relation to
presence of mental disorder
Parole readiness or probation:
measuring the risk of recidivism
Emotional injury: psychological
harm or damage

14. Forensic Clinical Assessment
Custody evaluations – assessment of parents or guardians and their parental capacity and
or of children and their parental needs and preferences
Test for Parents: Ackerman-Schoendorf Scales for Parent Evaluation of Custody
(ASPECT), Bricklin Perceptual Scales (BPS)
Tests for Children: Thematic Apperception Test, Kinetic Family Drawing
Child abuse and neglect: anatomically detailed dolls, Child Abuse Potential Inventory,
Parenting Stress Index

15. 8
Legal Insanity
Standards
◼ M’Naghten Standard: is the defendant able to determine what is
right or wrong?
◼ Durham Standard: if the unlawful act was the product of mental
disease or defect
◼ American Law institute Standard: at the time of the crime, the
person is insane as a result or mental disease or defect, lacks
substantial capacity to appreciate the criminality of his conduct, or
to conform his conduct to the requirements of the law.
◼ Test: Roger’s Criminal Responsibility Assessment Scale (RCRAS)

16. Lethality Assessment
Tests:
Beck Suicidal Ideation Scale;
Columbia Suicide Severity Risk Rating

17. Clinical vs Mechanical Prediction
Clinical prediction:
application of clinician’s own
training and clinical
experience as a determining
factor in clinical judgment and
actions
Mechanical prediction:
application of empirically
demonstrated statistical rules
and probabilities to the
computer generation of
findings and
recommendations