Introduction to Client Assessment HPR 451 Chapter 1

Why Assess? Meet Needs Provide interventions with a purpose Change client behavior or functioning Attitudes Knowledge Skills Abilities Use the right intervention with the right client CTRSs must have knowledge of assessment processes, procedures and instruments Discipline-specific vs. Interdisciplinary assessments

Purposes and uses – Table 1.1 Individual client information’ initial baseline for tx planning/program placement Monitoring progress (formative info) Summarizing progress (summative info) Research on program efficacy and effectiveness Communication within and among disciplines Administrative requirements

1st Reason to Assess Identify problem(s) so appropriate intervention(s) may be designed, monitored and evaluated to lead to outcomes Change client behavior in desired and predictable ways Assessment provides a baseline for placement, formative (ongoing) decisions and summative (end-of-service) decisions Includes knowledge, skills, abilities Also strengths, support, resources, attitudes, potential, etc Must collect the appropriate information accurately

2nd Reason to Assess Research purposes What is the most effective tx to use with future clients? Baseline data monitors overall efficacy and effectiveness of a TR program/intervention

3rd Reason to Assess Knowledge, Communication and Memory Professionals within a profession need a common language – ie. TR uses leisure barriers, leisure education, leisure awareness, perceived freedom, client assessment, leisure lifestyle, therapeutic recreation They all need to have common meanings for professional understanding

4th Reason to Assess Administrative Requirements External agencies (JC, CARF, CMS) that monitor quality and regulate coverage (reimbursement) ATRA has Code of Ethics and Standards of Practice (SOP) – Standard 1 = Assessment NCTRC Job Analysis Codes (Table 1.3 pg 7 and NCTRC Knowledge Areas (Table 1.4 on pg 8)

Definition of Assessment Peterson and Stumbo (2000) “the systematic process of gathering and analyzing selected information about an individual client, and using the results for placement into a program(s) that is designed to reduce or eliminate the individual’s problems or deficits with his/her leisure, and that enhance the individual’s ability to independently function in leisure pursuits.” Other definitions on pg 9 Table 1.5

Intervention and Nonintervention TR Programs Intervention – well-defined and systematic plan for getting clients from point A (entry) to point B (exit) Participant change Means to an end Assessment is critical – Why? Nonintervention – Diversional (fun, enjoyment, relaxation are goals End in itself Assessment is incidental (interests, abilities)

Principles of TR Client Assessment Assessment provides client characteristics and capabilities Pg 11 – Principles Principle #1 – Involves CTRS decisions What are the outcomes expected of programs? What are the typical needs of the clients? What is the best way to gather information from or about clients? How can results be analyzed for maximum benefit? What type program placement decisions can be made?

Principle #1 cont’d Assessment is an evolving process with goal of maximum benefits Systematic and deliberate Valid, reliable assessments are essential

Principle #2 (pg 11) There must be a logical connection between the assessment and programs delivered to clients ie. Client’s with depression share common deficits: low energy, poor eating patterns, poor concentration, difficulty making decisions, sense of hopelessness, loss of interest in daily activities Assessment would cover content related to fitness and exercise, nutrition and foods, decision-making and planning, ability to concentrate, etc Program offerings in these areas would result from the assessment findings

Principle #3 The assessment process must yield dependable and consistent results to be useful Reliability and Validity

Principle #4 Client placement into programs should be based on assessment results, not just opinions or judgments of the specialist A result when assessment is not done properly Client outcomes will not be achieved

Principle #5 The assessment process should provide baseline information from which a client’s progression or regression as a result of participation in programs can be judged

Assumptions and Measures Review assumptions – pgs 17 – 19 What should an assessment measure? Many varying opinions but commonalities: Functional abilities Leisure attitudes and barriers Leisure activity skills Leisure interests and participation