1. Using Assessment in Counseling
PSY 504: Psychological Measurement

2. Treatment Planning Varies with client
Assessment of the client’s level of functioning
Statistical methods are much better predictors than clinician judgment
Tests can lead to a better understanding of clients, which has a direct influence on the effectiveness of the treatment
Gather quality information and evaluate it with a scientific approach

3. Treatment Planning More than just determining diagnosis
To what degree are the problems affecting the client?
What environmental or social factors are contributing to the client’s issues?
What are the client’s strengths?
Are there cultural issues that need to be considered?
What is the prognosis?

4. Treatment Matching
Beutler, Malik, Talebi, Fleming, and Moleiro’s (2004) suggest the following client characteristics to consider in treatment selection:
Functional impairment – clients get worse if counselors underestimate level of impairment
Subjective distress
Problem complexity
Readiness for change – includes identification of problems and motivation
Reactant/resistance tendencies – more helpful to ask self, “what can I do to improve the therapeutic relationship and increase motivation?”
Social support – quality, not quantity
Coping style – clients tend to have patterns in how they respond to distress
Attachment style – may be contributing to clients’ current issues; the counseling relationship is a strong predictor of positive outcome

5. Treatment Matching
Rather than solely identifying client weaknesses, assessment procedures should also focus on identifying and enhancing human strengths and optimal functioning
Positive Psychology – focuses on developing strengths and enhancements of well-being, while at the same time not ignoring weaknesses
An important area to consider when assessing strengths is optimism – concerns hopeful expectation and a general expectancy that the future will be positive
Dispositional optimism is associated with fewer depressive episodes, coping strategies that are more effective, and fewer physical symptoms than a pessimistic outlook

6. Case Conceptualization and Assessment
A model for case conceptualization (Meir, 2003)
Step 1: Identify the initial process and outcome elements
Focus on the client’s problems and the processes that lead to the problematic behavior
Step 2: Learn etiology of client problem
The causes, precipitants, and maintaining influences of a client’s problems
Step 3: Choose interventions for selected problems
Should consider an empirically supported intervention
Step 4: Consider the time frame of interventions and outcomes
Step 5: Represent the conceptualization explicitly
The more explicit, the easier to test, modify, and act on
Step 6: Include at least one alternative explanation
Step 7: Consider the model’s balance between parsimony and comprehensiveness

7. Monitoring Treatment Progress (Evaluation and Accountability)
Two major types of evaluation:
Formative – continuous or intermediate evaluation typically performed to examine the process
Summative – more cumulative and focused on endpoint or final evaluation (i.e., product) [used for evaluation of accountability]
Emergence of managed-care = demand for accountability information from clinicians
Many managed-care organizations will not approve counseling services unless clinicians can show they are effective with clients

8. Monitoring Treatment Progress (Evaluation and Accountability)
Assessing outcome should occur throughout treatment, not just at termination – i.e., formative – not a “one-time event”
Counselors are increasingly required to evaluate their services and provide documentation of their effectiveness
Better therapeutic outcomes result when clinicians receive feedback about clients’ progress during therapy
And then shared with clients

9. Monitoring Treatment Progress (Evaluation and Accountability)
Counselors should be adapting the methodologies and measures developed in counseling outcome research
It is important to first determine what needs to be evaluated
There needs to be a direct connection between the services provided and the outcome measures used
Gather baseline information at the beginning
Outcome Questionnaire (OQ-45.2)
Symptom Checklist-90-Revised (SC-90-R)
Brief Symptom Inventory (BSI)

10. Monitoring Treatment Progress (Evaluation and Accountability)
Assessing outcome involves (Hill & Lambert, 2004):
Clearly specify what is being measured
Measure change from multiple perspectives (client, counselor, and outside observer)
Use diverse types of assessments (e.g., rating scales, checklists)
Use symptom-based and atheoretical measures
Examine patterns of change as much as possible
Scheme for Selecting Outcome Measures (Olges, Lambert, & Fields, 2002):
Content (cognition, affect, behavior)
Social level (interpersonal, intrapersonal, social role)
Source (self, therapist, trained observer, relevant other)
Technology (global, specific, observation, status)
Time Orientation (trait, state)