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Screening & Screening & AssessmentAssessment


ScreeningScreening

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What is the screening?What is the screening?

A screening is done as the client seeks services to best determine A screening is done as the client seeks services to best determine what the client’s potential problems may be and to determine if a what the client’s potential problems may be and to determine if a complete assessment is required.complete assessment is required.

The screening asks basic questions about the client’s drug/alcohol The screening asks basic questions about the client’s drug/alcohol use and the severity of that use.use and the severity of that use.

The purpose is to determine if there is a probability of a substance The purpose is to determine if there is a probability of a substance related disorder. If it appears that there might be a problem, an related disorder. If it appears that there might be a problem, an assessment then follows. If it does not appear there is a problem, assessment then follows. If it does not appear there is a problem, the client is then referred to a social services agency that can best the client is then referred to a social services agency that can best meet his/her needs.meet his/her needs.

In addition to a substance use screening, the client is also In addition to a substance use screening, the client is also screened for high risk behavior that could lead to HIV, STD, TB or screened for high risk behavior that could lead to HIV, STD, TB or Hepatitis transmission. If the client is engaging in these behaviors Hepatitis transmission. If the client is engaging in these behaviors he or she is referral for testing.he or she is referral for testing.


Screening InstrumentsScreening Instruments

There are several different types of screening There are several different types of screening tools.tools.

Many agencies now use their own specially Many agencies now use their own specially

created tools and there is no one tool that is created tools and there is no one tool that is required.required.

However, the tools used have a mechanism to However, the tools used have a mechanism to help make a recommendation for assessment, help make a recommendation for assessment, education, or the client being sent home. The education, or the client being sent home. The most commonly used tools are:most commonly used tools are:

►SASSI- SASSI- www.sassi.com►BHIPS Screening- Example AttachedBHIPS Screening- Example Attached►Agency Devised- Example AttachedAgency Devised- Example Attached


Collateral InformationCollateral Information

Often, if a client is not voluntarily seeking Often, if a client is not voluntarily seeking services, such as a referral from the criminal services, such as a referral from the criminal justice system or children's protective justice system or children's protective services, he/she is likely to give little services, he/she is likely to give little information, offer vague answers, or deny information, offer vague answers, or deny any use at all. any use at all.

It is important that the referral source or a It is important that the referral source or a family member be given the opportunity to family member be given the opportunity to offer collateral information regarding the offer collateral information regarding the client’s behavior. Not what they “think” is client’s behavior. Not what they “think” is occurring, but what behavior they have occurring, but what behavior they have observed the client engaging in.observed the client engaging in.

High Risk Behaviors

Texas Department of State Health Services (DSHS) wants each participant to be screened for high risk behavior that leads to the transmission of HIV, sexually transmitted diseases, tuberculosis, and hepatitis. This can be done with a short questionnaire.

The screener must document ,in a note, that

the client was screened and referred for testing.


ASSESSMENTASSESSMENT


What is the assessment?What is the assessment?

An ASSESSMENT is the gathering of relevant An ASSESSMENT is the gathering of relevant information about the client, their environment, information about the client, their environment, their problem(s), and what they hope to their problem(s), and what they hope to accomplish through the therapeutic intervention.accomplish through the therapeutic intervention.

There are many types of assessments used, the There are many types of assessments used, the most common are:most common are:►Addiction Severity Index (ASI)- Addiction Severity Index (ASI)- wwww.tresearch.org/resources/instruments.htm#topww.tresearch.org/resources/instruments.htm#top►BHIPS Assessment- See Example AttachedBHIPS Assessment- See Example Attached►General Psychosocial Assessment- See General Psychosocial Assessment- See AttachedAttached


Assessment Guides Assessment Guides DocumentationDocumentation


Goals of the AssessmentGoals of the Assessment

The assessment should answer the following The assessment should answer the following questions:questions:

► Is treatment of any kind required?Is treatment of any kind required?► What are the relative merits of the intervention?What are the relative merits of the intervention?► What types of treatment approaches might be What types of treatment approaches might be

appropriate?appropriate?► What is the depth of therapy needed?What is the depth of therapy needed?► Who should the therapy involve?Who should the therapy involve?► Have cultural issues been considered?Have cultural issues been considered?


Goals of the AssessmentGoals of the Assessment

The Assessment should answer these basic The Assessment should answer these basic questions:questions:

►Why is the client seeking treatment?Why is the client seeking treatment?►How have these problems affected the How have these problems affected the

client’s life?client’s life?►What is maintaining these problems?What is maintaining these problems?►What does the client hope to gain from What does the client hope to gain from

treatment?treatment?

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Who can conduct an Assessment?Who can conduct an Assessment?

Licensed Counselor (LCDC, LPC, LMSW, Licensed Counselor (LCDC, LPC, LMSW, Ph.D) Ph.D)

Registered Counselor InternRegistered Counselor Intern

Both are:Both are: Knowledgeable to assess the specific needs Knowledgeable to assess the specific needs

of the client being servedof the client being served Trained in the use of applicable and Trained in the use of applicable and

appropriate toolsappropriate tools Culturally sensitive to the client’s needsCulturally sensitive to the client’s needs


Parts of the Assessment Parts of the Assessment ► Presenting Problem or Chief ComplaintPresenting Problem or Chief Complaint► Alcohol and Other Drug Use History (Use)Alcohol and Other Drug Use History (Use)► Mental Health History (Mental/Emotional Mental Health History (Mental/Emotional

Functioning)Functioning)► Psychiatric and Chemical Dependency TreatmentPsychiatric and Chemical Dependency Treatment► Medical History (HIV, STD, TB, HEP)Medical History (HIV, STD, TB, HEP)► Relationships with Family Relationships with Family ► Social/Leisure History (Activities)Social/Leisure History (Activities)► Educational/VocationalEducational/Vocational► EmploymentEmployment► Legal HistoryLegal History► Client Strengths and LimitationsClient Strengths and Limitations► Diagnosis and RecommendationsDiagnosis and Recommendations


Presenting ProblemPresenting Problem

Asks the client:Asks the client:

What brings you here today?What brings you here today?

Why do you think you need Why do you think you need treatment?treatment?

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History of the ProblemHistory of the Problem Documentation should include the following:Documentation should include the following:

When the client began experiencing the problem When the client began experiencing the problem

Their perception of the cause of the problem Their perception of the cause of the problem

Significant events that occurred with or at the Significant events that occurred with or at the time the problem begantime the problem began

Precipitants of the problemPrecipitants of the problem


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History of the ProblemHistory of the Problem Documentation should include the Documentation should include the

following:following:

What maintains the problem’s presence What maintains the problem’s presence

The problem’s course over timeThe problem’s course over time

How the problem affects the client’s ability to How the problem affects the client’s ability to functionfunction

What the client has done to try to deal with the What the client has done to try to deal with the problemproblem


Alcohol and Drug UseAlcohol and Drug Use► Substances used in the pastSubstances used in the past► Substances used recentlySubstances used recently► Frequency/amount/durationFrequency/amount/duration► Route of administrationRoute of administration► Year or Age of first useYear or Age of first use► Behavior related to obtaining substancesBehavior related to obtaining substances► Use or recovering from alcohol or other drugsUse or recovering from alcohol or other drugs► Previous overdose, withdrawal, or adverse Previous overdose, withdrawal, or adverse

drug or alcohol reactionsdrug or alcohol reactions► Attempts to decrease/stop use Attempts to decrease/stop use ► History of previous substance abuse treatment History of previous substance abuse treatment

receivedreceived


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Mental Health HistoryMental Health History Can shed light on whether the current problem is Can shed light on whether the current problem is

part of a single or recurrent episode.part of a single or recurrent episode.

A progression of behavioral health problems over A progression of behavioral health problems over a period of time. a period of time.

What treatment approaches have or have not What treatment approaches have or have not worked. worked.

Client’s willingness to engage in the treatment Client’s willingness to engage in the treatment process.process.

Gives an idea of current emotional functioning.Gives an idea of current emotional functioning.


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Psychiatric & Chemical Dependency (CD) Psychiatric & Chemical Dependency (CD) TreatmentTreatment

► Any previous treatmentAny previous treatment

► Dates of ServiceDates of Service

► Type of ServiceType of Service

► Outcome- did they complete? are they still Outcome- did they complete? are they still going to treatment?going to treatment?

► Aftercare ServicesAftercare Services


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Medical HistoryMedical History

At a minimum, document these:At a minimum, document these:any significant illnesses any significant illnesses hospitalizations hospitalizations past and current physical illnesses or conditions past and current physical illnesses or conditions

breast or prostate cancerbreast or prostate cancerdiabetesdiabeteshypertensionhypertension

injuries or disorders affecting the central nervous injuries or disorders affecting the central nervous systemsystem

any functional limitationsany functional limitationsHIV, STD, TB or Hepatitis exposure or contactHIV, STD, TB or Hepatitis exposure or contactcursory family history of significant medical cursory family history of significant medical

problemsproblems


Family RelationshipsFamily Relationships

The family history should include:The family history should include: Spouse, children informationSpouse, children information

Relationship with spouse and/or childrenRelationship with spouse and/or children Family expectation of treatmentFamily expectation of treatment The occupation and education of parentsThe occupation and education of parents The number of siblings and their birth orderThe number of siblings and their birth order The quality of client’s relationship to parents and/or The quality of client’s relationship to parents and/or

siblingssiblings Significant extended family membersSignificant extended family members Substance use in familySubstance use in family Child or Domestic AbuseChild or Domestic Abuse


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Social & LeisureSocial & Leisure

►Components should include:Components should include: General number of friendships General number of friendships

Types of friendshipsTypes of friendships

Participation in team sports Participation in team sports

Involvement in clubs Involvement in clubs

Social activities- main form of socialization and leisureSocial activities- main form of socialization and leisure

Involvement in religion, political or gang activities Involvement in religion, political or gang activities

Opportunities requiring interpersonal interactionsOpportunities requiring interpersonal interactions

Experiences stemming from being a member of a racial or ethnic Experiences stemming from being a member of a racial or ethnic minorityminority


Educational & VocationalEducational & VocationalEducational/Vocational history can give:Educational/Vocational history can give:

Rough estimate of the client’s level of intelligence Rough estimate of the client’s level of intelligence Aspirations, goals, ability to gain from learning Aspirations, goals, ability to gain from learning

experiences experiences Willingness to make a commitmentWillingness to make a commitment Amount of perseverance Amount of perseverance Ability to delay gratificationAbility to delay gratification

Information should include:Information should include: Highest grade completedHighest grade completed Graduation statusGraduation status Feeling regarding education/vocational trainingFeeling regarding education/vocational training Willingness to attend more (school or training) in futureWillingness to attend more (school or training) in future


EmploymentEmployment Employment history can: Employment history can:

be useful in developing an effective treatment planbe useful in developing an effective treatment plangive insight into the client’s ability to get along with give insight into the client’s ability to get along with

others and take directionothers and take direction show client’s ability for assuming the role of a client show client’s ability for assuming the role of a client show compliance with treatment recommendationsshow compliance with treatment recommendations

Employment history should include:Employment history should include:Last job heldLast job heldLength of longest employmentLength of longest employmentJob preferenceJob preferenceMilitary experienceMilitary experienceTermination for job reason (if applicable)Termination for job reason (if applicable)


Legal HistoryLegal History Current legal problems Current legal problems

probation probation parole parole awaiting trial/sentencing awaiting trial/sentencing recently released from jail/prisonrecently released from jail/prison

Complications with legal situationComplications with legal situation positive UApositive UA

Are legal problems directly related to Are legal problems directly related to substance use?substance use?


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Client StrengthsClient Strengths Force clients to consider that their psychological Force clients to consider that their psychological

assets can have therapeutic value(s) in assets can have therapeutic value(s) in themselves.themselves.

Strength-based assessments can serve as an Strength-based assessments can serve as an intervention before formal treatment actually intervention before formal treatment actually begins.begins.

Can help build self-esteem and self-confidence .Can help build self-esteem and self-confidence .

Reinforce the client’s efforts to seek help. Reinforce the client’s efforts to seek help.

Increase their motivation to return to engage in Increase their motivation to return to engage in the work of treatment.the work of treatment.


DiagnosisDiagnosis

Must be a Five Axial Diagnosis: Must be a Five Axial Diagnosis: Must use criteria in DSM-IV-TRMust use criteria in DSM-IV-TR

Each Axial Diagnosis must be supported in Each Axial Diagnosis must be supported in a body of assessment by describing a body of assessment by describing behavior that demonstrates the DSM-IV behavior that demonstrates the DSM-IV diagnostic criteriadiagnostic criteria

You must determine if the client has a You must determine if the client has a substance-related disorder, if not, they are substance-related disorder, if not, they are not eligible for treatment services not eligible for treatment services


DSM-IV Multi-axial Diagnostic DSM-IV Multi-axial Diagnostic SystemSystem

► Axis IAxis I (Clinical Disorders, other conditions that may be a (Clinical Disorders, other conditions that may be a focus of attention) Examples: Substance abuse, substance focus of attention) Examples: Substance abuse, substance dependence, anxiety disorders, mood disorders, schizophreniadependence, anxiety disorders, mood disorders, schizophrenia

► Axis IIAxis II (Personality disorders, mental retardation) (Personality disorders, mental retardation) Examples: Borderline personality disorder, antisocial personality Examples: Borderline personality disorder, antisocial personality disorder, avoidant personality disorder, mental retardationdisorder, avoidant personality disorder, mental retardation

► Axis IIIAxis III (General medical conditions) Examples: Cancer, (General medical conditions) Examples: Cancer, Hypertension, Diabetes, Migraines, Chronic Pain, InjuriesHypertension, Diabetes, Migraines, Chronic Pain, Injuries

► Axis IVAxis IV (Psychosocial and environmental problems) (Psychosocial and environmental problems) Examples: Problems with primary support group, occupational Examples: Problems with primary support group, occupational problems, problems relating to social environmentproblems, problems relating to social environment

► Axis VAxis V (Global assessment of functioning) Example: GAF (Global assessment of functioning) Example: GAF ScoreScore


RecommendationsRecommendations The assessment must include:The assessment must include:

The clinical recommendationsThe clinical recommendations counselingcounseling education education treatmenttreatment

Recommendation for treatment must indicate the level of Recommendation for treatment must indicate the level of care care Detox Detox Residential Residential OutpatientOutpatient

► What are the recommended:What are the recommended: services services length of stay length of stay intensity of servicesintensity of services

► Diagnostic Justification SummaryDiagnostic Justification Summary


Treatment EligibilityTreatment Eligibility

To be eligible for treatment, To be eligible for treatment, clients must meet clients must meet the diagnostic criteria for substance abuse or the diagnostic criteria for substance abuse or substance dependence.substance dependence. If they do not meet If they do not meet the diagnostic criteria, as supported and the diagnostic criteria, as supported and documented in the assessment, you can not documented in the assessment, you can not admit the client into treatment, they must be admit the client into treatment, they must be referred for education or sent home.referred for education or sent home.

Once it is determined that they meet the Once it is determined that they meet the diagnostic criteria diagnostic criteria the level of treatment is the level of treatment is determined by the Texas Department of determined by the Texas Department of Insurance admission placement criteriaInsurance admission placement criteria and if and if DSHS is to pay for the services, DSHS is to pay for the services, determined determined by DSHS placement criteria. by DSHS placement criteria.

Admission

Once the clinician has determined that the client meets the diagnostic, level of care, and financial eligibility criteria for admission, they may begin the admission process.

It is important that the admission be justified in writing by acknowledging the diagnostic criteria has been met, the placement criteria has been met, and the financial criteria has been met.

The decision to admit should be supported by the assessment, and the assessment is always done before an admission.


Other Issues to ConsiderOther Issues to Consider

► Problem ComplexityProblem Complexity

► Readiness to ChangeReadiness to Change

► Social SupportsSocial Supports

► Coping StylesCoping Styles

► MotivationMotivation


Problem ComplexityProblem ComplexityPresenting problems can have an importantPresenting problems can have an important bearing on the treatment planning process.bearing on the treatment planning process.

Problem complexity can be facilitated byProblem complexity can be facilitated by historical information about other aspects of thehistorical information about other aspects of the client’s life. client’s life.

Historical information can allow for the revelation of Historical information can allow for the revelation of “recurrent patterns or themes arising within“recurrent patterns or themes arising within objectively different, but symbolically related,objectively different, but symbolically related, relationships”.relationships”.


Non-Complex ProblemsNon-Complex Problems The following may be exhibited or reported The following may be exhibited or reported

during the assessment:during the assessment:Chronic habits and/or transient responses.Chronic habits and/or transient responses.

Behavior repetition maintained by inadequate Behavior repetition maintained by inadequate knowledge or by ongoing situational rewards.knowledge or by ongoing situational rewards.

Behaviors having a direct relationship to Behaviors having a direct relationship to initiating events.initiating events.

Behaviors that are situation specific.Behaviors that are situation specific.


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Complex ProblemsComplex Problems

The following may be exhibited or reported during the The following may be exhibited or reported during the assessment:assessment:

Behaviors are repeated as themes across unrelated or dissimilar Behaviors are repeated as themes across unrelated or dissimilar situations.situations.

Behaviors are ritualized (yet self-defeating) attempts to resolve Behaviors are ritualized (yet self-defeating) attempts to resolve dynamic or interpersonal conflicts.dynamic or interpersonal conflicts.

Current conflicts are expressions of the client’s past rather than Current conflicts are expressions of the client’s past rather than present relationships.present relationships.

Repetitive behaviors results in suffering rather than gratification.Repetitive behaviors results in suffering rather than gratification.

Symptoms have a symbolic relationship to initiating events.Symptoms have a symbolic relationship to initiating events.

Problems are enduring, repetitive and symbolic manifestations of Problems are enduring, repetitive and symbolic manifestations of characterlogical conflicts.characterlogical conflicts.

(Patrick, 32)


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Readiness to ChangeReadiness to Change Prochaska, DiClemente and colleagues: Prochaska, DiClemente and colleagues:

Five Stages of Change:Five Stages of Change: Pre-Contemplative Pre-Contemplative

Contemplative Contemplative

Preparation Preparation

Action Action

MaintenanceMaintenance


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Prochaska’s Stages of Change:Prochaska’s Stages of Change:Pre-contemplativePre-contemplative

Little or no awareness of problemsLittle or no awareness of problems

Little or no serious consideration or intent to changeLittle or no serious consideration or intent to change

Often presents for treatment at the request of/or pressure Often presents for treatment at the request of/or pressure from another partyfrom another party

Change may be exhibited when pressure is applied but the Change may be exhibited when pressure is applied but the client reverts to previous behavior(s) when pressure is client reverts to previous behavior(s) when pressure is removed. removed.

““Resistant to recognizing or changing the problem”Resistant to recognizing or changing the problem” is the is the hallmark of the pre-contemplative stage.hallmark of the pre-contemplative stage.


Prochaska’s Stages of Change:Prochaska’s Stages of Change:ContemplativeContemplative

Awareness of problem and serious thoughts Awareness of problem and serious thoughts about working on it.about working on it.

No commitment to begin to work on it. No commitment to begin to work on it.

Weighing pros and cons of the problem and Weighing pros and cons of the problem and its solution. its solution.

““Serious consideration of problem resolution”Serious consideration of problem resolution” is the hallmark of the contemplation stage.is the hallmark of the contemplation stage.


Prochaska’s Stages of Change:Prochaska’s Stages of Change:PreparationPreparation

Intention to take serious, effective action in Intention to take serious, effective action in the near future (e.g., within a month). the near future (e.g., within a month).

Has already made small behavioral Has already made small behavioral changes. changes.

““Decision making”Decision making” is the hallmark of this is the hallmark of this stage.stage.


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Prochaska’s Stages of Change:Prochaska’s Stages of Change:ActionAction

Overt modification of behavior, experiences Overt modification of behavior, experiences or environment in an effort to overcome the or environment in an effort to overcome the problem.problem.

““Modification of problem behavior to an Modification of problem behavior to an acceptable criterion and serious efforts to acceptable criterion and serious efforts to change”change” are the hallmarks of this stage. are the hallmarks of this stage.


Prochaska’s Stages of Change:Prochaska’s Stages of Change:MaintenanceMaintenance

Continuation of change to prevent relapseContinuation of change to prevent relapse

Consolidate the gains made during the Consolidate the gains made during the action stage. action stage.

““Stabilizing behavior change and avoiding Stabilizing behavior change and avoiding relapse”relapse” are the hallmarks of this stage. are the hallmarks of this stage.


Potential Resistance to Therapeutic Potential Resistance to Therapeutic InfluencesInfluences

Two different types of resistance exists:Two different types of resistance exists: ResistanceResistance

►a state-like quality in which clients fail to a state-like quality in which clients fail to comply with external recommendations or comply with external recommendations or directions.directions.

Reactance Reactance ►a more extreme trait-like form of resistance a more extreme trait-like form of resistance

that stems from the client’s feelings that that stems from the client’s feelings that their freedom or sense of control is being their freedom or sense of control is being challenged by outside forces. This is challenged by outside forces. This is manifested as manifested as active oppositionactive opposition..


Social SupportsSocial Supports

Objective social supports can be Objective social supports can be assessed from assessed from external evidence of external evidence of

resourcesresources available to the client, such as available to the client, such as marriage, physical proximity to marriage, physical proximity to

relatives, network of identified friends, relatives, network of identified friends, membership in organizations and membership in organizations and

involvement in religious activities. Also involvement in religious activities. Also includes the quality of social includes the quality of social

relationships.relationships.


Coping StylesCoping Styles

Coping style is defined as:Coping style is defined as:““an enduring trait that relates to the way one an enduring trait that relates to the way one

copes with (handles) personal or copes with (handles) personal or interpersonal threats”.interpersonal threats”.

Two identified coping styles: Two identified coping styles: internalization internalization externalizationexternalization


InternalizationInternalization

This style of coping is suggested in This style of coping is suggested in clients who tend to:clients who tend to:Avoid, deny, repress, or compartmentalize Avoid, deny, repress, or compartmentalize

sources of anxietysources of anxiety

Be overly introverted, introspective, self-Be overly introverted, introspective, self-critical, and self-controlledcritical, and self-controlled

Be emotionally constrictedBe emotionally constricted


ExternalizationExternalization

This style of coping is suggested This style of coping is suggested in clients who tend to:in clients who tend to: Directly avoid, rationalize, project or act-Directly avoid, rationalize, project or act-

out onto their environment(s).out onto their environment(s).

Exhibit a degree of insensitivity to their Exhibit a degree of insensitivity to their own and others’ feelings.own and others’ feelings.

Be spontaneous, impulsive, extraverted, Be spontaneous, impulsive, extraverted, and sometimes manipulative.and sometimes manipulative.


Motivation to ChangeMotivation to Change How to determine the client’s level of How to determine the client’s level of

motivation to change:motivation to change:Is the client seeking treatment from their Is the client seeking treatment from their

own desire for help or from the own desire for help or from the request/demand of another?request/demand of another?

What is the client’s stated willingness to What is the client’s stated willingness to be actively involved in the treatment be actively involved in the treatment process?process?

What is the client’s subjective distress What is the client’s subjective distress and reactance?and reactance?

What is the client’s readiness for, or stage What is the client’s readiness for, or stage of, change?of, change?


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Motivation to ChangeMotivation to Change

Factors that should be considered in the evaluation of Factors that should be considered in the evaluation of motivation to engage in treatment:motivation to engage in treatment:

A A willingness to participatewillingness to participate in the diagnostic evaluation. in the diagnostic evaluation.

Honesty in reporting about oneselfHonesty in reporting about oneself and one’s difficulties. and one’s difficulties.

Ability to recognizeAbility to recognize that the symptoms experienced are that the symptoms experienced are psychological in nature.psychological in nature.

Introspectiveness and curiosityIntrospectiveness and curiosity about one’s own behavior and about one’s own behavior and motives.motives.

Openness to new ideasOpenness to new ideas, with a , with a willingness willingness to consider different to consider different attitudes.attitudes.

Realistic expectationsRealistic expectations for the results of treatment. for the results of treatment.

Willingness to make a reasonable sacrificeWillingness to make a reasonable sacrifice in order to achieve in order to achieve a successful outcome.a successful outcome.


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Involving OthersInvolving Others

► The client's family is an important factor in the client's The client's family is an important factor in the client's involvement in, and treatment for, substance use disorders. involvement in, and treatment for, substance use disorders.

► Therefore, it is critical to form a therapeutic alliance with Therefore, it is critical to form a therapeutic alliance with the family to the fullest extent possible, and to involve the the family to the fullest extent possible, and to involve the family in the assessment process. family in the assessment process.

► If there is evidence that the client is being abused at home, If there is evidence that the client is being abused at home, the family should still be questioned about the matter. the family should still be questioned about the matter.

► It is important to pursue what is known about possible It is important to pursue what is known about possible abuse from the parents, even the abusing parent, as well abuse from the parents, even the abusing parent, as well as other family members (e.g., siblings). as other family members (e.g., siblings).


Involving Others-Involving Others-ContinuedContinued

The assessment should not be The assessment should not be considered complete until there has considered complete until there has been time to assess the traditionally been time to assess the traditionally defined family and others identified by defined family and others identified by the court as legal custodians who can the court as legal custodians who can speak for the best interests of the speak for the best interests of the client, as well as the family that is client, as well as the family that is defined by the young person. defined by the young person.


Involving Others-Involving Others-ContinuedContinued

If other people, such as the client's family, are If other people, such as the client's family, are involved in the assessment process, the involved in the assessment process, the assessor should determine the order of the assessor should determine the order of the interviewing process. interviewing process.

For example, it may be advisable to first For example, it may be advisable to first interview the young person in private, then interview the young person in private, then the parent(s) in private, then with the group the parent(s) in private, then with the group as a whole, being sure to tell each person as a whole, being sure to tell each person that no information given in confidence will that no information given in confidence will be shared with the entire group unless prior be shared with the entire group unless prior permission is granted. This strategy will permission is granted. This strategy will maximize comfort and confidentiality.maximize comfort and confidentiality.


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SettingSetting

The assessment should be conducted in an office or other The assessment should be conducted in an office or other site where confidentiality can be ensured and where site where confidentiality can be ensured and where the client can feel comfortable, private, and secure. the client can feel comfortable, private, and secure.

The validity of information provided by the client may The validity of information provided by the client may depend on the setting (especially if the setting is seen depend on the setting (especially if the setting is seen by the client as adversarial or threatening), the level of by the client as adversarial or threatening), the level of trust between the client and the assessor, and the trust between the client and the assessor, and the client's understanding of the potential use and client's understanding of the potential use and audience for the information he is about to divulge.audience for the information he is about to divulge.

If the client feels that he will be overheard by others in If the client feels that he will be overheard by others in the assessor's office, or that providing information will the assessor's office, or that providing information will result in punishment, he is unlikely to tell the full truth. result in punishment, he is unlikely to tell the full truth.

If an interview is conducted in a detention center, the If an interview is conducted in a detention center, the juvenile should be assured that no one in authority at juvenile should be assured that no one in authority at the center can overhear the interview. the center can overhear the interview.

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client engaging

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