Clinical Assessments

The discussion in Chapter 13 was really timely for me this week, as I recently had a conversation with a colleague about her experiences working as a community counselor in a walk-in clinic. She interacted with a variety of clients who had serious issues such as anxiety and depression, eating disorders, and suicidal symptoms. After our conversation, I wondered how I would cope if presented with clients with these sorts of issues and was glad that I had the opportunity to learn more the tools available for assessing and then treating clients with mental disorders. Because I do not have any experience in this area, I appreciated knowing that there are structured interview questions available to determine whether a person meets the criteria for a certain disorder. Even the semi-structured interview questions are fairly specific, such as the SCID-CV Mood Disorder Module which appears in the book and ask questions about changes in general mood, weight, and interests. Unstructured interviews would be more difficult because they are counselor-directed, but they still assess some general domains, such as the presenting problem, family history, social and academic performance, medical background, and past experiences with substance abuse. Counselors are also encouraged to ask questions about the client's problems in three main areas, examining the onset/course of the problem, the severity of the issue, and the characteristics of the stressor itself (Drummond & Jones, 2010). I would really appreciate having these prompts available if I was ever in the position of having to diagnose a particular client on my own. The Mental Status Exam (MSE) is an important tool in clinical assessment, and it is one that I think that I would be fairly comfortable with as it is really descriptive, outlining specific questions in categories like appearance, attitude toward examiner, affect and mood, thought, orientation, memory, and concentration and attention. The book outlines a description of several general categories of MSEs which are fairly comprehensive in their own right, so I do wonder how long and cumbersome an actual assessment would be. In cases where a quick survey of functioning is required, the mini mental status exam may be more appropriate as it only focuses on cognitive questions and does not contain questions pertaining to mood and thought processes. It is commonly used in the evaluation of Alzheimer's disease or other forms of dementia, but I think that it could be helpful in evaluating other disorders which impact cognitive functioning (Drummond & Jones, 2010). Drummond, R. J. and Jones, K. (2010). Assessment Procedures for Counselors and Helping Professionals. Upper Saddle River, New Jersey: Pearson Education, Inc.