Intake, Diagnosis, and
Treatment
MHS 6620
Lorayne Thayer &TeresaTilden
Diagnosing the Problem
•
Effective problem solving and decision
making involves the ability to collect and
select the information that is necessary to
solve the dilemma.
•
The nature of the interaction must be
controlled by the helper, who is trained to
collect and select the information necessary
to solve the dilemma, he/she helps the client
facilitate change.
Gazda, G.M., Asbury, F.R., Balzer, F. J., Childers, W. C., Phelps, R.E.,
Walters, R. P., 2003 p.10
Intake and Diagnosis
•
Before a helper can be of any assistance to a
helpee, he or she must understand the
helpee’s problem in depth.
•
An intake interview is the first step to
understanding, and then diagnosing the
problem.
Gazda, G.M., Asbury, F.R., Balzer, F. J., Childers, W. C., Phelps, R.E.,
Walters, R. P., 2003 p.10
What is an intake?

An initial interview used to gather data about
a client.

Can be conducted by an intake worker or a
counselor.
MacCluskie, K.C., Ingersoll E.R., 2001 chapter 5
What is the purpose of an intake?

To provide information to guide diagnosis and
selection of a treatment plan.

Helps to match the client to a counselor.
MacCluskie, K.C., Ingersoll E.R., 2001 chapter 5
What to do during Intake Interviews?!





Have a clear idea of why the individual is
being interviewed.
Be concerned about the physical setting or
environment.
Empathize and be warm to help establish
good rapport with the client.
Be alert to verbal and nonverbal behavior.
Be in charge and keep the goals of the
interview in mind.
Information Obtained During
Intake






Demographic Information
Presenting Problem
Past Psychiatric History
Medical History
Mental status
Personal & Social History
*Pay attention to how the client speaks, thinks,
feels, and evaluates situations.
How to Obtain Information: Models
of Clinical Assessment

During an intake, there are two ways of
gathering information, or two models of
assessment to help diagnose the client.
!.
Psychodiagnostic Model---holistic and
intended to describe the client in a variety of
ways.
2.
Psychometric Model---emphasizes more
objective use of tests and assessment
instruments.
Drummond, R. J., 2004
Types of Intake Interviews

Structured---A set of specific questions.
Each client is asked exactly the same
questions in the same manner.

Unstructured---Does not follow any specific
format. Allows the client to determine what is
important to talk about.
Drummond, R. J., 2004
Tools for Structure:
Data vs. Multimodal Schemas



Initial Client Contact Form (ICCF)
(DATA)
(Basic ID)
(Multimodal)
Mental Status Exam (MSE)
(Multimodal)
MacCluskie, K.C., Ingersoll E.R., 2001 chapter 5
Multimodal Therapy

Multimodal therapy was one of the first
attempts at comprehensive assessment
and treatment. It was developed by J.
Lazarus who saw it as an effective way
of tailoring the treatment to the client
rather than the other way around.
Structure: Initial Client Contact
Form (ICCF)



Used by the counselor to gather general data
about a potential client, often used during
phone interviews.
Used by the client in order to access
treatment or receive further information about
treatment options at an agency.
Is not usually fully comprehensive in terms of
putting together a diagnosis or treatment
plan.
MacCluskie, K.C., Ingersoll E.R., 2001 chapter 5
Structure: Basic ID




Acronym for the seven elements of the clients
experience.
Follows the psycho diagnostic model.
Comprehensive in initial assessment and
treatment.
Guides counselor’s thinking in determining a
diagnosis and treatment plan.
Basic ID continued…Comprehensive
initial assessment and treatment.
Behavior Interpersonal relationships
Affect
Drug (biological)
Sensations
Imagery
Cognitions
Structure: Mental Status Exam
(MSE)



Component of diagnostic interviewing.
Observation and documentation of:
appearance, attitude, activity, affect, speech,
language, thought process, content,
perception, cognition, insight and judgement.
Remember to secure the client’s approval to
do a mental status exam, or to document that
an MSE is being done if you are in an
emergency situation.
Tools for Structuring Intake



The ICCF can be used for quick intake over
the phone or in brief interviews that have time
constraints.
The ICCF is not as comprehensive as Basic
ID and MSE which are used to provide
general structure for data gathering while the
client shares his/her concerns as he/she feels
most comfortable.
Basic ID and MSE guide the counselor’s
thinking in determining a diagnosis and
treatment plan.
What is a Crisis?
Hoff (1995) defines crisis as: “acute
emotional upset arising from situational,
developmental, or sociocultural sources
and resulting in a temporary inability to
cope by means of one’s usual problem
solving device.”
Symptoms of Crisis





Lowered attention span.
Introversion.
Emotional reaching out.
Impulsive and unproductive behavior.
Subjective sense of extreme
vulnerability.
Assessing a Client in Crisis







Assess lethality and safety needs.
Establish rapport and communication; reflect
feelings.
Identify the major problem.
Process feelings and provide support.
Explore possible alternatives.
Formulate an action plan.
Follow-up.
Other Assessment Tools:



DSM-IV
Merck Manuel
Treatment and intake forms and resources
available:
http://www/4ulr.com/products/counseling/t
reatmentplannerbooks.html
http://www.coedu.usf.edu/zalaquett/ccs/ccsp.htm intake presentation
number two.
Treatment Modes




Individual
Couple
Group
Family
Models of Treatment:
Psychotherapy v Counseling

Counseling stresses the giving of information,
advice, and orders by someone considered to
be an expert in a particular area of human
behavior or in redirecting human behavior in
positive ways .

Psychotherapy is the process of helping
people discover why they think, feel, and act
in unsatisfactory ways.
Corsini, R.J., Wedding, D., 2005 ch. 1
Psychotherapy v Counseling
What may seem to be a simple problem at
first can become more complicated as
counseling goes on and may require the
more in depth approach of psychotherapy.
Counseling focuses on problem solving while
psychotherapy focuses on the person.
Corsini, R.J., Wedding, D., 2005 ch. 1
Techniques:
Psychotherapy v Counseling

Person-centered
Cognitive
Behavioral
Rational Emotive
Behavior Therapy
Gestalt

Eclectic







Brief
Solution Focused
Eclectic
Treatment: Final Thought
Your careful assessment of the
clients condition and prognosis
determines the extent and type of
intervention that needs to occur and
helps your clients reach their goals.
References
Corsisni, R. J., and Wedding, D. (2005).
Current Psychotherapies. 7th ed. Brooks/Cole.
Gazda, G.M., Asbury, F.R., Balzer, F. J., Childers,
W.C., Phelps, R.E., Walters, R.P.(1999).Human
Relations Development.6th ed. Needham Heights, MA: Allyn and Bacon.
MacCluskie, K.C., and Ingersoll, R.E., (2001). Becoming a 21st
Century Agency Counselor. Belmont, CA: Wadsworth/Thomson.
Thomson, R. A.(2003) Counseling Techniques. N.Y.,N.Y.:BrunnerRoutledge.
Drummond, R.J. (2004). Appraisal Procedures for Counselors and
Helping Professionals. 5th ed. New Jersey:Prentice Hall.