Lecture 2

• Using Problem Conceptualization Systems

• Understanding “A” in SOAP
• Note :clinical hypotheses in A will be discussed in
lecture 9
Lecture 3

 OTHER TOOLS TO INCLUDE IN INTERVIEW

 Life History with Timeline
 Genogram
 The Intake Report Outline
Life History with Timeline

 Organizing information about the client's personal history shows the stages
and transitions of a unique life.
 By using a visual timeline, therapists recognize gaps in their information and
how seemingly unconnected events coincide in time.
 It is also very useful to match the individual's life history timeline with a
timeline of historical events to grasp some of the social, economic, and
cultural factors in a person's history.
Time line template
Time line template (example)
Genogram

 This is a diagram of the family tree going back at least to the grandparent
generation.
 A visualization of this information,
 along with details about culture,
 relationships,
 and family dynamics, can be enormously helpful.
Genogram symbols

 GenoPro uses genogram symbols to create easy-to read family trees.

Genograms allow to illustrate complex situations such as reconstituted
families, multiple marriages, gay relationships, etc.
Genogram relationships

 GenoPro allows
the user to
illustrate the
various types of
relationships
uniting different
individuals. This
component gives
users the
opportunity to tell
the whole story.
Things to remember in intake
1= Reassurance and support
 Reassurance and support are essential parts of an effective closing
 When clients become upset during an intake interview, respond by
 (1) validating the client’s feelings and
 (2) instilling hope for positive change
Things to remember in intake
1= Reassurance and support
 when a client is experiencing painful or disturbing feelings. a therapist might
say the end of an intake follows:

 I want you to know that it’s very natural to have sad or upset feelings. Many
people who come in to talk to a counselor leave with mixed feelings.That’s
because it’s hard to talk about YOUR personal problems without having
uncomfortable feelings, but sort of good at the same time. What you’re
feeling is natural.
Things to remember in intake
2=client concern on outcome of session

 Another issue toward the end of the intake is the future.

 Clients come to counseling or therapy because they want change, and change
involves the future.

 the following question can be asked toward the end of the intake:
 “Let’s say that therapy is successful and you notice some major changes in
your life.
 What will have changed
 “How do you see yourself changing in the next several years?”
Things to remember in intake
3=client expectation about the session

 Client goals should be formulated from client problems at the beginning of an

intake interview.
 It’s also important to review client goals in a positive and upbeat manner
toward the interview’s end.

 Goal setting lecture 10

What you need to be clear before
taking intake session :
 it’s essential for therapists to be trained to conduct abbreviated intake
interviews.
 Intake interview objectives
 Obtaining information about clients’ problems and goals, the clients
themselves, and clients’ current situation is essential.
 Depending where you are practice you can use information present in the
 registration forms
 questionnaire data obtained from clients before an initial meeting.

What you need to be clear before
taking intake session :
 Depending if you are using intake form /clinical interview together
 Or in separate sessions
 If in separate sessions than
 In intake you can :
 therapists must use more questions and permit less time for client-directed
self-expression.
 Therapists must reduce time spent obtaining personal history and
interpersonal style information. Because using registration forms and
questionnaires and given before the session may cover these areas and
remaining can be covered during in dept clinical interview
 .
Therapist may say :

 We have only a few minutes to discuss your childhood and things that have
happened to you in the past. So, very briefly, tell me, what are the most
essential things I need to know about your past?
During intake:

 First, interpersonal information may be ignored unless clients exhibit DSM-5

personality disorder characteristics,
 In such cases, counselors can use a checklist to indicate whether a client
exhibits interpersonal behaviors consistent with one or more of the three
personality disorder clusters. If the presence of a personality disorder is
suspected, further and more definitive assessment may be pursued
You may also

 Use the intake form of your organization

 Or forms discussed in class
 Part of the forms can also be used depending if clent is able to understand or
connect
During intake:

 Second, therapists may employ an abbreviated questioners

 Third, therapists may reflect, after the session, After this reflection, some
hypotheses can be generated and written down to assure that, if necessary,
attention can be paid to further understanding of interpersonal dynamics
during the next session.
During intake:

 1. Inform your client in advance that you have only a limited amount of time
and therefore must stick to essential issues or key factors.
 2. If your client drifts into some less-essential area, gently redirect him or her
to the same topic.
 Overall, the key point is to politely prompt clients to only discuss essential
and highly relevant information about themselves.
Your competency is:

 Choosing the structure and content of your report.\

 Writing clearly and concisely.
 Keeping your report confidential.
 Sharing the report with your client. (if permitted or need to do so )
A Brief Intake Checklist

Please remember to Make one for yourself!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

A Brief Intake Checklist

 Obtain pre-session or registration information from the client in a sensitive manner.

Specifically, explain: “This background information will help us provide you with
services more efficiently.”
 Inform clients of session time limits at the beginning of their session. This information
can also be provided on the registration materials. All policy information, as well as
informed consent forms, should be provided to clients prior to meeting with their
therapist.

 Allow clients a brief time period(notmorethan10minutes)to introduce themselves and

their problems to you. Begin asking specific diagnostic questions toward the 10-
minute mark, if not before.
 Summarize clients’ major problem (and sometimes a secondary problem) back to
them. Obtain agreement from them that they would like to work on their primary
problem area.
A Brief Intake Checklist

 Help clients reframe their primary problem into a realistic long-term goal.
 Briefly identify how long clients have had their particular problem. Also, ask
for a review of how they have tried to remediate their problem (e.g., what
approaches have been used previously).
 Identify problem antecedents and consequences, but also ask clients about
problem exceptions. For example: “Tell me about times when your problem
isn’t occurring. What happens that helps you eliminate the problem at those
times?”
 .
A Brief Intake Checklist

Tell clients that their personal history is important to you, but that there is
obviously not time available to explore their past.
Instead, ask them to tell you two or three critical events that they believe you
should know about them.
Also, ask them about (a) sexual abuse, (b) physical abuse, (c) traumatic
experiences, (d) suicide attempts, (e) episodes of violent behavior or loss of
personal control,(f) brain injuries or pertinent medical problems, and (g) current
suicidal or homicidal impulses.
A Brief Intake Checklist

 If you will be conducting ongoing counseling, you may ask clients to write a
brief (two- to three-page) autobiography.
 Emphasize goals and solutions rather than problems and causes.
 Give clients a homework assignment to be completed before they return for
another session. This may include behavioral or cognitive self-monitoring or a
solution-oriented exception assignment.
 After the initial session, write up a treatment plan that clients can sign at the
beginning of the second session. In Pakistan what is normally done ??????????