Effective Assessment and Contracting in Counseling

Assessment & contracting Session Module 1 Terapia

Aims to clarify client s reason for counselling to clarify referrer s reason for counselling to clarify aspect of the working alliance to assess client s suitability for the work you are offering to assess your ability to work with the client to establish a working relationship to clarify and define concerns To give the client an opportunity to decide if they want to work with you!

Orientation and Boundaries Establishing core boundaries: timing of the sessions number of sessions being offered Boundaries about terminating the relationship Note taking, (recording sessions etc.) Limits of confidentiality

Information gathered during assessment session: Client s details, GP details, (these should be recorded separately to any other notes, which contain personal story) Client s reason for referral Break down broad issues of concern to specific details Why now Clients desired outcome of counselling

Clients history: Parents, siblings, upbringing, family history, past relationship, significant people in client s childhood and young adulthood, traumatic experiences, bereavement and losses Place client in social context Understand client s cultural, religious and ethnic background Be aware of patterns and the themes that informs you of client s view of self, others, the world and his/her strengths and resources. Be aware of themes that may inform you about what is maintaining his/her problem.

Client Current situation: Marital status, age, children yes/no, nature of current relationship (if any), work, employment,

Mental health History Suicide risk, drug and alcohol history, Type, dose of medication, if any Medical History Client s smoking, alcohol and drug habits

Previous experience of counselling/psychotherapy Nature, length, theoretical approach. Outcome, what helped or hindered the outcome, Client s feeling about that experience

Observations: Client s behaviour, personality, mood, eye contact, ability to express his/her feelings, Ability to gain insight, general suitability for therapeutic intervention. Nature of issues brought to counselling. Formulate your working hypothesis

Recommendations: Tentative treatment plan Any alternative referral (if appropriate)

Some Contra-Indicators for Counselling: Psychotic disorders Acute stage of Depressive or Bipolar I &II disorders Poor motivation to counselling

Some Contra-Indicators for Short Term Counselling All above Inability to establish rapport Chronic problem history with no recent identifiable change Little motivation to explore issues Some childhood issues which influenced long-term, repeated patterns throughout client s life

Contracting CONTRACTING MAY INCLUDE Written: Confidentiality and its limits Payment details Cancellation policy Holiday policy Session length and appointment time(s) Ending notice period (if applicable)

Contracting (continued) Written (continued) Clinical supervision role and function GDPR/data protection information about notes Alcohol / drugs Information about: emergency contact, GP, school (children) Arrival (if relevant) e.g no waiting area, don t arrive early How / when to contact between sessions Verbal What to do if you meet outside the therapy room? Safe behaviour in the therapy room (particularly children)