assessment

[Adam Blatner]

Addendum: Now I do use tools such as the social atom, described by Kate Hudgins, or variations as we get into the phase where it's time to take stock of the available strengths and possible other stresses, but that's after we've made some after-diagnosis treatment plan and go for phase 2 (see my website art of case formulation)... It's a good tool for this deepening... 
       Warmly, Adam

Sent: Monday, January 25, 2010 4:51 PM Subject: assessment

Contemplating assessment in psychotherapy, it occurred to me that if I were a client I would resent much of the "testing" that administrators add to the process of intake, finding it intrusive and irrelevant---or at least I'm not warmed up to seeing how most of the questions on a standard assessment fit my perceived needs. It would be like going in for a cut on my forehead and having folks say they're duty-bound to do a full physical exam plus colonoscopy. It requires time, often they would charge me extra money for the professionals' time, etc.

           More satisfactory would be a process in which I would present my complaint and relevant story, feel heard, and questions asked. Further questions would seem reasonable if they are related to what wasn't clear on the first go-round. So the process unfolds like a complex decision tree, an algorithm: Most probable diagnosis and alternative diagnoses (not just labels, but understanding of actual causes). Exploration of alternatives if things don't fit neatly. One of my mottos: If you aren't clear on the diagnosis after taking a careful history, before you resort to any tests, take the history again. (Maybe even a third time.) There are a number of hints on how to follow-up on clues, too. (Remember, the character of Sherlock Holmes was based on the qualities of Dr. Joseph Bell, the diagnostician under whose training the Holmes' author, Conan Doyle, studied medicine.)

     Warmly,      
  Adam Blatner, M.D.
     website: www.blatner.com/adam/   


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