Why Bother?

For anyone who has worked in mental health field, the term “Assessment Tool” should be a familiar one. What it is referred to, is a pre-set questionnaire that an interviewer could use to get to know the client, or in clinicians’ terms, “Assess” the client. Just like a physician who performs a number of examination tasks and questions, a mental health clinician uses an assessment tool to get to know the client better.

Having used these tools in many different setting, I don’t believe that any one of them get us even close to knowing our clients. These tools are nothing but a large number of questions. In them, they give you specific detailed instructions on how to ask the questions and what to ask next after receiving a particular answer from the client. After completing the many pages of questionnaire, the interviewer can sit back and say: “Now I know what is going on with this client”, or can they?

Let’s look at this practice from the client’s point of view. They come into the interview often distressed, anxious and in pain. They are looking to receive comfort and hope. Instead, they sit with a stranger who holds a thick pile of paper in their hand as keeps asking one question after another one. The client gets a good view of the top of the interviewer’s head as they continue writing their answers down. At the end, while both the client and the interviewer are tired out of their minds, the client gets to go home wondering what was the purpose of answering all these questions? It is not until the following session that the client actually gets to tell their story and the reasons for which they seeked help in the first place. That is if they decide to come back after the boring useless assessment session.

So what does the clinician do after the client leaves? They put the completed thick assessment tool in the client’s file. Does anyone ever read these questionnaires? I guarantee you not. The clinician will have to write a summary of the assessment, containing the history of presenting problem, family history etc., which has very little to do with the many questions been asked in the assessment tool. In other words, the interviewer will not be relying on the assessment tool to write their assessment report. Anyone going over the client’s file will briefly glance at the report and not the questionnaire. No one has time to go over so many questions and try to make sense out of them.

So what is the point of asking all these questions? I would say to do the job for those clinicians who don’t have the innate skills of being in the mental health practice. You either have what it takes to relate to clients or you don’t. Furthermore, these tools cover the clinician from ever being accused of not having done their job. When I conduct an assessment interview, I do not relay on any assessment tools. Nor do I use a thick endless questionnaire to get to know my clients. After having a casual conversation for half the time spent on completing any assessment tool, I get an idea of where to go from there.

The problem is rooted in our education system, where people who do not have the skills to be in the profession are being graduated and thrown into the practice. How do we compensate for their lack of people’s skills? Give them a bunch of questions to ask their clients and give it a fancy name such as “Assessment Tool” is not going to make them good clinicians. To me, these tools are nothing but waste of time which will only scare the clients away.

Shahrzad Shahriari
BSc.Psych., MSW., RSW.
www.shahrzadtherapy.com
647-405-7706