What is important to know and when is it important to know it? To intervene in a problem, a social worker must first identify the problem. Screening and initial assessment can be useful to identity in

Week 5: Assessment of Adults

Assessment is the first step in the treatment process. A comprehensive and well-planned assessment is necessary to provide the most effective intervention. While initially assessment might seem to be a small first step, used to merely collect data, it actually has the potential to lead the entire treatment protocol. This step should not be minimized nor completed in a rushed manner because critical information about the client and his or her presenting problem may be missed. Further, during this part of the process, it is essential to take a holistic approach rather than merely focus on identifying pathology. The social work profession sets itself apart from other disciplines by identifying the client’s strengths. During this week you will read two cases and learn about these women’s presenting concerns.

Learning Objectives

Students will:

Analyze use of screening and assessment tools for practice
Analyze comprehensive assessment models

Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

Congress, E. (2013). Assessment of adults. In M. Holosko, C. Dulmus, & K. Sowers (Eds.), Social work practice with individuals and families: Evidence-informed assessments and interventions (pp. 125–145). Hoboken, NJ: Wiley.

Cowger, C. D. (1994). Assessing client strengths: Clinical assessment for client empowerment. Social Work, 39(3), 262– 268.

Plummer, S.-B., Makris, S., & Brocksen, S. M. (Eds.). (2014b). Social work case studies: Concentration year. Baltimore, MD: Laureate International Universities Publishing. [Vital Source e-reader].

Mental Health Diagnosis in Social Work: The Case of Miranda (pp. 7–9)

Note: Depending on your concentration, you may not receive a case study book until a later term. Therefore, if you did not receive a copy of Social Work Case Studies: Concentration Year in your previous course, use the linked PDF provided here. If you did receive the book referenced above, you may find the cases there or use the PDF.

Hawkins, R. L., & Kim, E. J. (2012). The socio-economic empowerment assessment: Addressing poverty and economic distress in clients. Clinical Social Work Journal, 40(2), 194– 202.

Plummer, S.-B., Makris, S., & Brocksen, S. M. (Eds.). (2014a). Sessions: case histories. Baltimore, MD: Laureate International Universities Publishing. [Vital Source e-reader].

The Cortez Family (pp. 23–25)

Resources for Discussion

American Psychiatric Association. (2018). Online assessment measures. Retrieved from https://www.psychiatry.org/psychiatrists/practice/dsm/educational-resources/assessment-measures#Disorder

Beidas, R. S., Stewart, R. E., Walsh, L., Lucas, S., Downey, M. M., Jackson, K., ... & Mandell, D. S. (2015). Free, brief, and validated: Standardized instruments for low-resource mental health settings. Cognitive and behavioral practice, 22(1), 5-19. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4310476/

SAMSHA. (n.d.) Screening tools. Retrieved from https://www.integration.samhsa.gov/clinical-practice/screening-tools

Optional Resources

Use this link to access the MSW home page, which provides resources for your social work program.

Discussion: Screening and Assessment Tools

What is important to know and when is it important to know it? To intervene in a problem, a social worker must first identify the problem. Screening and initial assessment can be useful to identity individuals who may be experiencing mental health concerns and could benefit from seeing a clinical social worker. This then would lead to a more comprehensive assessment from which a treatment plan is built. However, deciding who to assess, when, and using which tools can feel like a confusing process. For example, should you provide depression screenings in the community to people who are not clients? Should you screen all new clients for substance abuse regardless of presenting problem? Should you ask about suicide in every session or only when it feels like it could be a concern?

For this Discussion, review the following resources and consider the different screening and assessment tools currently available. Identify the tools you think you would be most likely to use in your practice.

American Psychiatric Association. (2018). Online assessment measures. Retrieved from https://www.psychiatry.org/psychiatrists/practice/dsm/educational-resources/assessment-measures#Disorder

SAMSHA. (n.d.) Screening tools. Retrieved from https://www.integration.samhsa.gov/clinical-practice/screening-tools

Provide Discussion Responses - to at colleagues who recommended a different screening/assessment practice and provide feedback.

Support your responses with specific references to the Learning Resources. Be sure to provide full APA citations for your references.

The following are the original posts to which you need to provide responses. Must provide references and citations!

Kas B

RE: Discussion - Week 5

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My area of interest deals with addiction, specifically gambling addiction. The NORC Diagnostic Screen for Gambling Addiction is an assessment tool used to help prospective clients determine if they have an issue that should be addressed. The assessment would part of initial contact with the client. The good part about the assessment tool is that it is administered by the client (self-assessment). The ten-question assessment prompts the client to take an honest look at their activities. In a way, the assessment provides a reality check for the client. The questions help define exactly what a gambling addiction looks like. The client’s answers will also provide information about the severity of their addiction as the results can range from mild to pathological. After completing the assessment, I could go over the answers with the client and began the conversation about their addiction, gain more insight into the client’s mind, and build rapport.

References:

National Council on Problem Gambling: Screening Tools. NORC DIAGNOSTIC SCREEN FOR GAMBLING PROBLEMS-SELF ADMINISTERED (NODS-SA). Retrieved from:

https://www.ncpgambling.org/help-treatment/screening-tools/

Ash H

RE: Discussion - Week 5

COLLAPSE

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Screening or assessment tool(s):

Beidas, Stewart, Walsh, Lucas, Downey, Jackson, Fernandez, and Mandell (2015) included in their article trauma assessment tools that can be retrieved from the Veterans Affairs government website. Bedias, et al., (2015) also stated that clinicians should first select broader assessment tools that allow for more options related to the presenting problem and then narrowing down and using more specific tools as the presenting problem is more understood. PTSD can be assessed using the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) in order to make an accurate diagnosis (U.S. Department of Veterans Affairs, 2018). The assessment tool National Stressful Events Survey PTSD Short Scale (NSESSS) can also be used to further specifically assess the severity of the posttraumatic stress symptoms (American Psychiatric Association, 2018).

Type of practice and client population:

The population I want to work with are military veterans who are experiencing PTSD symptoms. The selected assessment tools can be used to accurately diagnosis an individual as well as determine the level of severity of the symptoms and problem areas in the veteran’s life that affect their daily living. This would then be able to inform a person-centered treatment approach that is specific to their own symptoms and not the general consensus.

How and when to use:

CAPS-5 would be conducted to make a current diagnosis of PTSD as well as a potential lifetime diagnosis if it were to be repeated post treatment. This would occur before any initial treatment as the answers to the questionnaire can inform specific problem areas. This is a 30-item structed interview that assesses not only the symptoms, but includes questions that target social and occupational functioning, if any improvement from previous CAPS, severity of symptoms and dissociative subtype specifications (U.S. Department of Veterans Affairs, 2018). The scoring includes combining the information about the frequency and intensity into one single severity rating that correspond to different levels that indicate the criteria to receive a diagnosis.

The NSESSS assessment would be useful for determining the level of severity and where it affects their daily life to determine the target areas of treatment. It is a 9-item measure designed to be completed upon receiving a diagnosis of PTSD (American Psychiatric Association, 2018). An average total score is calculated from the 5-point scale questions to determine severity. This assessment would be beneficial to track changes over time and if further assessment and treatment is needed.

Use of information gathered:

The information gathered from the assessments is used to determine the specifics of an event that led to a diagnosis of PTSD and how that impacts an individual’s daily living based on factors such as level of severity as well as any dissociations. The results from scoring create a guide for intervention methods as well as a closer look at the specific problem area that needs to be addressed.

Resources:

Beidas, R. S., Stewart, R. E., Walsh, L., Lucas, S., Downey, M. M., Jackson, K., ... & Mandell, D. S.

(2015). Free, brief, and validated: Standardized instruments for low-resource mental health settings. Cognitive and behavioral practice, 22(1), 5-19. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4310476/

American Psychiatric Association. (2018). Online assessment measures. Retrieved from https://www.psychiatry.org/psychiatrists/practice/dsm/educational-resources/assessment-measures#Disorder.

U.S. Department of Veterans Affairs. (2018). PTSD: National Center for PTSD. Retrieved from https://www.ptsd.va.gov/professional/assessment/adult-int/caps.asp.

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Chris Transylvania (Tranny)

RE: Discussion - Week 5

COLLAPSE

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As a mental health social worker for adults with severe mental illness, the screening tools that are most effective for my clients are the Patient Health Questionnaire (PHQ-9) and the Life Event Checklist (LEC). While my clients have a variety of different mental health diagnoses, most of them present with symptoms related to depression attributed to traumatic events so I feel like these assessment tools would be the most effective. The PHQ-9 screens for depression based on a series of questions related to symptoms and indicators of depressive episodes (SAMHSA, 2020). The LEC screens for potential traumatic events throughout the client’s entire life based on the client’s response to their level of exposure to a list of distressful events (SAMHSA, 2020). Since I am working with adults, it would be easier to obtain answers to the screening tools through self-reports and gives a broader view of all the strengths and stressors the client possesses.

Both assessment tools would be effectively utilized during the initial intake assessment process to set as a baseline for the treatment plan. It would also be effective if the client were screened with the PHQ-9 on a consistent basis to track their progress (i.e.: monthly, quarterly, etc.). I would utilize the information I gathered from the screening tools as a framework for my treatment plan. Based on the responses to these screening tools, my client and I could focus on developing positive coping skills to deal with the negative stressors that are affecting my client.

SAMSHA. (n.d.) Screening tools. Retrieved from https://www.integration.samhsa.gov/clinical-practice/screening-tools

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