Healthinmind/Getting Services

Initial Evaluation/Assessment

(You should read Issues of Confidentiality) before or after reading this page)

This is also known as the intake evaluation, the assessment, etc. It is the first face-to-face meeting between the client or patient and the therapist. It is usually scheduled to last at least 1.5 hours (as opposed to the traditional 50-minute therapy hour). 

During this evaluation, the therapist attempts to obtain as much information as possible about the patient, including:

	Demographic information: age, education, family structure, etc. Sometimes therapists ask clients to complete a mail-in form with demographic questions, which saves time during the initial assessment.  Some therapists prefer to fill in the form with the client so that they can discuss parts of the form as it is filled in.
	Family history: any history of psychiatric illness in the family . There are at least two important reasons for this: first, many mental disorders have a hereditary component, and second, growing up with people with certain mental illnesses can predispose individuals to develop psychiatric problems.
	History of current problem: here the therapist will assess when the symptoms began, what the symptoms are, how they are disrupting the daily functioning of the individual, etc.
	Psychiatric history: the therapist will assess whether these or other symptoms have been present before, and, if so, will ask a series of questions regarding these past events.
	Mental status exam: this can take various forms. The therapist is trying to assess level of intelligence, cognitive functioning, etc.

Based on this information, the therapist will develop a plan that includes:

	Other information that needs to be obtained. This may include medical records, past psychiatric records, accounts from other family members, etc. For each of these, the therapist will request your permission in writing (there are forms to sign). Without your written permission the therapist is not allowed to request information.
	Type of treatment that you need
	Whether you need medication immediately. If so, you will probably be referred to a psychiatrist for the medication (the therapist will continue to work with you also). If not, the therapist will work with you for a few sessions before making a referral.
	The therapist will decide whether he or she is the best qualified person to work with you. Sometimes, because of the specific circumstances of the client or therapist, therapists refer clients to other therapists, centers, etc. that specialize in the type of problem for which the client needs help.

     
During this initial session you, the client, will have the opportunity to:

	Assess the therapist's training:  you should assess the credentials of the clinician.  Preferably he/she will be licensed.  If not, a licensed supervisor will meet with him/her to discuss your case on a regular basis. Visit our Mental Health Professionals page to see what types of professionals offer services.
	Inquire about the therapist's theoretical orientation:  does this therapist practice only one type of therapy (for example, only psychodynamic, or cognitive-behavioral) or is he/she experienced in various types?  Some disorders do well with any type of therapy, but others require very specific therapies.  You should make sure that the therapist either uses various forms of therapy or uses the one most appropriate for your situation.
	Assess the therapist's level of experience:  how many cases similar to yours has he/she treated?  How many years has he/she been practicing?  The confidence with which the therapist answers these questions will help you decide whether you want to invest in this relationship, which may well be one of the most important relationships in your life.
	Obtain some relief:  it is clear from the above that the initial session is a very structured session aimed at helping the therapist gain information. However, you will feel better after this session for various reasons:  first, the first session is over, and a great deal of stress and worry has probably been associated with thinking about this first meeting.  Second, you are on your way, you have taken the first step and just knowing this will make you feel better.  Third, even though your therapist has spent the session obtaining information, he or she will also provide you with some information and give you some education about what to expect, what your prospects are, etc.

Click here to read about psychological assessment.