Chapter 2: Effective Strategies for Assessing DSM-5 Disorders

Sources of Information

• Direct Report

• Parents, caregivers, and family

• Teachers or educators

• Peers

• Medical or pediatric professionals

Direct Report

• directly from the client is the most common form

• allows for the honoring of the client as the authority on his or her own life

• assessors can gather various information through an age-appropriate life history questionnaire the client fills out.

Parents, caregivers, and family

• has significant interaction with the client

• possess valuable assessment and diagnostic information

• Biological parents frequently have the greatest breadth of historical information

• it is important to begin with broad, open-ended questions and then proceed to further questioning that solicits greater detail.

Teachers or educators

• spend a significant amount of time in structured educational settings

• Teachers and educators can provide information about a child’s or adolescent’s behaviors, moods, concentration or focus, peer relations, anxiety or fears, and other diagnostically relevant symptomology

Peers

Children and adolescents often share information with peers that they do not share with adults

Medical or pediatric professionals

• can include current or past diagnoses and medical conditions, current or past medications, or medical procedures.

• interventions can have significant impact on the mental health of a client, as can physical health conditions.

Assessment Strategies

• Interviews

• Observations

• Cultural formulation interview

• Tests and inventories

• Checklists and rating scales

• Symptom and severity measures

• Projective personality testing

Interviews

• the primary method used to form a clinical diagnosis

• can be broad and vast and are often customized to the individual clinical assessor

• requires a particular skill set encompassing both clinical skill and interpersonal finesse

  • establishing trust and rapport

  • clinical interview

Observations

Mental Status Exam

• assessing and organizing clinical observations relating to a client’s current mental state or condition

• can transform conversational elements of the clinical interview into a rich and robust set of diagnostic data

Cultural Formulation Interview

• a means of assisting the assessing clinician in determining the impact of culture on key components of a client’s clinical presentation

• brief, semistructured interview consisting of 16 questions designed to strengthen the cultural validity of diagnostic assessment

Tests and Inventories

an effort to measure client phenomenon during the assessment process objectively

Checklists and Rating Scales

• are generally shorter and easier to use than tests and inventories and usually comprise only important dimensions being observed and rated

• Rating scales often use the services of an informant, or source of information. Informants are typically teachers, parents, and others who interact with the client being assessed

• Checklists help clarify the types and extents of mental health symptoms that might be diagnostically relevant with a child or adolescent

Symptom and Severity Measures

were designed for use both at the initial assessment meeting and in any follow-up meetings to measure symptoms’ improvement or change

Projective Personality Testing

• often struggle in their ability to express verbally the complicated set of human emotions felt during these years

• comprise a plethora of techniques thought to allow the child or adolescent to give free-form responses to sets of ambiguous stimuli