INCORPORATING ASSESSMENTS

If it is necessary for the client to fill out assessment questionnaires, maintain the spirit of collaboration using active listening skills, as in this extract:

Interviewer: You mentioned that you would like to lose some weight and that you’d like to learn how to control your food intake [summarising]. Is there anything else you would like to get out of these sessions? [open question]

Client: Yes. I would also like to know how I can eat more healthily and avoid falling back into bad habits.

Interviewer: You want to develop healthy eating habits [reflection], which is great [affirmation], but you are worried about whether you can stay motivated [reflecting emotion]. Before we talk a bit more about your experience, could I ask you to fill in a questionnaire about what you eat in a typical day, so that we both have an idea of your average food consumption. Is that ok with you? [asking permission]

Reflecting upon the assessment can be an effective method for both the client and the professional to learn more about the issue at hand. Such reflection may reveal the client’s feelings about their problems and the severity of their problem.

Interviewer: As you were filling in the questionnaire, was there anything that surprised you about your diet?

Client: I noticed that I eat a lot of bread. I seem to have it at every meal and quite often I make toast to eat in front of the TV after dinner, especially if I’ve had a bad day.

Interviewer: So comfort eating is a problem for you?

Although some clients may have a positive reaction to the assessments, some may become distressed or ambivalent. The practitioner may express empathy and explore the source of the distress by engaging in basic counselling methods. Work to normalise any ambivalence, reinforce autonomy by acknowledging their willingness to undergo the session, and ask permission to explore their feelings further as you move to the imagery-based motivational interviewing stage of the interview.

Interviewer: As you were filling in the questionnaires was there anything that surprised you about your diet?

Client: Yeah, I noticed that I eat a lot of rice. In every meal I will have some rice. That’s not good for me is it? I should probably cut down, but I like it. I don’t think I will be able to do it.

Interviewer: You’re feeling uncertain about how to cut down, given how much you like it, but you’re really concerned about the current situation [reflecting emotion].

Client: I think that although I do feel overwhelmed it is still important to me and I do want to try. It all just hit me all of a sudden realising how bad my diet is and I’m not sure if I will be able to change it. I also remembered all the times in the past when I have tried and failed at losing weight.

Interviewer: So you have tried in the past – that must have been a big step [amplifying success in past attempt]…