A Design for Conducting Effective Assessment:

Abstract

In recent years, increasingly restrictive mental health coverage by insurance companies has resulted in authorizations for shorter treatment periods. Mental health providers have been challenged to deliver briefer therapies, as well as find other ways to reduce costs. This paper presents a view that the assessment phase of therapy must become more effective in identifying the scope and severity of mental health problems, be more therapeutic in nature, and therefore more cost effective. A model based on systemic questioning is introduced as a method of increasing the efficacy of initial assessments. This model combines elements of the Milan school of family therapy, as well as Carl Tomm's concept of interventive interviewing. Two specific problem areas are chosen to illustrate this model: substance abuse and childhood sexual abuse. A series of interviewing questions are presented, with rationales given for particular questions. Special attention is given to creating an interview which minimizes denial, changes the perception of the problem, portrays the interviewer as non-judgmental, and combines questioning with therapeutic progress.