Diagnostic Information, Theoretical Orientation

A detailed review of your client’s current situation includes an evaluation of his or her social support network, coping skills, physical health , and personal strengths. Each of these areas may provide information crucial to the diagnostic process.

290 Structuring and Assessment

Case Conceptualization and Theoretical Orientation

One of the guiding forces determining what information is valued by interviewers and counselors is theoretical orientation. Although it may be too soon for you to identify your theoretical orientation, you may ?nd yourself having particular leanings. The following questions are designed to help you explore your theoretical perspective, and at the same time, develop greater focus during your interviewing assessments and treatment planning. While answering the questions, keep in mind a few cases with which you have worked or cases that have been discussed in class.

How would you de?ne your theory of therapy? In other words, what processes do you believe must occur for people to change? As you think of a particular case, how would your theory of therapy in?uence the information you want to obtain from your client? Given your response to question 1, what is your theory of etiology? In other words, what causes or contributes to individuals’ personal problems? Again, what information does this make you to want to obtain from your client? What factors do you believe play a strong role in symptom maintenance? What client information do you need to have to understand symptom maintenance? Given your theoretical perspective, what are your usual treatment goals and plans for your individual client? What intuitive reactions do you have when imagining yourself working with this particular case? How would you let your intuition guide or in?uence your assessment and treatment plan? Putting It in Practice 10.1Client Social Support Network Sometimes, it is critical to obtain diagnostic information from people other than the client, especially when interviewing children and adolescents. In such cases, parents are often interviewed as part of the diagnostic work up . However, even when interviewing adults, it may be necessary to obtain outside information to substantiate diagnostic impressions. To rely exclusively on a single clinical interview to establish a diagnosis may be inappropriate and unprofessional. As Morrison has stated: Adults can also be unaware of their family histories or details about their own development. Patients with psychosis or personality disorder may not have enough perspective to judge accurately many of their own symptoms. In any of these situations, the history you obtain from people who know your patient well may strongly in?uence your diagnosis.