Updated: Jul 15, 2020
By Dr Marianne Trent, Clinical Psychologist of Good Thinking Psychological Services
I know that even to reach out for mental health help can feel incredibly nerve wracking. I know that waiting for an initial assessment once you have reached out can be agonising. Then you get the date and you’re likely worried about what will be said, how it will make you feel and also, most importantly whether you’ll be triggered and therefore actually worse off after the appointment by what’s been discussed within the assessment.
These are the steps I go through in my private practice and NHS assessments. I hope you’ll find a great deal of crossover if you’re assessment is scheduled with a different clinician though.
1) Questionnaires / Outcome Measures
I love people and I love data. Therefore, data on people really floats my boat. This means I like to do questionnaires with people so that we can do them again during the course of therapy to check that what we are doing is making a difference. I know that what you don’t want is to spend the precious time from your assessment filling in the questionnaires though. That’s why I’ll always try to send across the questionnaires to you before our assessment so that you can give me the answers when we meet.
2) Identifying / Describing Difficulties
I need to be able to hear what difficulties you’re struggling with. However, that doesn’t mean that you need to be able to discuss with me in a full and frank manner everything that’s’ ever happened to you. I know that to you, I’m a stranger and that sharing your life with a stranger might not feel safe. I promise I’ll help keep you feeling safe. You’re in control. You get to decide what to share with me. I will help you. It’s okay to say, ‘No.’ It’s okay to say ‘not yet……’
3) Goals For Treatment
I need to hear what your mental health goals for treatment are. However, it’s also helpful to think about your wider life goals too because if mental health struggles are a thorn in your side it can be difficult to ever imagine that you’ll get to where you want to go. I want you to believe that you can!
I want to hear about the things which are going well for you at the moment. That might be your partner, your children or maybe even just a good Netflix series you’re enjoying! I need to hear about what drives you and what you enjoy because it tells me how engaged with life you are currently and what is driving you to feel better and to keep you here in this world.
5) A mini stand alone intervention - learning Psychological skills
I want you to feel that even the assessment alone has been super helpful to you and that you’re glad you did it. That’s because, unfortunately, when working in the NHS where there are long waiting lists an assessment session might be all you get for a while. Therefore, I want to be able to use the time we have together to teach and practice skills with you. I want to be able to shape your understanding of your experiences and to be able to impart skills which you can practice with me in the appointment but also in the days and weeks after the appointment. I also do this because I need to be able to be sure that you are going to be able to roll with the types of things I think will be helpful to you. If you struggle to access the skills and approaches we go through then we can think again about something else which might work better for you.
6)Action Plan and Goal Setting
I want to be able to come up with a plan which we both think is going to be the right way to go ahead to help you achieve your goals. Surprisingly, this plan might not involve me or the services I work for! It might be that upon discussion and reflection, you and I think that actually the next step might be to work with a different profession or a different service offered by an organisation. Of course, the plan is often that we decide work with Clinical psychology / A Clinical Psychologist / A CBT therapist is the way to go. If this is the case then we will come up with a plan about what types of treatment approaches are likely to be most helpful and an expected date for when treatment can start. In my private practice the answer is usually pretty immediately! In the NHS it might mean that I need to signpost you to other avenues of support or group work before any 1:1 work can commence.
I’d love to know what you think. Has this piece been helpful?