Tools of the Trade: Soft ware for Counselors
Healthcare Organizations (JCAHO). The clinician can review this information prior to the next session and pursue face-to-face matters that need clarification and elaboration. Add additional clinical notes, make any necessary changes or deletions, sign off the report, and it is now ready to enter into the clients chart. A complex clinical procedure has been accomplished in a cost, time, and energy efficient manner. Notice that a computer generated report never becomes part of the clinical record without the counselor’s careful scrutiny and approval, because it is the counselors report. After using such an approach for years, client feedback has been extraordinarily positive as direct contact time is more focused and productive.
The client has been helped to selectively communicate samples of confusing but necessary information. Using material gleaned through a personalized intake session along with the automated procedure, the clinician is ready to decide if additional assessment would be useful while the direction for counseling is being determined. If more data on symptoms is needed to support medical necessity of treatment, a checklist such as the SCL-90-R (NCS) might be useful. The seeking- and sifting-process using the assistance of technology may continue through the use of specialized scales or questionnaires to get a clearer picture of possible substance abuse, symptoms of depression, or career interests.3
Such assessment tools, usually of the self-report variety, supplement critical data obtained from personal interview and organize information in formats that make goal setting, progress evaluation, and outcome measurement manageable.4 Many tools that were once time prohibitive with hand scoring are worth a look now that computer assisted administration and/or scoring makes the task easier. If the tool meets applicable validity standards and has clinical utility, which means it adds useful information that can enhance treatment, check to see whether new technology makes its use a viable option.
*Strengthening Quality*
Today, the benchmarks of quality counseling typically center on three broad areas: appropriate evaluation relevant to the referral request to formulate a conceptualization of the issue for and with the client; a reasonable, planned approach to treatment, using interventions known to address identified concerns; and evaluation of client progress and the effectiveness of the services supplied. Christian counselors seek to address these matters in a manner that is consistent with the Scriptures and that honors our Lord. It is recognized that as those in a position of responsibility for guiding others, Christian counselors will be accountable to our Lord (James 3:1).
In addition, the practice standards of our field require that we also follow professional conventions. This means that documentation of the counseling encounter through the clinical record is essential for demonstrating that the counseling provided was done according to generally accepted guidelines. It is my view that in today’s service climate, the quality of counseling services is strengthened when there is meaningful depth and purpose in the person-to-person interactions with sufficient detail documented in the clinical record. There are tools that may help add depth to clinical work. Here the term depth is being used to signify counseling efforts aimed at increasing client self-reflection, enhancing interpersonal relationships, or identifying and/or modifying long-term issues or concerns.
It is important to note before proceeding that not every client, request, or counseling situation needs greater depth.Thus deeper is not necessary better. Rather, ask what God might be seeking to change or accomplish through this counseling encounter. How can the counselor best fulfill this task, given the assigned counseling role and setting? These questions enable the counselor to determine where to target exploration and interventions.
Staying within the barbershop criteria, there are two suggestions to consider if the counseling context of your practice calls for more depth. Personality assessment has been a staple in psychological practice and counseling work for decades.5 Theoretical differences, controversy over the appropriate use of psychological testing with certain populations, or cost-cutting endeavors may have diminished enthusiasm for using such measures in clinical practice. However, personality tests have been steadily undergoing investigation and revision, while technology has made access to the information these measures yield more accessible to clinicians.6 As professionals we need to evaluate both the measure and the application carefully before use, just as the various ethical codes require. As evangelical Christians, we also need to recognize the values and implications implicit in these measures.