Abstract
As a new practitioner, learning how to conduct assessments and therapy can be challenging. In their book, Essential Assessment Skills for Couple and Family Therapists, Williams, Patterson, and Chamow (2011) take the guess work out of foundation assessment procedures. In this book, authors provide readers with the knowledge and information to develop a beginning set of assessment skills with families and couples. It was written as a complement to the author’s earlier work, Essential Skills in Family Therapy (Patterson, Williams, Edwards, Chamow, & Grauf-Grounds, 2009). Authors contend that this “book emphasizes what therapists should explore through clinical interviewing, as well as specific issues or questions to consider within these area” (xi). All 13 chapters are devoted to teaching new therapists how to become efficient in developing a personal style in conducting clinical assessments and interviews.
This book is different from many introductory text books on family assessment in that it does not focus specifically on one problem or population; rather, it provides a wide range of issues a therapist might encounter in diverse treatment settings. Chapters include information on how to conduct assessments with clients across the life span from children to adults. The strength of this book is how family is conceptualized for readers, as families are discussed in a variety of existences including stepfamilies, single-parent families, as well as gay- or lesbian-headed families. Readings provide assessment frameworks from a systemic perspective reminding practitioners to consider the “impact of individual functioning on families and couples” (xii). In order to conduct a thorough assessment at any point in the treatment process, one must be keenly astute to the “bidirectional influences” on individual and relationship functioning. Authors contend that this book does that and assists new practitioners in conceptualizing assessment information throughout the clinical relationship rather than as one single step in the clinical interviewing process. Time is devoted to outlining the how, what, why, and who of the assessment process. By learning these skills for assessment, a therapist will be ready to engage thoroughly in each part of the intervention and treatment process.
William et al. (2011) assist readers in understanding how to conceptualize assessment data through the use of easy to follow case studies and the emergence of theory over time. “The philosophy of this book is that the appropriate theory for conceptualizing the case will ideally emerge from the assessment data” (p. 3). Discussions of how to utilize differing theories based on the diverse factors that arise in a clinical interview including the “presenting issue, underlying cause, client characteristics, and the fit between the therapist’s and clients’ theories of change” are also addressed (p. 3). This book does not afford a specific theoretical approach to guide practitioners, but rather information from a variety of perspectives from which the practitioner can choose. Authors do provide a biopsychocial systems model in which to place a family client and remind readers that they need to assess biological as well as psychological determinants of behavior. The reader must remember that families and couples exist in their environment and therapists must assess for cultural and contextual factors that exist and influence client lives.
This book is organized into 13 chapters that range in topics from general level skills in assessment and interviewing to assessing more specific areas of health and mental health with couples and families. It provides an easily read, focused, and practical guide for practitioners of all levels who wish to learn or increase knowledge on specific topics pertaining to assessment. The overall theme of the book is that assessment is intervention, not a separate entity. Learning to conduct assessments effectively throughout the clinical relationship encourages the beginning therapist to cultivate knowledge and increase skill development over time while being both creative and open to the diverse possibilities of client responses. Authors discard the notion of “phases” of assessment but rather as an ongoing, systematic process that lasts the duration of the clinical relationship. This conceptualization of the assessment is the foundation of the clinical interviewing process and relationship with clients.
In assessment, beginning therapists are not only responsible for getting information from the client but also conceptualizing the information into a case format for appropriate intervention and treatment modalities. Williams et al. (2011) acknowledge the feelings and angst that often accompanies the first few sessions for both the client and the therapist. As new practitioners begin to learn their craft, they are worried about whether what they are choosing to do is the “right” thing which can conjure up a host of emotions, both positive and negative. In chapter one, authors provide an overview of seven guiding principles for conducting assessment. These seven are then further discussed more thoroughly while providing a framework of the remainder of the readings.
In chapter two, Williams et al. (2011) offer a short overview of different methods of assessment including clinical interviewing, assessment instruments, observation of behavior, and physiological assessment. Additionally, readers are provided with guidelines for asking questions and for using assessment instruments. This section provides a basic overview of the above topics, though for the beginning therapist, guidelines are not enough to become a skilled practitioner.
In chapter three, authors address the process of the initial interview and how to address the presenting problem/problems. Williams et al. (2011) are quick to point out that there are multiple viewpoints from which to begin with couples and families in the clinical session. It is the responsibility of the practitioner to listen to all viewpoints and help the clients move forward in their treatment. Practitioners must assess the client goals, expectations for therapy (as well as for the therapist), client motivation, and what the client has attempted in the past to correct the problem. Strength of this chapter is that authors address what happens if a client questions a therapist’s competence, often also simultaneously occurring for many new practitioners. This chapter ends with focusing how to utilize the strengths of the clients, a central factor to a successful assessment and treatment.
Regardless of a practitioner’s field of study, all graduate level practitioners abide by a specific code of ethics that provide guidelines for ethical and appropriate behaviors with clients. In chapter four, Williams et al. (2011) present a solid introduction to an often neglected area of discussion for new therapists, assessing issues of safety. Information regarding conducting suicide assessments and specific interviewing frameworks provide the beginning therapist with a general framework for intervention. This chapter should be discussed with supervisors and in general coursework and should not serve as the only information given to novice therapists. It is imperative that practitioners have opportunities to apply the assessment skills noted in the chapter before they have to conduct an actual assessment. The reader is also presented with information about assessing harm to others, child abuse, elder abuse, and domestic violence. These sections are brief in duration and should also be supplemented with additional material in the learning process.
In chapters five through eight, assessment information on health, mental health (psychopathology), and working with children is presented. Authors discuss the connection of physical well-being and psychological well-being and categorize possible components of each for better understanding of what specifically would be assessed in a clinical session. The focus on health is to help the beginning therapist move away from assessing only for psychopathology. Despite this, the next chapter focuses solely on assessing for psychopathology in adults. Although these two topics follow each other due to the population that is being discussed, the organization of this material is a bit confusing to the beginning therapist. Chapters pertaining to child clients follow the same progression, as well discussion on special issues in addressing children and adolescents including play therapy, drawings, developmental issues, and challenges. Williams et al. (2011) supply a conceptual model and checklist for evaluating child and adolescent functioning that is simple and easy to follow for beginning therapists. The developmental section appears to be quiet brief and may need further research on the part of the beginning therapist.
The remaining chapters of the book include assessing different types of families and couples with the last chapter devoted to the process of combining assessment and treatment. The chapters devoted to family assessment provide a great starting discussion on barriers to effective family assessment that often perplex beginning therapists. An overview of systematic family assessment and how to assess diverse family structures follow. These sections provide a basic framework, but at times only provide a snapshot or generalization of particular populations. Readers will want to seek additional material when working with diverse populations to cultivate and define their assessment skills with these populations. Authors provide a solid foundation for information on assessment with couples, including common behaviors, interactions, and personal traits to watch for within couples. In the special topics section devoted to couples, Williams et al. (2011) provide a general overview of sexual problems that may occur during treatment including sexual dysfunctions and infidelity. Areas not addressed in the book include reproductive and fertility concerns for couples, as well healthy sexual development for relationships. Other areas that could have had more emphasis are intimate partner violence and abuse. This information was briefly addressed early in the book but may have been appropriate to address in additional detail in this section as reminder of the importance of assessing for violence. This would be helpful for beginning therapist to be aware of because the type of treatment for the couple will depend on whether or not violence exists. The last chapter provides the reader with how to take all the assessment data and begin to formulate a treatment plan. Authors again point out barriers therapists may encounter and how to measure change. They also remind the reader that assessment is an ongoing process and will continue throughout the treatment phase.
In summation, this is a well-organized, easy to follow informational guide for new therapists. It provides a solid foundation on which beginning practitioners can rely. Authors provide specific strategies for the evaluation of clinical issues across the life span and in a variety of relationships through the use of case studies and interviewing techniques to assist the novice practitioner to begin to understand individual, couple, and family functioning.