Orienting for an Assessment
• We are asking questions to get to understand enough to sort out if and how we can be helpful
• In the process people will experience an increased sense of their agency and resources

People are likely to arrive to see us expecting us to ascertain knowledge about them, find pathology and recommend potential solutions. We can frame our contact in a way more oriented towards presence rather than identifying and addressing absence or pathology:

“Our job is to do what we can to support you to live your life in the way you are wanting to. We will start by listening to your concerns and asking a lot of questions. The purpose of this is to get to understand enough about the issues you are facing, your experiences, your family and the life you are wanting to figure out if we can be helpful.”

We have found people very receptive to this orientation.

The agenda that, in the process of the conversation people will experience an increased sense of agency and their own knowledge and resource, is not so easily taken up by people. But it is a powerful frame for the clinician. Each interaction has the potential to be empowering. Each inquiry and each response can be focused and constructed to open possibility and facilitate discovery.

Disclosing referral information indicates openness and transparency which can support collaborative process. However, care may need to be taken. Referrals can sometimes be made in pathologising, totalising or deficit based language. Disclosure of this can sometimes be managed by using relational language. For example:

“Dr X wrote a letter indicating a concern that you may be experiencing suicidal thoughts, struggling with depression, hearing voices which are getting in the way of your concentration, etc.”

It may be most useful, particularly with a child or young person brought by their family, to explore what they know and understand about the referral. This gives an opportunity to centralize their experience and hear the language they use.