Running head: intake process 1
The Intake Process: Different Theories
Stephnie A Schaap-Jones
University of the Rockies
10 March 2014
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Abstract
The intake process for beginning psychotherapy can be a daunting process for both client and
counselor. This brief period before therapy begins often dictates the entire course of the therapy
and the client/counselor relationship for the duration of the therapy. While therapists and intake
workers prescribe to a variety of theories which may dictate the value of certain pieces of
information, the intake process is likely the first, and most crucial, element of fully successful
psychotherapy.
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The Intake Process: Different Theories
Name Age Birthdate
Address Email
City State Zip
Home Phone Work Phone Cell Phone:
Occupation Employer
Marital Status Name of Spouse/Partner
How Long?
Family:
NAME RELATIONSHI AGE LIVES WITH NOTES
P
Do you smoke? How much? Do you drink? How much?
Do you take drugs? If yes, what kind? How often?
Previously hospitalized for mental illness or disorder?
Previous Therapy/Counseling:
THERAPIST DATES REASON NOTES
Reason for seeking therapy?
How long have your current problems existed?___________________________________________________
Describe your present concerns: (Circle one) Mild Moderate Severe A Crisis
What is causing or making the problem worse?
What would make the problem better?
Ideal outcome?
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The intake process for psychotherapy usually begins with forms to fill out and interviews
with intake workers (Helstone, Van Zuuren, & Houtkooper, 1999). The goal of the intake
process is to gather a large amount of information in a short amount of time in order to devise a
therapy plan for each individual client that is tailored to the needs and concerns of the client
(Helstone, Van Zuuren, & Houtkooper, 1999). In order to accomplish this, intake workers ask
potential clients a series of both direct and open-ended questions in order to gather the necessary
information while getting some insight into the individual client and avoiding questions that may
cause the client to shut down (Helstone, Van Zuuren, & Houtkooper, 1999). While most intake
workers ask similar questions to all of their clients, how they interpret this information while
suggesting a therapy plan for a client can differ greatly depending on the theory to which a
therapist prescribes. Nonetheless, the role of an intake worker is one which requires the
individual to engage clients in such a way that they are able to extract as much information from
the clients as possible while avoiding crossing any boundaries which may offend the client in an
effort to suggest the best course of action to help the client.
Person-Centered Therapy
Person-centered therapy follows the theory that individuals are capable of solving their
own problems with the therapist acting as a guide (McCarthy & Archer, 2013). Person-centered
therapy can be used to treat a variety of psychological disorders as well as help individuals to
resolve specific problems (Chadwick, 2006). Using the intake form on page 3, an intake worker
that follows this theory would likely focus on the client’s perceptions of their problem,
themselves and what they hope to achieve. Using this theory, an intake worker would be
inclined to ask the client to expound on their thoughts and feelings, rather than specific facts.
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For example, if a client is seeking therapy for marital problems, the intake worker would
be very interested in the client’s perceptions of their spouse, their marriage and the problems
within the marriage. If the client perceives their spouse as the cause of their problems, they
could then be guided to consider what their spouse may see as the cause of the problems or to
consider what may be causing their spouse to do the things that are causing the problems.
Likewise, the intake worker may ask the client to expound on what would cause the problem to
improve in order for the counselor to guide the client in creating ways for those improvements to
occur.
Solution-Based Therapy
Solution-based therapy, just as it sounds, focuses on the solution to the problem and the
desired outcome, nearly to the exclusion of the problem (McCarthy & Archer, 2013). The goal
of solution-based therapy is to shift the client’s focus from the problem or failure to possible
solutions or strengths (Watts & Pietrzak, 2000). For this reason, an intake worker that prescribes
to this theory would be extremely interested in the last two questions on the intake form
concerning things that will help to improve the problem and the client’s ideal outcome.
For example, if the same client from the previous example were to be interviewed by a
worker in solution-based therapy, the intake worker would likely look for things that the client
considers positive or would consider as improvement. If the client indicates that they feel that
their spouse doesn’t want them to do something, they could be directed to think of ways that
their spouse may be persuaded to accept them doing whatever it is that they want to do.
Likewise, if the client indicates that their ideal outcome would be a happy marriage, the intake
worker would likely suggest therapy focused on determining what a happy marriage is and how
to reach that goal.
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Open-Ended Questions
In the assignment for Week 4, I considered my strengths to be my familiarity with diverse
cultures, my interest in variety and differences and my ability see the client as an individual in
spite of their cultural influences. I think that these strengths can help me to formulate open-
ended questions that will help to encourage a client to provide me with the information and
insight I would need. Open-ended questions are questions that require the client to come up with
an explanation or description in their own words; a question that cannot be answered with a
simple yes or no (Murphy, 2011).
My familiarity with a variety of cultures provides me with a vast number of options from
which to choose the appropriate words to entice a particular client to provide information. For
example, experience has shown me that if I ask a Hispanic woman what her response to an event
was, she will provide me with her emotional response and how her emotions led to her actions,
but if I ask a Hispanic man the same question, he will tell me what actions he took, but he will
not provide me with his emotional response unless I ask specifically about how he felt.
Likewise, I know that I can ask someone from the southern US why something is right or wrong,
and they will give a long, detailed explanation, but if I ask the same question to someone from
the North-eastern US the same question, I will likely receive a short reply regarding where it has
been declared right or wrong.
My intense interest in variety and differences will also help me to create open-ended
questions because I honestly want to hear the answer in the words of the client. A simple yes or
no answer does not provide me with the answer that I want, which inherently leads me to ask
more open-ended questions. Even something as simple as determining who a client lives with
leads me to ask an open-ended question because I hear different meanings in how an individual
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describes the people they live with. For example, a client that claims to live with their “parents”
indicates a more formal or negative relationship than one who claims to live with their “mom and
dad.”
Finally, my ability to see beyond cultural influences to see the individual underneath can
help me to ask questions that will lead me to determine where a person’s culture ends and where
their individual personality starts. One of my favorite questions to ask is “how would you
describe yourself to someone who could not see you or hear you?” This question forces people
to determine which cultures influence them the most. An African-American woman may
describe herself as “a strong, independent, hard-working woman” and completely omit her
African-American heritage, while a company CEO may describe themselves as “a dedicated and
loyal African-American” and completely omit their gender. An individual’s answer to this one
question tells me more than many other questions because it invariably tells me what groups and
cultures influence them and which traits they consider to be most important for others to know
about them, which also tells me what they aspire to become.
Observing Boundaries
It is imperative for anyone performing an intake interview to be extremely mindful of the
client’s boundaries and to find ways to extract information from a client without crossing any of
these boundaries (Murphy, 2011). I believe that my extensive experience with people with a
variety of cultural influences will help me to determine where the boundaries of my clients may
be as well as determining how to help them to open up and reveal information that I need. While
some people deal with a direct approach and being asked directly how they felt about something,
others require a more subtle approach such as being asked to guess how others may feel about
the same thing.
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It has been my experience so far that there are some universal signs that people give to
indicate that someone is close to or crossing their boundaries. For example, most people will
begin to physically move away from someone asking questions that are making them
uncomfortable. It is important to observe the non-verbal communication coming from a client in
order to discern whether or not their boundaries are being reached. Things like body-language,
tone of voice and eye contact can often reveal that boundaries are being crossed before a client
shuts down completely. By paying close attention to a client’s verbal and non-verbal responses,
I should be able to detect problems before they arise.
Conclusion
The intake process may be the most important step in the therapeutic process. The intake
process is the first chance for a client to be put at ease and to feel accepted by a therapist. How
the intake process is handled has the potential to make a client feel comfortable enough to take
an active role in their therapy or to drive them away completely. While an intake worker or
therapist’s choice in theories may impact which information they find pertinent and which
questions they ask, their ability to handle the delicate and tactical elements of the intake process
may be the most important skill they possess.
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References
Chadwick, P. (2006). Person-Based Cognitive Therapy for Disterssing Psychosis. West Sussex,
England: John Wiley & Sons Ltd.
Helstone, F. S., Van Zuuren, F. J., & Houtkooper, S. (1999). A cross-case comparison of two
independent analyses of intake workers' descriptions of the process of assessment for
psychotherapy. British Journal of Medical Psychology, 33, 355.
McCarthy, C. J., & Archer, J. J. (2013). Theories of counseling and psychotherapy. San Diego,
CA: Bridgepoint Education, Inc.
Murphy, B. C. (2011). Interviewing in action in a multicultural world (4th ed.). Belmont, CA:
Brooks/Cole.
Watts, R. E., & Pietrzak, D. (2000). Adlerian "encouragement" and the therapeutic process of
solution-focused brief therapy. Journal of Counseling and Development, 78(4), 442.
