Conclusion
This overview in limited in its ability to fully discuss all
relevant factors in assessment; a decision was made to
include issues that would be pertinent to a wide audience.
Likewise, the scope of this overview precludes discussion
of the steps instigating treatment following from assessment,
although it follows that management of acute physical
and psychiatric problems naturally take priority.
Experienced clinicians know that the process of assessment
is an on-going one, encompassing a need to repeat
and monitor medical investigations and revise psychological
formulations as more information comes to light,
symptoms worsen or improve and priorities shift. A preliminary
assessment should never attempt to reach firm
opinions about cause although formulations relating to
factors maintaining the disorder may be more apparent.
In conclusion, assessments require a systematic, rigorous,
and empathic approach that strikes an important
balance between carefully listening to patient needs and
dilemmas, while remaining firm and focused about the
need for treatment. Even difficult assessment interviews
conducted under duress should leave the patient with a sense of dignity and that they have been heard. The assessment
interaction should be seen as an important
therapeutic interaction to begin building a therapeutic
alliance, balancing both an atmosphere of acceptance
[120] yet firmness without being over-confident or
paternalistic. The most important assessment tool is the
clinician and the knowledge and stance they take into
the interpersonal interaction. An assessment will always
be a deeply complex interpersonal interaction requiring
a careful clinical interview, and one based on a sound
understanding of the symptoms and issues faced by the
patient