It is likely that for most agencies 80% of the work is in relation to a few disorders, (Pareto’s Law of the ‘Vital Few’) so developing an expertise at identifying these accurately represents a good investment of time and effort. First of all it is necessary to accurately audit what is coming in through you agency, this could involve using a screen for the 10 most common disorders, the First Step Questionnaire Revised ( available freely on this blog) and then ask the further diagnostic questions in Simply Effective CBT [ Scott (2009)] for any positive screen. Knowing say the 4 commonest disorders dealt with by your agency it would be comparitively easy to cascade training for the accurate identification of these to front line staff, who have perhaps little training. At a later date training can be given in say the next 4 most common disorders and so on so ultimately there is a comprehensive assessment. Such rigorous assessment is also the best way of monitoring outcome.
Questionnaires completed by the client are subject to demand characteristics, clients wanting to please the therapist or convince themselves that they haven’t wasted time in attending therapy. Administration of weekly psychometric tests are particularly suspect, as clients can remember their scoring and show reductions which can be mistaken for real world differences.
Dr Mike Scott