Assessment and Intervention Planning
What the questions test
Assessment and planning items ask you to gather, organize, and interpret information before committing to a course of action. Know the components of a biopsychosocial and spiritual assessment, the mental status exam (appearance, mood and affect, thought process and content, cognition, risk), the difference between screening and full assessment, and the value of collateral contacts. You must recognize urgency - suicidal or homicidal ideation, plan and means, recent loss, prior attempts, access to firearms - and understand that risk findings drive the sequence of everything else. Legal duties appear here: mandated reporting of child and elder abuse, duty to protect, informed consent, and the limits of confidentiality. Planning content includes strengths-based and person-centered goals, measurable objectives, service coordination, and cultural formulation - how the client explains the problem and what help is acceptable to them.
Traps
Many stems describe a client in distress and then offer an appealing intervention. If the worker has not yet assessed, the intervention is the wrong answer. Other frequent traps: diagnosing from a single observed behavior; ignoring a medical rule-out such as delirium or medication effects; treating a screening score as a diagnosis; contacting collaterals before consent; and letting the agency's available service menu define the plan instead of the client's need.
Worked example
A 68-year-old presents confused and agitated. Options: refer to a dementia support group; complete a mental status exam and arrange medical evaluation; begin reminiscence therapy. Acute-onset confusion in an older adult is a medical emergency until proven otherwise, so the exam and medical rule-out come first. Sequence beats sophistication.