Counseling Today, Online Exclusives

Voice of Experience: Intake: Avoid wasting paper — and clients’ time

By Gregory K. Moffatt December 14, 2020

If I were a teacher at any level other than the collegiate level, I would want to be a kindergarten or pre-K teacher like my wife. Over the years, I have spent hours in her classroom reading to children and helping her with the joys of managing her young students.

I especially love watching children being exposed to a formal educational experience for the first time at the beginning of a school year. That pre-K year is the foundation on which the rest of the child’s academic life will be built. If that experience is positive, the child is much more likely to enjoy the learning process in future years.

Internship for graduate students is sort of the adult equivalent of kindergarten in the counseling field. These students are mature adults, of course, but new clinicians are walking into the clinical world for the first time. In their faces I can see the same excitement, nervousness and fear that my wife sees in her students at the beginning of every fall. I love it.

As a supervisor, I’m in a unique position with my interns because I take on only one intern each year and, since I direct our counseling program, I can run it any way I want to. That gives me plenty of latitude and daily one-on-one personal mentorship time with interns, plus the freedom to expose them to the field however I see fit.

I enjoy supervision of postgrads, but what I absolutely love is watching new counselors actually begin to practice what they have previously only heard about in the classroom. Witnessing their development from those first weeks in sessions with clients to graduation months later is always a pleasure.

During our year together, we examine every aspect of the counseling process in detail — intake, assessment, rapport building, treatment planning, record-keeping, ethics, risk management, the law, termination, just to name a few. But one of the many things I do — and I doubt most other interns experience this — is help my interns develop their own intake forms and processes. I have never talked to any clinician who, during internship, didn’t simply have intake processes provided for them. Their job was to then simply follow orders.

Once clinicians move into regular practice, they either adopt some version of the forms they have always been told to use or they use forms provided to them by the hospital or clinic where they are working. This means that most clinicians never have to really think about the intake process. They just do what they have been told and simply assume this is the best way to do it.

Most counselors consider quality-of-life issues when suggesting that clients change behaviors, pursue medical treatment options or engage in other interventions. But I doubt most clinicians ever give a second thought to the intake process as a quality-of-life question because they have never been forced to do so.

Isn’t it irritating when you go to a doctor for the first time, fill out pages and pages of forms (many of which ask repeatedly for the same information) and then, when you see the physician in the examining room, you hear, “So, what brings you here today?”

Do you not find yourself wondering, “Well, I just spent 30 minutes writing that down for you. If you’re beginning by asking me why I’m here, why did I have to spend all that time filling out paperwork?”

During our first few weeks of supervision, I help interns think through this process. THE question is this: What is essential for you to know when you see a client for the first time? Some things are inescapable — HIPAA forms and informed consent, for example. But beyond that, what is critical? If it isn’t essential, then maybe it shouldn’t be a part of your intake paperwork.

My short-version intake form is only one page. In my practice, I need to know the child’s name, contact information, legal guardian and presenting issue. This is oversimplified but, generally, that is all that is critical for me. I have a longer form that I use if I know the case may go to court or if it involves an evaluation for a school or foster care system, but many of my clients don’t fall under those two situations. Anything that matters beyond the information captured on my short form will eventually come up in therapy.

So, I’m suggesting that you examine your paperwork. If we are going to ask a client to do something — complete homework, see a physician, change life habits or, yes, even fill out pieces of paper — we need to have a good reason for it.

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Gregory K. Moffatt is a veteran counselor of more than 30 years and the dean of the College of Social and Behavioral Sciences at Point University. His monthly Voice of Experience column for CT Online seeks to share theory, ethics and practice lessons learned from his diverse career, as well as inspiration for today’s counseling professionals, whether they are just starting out or have been practicing for many years. His experience includes three decades of work with children, trauma and abuse, as well as a variety of other experiences, including work with schools, businesses and law enforcement. Contact him at Greg.Moffatt@point.edu.

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Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

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