Assessment of Clients in Pretreatment Planning

Pretreatment planning is an essential element in psychotherapy. Constraints imposed by managed care, efficiency-of-treatment/cost-effectiveness issues, and increased likelihood of change and increased magnitude of change are obvious justifications for the provision of individualized and comprehensive pretreatment assessment. Relatedly, quality pretreatment assessment is essential for accurate patient–treatment matching. In this vein, systematic treatment selection, prescriptive psychotherapy, systematic treatment, and Innerlife are variants of an overriding empirically supported model of patient–treatment matching. More specifically, they employ accurate, comprehensive pretreatment assessment to help guide the clinician in the selection and matching of specific psychotherapeutic strategies and principles. Questions regarding diagnosis, prognosis, current level of functioning, most effective treatment, and causation/maintenance are answerable through an evaluation of relevant patient predisposing variables. While there are many qualities of problems that vary as a function of specific situations and circumstances, three appear to be of major importance to the differential assignment of treatment: patient expectations, subjective distress, and functional impairment.