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Diagnosis: The Intake Interview

The first time a therapist meets with a client, s/he does an intake interview.

The goal of the intake is to gather information on the client's presenting problem and develop a preliminary diagnosis. Typically the intake is also used to gather background information on the person's life and problems.

Different therapists take different approaches to intakes, and over time each one develops a unique style. Some prefer a fairly structured interview in which they ask standard questions; others prefer to let the client talk and see where the conversation takes them.

At the beginning of any intake, the therapist is required to tell the client several things, including:

Confidentiality

The therapist is required to explain the limits of confidentiality, i.e. that if the client tells the therapist that she is planning to hurt herself or someone else, or that she knows of a child or elder who is being abused.

Despite many people's beliefs, a therapist does not have to report drug abuse, infidelity, or other secrets unless they are putting someone in immediate danger.

There has been considerable controversy over whether the admission that someone who has not told a sexual partner that he is HIV positive falls under a therapist's duty to warn someone who is in danger due to a client's actions or potential actions.

Training and Supervision

If she is in training and under the supervision of another (licensed!) clinician, the therapist must tell the client. She must also let the client know who her supervisor is, and the client has the right to meet that supervisor if he wants to.

Recording

If she is video or audio taping the session, the therapist must tell the client, show him where the camera is, and explain how the electronic files will be safeguarded and when they will be erased. This is fairly common in situations where the therapist is still in training. Most clients are all right with the taping, though, once they understand that thanks to the camera, they're getting the wisdom of at least two clinicians, rather than just one! (Video taping can also be used when clients are practicing social skills and want to see how their new behaviors will look to others.)

Topics covered in the intake may include: