Collecting Multidimensional Client Data Using Repeated Measures: Experiences of Clients and Counselors Using the CCAPS‐34

Many college counseling centers do not collect client data at each session because of perceived burdens. This study explored 55 clients' and 16 doctoral counselor trainees' experiences collecting and using data on client distress at each session over the course of counseling at a large public university's counseling center. Results indicated that the majority of both clients and counselors found the process convenient and clinically useful. Findings, clinical implications, and future directions are discussed. Keywords: college students, repeated measures, feedback ********** As counselors, information and data are our friends. This may not always be apparent to counselors because the benefits of collecting client data are typically overshadowed by perceived barriers that exist within the time constraints and limited resources of many college counseling centers. Assessment helps counselors gain a breadth of information about an individual that, when paired with a clinical interview, creates a rich gestalt from which we can help clients create change. Clients may also benefit from ongoing assessment by being provided with feedback on their progress and discussing it with their counselors. With its focus on assessing clients' treatment progress and providing timely feedback to counselors over the course of therapy, patient-focused research has the potential to reduce the "scientist-practitioner gap." A number of studies have examined the effect of providing counselors with feedback on client outcomes (e.g., Harmon et al., 2007; Lambert et al., 2001, 2002), and several studies have examined client outcomes in relation to providing clients with feedback on their progress (e.g., Harmon et al., 2007; Hawkins, Lambert, Vermeersch, Slade, & Tuttle, 2004). No known studies have focused on clients' and counselors' experiences of how their work together is affected by being provided with regular feedback on client symptomatology. Our interest was in exploring the effect and utility of repeated assessment of client distress levels on clients, counselors, and the treatment process. Benefits of Collecting Client Data Over Time Repeated assessment during treatment provides counselors with unique sources of data to inform clinical judgment and decision making (Lambert et al., 2001). While counselors gather a great deal of information by speaking with and observing their clients in session, they cannot assess or attend to all relevant concerns at every session. The repeated use of a brief assessment tool allows counselors to monitor multiple aspects of a client's presentation and raise them for further discussion when they become relevant. In this way, repeated assessment can help counselors focus sessions on a primary problem (e.g., depression) while simultaneously considering the relevance of other areas of concern (e.g., social anxiety). Using a brief assessment tool of diverse areas of distress may help both clients and counselors recognize relevant areas of concern that clients fail to raise in session. Clients may not disclose certain issues for a number of different reasons. They may be reticent to discuss an issue they perceive as embarrassing or shameful (e.g., feeling concerned that peers do not like them) or issues about which they are ambivalent or do not wish to change (e.g., eating disordered behaviors). Alternatively, clients may not raise certain issues because they do not see them as problems (e.g., alcohol or drug use) or view them as irrelevant to the primary focus of counseling (e.g., academic difficulties). Providing counselors with feedback about client progress has been shown to be helpful in a number of ways, including helping the counselor detect clients who are deteriorating or at risk for treatment failure and altering the treatment approach in response, reducing premature termination (e.g., Lambert et al., 2001; Slade, Lambert, Harmon, Smart, & Bailey, 2008; Whipple et al. …