TR Process_01

ASSESSMENT PHASE
 A sound assessment identifies the client’s health status, needs, and strengths.  Assessment is a critical dimension because, without adequate and valid data on which to base TR interventions, much time may be lost in effective treatment and rehabilitation programs.
 Efforts should be made to involve the client in assessment as soon and as much as possible.  The client also needs to have confidence that the information collected is to be used in a confidential manner for the sole purpose of helping him or her toward achieving optimal health.
 Even when we establish excellent rapport, client assessment is not as straightforward as it might initially seem.  That is, sometimes clients may tell us what they believe we want to hear or what they perceive a “good” or “rational” client may say.  Thus, the helping professional must look past the client’s verbalizations to examine behavioral expressions of needs, as well as go beyond the client to seek other sources of assessment data.  Although the client is typically the chief source of data, other data sources are interviews with family members and friends, conferences with other healthcare professionals, test results, medical records, social histories, educational records, progress notes, and team meetings.
Methods of Assessment
• Observations
o Advantages:
o Disadvantages:
• Interviews
o Advantages:
o Disadvantages:
• Self-Administered Survey
o Advantages:
o Disadvantages:
• Records Review
o Advantages:
o Disadvantages:

Assessment Instruments
General Factors to Consider in an Assessment
 In addition to leisure patterns and interests, a number of factors are considered in the TR assessment.  Biographical data are normally gained from the admissions report and the initial interview with the client.  These data include name, address, telephone number, date of birth, gender, marital status, religious preference, primary language spoken, occupation, and education.
Data
• Subjective Data-
• Objective Data-
• Individual Program Plan (IPP)/ Treatment Plan-