Chapter 1: Assessment & Engagement
The assessment and engagement process is essential as it establishes the therapeutic connection from which growth and change will occur. Interventions in this chapter focus on engaging and connecting with clients in a developmentally appropriate way to assist in collecting assessment information. Because many children, adolescents, and families enter treatment involuntarily, normalizing the process of therapy and highlighting the importance of addressing presenting problems as opposed to ignoring or “forgetting” them is a crucial concept for the early stages of treatment. The creative approach of these assessment and engagement interventions will serve to assist in this process.
During the assessment process, it is not only necessary to gather information from parents and collateral sources, but also from the child. This is particularly important based on clinical literature that indicates parents often underreport children’s internalizing symptoms compared to child reports. To address this, interventions in this chapter offer tools for collecting information from the child’s perspective to help clarify treatment goals.
Generally, assessment and engagement techniques are employed in the early stages of treatment to gather information and assist with the process of treatment planning. However, because assessment is an on-going process, the interventions presented in this chapter can be utilized at any point in therapy to serve as a gauge to measure and monitor therapeutic gains and progress.
Interventions utilized during the assessment and engagement portion of therapy often set the stage for treatment. Therefore, the creative and engaging nature of the interventions included in this chapter will help provide a therapeutic tone
This getting-to-know-you activity is a modified version of the board game Don’t Break the Ice™ (Milton Bradley). Colored stickers are placed on the underside of the game ice cubes with each color corresponding to one of six categories (likes, dislikes, self/family/friends, hopes/dreams, ask a question to the other player, treat). As players knock ice cubes out of the game, they share something about themselves based on the color of the sticker located on the underside of the ice cube.
• Begin to establish the therapeutic relationship
• Acquaint the client and therapist
• 5–18 years
• Don’t Break the Ice™ (Milton Bradley)
• Star stickers
• Small candy/stickers (optional)
Engagement begins at the first contact and is essential to establish the therapeutic relationship. This technique is intended to “break the ice” between the client and therapist and provides an engaging way for individuals to get acquainted.
The game Don’t Break the Ice™ (Milton Bradley) is played using the regular rules of play and the additional rule that after players have tapped an ice cube out of the game, the player shares something about themselves according to the color of the star sticker located on the underside of the ice cube.
Prior to the game, colored star stickers are placed on the underside of each game ice cube. A traditional package of self-adhesive foil star stickers, which can be purchased at discount stores, craft stores, or online, contains five colors (i.e. blue, red, green, gold, silver). For this intervention, an additional “smiley face” sticker category is created by drawing a smiley face on one color resulting in six categories of stickers (i.e. blue, red, green, gold, silver, smiley face). Since there are 36 cubes in the game, six stickers of each color/category will be used. Each sticker “color” corresponds to a different category. Categories include the following:
• Blue = Something I like
• Red = Something I don’t like
• Green = Something about myself, my family, or my friends
• Silver = One of my hopes or dreams
• Gold = Ask a question to the other player
• Smiley Face = Small Candy/Sticker (optional)
(Note: The Don’t Break the Ice™ game has one large ice cube that is the size of four individual ice cubes. When the game is played using the traditional rules, this large ice cube serves to hold the ice skater. In addition to the large ice cube, the game typically comes with extra small ice cubes that serve as replacement ice cubes in the event pieces of the game become lost or misplaced. For this therapeutic version of the game, the replacement ice cubes are used in lieu of the large ice cube. If there are not enough extra ice cubes to fill the frame of the game, the large ice cube can be used and four star stickers can be placed on the underside. If the large ice cube is used, a player who knocks this ice cube out must respond to all four categories according to the star stickers located on the underside of the cube.
The game Don’t Break the Ice™ (Milton Bradley) is played using the regular rules of play plus the additional rule that after each player’s turn, the player must share about themselves based on the categories assigned to the stickers on the bottom of each ice cube that fell during their turn. If an ice cube includes a star sticker with a smiley face, the player selects a piece of candy. Stickers can be used instead of candy if desired. The use of candy or stickers is an optional component of the intervention, but the prospect of “winning” something during the course of the activity may lower defenses and incorporates an additional component of engagement and playfulness to the technique.
Throughout the activity, players get better acquainted by sharing non-threatening information in an engaging, yet structured manner. Using this intervention in the early stage of treatment assists in creating a playful, client-friendly therapeutic environment and orienting the client to the process of play therapy.