Area 1: Experience of the Semi-Structured Interview
Juggling multiple objectives during the intake, such as covering a comprehensive list of required items,
managing time to ensure completion, and maintaining an authentic emotional connection, proved
unexpectedly challenging. Despite extensive advanced preparation, including reorganizing standardized
questions into topics that blend naturally into conversation, using cue cards for seamless transitions,
and practicing with friends, as an strategic attempt to balance stability in administration while allowing
for the flexibility needed to build rapport (Hays, 2024, p. 84). I still struggled to simultaneously record
precise details of the client’s responses while capturing the nuanced insights embedded in our
dialogues.
Furthermore, I did not expect that clients might selectively disclose information, often revealing only
what they consciously choose to share. This may indicates Sara’s readiness for change, as those in the
precontemplation or contemplation stages may not yet be aware of their problems or ready to discuss
them accurately (Hays, 2024, pp. 40–41). This also created a delicate clinical dilemma: pushing too
hard for clarification risks straining the therapeutic alliance, whereas avoiding it leaves gaps in our data
and also lead to diagnostic overshadowing, where less noticeable problems are minimized because the
focus remains on more prominent symptoms (Hays, 2024, p. 160).
Strategically managing time and cognitive load ultimately led me to overlook secondary details, such
as past physical symptoms and work histories. Despite these hurdles, successfully navigating the
structural flow and receiving positive client feedback fostered a genuine sense of emerging
competence. Realizing that I could blend even difficult topics, such as assessing suicide via naturalistic
phrasing like “Sometimes when people feel the way you do right now…”, into the dialogue made the
questioning feel less like an interrogation and more like a supportive exploration.
Area 2: Omitted Information and Reluctance
Reflecting on the clinical record and my missing questions, I realized I ended up omitting details such
as the client’s past physical symptoms and previous work experiences, partly due to cognitive overload
and partly due to strategic compromises made to protect the therapeutic time frame and relationship.
Such omittance could affect accuracy of diagnosis as past physical condition could be exacerbate
original minor symptoms leading to client’s current conditions (Hays, 2024, p. 163). Moreover, I felt
distinctly reluctant to explore the relevance of the client’s sexual minority identity, as she did not
present it as a significant factor in her anxiety. I worried that probing further would impose undue
emphasis, inadvertently communicating bias or treating her identity as something abnormal that
required special treatment. Processing these feelings of oversight made me realize that avoidance often
stems from a therapist's internal anxiety about causing offense rather than the client's actual capacity to
discuss these topics. In hindsight, a more effective approach would be to humbly acknowledge her
perspective first, inviting her view on the matter before making assumptions. This experience
highlights my tendency to tread lightly around sensitive domains to preserve immediate comfort,
suggesting an ongoing need to balance relational safety with thorough, courageous clinical exploration.
Area 3: Assessment Direction and Skill Development
To deepen the assessment, I plan to collaborate with Sara to select the suitable, psychometric,
such as the General Anxiety Disorder Questionnaire (GAD-7) and Beck Anxiety Inventory (BAI), to
quantify the severity of her anxiety (Hays, 2024, pp. 160, 198). Qualitatively, I intend to prioritize
strengthening the therapeutic alliance before revisiting sensitive areas where I sensed her reluctance,
such as the details of her past and current symptoms, the roots of her strained family dynamics, and her
views on her sexual minority status (Hays, 2024, pp. 80, 188). It will also be vital to explore issues I
suspect contribute to her anxiety, such as the internal conflict between her friendly demeanor and her
resistance to deeper self-exploration. Additionally, I intend to evaluate her readiness for change,
address the ambivalence of leaving a comfortable life for a demanding career, and process the grief of
ending a major life chapter, (Komischke-Konnerup, et al., 2021; Miller & Rollnick, 2023). If time
permits, rather than rushing to a diagnosis, I will collect data gradually over several sessions to allow
the relationship to develop and ensure a more holistic appraisal (Hays, 2024, p. 219).
While I currently lack full confidence in pinpointing the core issues immediately, I recognize
this uncertainty not as a failure, but as a normal and grounding part of professional development and as
an essential component of counselor self-awareness (Hays, 2024, p. 79). My feeling of incomplete
confidence tells me that assessment is an evolving dialogue rather than a checklist; it signals my
growing awareness of the complexity inherent in human experiences and my commitment to
developing a more nuanced, flexible clinical intuition as I continue to build my foundational skills.
Ultimately, this exercise reminds me that assessment is a continual dialogue that evolves alongside the
client’s narrative (Hays, 2024, p. 101).