Practicum Client Assessment and Genogram Assignment Guide

Fifteen of the sixteen listed elements are evidence and only one is a decision. Demographics through mental status exam are what you gathered; differential diagnosis and case formulation are what you concluded; and the treatment plan is the only place where you commit to doing something. Reading the list that way fixes the proportions, because students routinely spend four pages on history and two sentences on the plan, which inverts where the clinical judgement actually is. Write the plan first in draft, then check that every element of it is supported by something you recorded earlier — that check usually reveals which history sections were gathered out of habit rather than for a reason. The learning objectives name assessing clients presenting *for psychotherapy*, so the plan is a psychotherapy plan and the modality has to be chosen rather than assumed.

The assignment changes its unit of analysis between the two parts and the transition has to be handled deliberately. Part One is an assessment of one person — their illness, their history, their mental state, their diagnosis. Part Two is a diagram of a system across three generations. Those are different levels, and the paper is stronger when it says what the family diagram is *for*: it supplies the intergenerational evidence that the individual formulation otherwise has to assert. A genogram attached without that argument is a second deliverable rather than part of one assessment. Name in the formulation at least one thing you could only have seen because you drew the family, since that sentence is what makes the two parts a single piece of work. Where the family evidence contradicts what the client reported about themselves, that discrepancy belongs in the formulation rather than being resolved silently in favour of one account.

The mental status exam is the section most often written wrongly, and the error is consistent: it records conclusions where it should record observations. "Anxious" is a conclusion; restless posture, rapid speech and a client who checked the door twice are observations that support it. Work the domains in order — appearance and behaviour, speech, mood as reported and affect as observed, thought process and thought content, perception, cognition, insight and judgement — and keep the two-part distinction between mood and affect visible, since a stated mood that does not match the observed affect is itself a finding. Insight and judgement are also genuinely separate: a client may understand their diagnosis completely and still make decisions that place them at risk, and collapsing the two loses that. Quote the client directly for mood and for thought content where you can, since a recorded phrase is both more accurate than a paraphrase and harder for a reader to dispute.

Differential diagnosis and case formulation do different jobs and neither substitutes for the other. The differential is categorical — which conditions could account for this presentation, and what in the history argues for and against each. The formulation is explanatory — why this person, with this history, is presenting this way now. A formulation that names the diagnosis again has not explained anything; a good one draws predisposing, precipitating, perpetuating and protective factors from the history into a causal account that the treatment plan can then act on. The test is simple: if your formulation would be equally true of any other client with the same diagnosis, it is a definition rather than a formulation. Protective factors are the ones most often omitted, and they matter most, because the treatment plan has to build on something the client already has rather than only on what they lack.

Three generations means great-grandparents, grandparents and parents, and the depth requirement is easier to satisfy than the information requirement. Most clients cannot supply full detail that far back, and the honest response is to mark unknowns as unknown rather than to leave blank space — an unknown paternal line is a fact about the client's history and often a clinically relevant one. Use standard notation and add a legend, since conventions differ between texts. Draw the diagram after the assessment rather than before it, so it depicts the family you actually documented, and check the two against each other line by line before submitting. Record ages rather than dates on the diagram, since ages carry the developmental information a clinician needs while dates of birth are identifiers you have already committed to removing. Where a relationship is significant but you have only the client's account of it, say so on the legend rather than drawing it as though it were observed.

Two things about the source material are worth acting on. The Wheeler pages named in the preparation define what a comprehensive client assessment contains in this tradition, and the section vocabulary should match that text rather than a general psychiatric intake format the marker is not using. And the brief states that a sample is attached *and reminds you it has two parts* — an instruction repeated only where submissions routinely arrive with one. On confidentiality: this is a real client from your practicum site, so identifiers come out of both the prose and the diagram, and your site's own policy may be stricter than the regulation. Choose a client about whom you hold enough history before you start, because a thin case leaves seven of the fifteen evidence sections thin however well the writing is done.