K-State Problem Identification Rating Scales for College Students

Article excerpt

The K-State Problem Identification Rating Scales, a new screening instrument for college counseling centers, gathers information about clients' presenting symptoms, functioning levels, and readiness to change. Three studies revealed 7 scales: Mood Difficulties, Learning Problems, Food Concerns, Interpersonal Conflicts, Career Uncertainties, Self-Harm Indicators, and Substance/Addiction Issues.

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Effective treatment planning for psychotherapy requires a reliable and valid assessment of the problems that need to be addressed. For more than 90% of medium to large university counseling centers, this diagnostic process is set in motion when the client is given a brief checklist of symptoms (Zalaquett, 1996). Often completed in the waiting room, these intake checklists provide counselors with an initial screening of common problem areas that might need a more detailed assessment by the clinician. This practice is not novel to counseling centers; many physicians also ask their patients to endorse various problem areas on a checklist before beginning the clinical interview in the examining room.

Checklists function to identify symptoms that need to be explored further, either during the clinical interview itself or through the judicious use of standardized diagnostic instruments. These three resources--an intake checklist, the clinical interview, and selected standardized assessment instruments--enable the counselor to develop a diagnostic impression that leads to appropriate treatment plans and strategies.

Two factors in the current university climate underline the importance of using an intake screening instrument that is both reliable and valid. First, college counseling centers are reporting an increase in the demand for services from students with more complex and serious problems (Benton, Robertson, Tseng, Newton, & Benton, 2003; Gallagher, Gill, & Sysco, 2000; O'Malley, Wheeler, Murphey, O'Connell, & Waldo, 1990; Robbins, May, & Corazzini, 1985). At the same time, counseling center psychologists are experiencing higher demands from university administrators for evidence of the efficacy and efficiency of psychotherapy services (Hiebert, 1997; Stewart & Cairn, 2002). Psychologists and other mental health specialists working in counseling centers must therefore respond to two pressure points: students who are struggling with severe difficulties and administrators who are making decisions about university budget cuts and belt-tightening measures. In this context, it makes both therapeutic and economic sense to begin the assessment process with a psychometrically sound screening instrument that identifies problems needing a more thorough assessment.

INTAKE MEASURES

The checklists currently used in college counseling centers vary widely in length, quality, and evidence of psychometric examination (Zalaquett, 1996). Several checklists have been subjected to factor analysis, including the Mooney Problem Checklist (Mooney & Gordon, 1950), the Symptom Checklist-90-Revised (Derogatis, 1993), and the Brief Symptom Inventory (Derogatis & Melisaratos, 1983). In addition, several other authors have reported results of factor analyses on unpublished problem checklists used in university counseling centers (e.g., Bauman & Lenox, 2000; Miller & Rice, 1993; Zalaquett & McManus, 1996).

These problem checklists have several advantages. They are easy for clients to complete. They take little client time, and they enable psychologists to effectively scan a wide variety of client concerns. Furthermore, checklists allow clients to endorse sensitive items that they might not readily report in an interview, and they also may prepare clients for the intake interview by focusing attention on specific symptoms.

However, the checklist format does have some important disadvantages. For example, the yes/no format used by most checklists is less sensitive than a rating scale approach to gauging the severity of a symptom. …