Balancing a Solution-Focused Approach With Traditional Psychiatric Assessment in a Canadian Emergency Room

Abstract

The assessment of a client’s need to be admitted to acute psychiatric care during an emergency room (ER) visit can be quite difficult. This article outlines ways in which an effective evaluation of a client’s strengths and abilities can be integrated into the assessment of clients presenting in the ER. Assessing client strengths integrates well with traditional forms of mental health assessment that focus more exclusively on the exploration of risks and challenges faced by the client. However, the investigation of a client’s strengths requires training and skill in a strength-based model, such as Solution-Focused Therapy (SFT). The Crisis and Response Team at the Red Deer Regional Hospital, Alberta, Canada, has found that the skillful use of SFT during crisis assessment enables mental health professionals to provide a more balanced and client-centered picture of the client. This more balanced assessment can better determine a client’s level of risk and level of resources. A balanced assessment also improves decisions about admission and provides a more helpful experience for clients. This article explores how SFT in conjunction with the medical model in psychiatric crises supports decision making, leads to goal-oriented strategies by therapists, empowers clients, and facilitates positive conversations. It also describes the commitment to ongoing learning required to establish and reinforce the skills required to provide a balanced assessment.