Deconstructing Pathology: A Narrative View of the Intake Process

Abstract

Many intake interviews begin, explicitly or implicitly, with the expectation that there is something “wrong” with the client. The structure of many psychological assessments supports this dominant pathogenic belief. They are often composed of checklists in which the client is asked to note any past illnesses, addictions, suicidal behavior, and so on. This emphasis on pathology from the beginning may cause an already vulnerable client to feel further destabilized. Moving away from a pathology-focused intake assessment can instead be viewed as an excavation of the client's often problematic dominant story and of the implicit endorsement of the client as “fused” with his or her problem. A narrative approach is uniquely situated to assist the client in excavating hope in the intake interview by inspiring use of questions that are attuned to gathering stories of strength alongside stories of difficulty.