Prior to the assessment:
1. Reflexivity. Before ever starting an assessment, one should engage in personal reflection about the purpose of assessment and the clinician’s role in the process. What do you believe about assessment? What can an assessment tell us and what are its limits? How do your views on assessment inform the way you conduct assessments, interact with clients, and communicate findings in reports?
2. Do your research. Know the history of local Indigenous groups. Where were the nearest residential schools and Indian Hospitals? Engage with the communities near you in big and small ways (e.g., buy your groceries there) so that you are not disconnected from the communities that you serve.
Meeting your client:
3. Build meaningful relationships with your clients. The assessment begins with your very first interactions with the client. Create a safe environment by providing food, giving a meaningful land acknowledgement, and generally slowing down the process in order to get to know your client more holistically. Step out of your comfort zone and “professional” role to thoroughly introduce yourself (e.g., information about the lands you grew up on and what brought you to where you are now).
4. Understand your client’s goals. Reflect on your goals and the referral source’s goals for the assessment. Ask what your client’s goals are for the assessment. Are they the same or different from your own? Ask yourself whose interests are being served by this assessment and make sure to represent your client’s goals in the assessment.
The assessment and the report:
5. Collect holistic, contextualized, and strengths-based information. Starting with the intake and continuing throughout, make use of tools that will allow you to see your client in a holistic and contextualized way. For instance, the Medicine Wheel captures multiple dimensions of health, including spiritual, cognitive, emotional, and physical. Similarly, the Tree of Life goes beyond individual strengths to also assess community and cultural strengths and resources. It is also important to understand the family history of your client (e.g., did their parents or grandparents generations attend residential school?). Make sure to capture client and community strengths, rather than only focusing on deficits or problems.
6. Include holistic, contextualized, and strengths-based information in your report. Your report should communicate your holistic and contextualized understanding of the client throughout the document. For example, go beyond simply acknowledging if the client’s cultural group is not represented in test norms. Also acknowledge that the tests were created in a Western context and often measure North American cultural knowledge, use of standard English, etc. Consider culturally-relevant ways of knowing that are not represented in the Western ways of conceptualizing cognition, language, etc. Client and community strengths should be woven in throughout the report. Acknowledge the context of your client in the report (e.g., was the assessment conducted during COVID-19, what is your client’s care context?).
7. Be thoughtful about your recommendations. Fewer recommendations that are meaningful and relevant to the client are often more helpful than a laundry list of possibilities. Which possible recommendations are the most accessible to your client and are attuned to their goals and culture? Include recommendations that foster strengths as well as those that improve areas of difficulty.
