Interpreting Screening and Assessment Results

What a screening result is

A screening instrument sorts people into those who warrant further assessment and those who probably do not. It shifts a probability. It does not diagnose, it does not establish severity on its own, and it does not exclude anything it was not designed to detect.

The score is one input alongside the clinical interview, your behavioral observations, functional information, collateral report, and context. When the score and the interview disagree, that disagreement is data, not an error to resolve in favor of the number.

The method: READ, BOUND, INTEGRATE, COMMUNICATE

READ what the result suggests, in the terms the instrument actually supports.

BOUND it. State explicitly what it does not establish. This is the step that separates competent interpretation from over-reading.

INTEGRATE it with the interview, observation, function, and context, and decide whether further assessment is warranted.

COMMUNICATE it to the client in plain language, invite their interpretation, and connect it to what happens next.

The false-negative trap

A below-threshold score does not rule out a clinically significant presentation. The most common reason is successful avoidance: a client who has reorganized her life so that she never encounters the feared situation may genuinely report little distress while being substantially impaired.

Always read the score against function. Someone who changed jobs, stopped driving, and declines family invitations is impaired regardless of what the instrument returned.

Discussing results

Clients ask what a result means about them, often in the form of a label. The response that serves them explains what the measure does and does not tell you, hands interpretation back to them, situates it as a starting point, and connects it to a next step.

Two failure modes bracket this. Confirming a diagnostic label the instrument cannot support is inaccurate. Minimizing the result to keep the client comfortable withholds information they need and teaches them the topic is too dangerous to discuss.