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What is a Clinical Assessment?

By Kimberly Miller
Updated: Mar 03, 2024
Views: 82,193
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A clinical assessment, sometimes also referred to as a health assessment, is a documented process that is used to evaluate and diagnose individuals’ overall well-being, whether mental, physical, or both. Evaluators tend to use standard rubrics and checklists for quantifying health, wellness, and fitness. In most cases these assessments are similar in format to a routine health check-up or physical, but the driving reasons why each is done tends to be different. While a check-up is typically designed as a periodic measure of health for personal and preventative reasons, a more formal assessment is usually done because it’s required for some purpose. Employers, insurance companies, or even government agencies may insist that people undergo assessment before they can be hired, paid, or promoted, for instance.

General Purpose

In most cases the main goal of any clinical assessment is to get a standardized and quantifiable understanding of a person’s health. These assessments provide results that only take into account the individual that is being evaluated rather than evaluating individuals based on data that is compiled from multiple sources, and as a result they tend to be highly specific and are in many cases often quite detailed. Some are geared towards mental health, while others are looking for overall wellness; still more are looking for more specific measures of cardiovascular strength or fitness level.

A lot depends on who is ordering the test and why it is being done. In nearly all cases, though, the assessments are conducted by trained medical professionals, and the results are usually intended to be streamlined so that individual results can be quickly and meaningfully compared against each other. When evaluators uncover problems they usually recommend that the person impacted get treatment, but it is usually somewhat rare for that specific professional to be the one providing the treatment. Evaluators don’t always take on their own patients, and many work full-time conducting assessments. Most are able to make referrals, though, and can recommend different courses of action.

Specific Procedure

In most cases assessments follow a somewhat streamlined protocol no matter where they’re conducted or by whom. Everything from the questions to be asked and the measurements to be taken to the ways to fill out paperwork and the proper presentation of findings is usually uniform. What this uniformity looks like can vary from jurisdiction to jurisdiction, and in most cases an oversight committee for a particular city, state, or country is the one to set the standards and decide on the baseline requirements. Within each specific place, though, the results should be more or less equivalent.

It’s not uncommon to find separate protocol for mental and physical assessments, and the two are often performed separately. Internal medicine specialists are more commonly tracked to perform physical tests, too, while mental health experts and psychiatrists tend to fill out forms about emotional health and stability.

Mandatory Reporting

Some clinical assessments are mandated by government agencies to ensure safe medical practices, or to disburse related health benefit payments to patients. These are usually intended to make sure that all available medical treatment options are in a patient’s best interest. People may be required to submit to a formal assessment before claiming social welfare payment for something like a disability, and may also have to undergo evaluation before receiving an insurance payout.

In the United States, the Centers for Medicare and Medicaid Services require a clinical assessment that is referred to as a minimum data set (MDS) for all patients admitted to long-term care facilities that are certified to receive Medicare or Medicaid benefits. The initial assessment is required by the 14th day of the resident’s stay, and additional assessments are required quarterly and yearly. In most cases patient results are submitted electronically to the government and kept on file for future use and reference.

Use in the Workplace

Employers sometimes also require these sorts of evaluations, often as a precursor to hiring or, depending on the job, as a condition of promotion or continued employment. In some cases, the employer may consult with a medical professional to develop or analyze wellness assessments and assist in planning or implementing programs to improve results. Although this assessment can be costly for an employer, it often improves profitability over time by decreasing healthcare costs and improving employee productivity.

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Discussion Comments
By cafe41 — On Feb 07, 2011

Suntan12 -I can tell you that most people overeat because of anxiety, stress, depression, or entertainment.

I know that many psychologists would narrow down the reason pretty quickly by using their clinical assessment workbook to outline how to proceed.

I imagine that food addictions are a little harder to treat because food is something that we all have to deal with because everyone has to eat, but not everyone has to drink, smoke or do drugs.

People always have to learn how to deal with food and if this is the problem the psychologist will recommend an alternative activity in place of eating.

Sometimes they will ask the patient to record their feelings throughout the day and include what they ate to determine what the problem is. Journaling is a widely used tool for assessing patient’s state of mind.

By suntan12 — On Feb 07, 2011

Helene55- That is how I see it too. I wanted to add that a clinical psychological assessment often helps someone overcome destructive or addictive behavior.

Psychologists may use a variety of therapeutic measures to determine the best way to treat a patient.

For example, cognitive behavioral therapy is really effective in treating addictions. With cognitive behavioral therapy the patient learns how to replace the destructive behavior with a healthier approach.

Through role playing and mentally rehearsing new steps a patient can slowly change their behavior for the best.

For example, if you have a person that is addicted to food and is overweight, the psychologist would determine the triggers that caused the person to overeat and address them.

By helene55 — On Jan 31, 2011

The difference between a clinical assessment and a regular check up is that these assessments are usually done for a reason, like a job. They're more like physicals that way, making sure a person is healthy enough to be "fit" for something and seeing, if there are any problems, just what they are.

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