The Hand-Off: Setting the Stage for a Successful Evaluation
Anticipatory Anxiety and the Clinical Key to Unlocking Client Narratives
Featured │ Reading Time: ~ 6 minutes
Today, let's talk about setting up the mental health evaluation. Your client is entering a forensic-style meeting, and their anxiety influences every minute of it, potentially changing their demeanor and how they approach answers to questions. Minimized responses are part of a trauma response; guarded answers and held-back secrets follow, but your assistance can change that. We can soften the butter a little better before it gets to the bread. Let's see how to proactively mitigate their initial pressure, leading to more comprehensive and robust evaluations.
The Psychological Setup: Why Clients Hold Back Information
Navigating the Boundary: Fear and the Forensic Lens
The goal of an interview is an open, non-threatening dialogue (Financial Crime Academy, 2025). In the words of Dr. Bow (n.d.), a forensic assessor maintains an objective, neutral stance, whereas a psychotherapist offers an accepting, helpful role. In my opinion, in the case of an immigration evaluation, it's a two-way street; even though we might not be offering therapy during an evaluation, we still maintain the fundamental attitudes defined by our profession. My therapeutic, systemic lens helps overcome initial client fear to get the complete, trauma-informed story needed to solidify the mental health gaps useful for their case. Though I must admit, I have hit a snag: I believe clients are intimidated by the word 'evaluation,' causing them to hold back beneficial truths.
The Clinical Evidence: Chronic Stress and Anticipatory Anxiety
Perhaps holding back pertinent information comes from anticipatory anxiety and the perception of their story. According to a study by Donaldson and colleagues (2023), individuals who suffer from social anxiety visualize themselves with a negative image before going into a social setting. They then start getting ready for what they perceive to be a horrible experience, which increases their anxiety otherwise called anticipatory anxiety. Or, perhaps trauma exposures are the cause of this 'snag,' with minimized responses extending the fear of how information could be used for their case. This pattern is well explained by Bojánquez-Chapela and their team (2024), who studied the journey of forced migration and described mental health problems as emotional responses developed during unplanned and involuntary travel. This is helpful because, while not all clients meet the criteria for a trauma disorder, nearly all have experienced an emotional response to a disturbing transition from one location to another.
From Trauma to Trust: Overcoming the Interrogation Myth
What would happen if our clients experienced something similar? Throughout their travels to the United States, shame develops along with a host of other mental health symptoms. These emotional reactions could lead them to construct a negative picture of who they believe themselves to be, which limits the information they provide during interviews. This again, often the result of a possible misconception that the 'evaluation' is an interrogative process and their "true selves" will lessen their chance of winning the case. I imagine there is no worse feeling than having risked your life for safety, only to feel you're under a microscope in court, asked to prove your credibility just to stay safe. So, as mentioned, my role is to be the soft, understanding, validating clinician who gathers data. I write it as accurately as possible, look over those symptoms that developed en route, write it down, and send it off to you, their attorney.
Where to go from here: Treating the client's anticipatory anxiety as a response to external threat and relational stress, and their cumulative experiences.
🤝The Clinician’s Co-Sign 🤝
Let's set up your clients for more well-rounded, open evaluation responses from the get go. Consider briefing your clients on the process early on; this directly helps your evaluators [hi!]. We brief them too, but remember, you are a part of their journey and can aid in the management of their expectations; The part of their journey that is assisting and not harming. Everyone carries the torch; some people use it to burn others while others use it to shine the path forward. Use your new understanding of anticipatory anxiety and built-up emotional responses to help clients differentiate between interrogation and interviewing. This simple clarification reduces their perception of threat. Remember, while every therapist has their own style, we are universally trained to be a non-judgmental entity by way of documenting, recording, and presenting, being present with, and soliciting care via our recommendations and personhood.
Help us help you help them.
-Dr. Perocier