This document describes a strengths-based approach to integrating assessment of mind-body wellness into the client intake process. It involves exploring six evidence-based categories related to exercise, nutrition, sleep, relaxation, hobbies, and relationships. Research supports benefits of these areas for mental health. Briefly addressing client assets in these categories at intake may improve motivation and reduce dropout rates by focusing on self-directed wellness strategies within the client's control.

1. Mind-Body Wellness at Intake:
A Strengths-Based Approach
Richard LaBrie, M.A., Jeffrey Tirengel, Psy.D., M.P.H., R. E. Franco Durán, Ph.D. California School of Professional Psychology at Alliant International University, Los Angeles
Abstract
How might the exploration of mind-body
concerns and client assets upon intake influence
the motivation of clinician and client? This poster
presentation describes a practical structure and
process for integrating mind-body connections
and client assets into the intake process,
including inquiry into six evidence-based
categories:
Exercise/physical activity
Nutrition/eating habits
Sleep hygiene
Attentive awareness/relaxation
Avocational interests
Positive personal relationships
Based on a critical literature review and
interviews with psychologists, the poster
highlights potential benefits of this integrative
approach at intake and during continuing
psychotherapy.
Introduction
Searches of the relevant literature regarding
mind-body integration, wellness, lifestyle, and
quality of life reveal significant amounts of
research, with increased evidence for therapeutic
impact over the past 20 years. However,
practical clinical use of such integration may still
be lagging behind the research. Walsh (2011)
suggested clinicians are not taking full advantage
of lifestyle interventions and listed five of the six
constructs in his article. Rotheram-Borus,
Swendeman, and Chorpita (2012) suggested a
“disruptive innovations” approach to applying
such evidence-based interventions, which means
simplifying and speeding up dissemination in a
responsible, ethical, and more effective manner.
Thus, in our design:
 We limit our constructs to six as a means
to simplify the many possible elements inherent
in a definition of “mind-body” or “wellness.”
 We suggest presenting them at intake as
exploratory positive assets in an attempt at
effective, introductory implementation.
 We suggest appropriate consultation and
referral regarding the more physical items if the
client and clinician decide later that prescription
of an activity is desirable. This assures ethical
and responsible prescription, with special focus
on client ability and safety.
Design and Use Considerations
 A form encouraging collaboration on the six
constructs between client and clinician using a
scale (client) and unstructured notes (clinician).
 Motivational and positive labels: Clinicians
interviewed were concerned that standard Likert-
type scales might risk negative client self-
perceptions at the lower end.
 Clinicians are to note and support any
perceivable assets and assist the client in finding
the less obvious. For instance, a client may
consider themselves sedentary but reveal they
walk 25 yards round-trip daily to retrieve a
newspaper. The clinician can assist the client in
calculating a monthly total of nearly one half-
mile of walking per month as an asset.
 Use more common, less clinical item terms.
 Brevity for adoption into intake forms which
may already be lengthy.
Proposed Application
Conclusion
Further critical literature research, expert input,
and supervised use of the intake items is needed
before a final working model of the product is
published. Detailed instructions and suggestions
for use by clinicians will be developed for the
back of the form. Empirical research into the
efficacy and effectiveness of the the final product
is suggested after its future implementation, with
focus on the following:
 Does an assessment of mind-body wellness at
intake contribute to more integrated treatment
later in psychotherapy?
 Does addressing positive assets and client
strengths in these areas at the end of intake
improve odds of clients returning to begin
therapy?
 Does adding these items at intake encourage
and introduce mind-body approaches to clinicians
who might not otherwise have considered them,
thereby expanding clinical and real-world use of
the growing research in these areas?
References
Hamilton, S., Moore, A. M., Crane, D., & Payne, S. H. (2011).
Psychotherapy dropouts: Differences by modality, license, and DSM-IV
diagnosis. Journal of Marital and Family Therapy, 37(3), 333-343.
doi:10.1111/j.1752-0606.2010.00204.x
Lake, J. (2007). Integrative mental health care: From theory to practice,
part 1. Alternative Therapies in Health & Medicine, 13(6), 50-56.
Lake, J. (2008). Integrative mental health care: From theory to practice,
part 2. Alternative Therapies in Health & Medicine, 14(1), 36-42.
Perlman, L. M., Cohen, J. L., Altiere, M. J., Brennan, J. A., Brown, S. R.,
Mainka, J., & Diroff, C. R. (2010). A multidimensional wellness group
therapy program for veterans with comorbid psychiatric and medical
conditions. Professional Psychology: Research and Practice, 41(2),
120-127. doi:10.1037/a0018800
Rotheram-Borus, M., Swendeman, D., & Chorpita, B. F. (2012). Disruptive
innovations for designing and diffusing evidence-based interventions.
American Psychologist, 67(6), 463-476. doi: 10.1037/a0028180
Simon, G. E., Imel, Z. E., Ludman, E. J., & Steinfeld, B. J. (2012). Is dropout
after a first psychotherapy visit always a bad outcome? Psychiatric
Services, 63(7), 705-707. doi:10.1176/appi.ps.201100309
Steel, Z., Jones, J., Adcock, S., Clancy, R., Bridgford-West, L., & Austin, J.
(2000). Why the high rate of drop-out from individual cognitive-
behavior therapy for bulimia nervosa? International Journal of
Eating Disorders, 28, 209–214.
Walsh, R. (2011). Lifestyle and mental health. American Psychologist, 66(7),
579-592. doi:10.1037/a0021769
Zalaquett, C. P., Chatters, S. J., & Ivey, A. E. (2013). Psychotherapy
integration: Using a diversity-sensitive developmental model in the
initial interview. Journal of Contemporary Psychotherapy, 43(1),
53-62. doi:10.1007/s10879-012-9224-6
Thank you to the clinicians of Santa Anita Family Service for their feedback on
this project.
For more information contact Richard LaBrie at
rlabrie@alliant.edu
Selected Research
 Mind-Body Wellness
Psychological, physiological, neurobiological, and
outcome effects of the six constructs on mental
health are widely revealed in literature searches.
Lake (2007, 2008) reported the positive
influences of mind-body practices in research and
suggested that clinicians should not hesitate to
motivate clients - after assessing for impairments
- to engage in these self-directed activities.
A study using wellness methods for veterans in
group therapy drew on existing positive research
covering all six constructs in our application
(Perlman et al., 2010).
 Intake
One third of clients do not return for
psychotherapy after one visit (Simon, Imel,
Ludman, & Steinfeld, 2012).
Dropouts can be attributed to clients’ feelings of
helplessness and external locus of control (Steel
et al., 2000 as cited in Hamilton et al., 2011).
Interviewed clinicians acknowledged that
traditional intake formats are often problem-
focused. Shifting focus at the conclusion of
intake to elements of self-directed control like
mind-body issues may reduce this mediating
factor, especially when addressed with a
strengths-based approach. Therefore we
suggest our list be added to the end of intake.
 Strengths and Positive Assets
A motivational interviewing style with a
strengths-based, client-assets approach to the
six constructs is suggested to further solidify the
instillation of hope as the client leaves the intake.
Zalaquett, Chatters, and Ivey (2013) suggested
collecting positive assets at intake while not
diminishing concerns and deficits the client may
feel. This synchronizes the clinician to the
developmental level of the client and strengthens
the therapeutic relationship.
Such an approach may motivate client and
clinician to further address the six wellness items
later in psychotherapy as the client assets
become “building blocks for change” (Zalaquett,
Chatters, & Ivey, 2013, p. 59).
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