Workplace Triage, Assessment and Formulation Policy

Triage and assessment policy

2025

Introduction

This paper sets out the principles and role of assessment and triage services in Atrium community pathway. Triage refers to the allocation of urgency, and suggested pathway for support following on from an initial assessment of need by a trained pathway coordinator working to a specific assessment framework.

2. The introductory screen/assessment

Assessment should always be for a purpose. It is neither efficient nor fair to the person assessed to ask questions and obtain information for no good reason. A good assessment just collects information relevant for the purpose or purposes of that assessment and should not ask questions beyond those needed to fulfill that purpose. As such our  services coordinator will ask you questions about your needs, clarify risk if appropriate and share a plan of action with you as a result of your assessment session.

Atrium initially screens for the following reasons:

• A brief assessment to determine whether a person is eligible for the service and/or to determine means of practitioner allocation (for wellbeing and counselling services.) The outcome of this assessment is usually a yes/no decision as to whether the person is eligible for the service in terms of our contract and/or decision about appropriateness of service through Atrium. This light-touch screening typically requires responding to some wellbeing psychometric and biographical questions. There may be additional questions in our screening as agreed with our commissioners of the service to fulfill general data collection requirements. For non-therapy/coaching assessments, the assessment stage can be merely a signposting service to our advice practitioner, and coordination of next steps.
• If further assessment or further risk assessment is considered as appropriate to meet the client’s needs, a clinician appointment is made to call the client back usually within 1 hour to evaluate potential risk of a client to self or others. The outcome of this assessment is a referral to further help, advice or an indication of continuity to an Atrium service and next steps.
• Additional or bespoke assessments. The outcome is a provisional consultation with senior clinician in preparation for assessment when the objectives are clear and if they fit with our service offer.

 

3. Ongoing assessment

• Problem formulation assessment session 1: to come to an initial shared understanding of the client’s problems, where the client feels they have communicated their problems and been understood. The outcome is a shared understanding of the problem, protective factors and strengths in person’s life and an outline plan for the work together. Explain the risk assessment framework running through the Atrium counselling process (CORE 10) to ensure that the client’s needs are being met and to review the wellbeing of the employee. See 5Ps formulation approach below.
• Session 2, therapy work planning assessment: to come to a shared decision as to the goals and type of work together (types of help to run alongside therapy such as self-directed resource use, learning and participation style preferred) that would be appropriate for the client. The outcome of this assessment as an integral part of these early sessions is a refined plan for working well together
• Assessments are updates and re-formulate alongside risk assessment at the beginning of sessions and in notes

Recording of assessments and notes

As soon as the client contacts us, the pathway coordinator creates an account for the client, taking details such as address and GP details as well as including the initial screening results for wellbeing.

Before the client accesses a psychological service they complete a consent form to receive our services and agree to this data collection within our GDPR protocol including an understanding that data can be used for anonymised research purposes.

Client assessments and ongoing session notes are reviewed by our quality pathway administrator to ensure record keeping compliance and manage risk as part of the Atrium case management protocol.

Therapy assessment notes are updates as part of our confidential clinical note protocol by the practitioner.

Practitioners access clinical supervision and formulation assessments and further assessments are considered as part of that case management overview.

5 P’s approach to formulation

What are the 5Ps

The 5 Ps formulation model offers a structured yet flexible way of examining psychological and coaching-related challenges, enabling individuals and their practitioners to gain a fuller, more integrated understanding of what drives and sustains certain difficulties, as well as what might alleviate them.

Essentially, the model breaks down one’s experiences into five interconnected elements: Presenting Problem, Predisposing Factors, Precipitating Factors, Perpetuating Factors, and Protective Factors. By clarifying these distinct yet interwoven domains, the formulation invites a nuanced perspective, ensuring that one’s current situation is not oversimplified, but rather understood in the context of past influences, ongoing patterns, and inherent strengths.

1. Presenting Problem: This component focuses on the issues or symptoms the individual is currently facing, emphasising what is bringing them into therapy or coaching at this particular juncture. By identifying these difficulties clearly, the formulation sets the stage for targeted intervention and meaningful progress.
2. Predisposing Factors: These are the historical, often deep-rooted elements that may have increased a person’s vulnerability to their current challenges. Experiences such as adverse childhood events, long-standing personality traits, or family patterns might shape one’s susceptibility to certain issues later in life. Incorporating these factors into the formulation encourages empathy and underscores the importance of early influences.
3. Precipitating Factors: Precipitating factors address the recent catalysts that sparked the current presenting problem. These might include stressful life events, relationship breakdowns, career setbacks, or health concerns. By highlighting what specifically triggered the current difficulties, the formulation helps direct attention towards coping strategies and immediate problem-solving techniques.
4. Perpetuating Factors: These factors maintain the cycle of difficulty, keeping the individual stuck or preventing resolution. They might manifest as maladaptive coping strategies, unhelpful thought patterns, or environments that reinforce negative behaviours. By targeting these sustaining elements, therapy and coaching can introduce transformative approaches that gradually dismantle the reinforcing mechanisms.
5. Protective Factors: Finally, this element focuses on an individual’s innate and environmental strengths—their resilience, supportive relationships, personal values, professional achievements, and adaptive coping skills. Highlighting these assets provides a source of hope and direction, reminding the person that change and growth are not only possible, but achievable with careful cultivation.