Initial assessment summary
A short summary of a first assessment, written with the client: the main problem, a first 5Ps outline, health, risk, starting scores, goals and plan. It is not a diagnosis or a risk assessment. Based on Kennerley, Kirk and Westbrook (2017) and Roth and Pilling (2007), with 5Ps headings as in Weerasekera (1993): the layout and prompts are our own.
Written by Tarun Vermani, Trainee Clinical Psychologist Last reviewed
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Initial assessment summary
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About the assessment
The main problem
Use the client's own words where you can.
A first outline using the 5Ps
The presenting problem is in the section above. Use the four prompts below for a first, tentative outline. Keep each to a few lines and mark anything you still need to check with the client. The 5Ps formulation sheet takes this further.
Health and previous help
Record what the client reports.
Risk and safety
Starting scores
Record each questionnaire used at assessment. These scores are the starting point: repeat the same measures, in the same way, at review, so you compare like with like. Describe what a score means only as the measure's own guidance states it.
| # | Measure | Date | Total score | Meaning, from the measure's guidance | Actions |
|---|---|---|---|---|---|
| 1 |
The client's goals
Up to three goals in the client's words. The problem list and goals sheet can follow for a fuller list.
| # | Goal, in the client's words | How the client will know | Actions |
|---|---|---|---|
| 1 |
Plan and agreement
Try it here — nothing you type is saved. Sign up to assign it and let clients complete it on any device.
When to use the Initial assessment summary
The Initial assessment summary is an interactive cognitive behavioural therapy (CBT) worksheet. As a core CBT skill it is used right across the model, with presentations including depression, anxiety, OCD, trauma and low self-esteem, rather than being tied to a single diagnosis.
It is designed to be used within therapy rather than as a standalone self-help tool: a therapist introduces it, works through it collaboratively, and helps make sense of what it surfaces. You can preview the full worksheet above, then assign it digitally for clients to complete between sessions on any device or download it as a print-ready PDF.
How it works
Most people work through it in around 20 minutes. It moves through six short steps:
- About the assessment
- The main problem: Use the client's own words where you can.
- A first outline using the 5Ps: The presenting problem is in the section above. Use the four prompts below for a first, tentative outline. Keep each to a few lines and…
- Health and previous help: Record what the client reports.
- Risk and safety
- Starting scores: Record each questionnaire used at assessment. These scores are the starting point: repeat the same measures, in the same way, at review, so…
Completed on the Formulate platform, your client's answers are saved automatically and shared straight back to you, so you can review them before the next session rather than waiting for a paper copy to come back.
The CBT approach behind it
In common with other CBT methods, the Initial assessment summary works by noticing the links between situations, thoughts, feelings, physical sensations and behaviour and finding practical ways to change unhelpful patterns. The aim is not positive thinking but a clearer, shared understanding of what keeps a difficulty going and practical, testable ways to change it.
Because it is a CBT tool it stays focused on the here-and-now links between thoughts, feelings, the body and behaviour, and it works best as one part of a wider course of therapy rather than as advice or a diagnosis.
Evidence & sources
This worksheet is grounded in established cognitive behavioural therapy theory and practice. Key sources include:
- Kennerley, H., Kirk, J., & Westbrook, D. (2017). An introduction to cognitive behaviour therapy: Skills and applications (3rd ed.). Sage.
- Roth, A.D., & Pilling, S. (2007). The competences required to deliver effective cognitive and behavioural therapy for people with depression and with anxiety disorders. Department of Health.
- Weerasekera, P. (1993). Formulation: a multiperspective model. Canadian Journal of Psychiatry, 38(5), 351-358. doi:10.1177/070674379303800513
For use alongside professional support
Formulate provides educational CBT resources for use with a qualified therapist. They are not a substitute for professional assessment, diagnosis, or crisis care.
If you need urgent help now:
- Emergency services: 999 — if you or someone else is in immediate danger
- NHS 111 (NHS 24 in Scotland): 111 — choose the mental health option for urgent help, in England, Scotland and Wales (in Wales, press 2)
- Lifeline: 0808 808 8000 — for urgent help in Northern Ireland, free, day or night
- Samaritans: 116 123 — free, day or night, 365 days a year
- Shout: 85258 — text SHOUT, free, day or night
- SANEline: 0300 304 7000 — 4pm–10pm, every day
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