How to avoid FAT File Syndrome so YOU actually start to make a difference for complex clients

  • Wednesday, March 2, 2016
  • Shona Innes Psychology

FAT FILE Syndrome… a sad and potentiality dangerous symptom of working with complex clients. A file full of assessments and reports that lead nowhere; expensive and wordy documents that are worth nothing to the client or the client’s team when it comes to creating the much-needed outcomes.

I’m determined to make assessments meaningful which is a direct result of years of working with young people in complex situations and the reams of paper generated about them. Here are 5 characteristics of useful psychological and behavioural assessments and reports that I believe Health, Forensic and Human service personnel should consider, indeed demand… 

If there is one thing that has been really noticeable throughout all of my years working with complex young people it’s the amount of reports generated for them. Nothing bothers me more than a file full or reports that have no meaningful actions recommended or make no sense to the worker and result in actions that are incompatible or in direct opposition to the report’s recommendations.

If our universal goal is to make sense of difficult often traumatic situations and challenging behaviours for troubled children and young people, then we must get better at assessments and reports. Sometimes dealing with a client in crisis is so overwhelming that there’s no time to review a file, particularly if it’s a FAT File so to ensure assessments and reports are useful, take these steps: 

Step 1 is to ask one specific question or several key questions and demand clear answers. The type of questions you might ask may include: What factors are contributing to the problem? Which of these have capacity for change? How should we go about making that change? And, who is best placed to implement, mentor and trouble shoot for that situation? 

Questions like these: What’s the best way to keep this girl safe? Which ways are best for responding to her offending? Does she have mental health needs; and How should we best provide treatment?

Next, there’s the problem of professionals working in isolation. Those reports are often perfect professional presentations, but lack relevance and fail to address recommendations for what you should do for your client the next time you meet them.  

Step 2 is to ensure you request assessments and reports that include information from multiple but relevant sources. For example: Information from the young person themselves, their family, their schools, their case workers, all the records/official documents associated with their issues (e.g. incident reports, charge sheets) and any past reports and files from other relevant agencies.

Money spent, experts consulted and high level knowledge translates to zip in terms of client outcomes, if it’s just another report.In those moments when you simply do not know what to do next, don’t be drawn into the “Let’s get another report cycle”.   

Step 3 is to only seek new reports if there are gaps, or if extra tests or an assessment is directly relevant to answering specific or pressing questions that are required to be answered. 

Step 4 is to set an expectation for the assessment and reporting to suit your specific audience.A report is worthless if it is written in a ‘different language’ than that used by you and the client’s team. There is no place for complex terminology or unexplained/hefty professional vernacular – you need straight talk.

Finally, Step 5 is to get real. Ask for assessments and reporting that can be implemented in the real world – the one where your clients live or in their best workable case scenario situation.  

To summarise, useful assessments and reports take you carefully through all of the complexities involved to provide you with clarity. This will enable you, and others who face the real-world issues with a troubled young person, to respond effectively.

I’m sure you will agree, it’s time for FAT files to go on a diet of less complexity and more of the good stuff – useful information and practical direction for implementation of appropriate action. 

While Shona is regularly engaged to deliver assessments, reports and treatment for troubled children and young people, she is also available for consulting, speaking and workshops. Call Shona Innes Psychology on 0400 150 106 or email