Assessment vs Diagnosis: What Counsellors Can Do in Canada
- Dr. Erinn Bailey-Sawatzky
- Nov 22
- 3 min read
Introduction
One of the biggest sources of confusion for Canadian counsellors is the difference between assessment and diagnosis. Many clinicians have feared it: “Don’t assess, that’s diagnosing,” which is not only inaccurate but professionally limiting. Assessment is about understanding. Diagnosis is about classifying.
This article provides clear, scope-aligned explanations to help counsellors practice confidently and ethically within their scope of practice that allows for assessment currently—regardless of where provincial regulation is at.
1. Diagnosis Is a Legal Act or sometimes a Restricted Act. Assessment Is a Clinical Skill.
These terms are wrongly treated as synonyms.
✔ Diagnosis
A regulated and/or restricted act in certain provinces
✔ Assessment
The process of:
gathering clinical information
identifying themes
forming a clinical impression
understanding functioning
measuring symptoms
understanding risk
making clinical recommendations
writing reports
making ethical referrals
helping a client gain insight into themselves and see growth opportunities
amongst others!
This is always a part of counselling practice. Diagnosis is a legal designation. Assessment is a core counselling competency.
2. Counsellors Across Canada Can Perform Clinical Assessment
No Canadian province prohibits counsellors from gathering assessment information. The only restriction is on assigning diagnoses where diagnosis is reserved for certain professions.
Counsellors can ethically and legally perform:
structured intake assessment
biopsychosocial assessment
risk assessment
outcome measurement
functional assessment
pattern identification
case formulation
treatment recommendations
review of client progress
discharge summaries
and much more!
All of these are assessment, not diagnosis. Restriction of diagnosis ≠ restriction of assessment.
4. Why Counsellors Confuse the Two
Graduate programs often provide foundational assessment knowledge with minimal practice opportunities. Some practicums offer no opportunities or supervision in assessment which leaves counsellors with:
anxiety around assessment
fear of working outside of scope
avoidance of tools or structured methods
leaning into other mental health professionals telling them "you just can't"
ASSESS+ corrects this misinformation.
5. Assessment Without Diagnosis: How It Works in Practice
You can perform high-quality clinical assessment without diagnosing by focusing on:
✔ clinical patterns
✔ themes in functioning
✔ symptom clusters without naming DSM labels and making appropriate referrals
✔ behaviour patterns
✔ emotional processes
✔ strengths and resilience factors
✔ contributing biological/psychophysiological factors
✔ risk indicators
✔ treatment recommendations
✔ formulation language
6. Structured Assessment Improves Client Outcomes
Counsellors with advanced assessment literacy demonstrate:
better session direction
clearer treatment planning
safer risk management
increased therapeutic effectiveness
ability to use assessments within therapy or as stand-alone services for clients
This is why assessment is considered foundational in most evidence-based therapies.
7. Many Assessment Tools Within Counsellor Scope
Many counsellors can use:
Level A tools (public access tools)
Some Level B tools (moderate complexity instruments)
Some Level C tools (higher complexity instruments)
In reality, counsellors can ethically administer assessments as long as they are not used for the purpose of diagnosing conditions.
8. ASSESS+ Helps Counsellors Build Assessment Confidence
The program teaches counsellors:
how assessment works within scope
how to avoid diagnostic language when inappropriate
structured clinical reasoning
how to integrate tools ethically
how to enhance clarity and reduce liability
how to communicate findings confidently and write professional assessment reports
how and when to make ethical referrals to diagnosticians
how to use and market assessments in your practice
Conclusion
Assessment is not synonymous with diagnosis. Counsellors across Canada can perform clinical assessment in the way their standards of practice allow them, and where they have been trained and received supervision to do so. The need for strong skills to practice safely and effectively exists- and now we have the training to offer you a pathway with ASSESS+!
If you’re ready to deepen your assessment confidence:
👉 View All ASSESS+ Courses
I look forward to seeing you advance your assessment skills in the course, and look forward to having you join other counsellors and psychotherapists advancing their assessment skills!
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