Lesson Plan
Core Intake Components Map
Enable school counselors to apply a structured, empathetic clinical intake process by identifying core components, practicing empathetic interviewing, accurately organizing intake data, and using quality checks for consistent Tier 2 support.
Consistent, empathy-driven intakes improve student trust, accurate needs assessment, and targeted interventions, strengthening Tier 2 support.
Audience
Small Group of School Counselors
Time
60 minutes
Approach
Interactive mapping, role-play, and reflective application
Materials
Prep
Prepare Materials & Space
10 minutes
- Reserve a small-group meeting space with chairs arranged in a circle or around a table
- Print or project the Empathy-Driven Interview Guide, Warm Welcome Dialogue, Intake Data Organizer, and Intake Quality Checklist
- Set up a whiteboard or flip chart for mapping core intake components
- Review all materials to familiarize yourself with key prompts and guidelines
Step 1
Welcome & Objectives
5 minutes
- Greet participants and emphasize the importance of structured, empathetic intakes
- Review session objectives and agenda
- Establish group norms (respect, confidentiality, active participation)
Step 2
Map Core Intake Components
15 minutes
- Introduce the concept of a Core Intake Components Map
- Distribute Intake Data Organizer
- In small groups, brainstorm essential intake elements (e.g., presenting concerns, history, strengths)
- Co-create a visual map on the whiteboard capturing these components
Step 3
Empathy-Driven Interview Role-Play
20 minutes
- Pair participants; assign roles of counselor and student
- Provide each pair with the Warm Welcome Dialogue and Empathy-Driven Interview Guide
- Conduct a 5-minute mock intake, focusing on empathetic tone and question flow
- Rotate roles and repeat, observing and providing peer feedback on empathy skills
Step 4
Documenting & Quality Checking
15 minutes
- Using notes from the role-play, participants complete the Intake Data Organizer
- Apply the Intake Quality Checklist to self-assess completeness and empathetic engagement
- Discuss in groups any gaps or strengths identified through the checklist
Step 5
Reflection & Next Steps
5 minutes
- Invite participants to share one key takeaway or action step
- Discuss strategies for integrating this intake framework into daily practice
- Highlight follow-up resources and schedule a brief coaching check-in
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Slide Deck
Empathy-Driven Interview Guide
Welcome to the Empathy-Driven Interview Guide
In this module, we will:
- Define empathy in intake interviews
- Explore core empathy principles
- Review a step-by-step interview flow
- Practice sample questions and prompts
Introduce the slide deck and set expectations. Emphasize the connection to the Core Intake Components Map and upcoming role-plays.
Why Empathy Matters
Empathy is the foundation of effective intake:
- Builds rapport and student comfort
- Encourages honest, open sharing
- Improves accuracy of assessment
- Strengthens ongoing support relationships
Explain why empathy matters in building trust and gathering accurate information.
Core Principles of Empathy
- Active Listening
• Full attention, minimal interruption - Unconditional Positive Regard
• Convey acceptance without judgment - Attuned Non-Verbal Cues
• Open posture, eye contact, nodding
Highlight the three core principles and provide examples of each.
Interview Flow Overview
- Warm Welcome & Rapport Building
- Exploration & Open-Ended Questions
- Reflective Listening & Clarification
- Summarizing Key Points
- Closing & Next Steps
Walk through each phase of the interview flow before diving into details.
Phase 1: Warm Welcome
- Greet student by name and introduce yourself
- Acknowledge any nerves: “I know meeting someone new can feel…”
- Explain purpose and confidentiality
See Warm Welcome Dialogue for full script
Refer counselors to the detailed script in the Warm Welcome Dialogue material for more examples.
Phase 2: Open-Ended Questions
Sample prompts:
- “Can you tell me more about what brought you in today?”
- “How have things been going at school and home?”
- “What strengths or supports have helped you?”
- “What concerns feel most pressing right now?”
Discuss how open-ended questions invite richer responses. Encourage adaptation to student context.
Phase 3: Reflective Listening
Techniques:
- Paraphrase: “So you’re saying…”
- Reflect emotions: “It sounds like you felt…”
- Validate: “That reaction makes sense given…”
- Clarify: “When you say…, do you mean…?”
Use examples of reflective statements and stress the value in validating feelings.
Techniques for Depth
• Embrace Silence
– Give student time to think
• Gentle Probing
– “What else comes to mind?”
• Avoid Leading Questions
– Stay neutral in phrasing
Offer tips on managing silence and gentle probing without leading.
Documenting with Empathy
- Use brief keywords to stay present
- Note emotional tone alongside facts
- Summarize back to student before writing
- Reserve space for follow-up questions
Encourage note-taking strategies that maintain engagement and accuracy.
Practice & Next Steps
- Pair up for a 5-minute empathy role-play
- Use this guide plus the Intake Data Organizer
- Provide peer feedback using the Intake Quality Checklist
Ready to build trust through empathy?
Prepare counselors for the role-play and point them back to practice materials.
Script
Warm Welcome Dialogue
Counselor: “Hi [Student Name], it’s nice to meet you. I’m [Your Name], one of the school counselors here at [School Name].”
Counselor: “Before we get started, I want you to know that this is a safe and confidential space. That means what we talk about stays between us—unless I’m really worried about your safety or someone else’s safety. If that ever comes up, I’ll let you know right away.”
Counselor: “I know meeting someone new and talking about personal things can feel a little uncomfortable. It’s totally normal to feel nervous.”
Counselor: “My job is to listen and support you, no judgment—just a caring ear. You can share as much or as little as you’re comfortable with, and you can take all the time you need.”
Counselor: “To begin, could you tell me what brought you here today? Or, if it’s easier, tell me how your day or week has been so far.”
Counselor (if student hesitates): “I’m here to help you feel heard. You’re in charge of this conversation—there’s no rush. Sometimes it helps to start by talking about something small, like what you enjoy doing outside of school.”
Counselor (follow-up prompts):
- “What’s one thing that’s been on your mind lately?”
- “How have things been going at school or at home?”
- “Is there anything that feels hard or stressful right now?”
Counselor: “Thank you for sharing. I appreciate you trusting me with what’s on your mind. We’ll move at a pace that feels right for you.”
Worksheet
Intake Data Organizer
Student Information
Name: ____________________________________________
Date: ____________________________________________
Grade/Year: _________________________________________
Referral Source (self, teacher, parent, etc.): ________________________________
Presenting Concerns
- Main reason for referral:
______________________________________________________________________ - Duration and frequency of concerns:
______________________________________________________________________ - Impact on school/home functioning:
______________________________________________________________________
Background & History
• Academic History (grades, learning challenges):
______________________________________________________________________
• Family/Environmental Context:
______________________________________________________________________
• Social/Peer Relationships:
______________________________________________________________________
• Behavioral or Emotional History:
______________________________________________________________________
Strengths & Resources
• Student’s personal strengths:
______________________________________________________________________
• Supports at school (staff, programs):
______________________________________________________________________
• Supports at home/community (family, mentors):
______________________________________________________________________
Observations & Emotional Tone
• Student’s affect/mood during intake:
______________________________________________________________________
• Nonverbal behavior (body language, eye contact):
______________________________________________________________________
• Notable quotes or key phrases:
______________________________________________________________________
Preliminary Assessment & Next Steps
- Emerging needs or areas for support:
______________________________________________________________________ - Recommended next steps (counseling goals, referrals):
______________________________________________________________________ - Timeline/follow-up date:
______________________________________________________________________
Additional Notes
______________________________________________________________________
Rubric
Intake Quality Checklist
Use this rubric to self-assess or peer-assess the quality of a clinical intake, focusing on structure, empathy, documentation, and action planning. Score each criterion on a 4-point scale:
4 = Exceeds Expectations
3 = Meets Expectations
2 = Approaching Expectations
1 = Needs Improvement
| Criterion | 4 – Exceeds Expectations | 3 – Meets Expectations | 2 – Approaching Expectations | 1 – Needs Improvement |
|---|---|---|---|---|
| Core Component Coverage | Thoroughly captures all essential intake elements (presenting concerns, history, strengths, observations, emotional tone, preliminary assessment) with rich detail. | Addresses most essential intake elements with sufficient detail; minor gaps in information. | Covers some key elements but omits important components or provides minimal detail. | Many essential components missing or addressed superficially. |
| Empathy & Engagement | Demonstrates exceptional empathy: active listening, unconditional positive regard, attuned non-verbal cues, and effective gentle probing throughout. | Shows consistent empathy: good use of reflective listening, positive tone, and appropriate non-verbals; minor lapses. | Uses some empathetic techniques but inconsistently; minimal non-verbal attunement or probing. | Little or no use of empathetic skills; interactions feel rushed, judgmental, or disengaged. |
| Documentation Quality | Organizes intake notes clearly and logically; accurately records emotional tone, key quotes, and contextual details; easy to follow. | Documentation is clear and organized with minor inaccuracies or omissions; most key details included. | Notes are somewhat disorganized or incomplete; missing contextual details or emotional tone. | Documentation is disorganized, incomplete, or illegible; fails to capture key details or tone. |
| Next Steps & Action Planning | Provides specific, realistic, and measurable next steps or referrals, including timeline/follow-up date. | Lists appropriate next steps with general timeline; may lack some specificity or measurability. | Suggests vague or partially relevant next steps; timeline or follow-up details missing or unclear. | No clear next steps or recommendations; fails to identify areas for support or follow-up. |
Total Score: ____ /16
Interpretation:
- 14–16: Exemplary intake practice—ready for implementation
- 10–13: Solid practice with room for enhancement
- 6–9: Inconsistent practice—focus on targeted improvements
- 4–5: Significant gaps—review intake framework and retry
Next Steps:
- Review areas scoring “2” or “1” and revisit the Core Intake Components Map
- Practice empathetic techniques from the Empathy-Driven Interview Guide
- Refine documentation using the Intake Data Organizer
- Seek peer or coach feedback and repeat the role-play cycle