Group Member Screening Questionnaire: Pre-Admission Interview

Dana already printed name tags. The referral from outpatient had a diagnosis that matched the flyer. Week 1, the new member used the round as a trauma narrative. Two other people went quiet. Dana spent the hour containing one person she had never screened.

A group member screening questionnaire is the interview you run before that chair is assigned. You ask a short set of questions, you listen for fit with this contract, and you stamp seat, hold, or route. You do not wait for week 1 to find out.

The questionnaire below is original material, written for this page. It does not reproduce a published selection inventory, and it is not a session check-in list or a paragraph of generic inclusion criteria.

This form decides who enters the group. It is not the questions to ask in a counseling session once they are in the room.

Educational resource for licensed mental-health clinicians. Adapt every question to the group’s population, risk, culture, consent, developmental stage, clinical contract, and local policy. This interview does not replace assessment, supervision, emergency procedures, or individualized treatment.

What this group member screening questionnaire is for

Use it when a referral is sitting on your desk and you still have to decide whether this closed adult group can hold them. The sample contract is a weekly 60- to 90-minute skills or psychoeducation group. If you are writing the eight-week plan rather than seating one person, start with the group therapy curriculum template.

SAMHSA’s TIP 41 chapter on placing clients in groups is written for substance-use programs, and the placement job is the same in outpatient mental health: “Either the group leader or another trained staff person should meet with a client before assignment to a group.” In that interview, “it is important to evaluate how the client reacts to the group leader and to assess current and past interpersonal relationships.”

The Association for Specialists in Group Work Best Practice Guidelines say “Group Workers screen prospective group members if appropriate to the type of group being offered.” When selection is appropriate, they “identify group members whose needs and goals are compatible with the goals of the group.” Compatibility is a decision. It is not a vibe.

How to run the interview

Thirty to forty-five minutes. You, the person, and the written contract for this group. Keep this group member screening questionnaire in your charting packet, not on the member’s clipboard. Do not run it as a second intake that restates the diagnosis. A first diagnostic hour is a diagnostic clinical interview, not this pre-admission stamp.

Name the group in one sentence: closed adult anxiety skills, trauma-informed psychoeducation, parenting, IOP. Name the pass option, the disclosure ceiling, attendance, and what belongs in individual care. Then work the table. Stamp as you go. If a later domain would change an earlier stamp, change it in the room. Do not leave two conflicting stamps.

Keep the questions in your words. Do not read them like a script. If the person cannot tolerate this interview, they will not tolerate the hour.

Say the stamp out loud before you write it. Seat means this room, this contract, this cycle. Hold is not a refusal of care. It delays the chair until a hearing, a collateral call, or a quieter week is done. Route means the work belongs somewhere else, and you name where. If you cannot say that sentence in the room, the stamp is not ready.

This interview is still a planning conversation, not a second assessment. You are deciding whether this contract, this mix, and this cycle can hold the person. Keep the questions short enough that you leave with a stamp, not a new history.

The pre-admission questionnaire

Each row is one domain. The question is what you ask. The listen column is the signal, not a score. The decision field is the stamp plus one reason. Leave no field blank.

The decision field is the job of this table. Do not hide the stamp in a later comment. Write seat, hold, or route, then one reason another clinician could act on without calling you.

Stamp seat when this contract can hold them this cycle. Stamp hold when you need one more cycle, a collateral call, or a quieter week. Stamp route when the work belongs in individual care or in a different lane. TIP 41 is blunt: “Not all clients are equally suited for all kinds of groups, nor is any group approach necessary or suitable for all clients with a history of substance abuse.” That sentence still applies when the flyer matches the diagnosis.

If your clinic already uses a named measure, run it. Then still stamp. A score does not assign the chair.

After the individual screen, check the mix

A yes on every domain is not enough if the last four people you seated all need the same role. Composition is a second pass, not a rewrite of the interview.

Write the mix check on the same card. Do not keep it in your head.

You are looking at the last four seats, not at whether this person is likable. If the room already has two people who fill every silence, a third will turn the hour into a waiting room. If one member is already holding a crisis the group cannot process, do not add another. Write the current mix on the card so you are not guessing from memory after the last session.

What you write after the interview

One stamp. One reason. Who will tell the person, and by when. Any same-day risk follow-up.

A usable line: “Pre-admission screen 20 Sep. Contract fit: can name the skills job. Crisis load: housing hearing Thursday. Stamp: hold one cycle. Reason: the hearing will swallow week 1. Told member by phone. Individual follow-up remains with outpatient.”

Do not paste the interview into every later group note. The group note records what happened in the hour. The screen stays in the admission record.

If you seat, the first hour still has to name purpose and ground rules. Screening does not replace that opening. For live moves once chairs are filled, use how to facilitate a group therapy session.

Common failure modes

Using week 1 as the screen. You already committed the other members.

Treating a matching diagnosis as a seat. Diagnosis is a referral filter. The interview is the fit filter.

Leaving the decision field blank because the person was “nice.” Nice is not a stamp.

Seating someone who needs a trauma-processing group into a skills hour because you do not want to disappoint the referrer. Route them. If the work is trauma-specific, the trauma group curriculum is a different lane, with a different readiness check.

Reading the questionnaire as a consumer checklist. The person does not fill this in the waiting room. You run it.

Where the facilitation pack fits

The Group Curriculum Facilitation Pack includes the screening card this interview feeds. Use this group member screening questionnaire to run the conversation. Use the card to keep the stamp, the reason, and the mix check on one page.

Where Emosapien fits

You still hold the interview, the stamp, and who gets told. Emosapien can keep the screening decision next to the weekly aim and the after-group follow-up so the chart does not lose the reason you seated or held. You review and edit every note before it becomes part of the record.

Start your journey with Emosapien if you want that thread without another after-hours pass through a paper card.