The Clinical Interview PSY 614 Instructor: Emily E. Bullock, Ph.D.

Clinical Interviewing: An Overview Terminology Interviewing as information-gathering? Interviewing as treatment? “Interviewing skills” generally refer to core counseling micro-skills (e.g., open questions, restatement, reflection of feelings). Across theoretical orientations, good interviewing draws heavily from the client-centered perspective.

Types of Clinical Interviews Initial assessment interview (intake) Interview during treatment (e.g., suicide assessment) Assessment interview

Structured vs. Unstructured Interviews Most clinical interviews are unstructured. Primary advantage is flexibility Structured interviews have many advantages: Standardization permits high inter-rater reliability and facilitates research. Standardization guards against interviewer bias.

The Role of Assessment in Treatment Diagnosis Guiding Treatment What type of treatment? Is this treatment effective? What to expect from this client? Therapeutic Assessment Documenting Outcomes

Assessment in the Counseling M.S. and Ph.D. Programs Role of This Course Role of Supervision Assessment in Practicum Courses Practicum I Practicum II Masters Internship Doctoral Training

The Assessment Interview: Importance & Goals Included in every assessment Client’s first contact with agency/professional Often serves to match client with provider Goals Building rapport Gathering information Providing information

Assessment Interview Outline Introduction Introduce yourself and note your status/credentials Outline the time and goals for this meeting Mention that you will be taking notes Review Limits to confidentiality Opening Provide the “client” with the opportunity to discuss his/her problem(s) Use counseling micro-skills to facilitate communication and convey empathic understanding

Assessment Interview Outline Body History of presenting problem(s) Mental health history Medical history and review of physical systems Coping & social support Suicidal/homicidal ideation & history Administer the MINI Personal & social history

Assessment Interview Outline Closing Summarize important themes/issues and inform client of the next step in the process.

Strategies for Effective Interviewing Start with open questions. Remember, this isn’t therapy. Don’t be afraid to direct the interview. Strive for a balance of information-gathering and rapport-building. Observe behavior and mood. Take notes. Use an outline and/or structured interview.

The MINI International Neuropsychiatric Interview Brief, highly structured interview of primary DSM-IV Axis I disorders Requires approximately 15 minutes Minimal training is necessary (for persons who have already had basic training in clinical interviewing) Modular structure saves time

Effective Interviewing with the MINI Make sure you preface it with a disclaimer. The MINI is only as good as the person using it, so you must be prepared to insert follow-up questions as needed. “Please give me an example.” The MINI will produce many false positives in settings where malingering is likely. May want to supplement with malingering test

Effective Interviewing with the MINI Interpreting the MINI 1) List all screening items endorsed 2) List the results of modules administered by listing all that client meets criteria for 3) Support or refute those issue that criteria was met for by giving examples from information gathered in the interview