1. Chapter 8 The Clinical Interview

2. Assessment is closely linked with the identity of clinical psychologists – No other mental health profession incorporates assessment into their work as clinical psychologists do Clinical interviews are the most frequent assessment tool – More than any specific test – Vast majority of practicing clinical psychologists use interviews

3. Essential Qualities of Assessment Techniques All assessment techniques (including interviews) should have adequate: – Validity—measures what it claims to measure – Reliability—yields consistent, repeatable results – Clinical utility—benefits the clinician and ultimately the client

4. Validity, Reliability, and Clinical Utility

5. Feedback Common to all kinds of psychological assessment Provide results of tests or interviews May be face-to-face, a report, etc.

6. The Interviewer General skills – Quieting yourself Minimize excessive internal, self-directed thoughts that detract from listening – Being self-aware Know how you tend to affect others interpersonally, and how others tend to relate to you – Develop positive working relationships Can segue into psychotherapy Respectful and caring attitude is key

7. The Interviewer (cont.) Specific behaviors – Listening—the primary task of the interviewer, consisting of numerous building blocks Eye contact Body language Vocal qualities Verbal tracking Referring to client by proper name

8. Components of the Interview Rapport – Positive, comfortable relationship between interviewer and client – How an interviewer is with clients Technique – What an interviewer does with clients – Directive vs. nondirective styles

9. Specific Interviewer Responses Open-ended and closed-ended questions – Open-ended questions Allow individualized and spontaneous responses from clients Elicit long answers that may or may not provide necessary info – Closed-ended questions Allow less elaboration and self-expression by the client Yield quick and precise answers

10. Specific Interviewer Responses (cont.) Clarification – Question to make sure the interviewer accurately understands the client’s comments Confrontation – For discrepancies or inconsistencies in a client’s comments Paraphrasing – Restatement of client’s comments to show they have been heard

11. Specific Interviewer Responses (cont.) Reflection of feeling – Echo client’s emotions, even if not explicitly mentioned Summarizing – Tie together various topics, connect statements that may have been made at different points, and identify themes

12. Pragmatics of the Interview Note-taking – Little consensus about note-taking – Provide a reliable written record, but can be distracting to client and interviewer Audio- and Video-recording – Also provide a reliable record, but can be inhibiting to clients – Must obtain permission

13. Pragmatics of the Interview (cont.) The Interview Room – Professional yet comfortable Confidentiality – Explain confidentiality and its limits to clients (e.g., child abuse, intention to harm)

14. Types of Interviews Intake interviews – To determine whether to “intake” the client into the agency or refer elsewhere

15. Types of Interviews (cont.) Diagnostic interviews – To provide DSM diagnosis – Structured interviews often used Minimize subjectivity, enhance reliability SCID is an example – Currently being revised for DSM-5 Semi-structured interviews include some structure but also some flexibility or opportunities to improvise

16. Types of Interviews (cont.) Mental status exam – Typically used in medical settings – To quickly assess how a client is functioning at that time Crisis interviews – Assess problem and provide immediate intervention – Clients are often considering suicide or other harmful act

17. Cultural Components Appreciating the cultural context – Knowledge of the client’s culture, as well as the interviewer’s own culture – For behavior described or exhibited during interview Acknowledging cultural differences – Wise to discuss cultural differences rather than ignore – Sensitive inquiry about a client’s cultural experiences can be helpful