Unit 2 Chapter 6 the assessment interview Assessment in clinical psychology o Definition and purpose Clinical assessment involves an evaluation of an individual s strength and strength and weaknesses a conceptualization of the problem at hand as well as possible weaknesses etiological factors and some prescription for alleviating the problem o The referral The assessment process begins with a referral It is important clinicians take pains to understand precisely what the referral source is seeking precisely what the question is or o What influences how the clinician are often heavily influenced by their own theoretical theoretical commitments commitments The interview o General characteristics of interviews An interaction Interaction between at least 2 persons information beliefs or attitudes in the most skilled fashion possible at least 2 persons interviewers are using it to elicit data Interviews occupy a position somewhere between ordinary conversation and Interview versus test tests The art of interviewing Interviewing has often been regarded as an art however a considerable amount of research has been carried out on interviewing When to probe when to be silent and when to be indirect or subtle are When to probe when to be silent and when to be indirect or subtle are decisions that test the ability of the interviewer decisions that test the ability of the interviewer o Interviewing essentials and techniques The physical arrangements The setting o Privacy closed doors closed doors o Protection from interruptions example phone calls example phone calls o Fairly neutral office furnishings know clients know clients Note taking and recording o Can be difficult to remember what clients say o Possible but unlikely the client will object o Use of audio and video taping should always be done with client consent consent Rapport Rapport Definition and function o Rapport is often used to characterize clinical relationship o Should also include a comfortable atmosphere and a mutual understanding of the purpose of the interview Characteristics o Many ways to achieve good rapport it does require the clients not to be prejudged based on the problems for which they are seeking help o attitudes of understanding sincerity acceptance and empathy are not techniques to be taught Communication Beginning a session oo May be useful to begin an assessment session with a casual May be useful to begin an assessment session with a casual conversation may help relax the client conversation may help relax the client Language understand The use of questions o Of extreme importance is use of language that the client can o Make sure the client understands words you chose to use words you chose to use o Open ended gives clients responsibility and latitude for responding o Facultative encourages client s flow of conversation o Clarifying encourages clarity or amplification o Confronting challenges inconsistencies or contradictions o Direct once rapport has been established and client is taking responsibility for conversation such questions can be efficient and useful Silence o Perhaps nothing is more disturbing to the beginning interviewer o Clinician s response to silence should be reasoned and responsive to the goals of the interview rather than to personal needs or insecurities Listening Listening Gratification of self own problems own problems o If therapists are to communicate effectively in the clinical role their communication must reflect understanding and acceptance oo The clinical interview is not the place for clinicians to work out their The clinical interview is not the place for clinicians to work out their o In some instances the client will ask personal questions usually clinicians should avoid discussing their personal lives or opinions The impact of the clinicians o Behooves all clinicians to cultivate a degree of self sight or at least a mental set to consider the possible effects of their own impact before attaching meaning to the behavior of their clients The clinician s values and background o Clinicians must examine their own experiences and seek the bases for their own assumptions before making clinical judgments of others The patient s client s frame of reference o If the clinician is going to be effective in achieving the goals of the interview it is essential to have an idea of how the client views the first meeting The clinician s frame of reference o Clinician should be prepared by carefully going over any existing records o Clinician should be perfectly clear about the purpose of the interview o Imperative that clinician remain objective o Depending on the purpose of the interview the clinician may need to the clinician may need to be prepared to provide some closure at the conclusion of the be prepared to provide some closure at the conclusion of the interview make a referral set up another appointment provide interview make a referral set up another appointment provide feedback etc feedback etc Varieties of interviews o The intake admission interview Generally has two purposes To determine why the client has come to the clinic or hospital To judge whether the agency s facilities policies and focus of competence will meet the needs and expectations of the client Sometimes done via phone Used to appraise the client of matters such as the clinic s function fees policies procedures and personnel o The case history interview As complete a personal and social history of the client as possible Purpose is to provide a broad background and context in which both the client and the problem can be placed Range of material is quite broad covers both childhood and adulthood and it includes educational sexual medical parental environmental religious and psychopathological matters Can be provided by the client themselves or other knowledgeable adults o Mental status examination o The crisis interview Used to asses the presence of cognitive emotional or behavioral problems Purpose is to meet problems as they occur and to provide an immediate resource immediate resource Intention is to deflect the potential for disaster and to encourage caller to enter into a relationship with the clinic or make a referral so that a long term solution can be worked out o The diagnostic interview Clinical psychologists evaluate patients according to DSM IV TR criteria Reliability and validity of interviews o Reliability Information variance refers to the variance in the questions the clinicians ask the
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