COMMDIS416 1stEdition Lecture 8Outline of Last LectureI. Bell Curve Theory Revisited-Score Interpretation PracticeII. GFTA Response Form III. Score Interpretation Process IV. Julia’s Sound Production ErrorsV. Testing Considerations Outline of Current Lecture I. The Client Care ProcessII. The Nature of Interviewing III. Purpose of Clinical Interview IV. Clinical Interview V. Assessment Interview Outline VI. The Nature of Interviewing VII. Strategies for Effective Interviewing VIII. Common Communication Mistakes IX. Open Vs. Closed Questions X. Ethnographic Interviewing XI. Case History Form XII. Assessment Interview-Specific Data Needed XIII. Tips for Gathering a Case History of Bilingual ClientsXIV. Counseling Clients XV. Active Listening XVI. ClarificationXVII. Paraphrasing XVIII. ReflectionXIX. Paraphrasing and ReflectionXX. Difficult Behavior During Clinical Interview XXI. Collaboration XXII. DocumentationXXIII. PVFD Current LectureI. The Clinical Care Process 1. Collect patient information2. Identify area of concern3. Select and recommend therapies 4. Follow-up to assess patient outcomes 5. Revise treatment plan when appropriate II. The Nature of Interviewing - An interview is a process of verbal and nonverbal communication between a trained professional and a client/parent who is seeking services - A purposeful exchange of meanings between two persons, a directed conversation that proceeds in an orderly fashion to obtain data, to convert certain information, and to provide counseling III. Purpose of Clinical Interview- Determine reason for referral and nature of the problem- Define problems to be worked on and establish meaningful goals - Initial step in the diagnostic process - Guide treatment o What type of treatment o What to expect from this client - Balance information-gathering with rapport building o Rapport: “The sense of mutual trust that characterizes a good relationship.”o Conveying acceptance, understanding and respect for the patient IV. Clinical Interview - Vehicle for giving information- Means of establishing and sustaining a relationship- Tool for data gathering - Medium of therapy V. Assessment Interview Outline- Introduce yourself and note your status and credentials - Outline the time and goals for your meeting - Mention that you will be taking notes - Review limits to confidentiality VI. The Nature of Interviewing - Conduct with adult client or parent/guardian of minor and minor (depending on age)- Roles are highly specified - Differs from social interactions - Clinician and client work together and cooperate - Interviews include asking follow-up questions-clinician must be knowledge and know what type of questions to ask  The Clinical Interview:o Proceeds in an orderly fashiono Professional interviewer provides directiono Follows a logical pattern and conclusions o Evolves: less structure-more structure o Focuses on specific content + topicso Control for location/physical barriers o Diagnostic History Guidelines o Example) Interviews/intakes VII. Strategies for Effective Interviewing - Start with OPEN questions - Don’t be afraid to direct the interview- Strive for balance of information-gathering and rapport-building - Observe behavior and mood - Open questions, restatement, reflection of feelings - Take notes - Use an outline to guide the interview VIII. Common Communication Mistakes - Failure to greet patients, tell them who you are and the purpose of your interaction with them- Failure to find out what is bothering the patient-worries, concerns, issues, how the patient feels about their condition - Accepting vague information too easily and not probing to find out specifics - Failure to verify information- Failure to be responsive to patient questions - Failure to pay attention to the patient’s verbal and non-verbal messages - Avoiding information that is personalo At times, unpleasant topics are brought up to better understand possible etiologies - Using too many closed-ended questions (see next section)- Allowing interruptions - Failure to provide appropriate information in the form of counseling - Not understanding the patient’s viewpoint - Communicate effectively o Avoid jargono Avoid ambiguity (be specific) IX. Open vs. Closed Questions -Open Questions:o Elicit information o What do you think of the movie?o How would you describe your symptoms?-Closed Questions:o Gather specific informationo Did you like the movie?o Would you describe your symptoms as bothersome? - Combining Open and Closed Questions:o E.g., Voice Disorder Patient: How would you describe your voice problem? (OPEN) Are your symptoms worse in the morning or night? (CLOSED) What treatments have you tried in the past? (OPEN) Were they successful? (CLOSED)X. Ethnographic Interviewing - In a traditional interview, the interviewer operates from the perspective that “I know what I want to find out, so I am setting the agenda for this interview.”- In an ethnographic interview, in contrast, the client, spouse, or parents help determine the important information to share  Principles of Ethnographic Interviewing Include:o Open-ended questions vs. dichotomous questions that trigger a yes or no response o Restate what the client says by repeating the client’s exact words o Summarize the cline or parent’s statements and give them the opportunity to correct yo if you have misinterpreted something they havesaid o Avoid asking multiple questions back-to-back and/or multipart questions  “Sarah, you mentioned you forget things. What things do you forget, in what situations do you forget them, and what do you do to remember things better?”  Sarah, you mentioned you forget things. Can you give me some examples of techniques you use to try to remember things?” o Avoid leading questions that tend to orient the person to a particular response o Avoid using “why” questions because such questions tend to sound judgmental and may increase the client’s defensivenesso Avoid use of excessive Yes-No questions o Avoid use of excessive Open-Ended questions o Avoid using technical language-Convey messages accurately and professionally using simple language XI. Case History Form- A case history is a detailed account of a person as it related to a communication disorder or concern- There are specific questions that are asked and the clinician should build off of