Essential Aspects of the Clinical Interview in Psychology

 
Chapter 8
 
The Clinical Interview
 
The Clinical Interview
 
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
 
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
 
Validity, Reliability,
and Clinical Utility
 
Feedback
 
Common to all kinds of psychological
assessment
Provide results of tests or interviews
May be face-to-face, a report, etc.
 
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
 
 
 
 
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
 
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
 
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
 
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
 
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
 
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
 
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)
 
Types of Interviews
 
Intake interviews
To determine whether to “intake” the client into the
agency or refer elsewhere
 
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
 
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
 
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
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Clinical interviews play a crucial role in the assessment conducted by clinical psychologists, showcasing essential qualities like validity, reliability, and clinical utility. Understanding the importance of feedback and honing general and specific skills as an interviewer are key components in conducting effective clinical interviews.

  • Clinical Psychology
  • Assessment Techniques
  • Interview Skills
  • Validity
  • Reliability

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  1. Chapter 8 The Clinical Interview

  2. The Clinical Interview 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 Validity measures what it claims to measure. Content validity has content appropriate for what is being measured. Convergent validity correlates with other techniques that measure the same thing. Discriminant validity does not correlate with techniques that measure something else. Reliability yields consistent, repeatable results. Test-retest reliability yields similar results across multiple administrations at different times. Interrater reliability yields similar results across different administrators. Internal reliability consists of items that are consistent with one another. Clinical utility improves delivery of services or client outcome.

  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

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