Submitted by:

Marichu B. CastroJunelyn Salum

Ladyzel MendozaJennica Faye Lappay

Efraim Albino

Submitted to Dr. Ryan Coroña

CLINICAL INTERVIEW SITUATIONS

Intake InterviewsThe most common type of clinical interview occurs when a client first come to the clinician because of some problem in living. Intake interviews are designed mainly to establish the nature of the problem. Clinicians may also use intake interviews to develop broader descriptions of clients and the environmental context in which their behavior occurs.

MENTAL STATUS EXAMINATION OUTLINE

General appearance Speech and thought Consciousness Mood and affect Obsessions and compulsions Orientation Memory Attention and concentration Fund and general information Intelligence Insight and judgment Higher intellectual functioning

Because a client is encouraged to ask questions and make comments, misconceptions that might obstruct subsequent treatment progress can be discussed and corrected.

Orientation interviews can help clients understand upcoming assessment and treatment procedures and what their roles in these procedures will be.

Orientation interviews are also important to research participants.

TREATMENT AND DEBRIEFING INTERVIEWS

ETHNIC AND CULTURAL ISSUES IN THE CLINICAL INTERVIEW

INTERVIEW STRUCTURE

ADVANTAGE AND DISADVANTAGE OF STRUCTURED INTERVIEWS

STAGES IN THE INTERVIEW

Section PreviewThis section will examine techniques commonly employed by clinical psychologists during the beginning, middle and end stages of interview. Certain features such as establishing and maintaining rapport, communicating the goals and purpose of the interviews. Both clinicians and clients must interpret verbal and non verbal behavior during an interview, so it is important that clinicians are sensitive to various ways. Sensitivity to differences of interpretation is especially important when clients come from cultural or ethnic backgrounds that differ from the interviewer.

STAGE I: BEGINNING THE INTERVIEW

The Setting Certain settings are especially conducive

to building rapport for more clients. Except for clients whose cultural background might cause such surroundings to be threatening, interviews are best conducted in a comfortable, private office because most people find it easier to relax when they are physically comfortable. Privacy makes it easier to assure the client of the interview’s confidential nature.

THE OPENING

It is important that clinicians handle the first few minutes of initial interviews carefully. This early stage is important because clients may not be ready to talk candidly about personal matters. Most clinicians see establishing rapport as their main task during the first part of initial interviews. Rapport can be built in several ways, many of which involve common sense and courtesy. A client’s anxiety and uncertainty can be eased by demystifying the interview.

FRAME SETTING AND TRANSITION

TECHNIQUES IN HANDLING THE INTERVIEW

Nondirective Techniques- Open-ended questions are used whenever the clinician wishes to prompt clients to speak while exerting as little influence as possible over what they say. These strategies are supplemented by tactics designed to help client express themselves fully and to enhance rapport by communicating the clinician’s understanding and acceptance.

Active Listening- involves responding to the client’s speech in ways that indicate understanding and encourage further elaboration.

PARAPHRASING

Wherein the clinicians restate what their clients say in order to show that they are listening and give clients a chance to correct the remark if it was misinterpreted. Carl Rogers called this strategy as reflection.

Directive Techniques Most interviewers’ supplements nondirective

tactics with more directive questions whose form, wording, and content are often the result of careful planning.

COMBINING INTERVIEW TACTICS

Because interviews can be flexible, clinicians are usually free to combine the tactics that we have described. They may facilitate the client’s speech with open-ended request, paraphrasing, prompts, and other active listening techniques, and then used more directive questions to “zoom in” on topics of special importance.

Maintaining Rapport

STAGE III: CLOSING THE INTERVIEW

The last of an interview can provide valuable assessment data as well as an opportunity to enhance rapport.Strategies for Building and Maintaining Rapport

Put the patient and yourself at easeEstablish a comfortable setting, recognize and respond to signs of uneasiness in the client and in yourself; confront sources of tension with empathy, honesty and patience.

Find the suffering-show compassion

Get down to business, ask what is bothering the client, and respond with reflective statements showing empathy.

Assess insight- become an ally

Ask the client for his or her understanding of the history and meaning of problems; seek examples; ally yourself with the healthy part of the client and set therapeutic goals.

Show Expertise

Demonstrate knowledge of the client’s problem or disorder, deal with his or her doubt, instill reasonable hope.

Establish Leadership

Set and maintain the frame. Explain the ground rules and conditions of the of the clinical contact; avoid overdoing it by becoming an authoritarian leader.

Balance the interviewer roles

Balance the interviewer rolesBe part empathic listener, part expert and part authority, with liberal doses of the first and smaller, judicious applications of the other two roles.

Balance the client rolesRegard the client as an ordinary person, deserving of respect, and experiencing an illness or disorder, avoid enabling the role of the sufferer.

Communication in the InterviewThe fundamental objective in interview communication is to encode, transmit and decode messages accurately. Speakers must encode what they want to convey into transmittable messages made up of words and gestures, which listeners must receive and decode within their personal and cultural frame of reference.

CHANNELS OF NONVERBAL COMMUNICATION

Physical Appearance- height, weight, grooming, style and condition of clothing, unusual characteristics, muscular development and hairstyle.

Movements- gestures, repetitive arm, hand, head, leg, foot motions; tics or other apparently involuntary movements: pacing, handling of cigarettes, matches or other objects.

Posture- slouching, rigidity, crossed or uncrossed arms or legs, head and hands.

Eye Contact- constant, fleeting, none

Facial Expressions- smiles, frowns, grimaces, raised eyebrows.

Emotional Arousal- tears, wet eyes, sweating, dryness of lips, frequent swallowing, blushing or paling, voice or hand tremor, rapid respiration, frequent shifts in body position, startle reactions, inappropriate laughter.

Speech Variables- tone of voice, speed, slurring, lisp, stuttering, blocking, accent, clarity, style, sudden shifts or omissions.

RESEARCH ON INTERVIEW

SELECTION PREVIEW

- primary tool of clinicians are often rich sources of data and has complex of social interactions that can interpreted in variety of ways. Clinicians must remain aware of empirical research on the value of interview. Awareness can point clinicians to areas where their own interviewing could be improved.

• 1942- Carl Rogers published the first transcripts from phonographic recordings

• The first recording devices first published• Relationship between interview

characteristics• Warmth and empathy• Outcome variables • -rapport building • -therapy effectiveness

Some studies focused on differences in interview while others try to define interview variables such as client resistance.

Investigations revealed that open-ended interviews of client can result in quite different information.

The significance of the interview is often in the eye of the beholder.

RELIABILITY AND VALIDITY OF INTERVIEW DATA

RELIABILITY

- depends also on the population on which the instrument was standardized

-the interview method having acceptable reliability with one group

Test- retest reliability- the consistency of the clients’ responses across repeated interview occasionsInterrater reliability- examine the degree to which different judges agree on the references they draw from the interview with the same client

VALIDITY

• -it may be limited to the population sample on which interview the interview was based

• -it concerned especially when clinicians interview persons from different cultural and ethnic backgrounds

• -the cross cultural validity of interviews is an empirical question in need of empirical research for each interview format and with various ethnic or cultural groups

ERROR AND BIAS IN THE INTERVIEW

EARLY STUDIES OF THE INTERVIEW

Malingering- creating the appearance of mental disorder

Impression management- the desire to present oneself in a particular light to a mental health professional

Worrisome -the possibility that personal biases might affect interviewers’ perception and color their inferences and conclusions about clients saying during interview.

SECTION SUMMARY:

Research interview as an assessment tool, does not justify all encompassing conclusions.

Clinicians should not automatically assume that their interview impressions are valid.

Clinicians should be aware of the limitations of interviews especially when working with persons from different backgrounds.

Any tendencies to view interviews as primarily an art form practiced by gifted clinicians therefore,

Exempt from scientifically rigorous examinations of reliability and validity will ultimately result in the loss of the interview’s utility as an assessment tool.

OBSERVATIONAL ASSESSMENT: GOALS AND BENEFITS

SECTION PREVIEW:

Clinicians can observe client behaviors that occur naturally in real situations such as in hospitals, schools, homes, and other setting.

Clinicians can also assess clients by developing contrived situations designed to elicit or assess particular kinds of responses.

GOALS OF OBSERVATIONAL ASSESSMENT SYSTEMS:

Collect information that is not available in other ways

Supplement other data as part of multiple assessment approach

ADVANTAGES OF OBSERVATIONAL ASSESSMENT

Supplementing Self-Reports

Highlighting Situational Determinants of behavior

Enhancing Ecological Validity

SECTION SUMMARY:

Observation on clients’ behavior is time consuming but has advantages; it can supplement or correct self- reports, reveal situational determinants of behavior and established ecological validity.

RESEARCH ON OBSERVATIONAL ASSESSMENT

SECTION PREVIEW

DEFINING OBSERVATIONAL TARGETS

RELIABILITY OF OBSERVATIONAL ASSESSMENT

REPRESENTATIVES OF OBSERVED BEHAVIOR

OBSERVER EFFECTS

TREND IN THE USE OF OBSERVATION METHODS

SECTION SUMMARY

CHAPTER SUMMARY

During controlled observation, clinicians may monitor clients physiological as well as overt.