Introduction to Clinical Psychology Science, Practice and Ethics Chapter 6 Clinical Interviewing This multimedia product and its contents are protected

Introduction toIntroduction to Clinical PsychologyClinical PsychologyScience, Practice and EthicsScience, Practice and Ethics

Chapter 6Chapter 6Clinical InterviewingClinical Interviewing

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Types of Clinical InterviewsTypes of Clinical Interviews IntakeIntake Case HistoryCase History Diagnostic InterviewDiagnostic Interview Mental Status ExamMental Status Exam Crisis InterviewCrisis Interview



IntakeIntake What is the client’s problem?What is the client’s problem? Can I help?Can I help?


Informed ConsentInformed Consent KnowledgeKnowledge

Freedom to ChooseFreedom to Choose

CapacityCapacity


Case HistoryCase History Birth and developmentBirth and development Family of OriginFamily of Origin EducationEducation EmploymentEmployment Recreation/LeisureRecreation/Leisure SexSex Dating and MaritalDating and Marital Alcohol and DrugsAlcohol and Drugs HealthHealth


Diagnostic InterviewDiagnostic Interview Goal: to arrive at a diagnosisGoal: to arrive at a diagnosis Threats to reliabilityThreats to reliability

Diagnostic rules/system is ambiguousDiagnostic rules/system is ambiguous Clinicians ask different questionsClinicians ask different questions Clients give different responsesClients give different responses

Reliability of diagnostic interviews Reliability of diagnostic interviews Overall percent agreementOverall percent agreement Kappa coefficientKappa coefficient Kappa > .75 is very goodKappa > .75 is very good


Structured Clinical InterviewsStructured Clinical Interviews Structured Clinical InterviewStructured Clinical Interview

SCID SCID (Structured Clinical Interview for Axis I DSM-IV Disorders)(Structured Clinical Interview for Axis I DSM-IV Disorders) ADIS-IV ADIS-IV (Anxiety Disorders Interview Schedule)(Anxiety Disorders Interview Schedule)

Comprehensive Drinker ProfileComprehensive Drinker Profile Improved ReliabilityImproved Reliability ComprehensiveComprehensive Apply decision rules correctlyApply decision rules correctly Cut down on confirmation biasCut down on confirmation bias


Mental Status ExamMental Status Exam Appearance and behaviorAppearance and behavior Speech and thoughtSpeech and thought ConsciousnessConsciousness PerceptionPerception Obsessions and compulsionsObsessions and compulsions OrientationOrientation MemoryMemory Attention/concentrationAttention/concentration General informationGeneral information IntelligenceIntelligence Insight and judgmentInsight and judgment


Crisis InterviewCrisis Interview Primary Goal: resolve the immediate problemPrimary Goal: resolve the immediate problem

Secondary Goal: refer to appropriate resourcesSecondary Goal: refer to appropriate resources


Communication StrategiesCommunication Strategies Verbal StrategiesVerbal Strategies Nonverbal StrategiesNonverbal Strategies Listening SkillsListening Skills


Verbal StrategiesVerbal Strategies Open-ended questionsOpen-ended questions Closed questionsClosed questions Funnel methodFunnel method


Nonverbal StrategiesNonverbal Strategies S – face client S – face client squarelysquarely O – adopt anO – adopt an open open posture posture L – L – lean lean toward the clienttoward the client E – frequent E – frequent eyeeye contact contact R – R – relaxrelax

CongruenceCongruence


Active ListeningActive Listening ClarificationClarification ParaphrasingParaphrasing ReflectionReflection SummarizationSummarization


Common Interviewing PitfallsCommon Interviewing Pitfalls The authenticity pitfallThe authenticity pitfall The jargon pitfallThe jargon pitfall The slave-to-the-intake-form pitfallThe slave-to-the-intake-form pitfall The diagnostic label pitfallThe diagnostic label pitfall The apology pitfallThe apology pitfall The reassurance pitfallThe reassurance pitfall


Diagnostic InterviewingDiagnostic Interviewing Goal: classification of client and his or her Goal: classification of client and his or her

problemproblem StepsSteps

Diagnostic cluesDiagnostic clues Diagnostic criteriaDiagnostic criteria Psychiatric historyPsychiatric history DiagnosisDiagnosis PrognosisPrognosis


Structured InterviewsStructured Interviews Structured Clinical Interview for DSM-IV Structured Clinical Interview for DSM-IV

(SCID)(SCID) Anxiety Disorders Interview Schedule – 4Anxiety Disorders Interview Schedule – 4 thth

Edition (ADIS-IV)Edition (ADIS-IV) Comprehensive Drinker Profile (CDP)Comprehensive Drinker Profile (CDP)


Reliability of Diagnostic InterviewsReliability of Diagnostic Interviews

Overall percent agreementOverall percent agreement Kappa coefficientKappa coefficient


Interviewing ChildrenInterviewing Children Developmental ConsiderationsDevelopmental Considerations Preschool – concrete, ego-centricPreschool – concrete, ego-centric Middle childhood – increasing sophistication, Middle childhood – increasing sophistication,

can make inferences about their own and can make inferences about their own and others’ behavior, feelings etc.others’ behavior, feelings etc.

Adolescence – increasing recognition of Adolescence – increasing recognition of complexity of humans complexity of humans

Considerable variabilityConsiderable variability


Interviewing Children: Things to Interviewing Children: Things to considerconsider

Open-ended = closed mouthOpen-ended = closed mouth Greater reliance upon concrete questioningGreater reliance upon concrete questioning Use simple questionsUse simple questions

““What do you like best about school?”What do you like best about school?” ““What don’t you like about school?”What don’t you like about school?”

Give praise frequentlyGive praise frequently Use alternative stimuliUse alternative stimuli

DrawingDrawing DollsDolls But draw inferences cautiouslyBut draw inferences cautiously


Interviewing and Cultural DiversityInterviewing and Cultural Diversity

““Multiculuralism is a social-intellectual Multiculuralism is a social-intellectual movement that promotes the value of diversity movement that promotes the value of diversity as a core principle and insists that all cultural as a core principle and insists that all cultural groups be treated with respect and as equals” groups be treated with respect and as equals” (Fowers & Richardson, 1990, p.609).(Fowers & Richardson, 1990, p.609).


Culturally sensitive interviewingCulturally sensitive interviewing Be aware of one’s own cultural background Be aware of one’s own cultural background

and experienceand experience Educate oneself about the ethnic groups and Educate oneself about the ethnic groups and

cultures with whom one workscultures with whom one works Modify characteristic communication style to Modify characteristic communication style to

facilitate communication (within reason)facilitate communication (within reason)

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Introduction to Clinical Psychology Science, Practice and Ethics Chapter 6 Clinical Interviewing This multimedia product and its contents are protected