Chapter 8-the Clinical Interview 3g3db

PSY 17A: CLINICAL PSYCHOLOGY Chapter 8: The Clinical Interview

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Clinical interview - A common assessment technique by clinical psychologists involving a purposeful conversation with clients characterized by questions and answers Defining Validity, Reliability, and Clinical Utility for Assessment Methods 1. Validity – measure what it claims to measure a. Content validity – has content appropriate for what is being measured. b. Convergent validity – correlate with other techniques that measure the same thing. c. Discriminant validity – does not correlate with techniques that measure something else. 2. Reliability – yields consistent, repeatable results. a. Test-retest reliability – yields similar results across multiple istrations at different times. b. Interrater reliability – yields similar results across different s. c. Internal reliability (e.g. splithalf reliability) - consists of items that are consistent with another. 3. Clinical utility- improves delivery of services or client outcome

Specific Behaviors –Listening can be broken down into fundamental building blocks of attending behaviors Specific Behaviors  

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Quieting yourself – does not simply mean that the interviewer shouldn’t talk much during the interview. What should be quieted is the interviewer’s internal, self directed thinking pattern. Being self-aware – ability to know how he/she tends to affect others

Eye Body language – general rules: face the client, appear attentive, minimize restlessness, display appropriate facial expressions and so on. Vocal qualities – Use pitch, tone, volume, and fluctuation to voices to let clients know that their feeling and words are being deeply appreciated. Verbal tracking – ensure clients that they have been accurately heard. - monitor the train of thought of client, if able to shift topics smoothly rather than abruptly. Referring to the client by the proper name – misuse of names in this way may be disrespectful and be received as microaggression.

Components of the Interview 

The Interviewer- the most pivotal element of a clinical interview is the person who conducts it. General Skills

interpersonally and how other tend to relate to him/her. Developing positive working relationships Established by attentive listening, appropriate empathy, genuine respect, and cultural sensitivity

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Rapport – positive, comfortable relationship between interviewer and client. How? = Put the client at ease(small talk), acknowledge the uniqueness of the clinical interview, and matching their language use to the clients’. Technique - What an interviewer does with clients; including questions, responses, and other specific actions.  Directive style - Get exactly the info they need by asking clients specifically for it; "yes" or "no" questions. (Closed-ended question)

 Nondirective style – allows the client to determine the course of the interview. (Openended question) 

Specific Interviewer Responses  Open-ended question and Closed-ended question  Clarification - communicate to the client that the interviewer is actively listening and processing what the client says.  Confrontation – used when notice a discrepancies or inconsistencies in a client’s comments.  Paraphrasing – used to ensure clients that they are being accurately heard. (echoes the client’s words)  Reflection of feeling – make clients feel that their emotions are recognized, even if their comment did not explicitly include labels of their feelings. (echoes the client’s emotions)  Summarizing – tying together various topics that have been discussed, connecting statements that have been made at different points, and identifying themes that have recurred during the interview.  Conclusions – may consist of a specific diagnosis made by the interviewer or may involve recommendations.

Pragmatics of the Interview   

Note Taking Audio and Video Recordings Interview Room – “when choosing a room[for interviews], it is useful to strike a balance between professional formality and casual comfort”

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Confidentiality

Types of Interviews 1. Intake interviews - Determines whether client needs treatment, form of treatment, and whether the current facility can provide the treatment or if the client should be referred out. 2. Diagnostic Interviews – diagnose the client’s problem a. Structured interview- is a predetermined, planned sequence of questions. Constructed for particular purposes, usually diagnostic. b. Unstructured interview determine their questions on the spot, seeking information that they decide is relevant during the course of the interview. c. Semistructured interview – unstructured for first then structured. 3. Mental Status Exam - Primary purpose is to quickly assess how the client is functioning at the time of evaluation; employed most often in medical settings. Following main categories are typically covered:  Appearance  Behavior/psychomotor activity  Attitude toward examiner  Affect and mood  Speech and thought  Perceptual disturbances  Orientation to person, place, and time  Memory and intelligence  Reliability, judgment, and insight 4. Crisis Interviews - Designed to assess a problem demanding urgent attention and provide immediate, effective intervention for that problem.