L3: Assessment Interview

• Clinical interview - is a dialogue between psychologist and patient that is designed to help the psychologist to diagnose and plan treatment for the patient. Often called 'a conversation with a purpose'
• Focus of clinical interview:

  1. A clinical interview has a focused purpose - to diagnose

  2. A clinical interview occurs within a defined time frame
• Types of interviews:

  • Intake interview
  • Case history
  • Diagnostic interview
  • Mental status exam
  • Crisis interview
• Intake interview

  For the Clinician :

  • Determine the nature of the client’s problems
  • Determine the appropriateness of services offered
  • Define problems to be worked on and establish goals
  • Balance gathering information with establishing rapport

  For the Client :

  • Determine appropriateness of services
  • Find out about psychologist’s fees, procedures and policies
• Case History or Psychosocial History:

  • Detailed description of the client’s background including birth, family, education, employment, and more
• Structured Diagnostic Interviews specify:

  • Symptoms and disorders to be assessed
  • Interview format
  • Order of questions
  • Wording of questions
  • Guidelines for additional questions
• Mental Status Exam:

  • The mental status examination is the psychiatrist’s version of the physical examination.
  • It is the defining status of the current state of the patient during evaluation.
  • The mental status examination is a structured assessment of the patient's behavioral and cognitive functioning.
  • A mental status exam is a clinical interview that looks at more than just the answers to your questions.
  • It is often used on patients who are not able to talk clearly about their problems.
• Crisis Interview:

  • A crisis interview is an interview that is conducted after an individual undergoes a life-threatening crisis
  • Goal: resolve the problem to avoid catastrophic outcome
  • Tasks: provide reassurance, assess the problem, explore potential resources
  • Method: convey understanding, projecting a calm and confident manner
• Conducting a clinical interview:

  • Offer a safe space for discussion
  • Use open-ended questions
  • Listen to non-verbal clues like posture and tone of voice
• Essential Elements of Clinical Interview:

  1. Rapport: mutual trust and harmony that characterizes a good relationship. Rapport involves a comfortable atmosphere and a mutual understanding of the purpose of the interview.

  • Establishing Rapport - Conveying acceptance, understanding and respect for the patient
  • 2. Effective communication strategies: verbal strategies like open and closed questions, listening skills, clarification, paraphrasing, reflection, and summarizing.
• • Open Questions - Elicit information
  • Closed questions - gather specific information
• Listening skills, four types of responses that convey listening

  • Clarification
  • Paraphrase
  • Reflection
  • Summarization
• Clarification is

  • questioning that helps the clinician understand an ambiguous message
  • confirm the accuracy of their perception
  • an intervention technique designed to guide the patient in focusing on and recognizing gaps and inconsistencies in his or her statements
• Paraphrasing

  • involves describing the content/thoughts of the client's message
  • paraphrase: the recasting of an idea in words different from that originally used, whether in the same language or in a translation.
• Reflection - describing the feelings of the client's message
• Summarizing -Two or more paraphrases or reflections that condense the client’s message or the session.
• Interviewing essentials and techniques

  • The physical arrangements
  • The setting
  • Note taking and recording
  • Rapport
  • Communication
  • Language
  • Listening
  • Gratification of Self
• Assessment Interview – is the most basic and the most serviceable technique employed by the clinician.
• Intake interview - happens the first time someone comes to see you. This is the interview where you, as the psychologist, ask what brings them to you, what their mental and physical health history is and what they would like to get out of their time with you.
• Nonverbal communication - is the transmission of messages or signals through a nonverbal platform such as eye contact, facial expressions, gestures, postures, and the distance between two individuals.
• Most commonly used psychological assessment:

  • The clinical interview
• The physical arrangements - An interview can be conducted anywhere that two people can meet and interact.
• The setting - Certain physical arrangement are especially desirable for an interview.

  • Soundproofing is also very important.
• Note-taking and recording – it would seem desirable to take occasional notes during an interview. A few key phrases jotted down will help the clinician’s recall.

  • Any attempt of verbatim notes should be avoided except when administering a structured interview.
  • Excessive note-taking tends to prevent clinician from observing the patient and from detecting subtle changes of expression or slight changes in muscular movements.
  • Videotape or audiotape interviews can be done with informed consent from the patient.
• Rapport - involves a comfortable atmosphere and a mutual understanding of the purpose of interview.
• Communication

  • Beginning a session – it is often useful to begin the session with a casual conversation. A brief conversation designed to relax things before plunging into the patient’s reasons for coming will usually facilitate a good interview.
• • Language – Of extreme importance is the use of language that the patient can understand.
  • Listening – it is by listening that the clinician come to appreciate the information and emotions that the patient is conveying.
  • Gratification of Self- clinicians should avoid discussing their personal lives or opinions during interview.
• Interviewer Appearance

  • Dress in professional attire congruent with community standards and the local environment.

  • Dressing too casually.

  • Avoid wearing a white coat or other attire that makes you look like a medical doctor.

  • Matching the gender of the interviewer and the child may facilitate communication especially for assessing sensitive issues such as sexual abuse or sexual orientation
• THE PURPOSE OF CLINICAL INTERVIEW IN A PSYCHOLOGICALASSESSMENT

  • Clinical psychologists perform a wide range of functions to help people suffering from different kinds of problems.
  • A psychologist will conduct an initial meeting, known as the clinical interview, with a client to assess what types of problems the client is dealing with.
• THE PURPOSE OF CLINICAL INTERVIEW IN A PSYCHOLOGICALASSESSMENT

  • Clinical Assessments - During the clinical interview, a psychologist will gather information regarding a client's family history, social life, employment, financial situation, previous experience in mental health treatment and other factors that can impact mental health and well being.
  • -The assessment provides the psychologist a comprehensive picture of the client's life, which helps in determining the diagnosis and course of treatment
• 2. Neuropsychological Assessments - is used to determine the way a client's cognitive processes work and the impact of potential brain or cognitive dysfunction on behavior.

  3. Psychological Testing - A clinical psychologist also performs different types of psychological tests to determine the level of a client's functioning on various levels.
• Personal Characteristics for Clinical Psychologists

  • Empathy - is one of the most important characteristics of a clinical psychologist. Empathy means that you have the ability to put yourself in your patient's shoes, to see the world through his eyes
  • Non-Judgmental - The ability to listen to others without making value judgments on their actions or beliefs is acritical characteristic of a clinical psychologist.
• • Confidence- If you don't have confidence in your abilities, your patients won't, either. Not only do you need to show that you have a firm grasp of psychological theories and concepts, you must be a confident person underneath it all, too.
  • Excellent Communication Skills - Clinical psychologists must have excellent communication skills, including the ability to listen to their patients with compassion, consideration and understanding.