Quiz 5: Chapter 8

• The clinical interview is the first step in the assessment process
• Any assessment technique used by a clinical psychologist should possess the qualities of validity, reliability, and clinical utility.
• Validity: it measures what it claims to measures
• 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
• A key element of reliability is standardization - the technique (i.e. the interview, IQ test) should have a uniform method, often detailed in a manual, that ensures that it will be administered and scored in the same way across psychologists and across situations.
• 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
• Assessment typically happens at the beginning of the client's process - assessment helps determine the next steps for the client such as a particular type of therapy or referral to a specialist.
• Assessment can be a recurring process to monitor progress as the weeks or months of treatment go by.
• Ambulatory assessment: technology that helps gather data throughout the client's daily life; the data can be physiological (heart rate or sleep pattern), mood-, thought-, or behavior-related.
• Quieting yourself: the interviewer's internal, self-directed thinking pattern should be quieted, the interviewer's internal voice should not drown out the voice of the client
• Being self-aware: the interviewer's ability to know how they tend to affect others interpersonally and how others tend to relate to them - in short how they come across
• Developing positive working relationships: attentive listening, appropriate empathy, genuine respect, and cultural competence play significant roles - they are a function of the interviewer's attitude and actions
• Primary task of the interviewer: listening - attending behaviors
• Eye contact facilitates listening and communicates listening

  • Diversity plays a significant role in the meaning of eye contact, as eye contact may communicate threat, seduction, or other messages

   
• Body language: general rules: face the client, appear attentive, minimize restlessness, and display appropriate facial expressions
• Vocal qualities: not just the words, but how they sound to the client's ears

  • Pitch, tone, volume, and fluctuation to let clients know that their words and feelings are appreciated.
• Effective interviewers are able to repeat key words and phrases back to their assure their clients that they have been accurately heard.
• Misuse of names can be disrespectful or even perceived as a microaggression
• Beginning of the initial interview is an ideal opportunity to ask clients how they would prefer to be addressed and to confirm that is being done correctly.
• Behavioral observations: describing the behavior of the client during the process

  • Observing behavior can offer important information to the psychologist about responding during the interview and understanding of them.
• Rapport: a positive, comfortable relationship between interviewer and client. (how an interviewer is with clients)
• When clients feel a strong sense of rapport with the interviewer, they feel that they have connected with them.
• Interviewer should make an effort to put the client at ease, such as engaging in small talk but not excessive distracting from the interview's purpose
• Interviewers can acknowledge the unique, unusual situation of the clinical interview, and let clients know that you recognize their position and appreciate their willingness to participate communicates empathy and enhances rapport.
• Can enhance rapport by noticing how the client uses language and then following the client's lead, and speak in similar terms
• Technique is what an interviewer does with clients.

  • i.e. questions, responses, and other specific actions.
• It's important for culturally competent interviewers to appreciate that for some clients, the interview and the system behind it may elicit feelings of cultural mistrust
• Cultural mistrust: a tendency to be wary or suspicious of people in positions of authority (in the U.S., white people) because of history or direct experience with racist, unfair, or discriminatory treatment.
• Cultural mistrust was originally applied to Black Americans, but has been increasingly relevant to other diverse groups.
• Suggestions for a culturally competent interview - approach the interview with humility, compassion, and appreciation.

  • Don't expect complete trust from the beginning and don't take it personally
  • Avoid microaggressions
  • Be flexible in the methods used
  • Offer to answer any questions about the clinical interview
• Directive style: get exactly the information they need by asking clients specifically for it

  • Targeted towards specific pieces of information, client responses are typically brief and single word.
  • Can provide crucial data
• Nondirective style: allow the client to determine the course of the interview, a client may choose to spend a lot of time on some topics and none on others

  • Indirect questioning can provide crucial information that interviewers may not otherwise know to inquire about
• An interviewer should not rely too heavily on either style.

  • Too many directive questions: may leave clients feelings as though they didn't express themselves enough
  • Too many nondirective questions: may not have enough data for valid diagnosis, conceptualization or recommendation.
• Open-ended questions allow for individualized and spontaneous responses from clients and tend to be relatively long - but may lack details important for the psychologist