Topic 5

• Validity


  The extent to which the assessment technique measures what it claims to measure
• Psychoanalytic arrangement


  Traditional (and increasingly rare) arrangement where the client lies on a couch while the interviewer sits in a chair
• Interview room


  • Facilitates the fundamental goals of the interview, such as gathering information and building rapport in a private setting free of interruptions
• Decisions clinicians make about the rooms where they conduct interviews and other clinical services can be quite important
• Overtly personal items


  Family photos, souvenirs, and memorabilia that may be inconsistent with the professional ambience and can influence the content of the interview
• Many people incorrectly assume that any session with a psychologist is absolutely confidential
• Intake interview


  Determines whether to "intake" the client to the setting, whether the client needs treatment, what form of treatment is needed, and whether the current facility can provide that treatment or the client should be referred
• Diagnostic interview


  Aims to diagnose the client's problems by assigning Diagnostic and Statistical Manual of Mental Disorders (DSM) diagnoses
• Structured interview


  A predetermined, planned sequence of questions that an interviewer asks a client, usually for diagnostic purposes
• Structured interviews


  • Produce a diagnosis based explicitly on DSM criteria, are highly reliable, and are standardized and uncomplicated in administration
• Structured Clinical Interview for DSM-5 Disorders (SCID)

  A comprehensive list of questions that directly ask about the specific symptoms of the many disorders included in the DSM
• Mental status exam


  Quickly assesses how the client is functioning at the time of the evaluation, does not delve into the client's personal history or definitively determine a DSM diagnosis
• Techniques may vary, the following main categories are typically covered (Sommers-Flanagan, 2016):
• Main categories covered in the mental status exam

  • Appearance
  • Behavior/psychomotor activity
  • Attitude toward interviewer
  • Affect and mood
  • Speech and thought
  • Perceptual disturbances
  • Orientation to person, place, and time
  • Memory and intelligence
  • Reliability, judgment, and insight
• Because of its lack of standardization, two interviewers who use the mental status exam may ask different questions within the same category.
• The mental status exam is not intended as a meticulous, comprehensive diagnostic tool. Instead, it is intended for brief, flexible administration, primarily in hospitals and medical centers, requiring no manual or other accompanying materials.
• Crisis interview


  A special type of clinical interview designed not only to assess a problem demanding urgent attention (most often, clients actively considering suicide or another act of harm toward self or others) but also to provide immediate and effective intervention for that problem
• Crisis interviews


  • Quickly establishing rapport and expressing empathy for a client in crisis, especially a suicidal client, are key components
  • Providing an immediate, legitimate alternative to suicide can enable the client to endure this period of very high distress and reach a later point in time when problems may feel less severe or solutions may be more viable
• Research on the use of "no-suicide contracts" suggests that they are questionable in their effectiveness and may have the unintended negative effect of communicating to the client that the psychologist is more concerned about protecting themselves from legal liability than the client's actual well-being.
• Five specific issues to assess when interviewing an actively suicidal person

  • How depressed is the client?
  • Does the client have suicidal thoughts?
  • Does the client have a suicide plan?
  • How much self-control does the client currently appear to have?
  • Does the client have definite suicidal intentions?
• Appreciating the cultural context is imperative, as behaviors, thoughts, or emotions that might be viewed as abnormal or pathological by some cultural standards may in fact be normal according to others.
• Clinical psychologists should make efforts, in interviews and other interactions with clients, to appreciate clients from a perspective that takes into account the clients' own cultures.
• Clinical psychologists also make adaptations to cultural expectations or norms when conducting the interview, such as perhaps including a bit more small talk with a member of a culture where its absence is likely to hinder rapport, or consulting with professionals who know the culture well.
• The culturally competent interviewer should not assume that every person from a culture holds identical values, as tremendous variability often exists among individuals within a cultural group.
• Open, respectful discussion of cultural variables can enhance rapport, increase the client's willingness to share information, and help the interviewer gain a more accurate understanding of the client's issues.
• Interviewers should continually seek other sources of information about specific cultures—written, experiential, or otherwise—to increase their cultural awareness.