Clinical Interview Eye contact not only facilitates listening, but it also

THE INTERVIEWER communicates listening.

The most pivotal element of a clinical interview is the person Be mindful of the interviewee’s cultural background
who conducts it. (e.g. Western vs. Asian cultures).
Skilled interviewer only is not a master of the technical and - Body Language
practical aspects of the interview but also demonstrates Culture can shape the connotations of body
broad-based wisdom about the human interaction it entails. language.
Face the client, appear attentive, minimize
THE INTERVIEWER: General Skills restlessness, display appropriate facial expressions,
- Quieting yourself and so on.
The term quieting yourself does not simply mean that - Vocal Qualities
the interviewer shouldn’t talk much during the interview. Vocal qualities of language do not only cover the
What should be quieted is the interviewer’s internal, words, but how those words sound to the client’s ears
self-directed thinking pattern. Utilize pitch, tone, volume, and fluctuation in their
The voice in the interviewer’s own mind should not own voices to make the clients know that they are
interrupt or drown out the voice of the client heard and appreciated.
- Verbal Tracking
- Being self-aware Effective interviewers are able to repeat key words
Being self-aware is another important skill. and phrases back to their clients to assure the clients
To know how he or she tends to affect others that they are accurately heard.
interpersonally and how others tend to relate to him or - Referring to the Client by the Proper
her. • Name
Cognizant of their unique traits, including their cultural Using the client’s name correctly is essential.
assumptions as well as more superficial characteristics, Inappropriately using nicknames or shortening
and consider their effect on the interview process. names, omitting a “middle” name that is in fact an
essential part of the first name, or addressing a
- Developing positive working relationships client by first name rather than a title followed by
Appreciate the importance of developing positive surname are presumptuous mistakes that can
working relationships with clients. jeopardize the client’s sense of comfort with the
There is no formula for developing positive working interviewer.
relationships
However, attentive listening, appropriate empathy, Validity measures what it intends to measure.
genuine respect, and cultural sensitivity play - The extent to which an assessment method captures
significant roles. what it is supposed to capture is known as validity. It
Always a function of the interviewer’s attitude as well guarantees that the tool is precise and in line with the
as the interviewer’s actions. intended construct.
Content Validity has content appropriate for what is being
measured.
Convergent Validity correlates with other techniques that
THE INTERVIEWER: Specific Behaviors measure something else.
A primary task of the interviewer is to listen. Listening may Discriminant Validity does not correlate with techniques that
seem like a simple enough task, but it can be broken down measures the same thing.
into even more fundamental building blocks of attending
behaviors (many described in Ivey, Ivey, & Zalaquett, 2010). Reliability yields consistent, repeatable results.

- Eye Contact
The consistency and repeatability of the outcomes that an • Native Americans: display indirect gaze during
evaluation instrument produce is measured by reliability. conversation
Consistent conditions will yield consistent • Asian Americans: inclined to avoid eye contact when
Test-retest reliability yields similar results across multiple speaking to people of higher status.
administrations at different times. • African Americans & Whites: likely to respond rather
Interrater reliability yields similar results across different quickly
administrators. • Native Americans, Asian Americans, & Hispanic
Internal reliability (split-half reliability) consists of items Americans: demonstrate a mild delay.
that are consistent with one another.
Men
Clinical Utility improves delivery of services or client • talk to assert themselves, promote their ideas, and achieve
outcome. goals
- When it comes to clinical decision making or • believes self-disclosure increases vulnerability.
treatment planning, a tool with high clinical utility • help is likely to take the form of advice or problem solving.
should be useful, effective, and practical. Women
• talk to build rapport and sustain relationships.
COMPONENTS OF THE INTERVIEW : Rapport • value self-disclosure for the closeness it brings
Rapport refers to a positive, comfortable relationship between • help is likely to take the form of empathy or understanding of
the interviewer and client. emotions.
Why is Rapport Important?
Builds Trust Directive Style
Encourages Openness • Get exactly the information they need by asking
Enhances Communication clients specifically for it.
Improves Interview Effectiveness • Targeted toward specific pieces of information
Fosters Client Engagement • Typically, brief (e.g., "yes" or "no")
Non-Directive Style
• Allow the client to determine the course of the interview
• Without direction from interviewer, a client may
COMPONENTS OF THE INTERVIEW : Technique choose to spend a lot of time on some topics
Refers to the specific actions, tools, and methods interviewers
use during clinical interviews. PROS CONS

RAPPORT TECHNIQUE • Direct questioning can • Directive approaches can

Refers to the specific Refers to the specific provide crucial data (e.g., sacrifice rapport in favor of
actions, tools, and methods actions, tools, and methods "When did you first notice information.
interviewers use during interviewers use during these feelings of sadness?
clinical interviews. clinical interviews. Has your weight changed • Nondirective may finish
during that time?) an interview without specific
data that are necessary for
• Indirect questioning can a valid diagnosis,
Communication across cultures provide conceptualization, or
• Asian Americans & Hispanic Americans: speak more crucial information recommendation.
softly that interviewers may not
otherwise know to inquire
• Whites: tend to speak more quickly
about. (e.g., "Can you tell
• African Americans: maintain direct eye contact when me more about your
speaking than when listening. feelings of sadness?")
SPECIFIC INTERVIEWER RESPONSES Clarification Example:
Open-ended questions Brianna mentioned in her initial phone call that she thinks she
• 'Can you please tell me more about the eating problems you may be bulimic.
mentioned on the phone?' Interviewer: "You mentioned that a few months ago you
• Allow individualized and spontaneous responses from started exercising excessively after eating large amounts of
clients food but that you've never made yourself vomit-do I have that
• Elicit long answers that may or may not provide necessary right?"
info
• nondirective interviewing style Confrontation
• Notice discrepancies or inconsistencies in a client's
Close-ended questions comments
'How many times per week do you binge and purge?' or 'Have Confrontation Example:
you been diagnosed with an eating disorder in the past?' Interviewer: Earlier, you mentioned that you had been happy
• Allow less elaboration and self-expression by the client with your body and weight as a teenager, but then a few
• Yield quick and precise answers minutes ago you mentioned that during high school you felt
• directive interviewing style fat in comparison with many of your friends. I'm a bit
confused.
Metaphorically Speaking Client: I guess I did feel kind of good about my body when I
Multiple-Choice, True/False was a teenager, but I always had these friends who were
• specific pieces of information. really slim, and I felt big next to them. Maybe I was more self-
• Responses are brief. conscious than I realized.
• Have more items because each question has a narrow Interviewer: So, even though you felt good about your body, it
scope. sounds like comparing yourself to your friends. How do you
• Reflect the knowledge areas deemed most important by the think those comparisons impacted how you saw yourself?
teacher.
Paraphrasing
Essay Exams • It assures clients that they are being accurately heard.
• "show what they know" in a broader and less restricted way. Paraphrasing Example:
• The number of questions is smaller Brianna: "I only binge when I'm alone,"
• Have a wider scope compared to MC/TF questions. Interviewer: "You only binge when no one else is around."

Closed-Ended Questions Reflection of Feeling

• similar to MC/TF questions. • Echoes client’s emotions
• part of structured interviews • Often involves an inference by the interviewer about
• precise and focused information emotions underlying the client’s words.
Reflection of Feeling Example:
Open-Ended Questions Client: I only binge when I'm alone.
• Allow for free-form, detailed responses, much like essay (It was delivered with a tone and body language that
exams. communicated shame-her hand covering her face, her voice
• Common in unstructured interviews quivering, and her eyes looking downward)
Interviewer: You don't want anyone to see you binging -do
Clarification you feel embarrassed about it?
It ensures that the interviewer has an accurate understanding
of the client's Summarizing
comments. • Ties together various topics connects statements and
identifies themes that have recurred.
Summarizing Example:
Interviewer: "It seems you are acknowledging that your 3)Interview Room
binging and purging have become significant problems in A clinical interview room should balance professionalism with
recent months, and while you may feel ashamed about it, you comfort.
want to work toward improving it." The seating arrangement is crucial to client comfort and
interaction dynamics. Options include a traditional
Conclusions psychoanalytic setup with a couch and chair, face-to-face
• Providing an initial conceptualization of the client’s problem seating, or chairs angled between 90° and 180°.
that incorporates a greater degree of detail than a brief Decor and Furnishings: The room should avoid overtly
summarization statement. personal items (e.g., family photos) that might distract or
Conclusions Example: affect the client’s comfort.
Client: I only binge when I'm alone. Privacy and Organization: Ensure the space is private,
(It was delivered with a tone and body language that orderly, and free from clutter or distractions.
communicated shame-her hand covering her face, her voice
quivering, and her eyes looking downward) 4)Confidentiality
Interviewer: You don't want anyone to see you binging-do you Confidentiality can be broken (e.g. intention to harm, child
feel embarrassed about it? abuse)
Interviewer: From what you're saying and how you're Some clients wrongly assume that others will have access to
expressing it, it seems that binge eating is tied to feelings of their records.
shame and vulnerability. You may be trying to keep it hidden
because you're afraid of being judged or criticized. It's TYPES OF INTERVIEWS
possible that this pattern is rooted in deeper fears about how 1)Intake Interview
An intake interview assesses whether a client needs
others perceive you or how you feel about yourself, which we
treatment, the type of treatment required, and whether the
could explore more to understand and address the emotional facility can provide this care.
triggers behind it.
It is used to decide if the client should be "taken in" to the
PRAGMATICS OF THE INTERVIEW treatment facility, and if a referral is necessary.
1)Note Taking
Little consensus on note-taking. It consists of:
• Demographic Information
Provide a reliable written record.
• Referral Source
Process of note-taking can be a distraction for: • Presenting Problem
The clinician, who may fail to notice the client’s behaviors. • Psychosocial History
The client, who may feel less rapport. • Medical History
Clinicians may explain their note-taking behavior to clients. • Mental Health History
Examples: • Risk Assessment
• Schizophrenia
2)Diagnostic Interview
A person with possible Schizophrenia was referred. The
clinician is taking verbatim notes during the interview. A diagnostic interview is conducted to diagnose the client’s
• Generalized Anxiety Disorder (GAD) condition, with the aim of assigning a specific DSM diagnosis.
A person with possible GAD was referred. The clinician is not It is used to gather information about the client’s symptoms and
taking notes during the interview. compare them with DSM criteria for mental health disorders.

Ex. Structured Clinical Interviews for DSM-5 (SCID-5) and

2) Audio and Video Recordings
Mini International Neuropsychiatric Interview (MINI)
Provides accurate details, but can be overwhelming to the
client
Audio and Video recordings require consent from the client
Structured Interview Brief paragraph that captures the psychological and cognitive
processes of an individual “right now”—like a psychological
a predetermined, planned sequence of questions that an snapshot
interviewer asks a client.
Format of the mental status exam is not completely
are constructed for particular purposes, usually diagnostic. standardized

Unstructured Interviews Main Categories of the Mental Status Exam

• Appearance
involves no predetermined or planned questions. • Behavior/Psychomotor Activity
• Attitude toward examiner
interviewers improvise: they determine their questions on the • Affect and mood
spot, seeking information that they decide is relevant during • Speech and thought
the course of the interview • Perceptual disturbances
• Orientation to person, place, and time
Advantages of Structured Disadvantages of • Memory and intelligence
Interviews Structured Interviews • Reliability, judgment, and insight
•
• Produce a • The format is
diagnosis based on usually rigid. Crisis Interview
DSM criteria • Typically, don’t
• Tend to be highly allow for inquiries Assess a problem that demands urgent attention
reliable. into topics not
• More empirically related to DSM Provide immediate and effective intervention for the problem
sound than criteria.
unstructured • Often requires a Can be conducted in person, but takes place often on
interviews. more telephones via suicide hotlines, crisis lines, and similar
• Standardized and comprehensive list services
typically of questions which
uncomplicated in lengthens the Quickly establishing rapport and expressing empathy for a
terms of interview. client in crisis are key components of the interview
administration.

Five (5) Key Issues to Assess When Interviewing an

Actively Suicidal Person
Example of Structured Interview: Structured Clinical • How depressed is the client
Interview for DSM-5 Disorders (SCID) • Does the client have suicidal thoughts?
• Does the client have a suicide plan?
• A comprehensive list of questions that directly ask • How much self-control does the client currently
about the specific symptoms of the many disorders appear to have?
included in the DSM. • Does the client have definite suicidal intentions?
• Each question has a one-to-one correspondence with
a specific criterion of a DSM diagnosis. CULTURAL COMPONENTS
• Most questions are designed to elicit “yes” or “no”
answers. Appreciating the Cultural Context
• It is modular. knowledge of the client's culture, as well as the interviewer's
own culture.
Mental Status Exam for behavior described or exhibited during interview.
Assess how the client is functioning at the time of the
evaluation Acknowledging Cultural Differences
wise to discuss cultural differences rather than ignore.
sensitive inquiry about client's cultural experiences can be
helpful.