Presentation on theme: "Clinical Assessment (I) : The Assessment Interview"— Presentation transcript:
1 Clinical Assessment (I) : The Assessment Interview Aska Primardi
2 Clinical assessmentAn evaluation of an individual's strengths and weaknessA conceptualization of the problem at hand (as well as possible etiological factors)Some prescription for alleviating the problemLead us to a better understanding of the clientAssessment is not something that is done once and then is forever finished, it's ongoing processWhether the clinician is making decisions or solving problems, clinical assesssment is the means to the end
3 The Referral The assessment process begin with a referral Someone (parent, teacher, psychiatrist, judge, psychologist) poses a question about the patientwhat influences how the clinician addresses the referral question? answer : influenced by the clinician's theoretical commitments (pychodynamic, behavioral, cognitive-behavior. etc)
4 The interviewThe assessment interview is at once the most basic and the most serviceable technique used by clinical psychologistGeneral characteristic of interviews :An InteractionInterviews versus tests : interviews are more purposeful and organized than conversation but sometimes less formalized or standardized then psychological testThe art of interviewingcomputer-assisted interview assessment : many nonverbal cues, only clinicians are able to apply "clinical judgment", only clinicians can encode & process information
5 Interviewing essentials and techniques The physical arrangementsFew patients are likely to be open and responsive if : Take place anywhere that 2 people can meet and interact, & Privacy and protection from interruptionsNote-Taking & recordingTo recall much from the earlier interviews
6 RapportDefinition : the relationship between patient and clinician. Rapport involves a comfortable atmosphere and a mutual understanding of the purpose of interviewCharacteristics :Patients realize that the clinician is trying tounderstand their problems in order to help them2. Patients accepts the clinician’s ultimate goal ofhelping.3. Patients recognize that the clinician is notseeking a personal satisfaction in the interview
7 Communication Beginning a session Language The use of question Silence ListeningGratification of selfImpact of the clinicianThe clinician's values and background
8 Five type of interview questions Open-ended : gives patient responsibility and latitude for responding. Ex : "would you tell me about your experiences in the army"Facilitative : encourage patient's flow of conversation. Ex: "Can you tell me a little more about that?"Clarifying : encourages clarity of amplification. Ex: "i guess this means you felt like....?"Confronting : challenges inconsistencies or contradiction. Ex : "before, when you said....?"Direct : once rapport has been established and the patient is taking responsibility. Ex : "what did you say to your father when he criticized your choice?"
9 Varieties of interviews (1) The intake-admission interviewPurpose : to determine why the patient has come to the clinic or hospital, & to judge weather the agency’s facilities, policies, and services will meet the needs and expectations of the patientsThe case-history interviewPurpose : to provide a board background and context in which both the patient and the problem can be placed
10 Varieties of interviews (2) The mental status examination interviewPurpose : to assess the presence of cognitive, emotional, or behavioral problemsThe crisis interviewPurpose : to meet problems as they occur and to provide an immediate resource
11 Varieties of interviews (3) The diagnostic interviewConsists of a standard set of questions and follow-up probes that are asked in a specified sequenceClinical psychologists evaluate patients according to DSM-IV criteria (ex : specific phobia section of the structured clinical interview for Axis I)All patients or subjects are asked the same questionInterrater reliability : two clinicians who evaluate the same patient will arrive at the same diagnostic formulation
12 Reliability of interviews Interrater / interjudge reliability : index of the degree of agreement between 2 or more raters of judges as to the level of a trait that is present or the presence/absence of a feature or diagnosisTest-retest reliability : index of the consistency of interview scores across some period of time
13 Validity of interviews (1) Content Validity : refers to the measure’s comprehensiveness in assessing the variable of interest (ex : measuring depression. Give multiple questions assessing various emotional, cognitive, & physiological aspects of depression)Predictive validity : the degree to which interview scores can predict (correlate with) behavior or test score that are observed or obtained at the same point in the future
14 Validity of interviews (2) Concurrent validity : the extent to which interview scores are correlated with a related, but independent, set of test/interview scores or behaviorsConstruct validity : the extent to which interview score are correlated with other measures or behaviors in a logical and theoretically consistent way.