1. Clinical Assessment Interviewing

2. Psychological Assessment
Key activity in clinical psychology (historically)

3. Psychological Assessment: Overall Process
I. Planning the assessment
II. Data collection** (our focus)
IV. Data processing
V. Communicating findings

4. I. Planning the Assessment
Why is the person being assessed? (referral question)
The goal of the psychological assessment follows from the referral question.

5. Goals of Psychological Assessment
Classification (diagnoses)
Description
Prediction (true positive, false positive)

6. II. Data Collection** Methods Clinical interview Tests Observations
Informal assessment
Examination of life records

7. III. Data Processing Organization and interpretation of data
Clinical judgment vs. statistical prediction

8. IV. Communicating Findings
Typical Report
Identifying Information
Reason for Referral
Background Information
Behavioral Observations
Assessment Results
Diagnosis
Interpretation
Summary and Recommendations

9. Clinical Interviewing
Clinical Interview vs. Social Conversation
Different social roles of the two participants
Interview usually takes place in a professional setting
Interview is usually one-sided

10. Types of Interviews Intake interview Case history Diagnostic interview
Mental status exam
Crisis interview

11. Intake Interviews 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

12. Case History or Psychosocial History
Detailed description of the client’s background which usually includes:
Birth and development
Family of origin
Education
Employment
Recreation/Leisure
Sexual history
Dating and Marital
Alcohol and drugs
Physical health

13. Structured Diagnostic Interviews
Structured Interviews specify:
Symptoms and disorders to be assessed
Interview format
Order of questions
Wording of questions
Guidelines for additional questions

14. Structured Diagnostic Interviews
Professionals
Schedule for Affective Disorders and Schizophrenia (SADS) (semi-structured)
Structured Clinical Interview for DSM-IV (SCID)
Lay Persons
Diagnostic Interview Schedule (DIS)

15. Mental Status Exam General appearance and behavior Speech and thought
Consciousness
Perception
Obsession and Compulsions
Orientation
Memory
Attention and concentration
General information
Intelligence
Insight and judgment
Higher cognitive functioning
Intelligence
Speech
Orientation
Mood and Affect
Form of Though

16. Crisis Interview 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

17. Essential Elements of Clinical Interview
Rapport
Effective communication strategies

18. Rapport
The sense of mutual trust and harmony that characterizes a good relationship
Rapport involves a comfortable atmosphere and a mutual understanding of the purpose of the interview.

19. Establishing Rapport
Conveying acceptance, understanding and respect for the patient

20. Effective Communication: Verbal Strategies
Open Questions
What did you think of the movie?
How would you describe your relationship with your parents?
Closed Questions
Did you like the movie?
Do you have a good relationship with your parents?

21. Questions Open Questions Elicit information Closed Questions
Gather specific information

22. Combining Open and Closed Questions
How would you describe your marriage?
What do you enjoy about the relationship?
What are these arguments like?
Have you and your husband ever separated?
How long have you been married?

23. Listening Skills Four Types of Responses that Convey Listening
Clarification
Paraphrase
Reflection
Summarization

24. Clarification Definition Questioning that
helps the clinician understand an ambiguous message
Confirms the accuracy of the clinician’s perception
Example
Are you saying that….
Could you describe for me…
Say what you mean by…

25. Clarification: Purpose
To encourage elaboration
To check accuracy of what you heard
To clear up vague messages

26. Distinguishing Content vs. Emotion: An Exercise
What thoughts are you having about being in class today?
What are the feelings that go along with these thoughts?

27. Paraphrasing
Definition: Describing the content/thoughts of the client’s message
Provides an opportunity for client to clarify
Encourages client to say more about a topic
Provides an opportunity to redirect client to central topic

28. Paraphrasing
Example
Client: School has always been really difficult for me. I really have to work hard to do well. My grades have always been good but it hasn’t been easy. Not like my sister. Megan has always just waltzed right through school. She just reads a chapter once and its all there for her when test time comes.
Therapist: So while you’ve done well in school, you’ve had to work very hard.

29. Paraphrasing: Purpose
To help the client focus on the content of their message
To highlight content when attention to feelings is premature

30. Reflection Definition Describing the feelings of the client’s message.
Example:
Client: Since I have had the baby, my husband is always busy at work and I have to do everything by myself and it is hard to keep up.
Therapist: You are feeling overwhelmed by becoming a new mother?

31. Reflection: Purpose
To encourage the client to express more of his or her feelings
To have the client experience feelings more intensely
To help the client become more aware of their feelings
To help the client discriminate accurately among feelings

32. Paraphrasing and Reflection
Client: Everything is humdrum. There’s nothing new going on, nothing exciting. All my friends are away. I wish I had money to do something different.
Paraphrase: With your friends gone and no money around, there is nothing for you to do right now.
Reflection: You feel bored with the way things are for you right now.

33. Summarizing Definition:
Two or more paraphrases or reflections that condense the client’s message or the session.

34. Summarizing: Purpose
To tie together multiple elements of the client’s message
To identify a common theme
To interrupt excessive talking
To review progress

35. Overview Psychological Assessment
Planning the assessment (why is person being assessed?)
Data collection (interviews, tests, observations etc)
Data processing (clinical vs. statistical prediction)
Communicating findings (written reports)