1. Introduction to Clinical Psychology Science, Practice and Ethics Chapter 6 Clinical Interviewing This multimedia product and its contents are protected under copyright law. The following are prohibited by law: Any public performance or display, including transmission of any image over a network; Preparation of any derivative work, including the extraction, in whole or in part, of any images; Any rental, lease, or lending of the program Copyright ©Allyn & Bacon 2005

2. Types of Clinical Interviews Intake Intake Case History Case History Diagnostic Interview Diagnostic Interview Mental Status Exam Mental Status Exam Crisis Interview Crisis Interview Copyright ©Allyn & Bacon 2005

3. Intake What is the client’s problem? What is the client’s problem? Can I help? Can I help?

4. Copyright ©Allyn & Bacon 2005 Informed Consent Knowledge Knowledge Freedom to Choose Freedom to Choose Capacity Capacity

5. Copyright ©Allyn & Bacon 2005 Case History Birth and development Birth and development Family of Origin Family of Origin Education Education Employment Employment Recreation/Leisure Recreation/Leisure Sex Sex Dating and Marital Dating and Marital Alcohol and Drugs Alcohol and Drugs Health Health

6. Copyright ©Allyn & Bacon 2005 Diagnostic Interview Goal: to arrive at a diagnosis Goal: to arrive at a diagnosis Threats to reliability Threats to reliability Diagnostic rules/system is ambiguous Diagnostic rules/system is ambiguous Clinicians ask different questions Clinicians ask different questions Clients give different responses Clients give different responses Reliability of diagnostic interviews Reliability of diagnostic interviews Overall percent agreement Overall percent agreement Kappa coefficient Kappa coefficient Kappa >.75 is very good Kappa >.75 is very good

7. Copyright ©Allyn & Bacon 2005 Structured Clinical Interviews Structured Clinical Interview Structured Clinical Interview SCID (Structured Clinical Interview for Axis I DSM-IV Disorders) SCID (Structured Clinical Interview for Axis I DSM-IV Disorders) ADIS-IV (Anxiety Disorders Interview Schedule) ADIS-IV (Anxiety Disorders Interview Schedule) Comprehensive Drinker Profile Comprehensive Drinker Profile Improved Reliability Improved Reliability Comprehensive Comprehensive Apply decision rules correctly Apply decision rules correctly Cut down on confirmation bias Cut down on confirmation bias

8. Copyright ©Allyn & Bacon 2005 Mental Status Exam Appearance and behavior Appearance and behavior Speech and thought Speech and thought Consciousness Consciousness Perception Perception Obsessions and compulsions Obsessions and compulsions Orientation Orientation Memory Memory Attention/concentration Attention/concentration General information General information Intelligence Intelligence Insight and judgment Insight and judgment

9. Copyright ©Allyn & Bacon 2005 Crisis Interview Primary Goal: resolve the immediate problem Primary Goal: resolve the immediate problem Secondary Goal: refer to appropriate resources Secondary Goal: refer to appropriate resources

10. Copyright ©Allyn & Bacon 2005 Communication Strategies Verbal Strategies Verbal Strategies Nonverbal Strategies Nonverbal Strategies Listening Skills Listening Skills

11. Copyright ©Allyn & Bacon 2005 Verbal Strategies Open-ended questions Open-ended questions Closed questions Closed questions Funnel method Funnel method

12. Copyright ©Allyn & Bacon 2005 Nonverbal Strategies S – face client squarely S – face client squarely O – adopt an open posture O – adopt an open posture L – lean toward the client L – lean toward the client E – frequent eye contact E – frequent eye contact R – relax R – relax Congruence Congruence

13. Copyright ©Allyn & Bacon 2005 Active Listening Clarification Clarification Paraphrasing Paraphrasing Reflection Reflection Summarization Summarization

14. Copyright ©Allyn & Bacon 2005 Common Interviewing Pitfalls The authenticity pitfall The authenticity pitfall The jargon pitfall The jargon pitfall The slave-to-the-intake-form pitfall The slave-to-the-intake-form pitfall The diagnostic label pitfall The diagnostic label pitfall The apology pitfall The apology pitfall The reassurance pitfall The reassurance pitfall

15. Copyright ©Allyn & Bacon 2005 Diagnostic Interviewing Goal: classification of client and his or her problem Goal: classification of client and his or her problem Steps Steps Diagnostic clues Diagnostic clues Diagnostic criteria Diagnostic criteria Psychiatric history Psychiatric history Diagnosis Diagnosis Prognosis Prognosis

16. Copyright ©Allyn & Bacon 2005 Structured Interviews Structured Clinical Interview for DSM-IV (SCID) Structured Clinical Interview for DSM-IV (SCID) Anxiety Disorders Interview Schedule – 4 th Edition (ADIS-IV) Anxiety Disorders Interview Schedule – 4 th Edition (ADIS-IV) Comprehensive Drinker Profile (CDP) Comprehensive Drinker Profile (CDP)

17. Copyright ©Allyn & Bacon 2005 Reliability of Diagnostic Interviews Overall percent agreement Overall percent agreement Kappa coefficient Kappa coefficient

18. Copyright ©Allyn & Bacon 2005 Interviewing Children Developmental Considerations Developmental Considerations Preschool – concrete, ego-centric Preschool – concrete, ego-centric Middle childhood – increasing sophistication, can make inferences about their own and others’ behavior, feelings etc. Middle childhood – increasing sophistication, can make inferences about their own and others’ behavior, feelings etc. Adolescence – increasing recognition of complexity of humans Adolescence – increasing recognition of complexity of humans Considerable variability Considerable variability

19. Copyright ©Allyn & Bacon 2005 Interviewing Children: Things to consider Open-ended = closed mouth Open-ended = closed mouth Greater reliance upon concrete questioning Greater reliance upon concrete questioning Use simple questions Use simple questions “What do you like best about school?” “What do you like best about school?” “What don’t you like about school?” “What don’t you like about school?” Give praise frequently Give praise frequently Use alternative stimuli Use alternative stimuli Drawing Drawing Dolls Dolls But draw inferences cautiously But draw inferences cautiously

20. Copyright ©Allyn & Bacon 2005 Interviewing and Cultural Diversity “Multiculuralism is a social-intellectual movement that promotes the value of diversity as a core principle and insists that all cultural groups be treated with respect and as equals” (Fowers & Richardson, 1990, p.609).

21. Copyright ©Allyn & Bacon 2005 Culturally sensitive interviewing Be aware of one’s own cultural background and experience Be aware of one’s own cultural background and experience Educate oneself about the ethnic groups and cultures with whom one works Educate oneself about the ethnic groups and cultures with whom one works Modify characteristic communication style to facilitate communication (within reason) Modify characteristic communication style to facilitate communication (within reason)