© 2013 Cengage Learning. All Rights Reserved. This edition is intended for use outside of the U.S. only, with content that may be different from the U.S. Edition. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Chapter 6 The Assessment Interview

© 2013 Cengage Learning. All Rights Reserved. This edition is intended for use outside of the U.S. only, with content that may be different from the U.S. Edition. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Assessment in Clinical Psychology Definition and Purpose – Clinical assessment involves an evaluation of an individual’s strengths and weaknesses, a conceptualization of the problem at hand (as well as possible etiological factors), and some prescription for alleviating the problem – All of these lead us to a better understanding of the client

© 2013 Cengage Learning. All Rights Reserved. This edition is intended for use outside of the U.S. only, with content that may be different from the U.S. Edition. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Assessment in Clinical Psychology Definition and Purpose – Ongoing Process – Our ability to successfully treat psychological problems is directly related to our ability to define the problems

© 2013 Cengage Learning. All Rights Reserved. This edition is intended for use outside of the U.S. only, with content that may be different from the U.S. Edition. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Assessment in Clinical Psychology The Referral – Referral by whom? Parent, friend, teacher, psychiatrist, judge – Referral question(s) What aspect of a patient’s behavior needs attention and clarification? Example: Why is Juan disobedient?

© 2013 Cengage Learning. All Rights Reserved. This edition is intended for use outside of the U.S. only, with content that may be different from the U.S. Edition. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Assessment in Clinical Psychology What influences how the clinician addresses the referral question? – Clinician’s theoretical orientation Psychodynamic, behavioral, etc. – Choice of assessment instruments Theoretical orientation impacts which assessment tools the clinician will use

© 2013 Cengage Learning. All Rights Reserved. This edition is intended for use outside of the U.S. only, with content that may be different from the U.S. Edition. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. The Interview General Characteristics of Interviews – An interaction Each participant contributes and influences the other(s) – Interviews vs. tests An interview falls between conversation and actual psychological test It is more purposeful and organized than a conversation, but not formal or standardized like a test – The art of interviewing

© 2013 Cengage Learning. All Rights Reserved. This edition is intended for use outside of the U.S. only, with content that may be different from the U.S. Edition. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. The Interview Interviewing Essentials and Techniques – Training and supervised experience – The physical arrangements Consider privacy and protection from interruption – Note-taking and recording Moderate note-taking is ideal

© 2013 Cengage Learning. All Rights Reserved. This edition is intended for use outside of the U.S. only, with content that may be different from the U.S. Edition. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. The Interview

© 2013 Cengage Learning. All Rights Reserved. This edition is intended for use outside of the U.S. only, with content that may be different from the U.S. Edition. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. The Interview Rapport – Relationship between patient and clinician – Acceptance – Empathy – Understanding – Respect – Competence

© 2013 Cengage Learning. All Rights Reserved. This edition is intended for use outside of the U.S. only, with content that may be different from the U.S. Edition. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. The Interview Communication – Beginning a session – Language – The use of questions – Silence – Listening – Impact of clinician (appearance, values, etc.)

© 2013 Cengage Learning. All Rights Reserved. This edition is intended for use outside of the U.S. only, with content that may be different from the U.S. Edition. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. The Interview

© 2013 Cengage Learning. All Rights Reserved. This edition is intended for use outside of the U.S. only, with content that may be different from the U.S. Edition. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. The Interview The Patient’s Frame of Reference – Why is s/he seeking help? – Pressure? – Goals – Understanding of therapy/consultation

© 2013 Cengage Learning. All Rights Reserved. This edition is intended for use outside of the U.S. only, with content that may be different from the U.S. Edition. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. The Interview The Clinician’s Frame of Reference – Be clear about the purpose of the interview – Remain focused – Provide closure

© 2013 Cengage Learning. All Rights Reserved. This edition is intended for use outside of the U.S. only, with content that may be different from the U.S. Edition. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Varieties of Interviews The Intake-Admission Interview – to determine why the patient has come to the clinic or hospital – to judge whether the agency’s facilities, policies, and services will meet the needs and expectations of the patient

© 2013 Cengage Learning. All Rights Reserved. This edition is intended for use outside of the U.S. only, with content that may be different from the U.S. Edition. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Varieties of Interviews The Case-History Interview – Provides a broad background and context in which both the patient and the problem can be placed. – Covers both childhood and adulthood, and it includes educational, sexual, medical, parental- environmental, religious, and psychopathological matters. – Informants Knowledgeable adults in the patient’s life that can provide additional information about the patient

© 2013 Cengage Learning. All Rights Reserved. This edition is intended for use outside of the U.S. only, with content that may be different from the U.S. Edition. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Varieties of Interviews The Mental Status Examination Interview – General presentation: appearance, behavior, attitude – State of consciousness: alert, hyperalert, lethargic – Attention and concentration – Speech: charity, goal-directedness, language deficits – Orientation: to person, place, time – Mood and affect

© 2013 Cengage Learning. All Rights Reserved. This edition is intended for use outside of the U.S. only, with content that may be different from the U.S. Edition. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Varieties of Interviews The Mental Status Examination Interview – Form of thought; formal thought disorder – Thought content: preoccupations, obsessions, delusions – Ability to think abstractly – Perceptions: hallucinations – Memory: immediate, recent, remote – Intellectual functioning – Insight and judgment

© 2013 Cengage Learning. All Rights Reserved. This edition is intended for use outside of the U.S. only, with content that may be different from the U.S. Edition. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Varieties of Interviews The Crisis Interview – Purpose of the crisis interview is to meet problems as they occur and to provide an immediate resource – Deflect the potential for disaster and to encourage person to enter into a relationship with the clinic or make a referral so that a longer term solution can be worked out – Such interviewing requires training, sensitivity, and judgment

© 2013 Cengage Learning. All Rights Reserved. This edition is intended for use outside of the U.S. only, with content that may be different from the U.S. Edition. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Varieties of Interviews Computerized interviewing – Incorporation of new technology – Structured testing limitations

© 2013 Cengage Learning. All Rights Reserved. This edition is intended for use outside of the U.S. only, with content that may be different from the U.S. Edition. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Varieties of Interviews The Diagnostic Interview – Unstructured Free-form, content varies greatly between clinicians – Structured Standard set of questions and follow-up probes in a specific sequence All patients asked the same questions More likely that two clinicians will come to similar conclusions (high inter-rater reliability)

© 2013 Cengage Learning. All Rights Reserved. This edition is intended for use outside of the U.S. only, with content that may be different from the U.S. Edition. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Reliability and Validity of Interviews Reliability – Inter-rater reliability The level of agreement between at least two raters who have evaluated the same patient independently Kappa Coefficient = the statistical index of inter-rater reliability – Test-retest reliability The consistency of interview scores over time

© 2013 Cengage Learning. All Rights Reserved. This edition is intended for use outside of the U.S. only, with content that may be different from the U.S. Edition. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Reliability and Validity of Interviews

© 2013 Cengage Learning. All Rights Reserved. This edition is intended for use outside of the U.S. only, with content that may be different from the U.S. Edition. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Reliability and Validity of Interviews

© 2013 Cengage Learning. All Rights Reserved. This edition is intended for use outside of the U.S. only, with content that may be different from the U.S. Edition. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Reliability and Validity of Interviews Suggestions for Improving Reliability and Validity – Whenever possible, use a structured interview – If one does not exist for your purpose, consider developing one – Develop good interviewing skills – Be aware of the patient’s motives and expectancies – Be aware of your own expectations, biases, and cultural values

© 2013 Cengage Learning. All Rights Reserved. This edition is intended for use outside of the U.S. only, with content that may be different from the U.S. Edition. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. The Art and Science of Interviewing Becoming a skilled interviewer requires practice Becoming a skilled interviewer requires good self-awareness