The Clinical Interview

1
The Clinical Interview

• PSY 614
• Fall 2007
• Instructor Emily E. Bullock, Ph.D.

2
Clinical Interviewing An Overview

• Terminology
• Interviewing as information-gathering?
• Interviewing as treatment?
• Interviewing skills generally refer to core
  counseling micro-skills (e.g., open questions,
  restatement, reflection of feelings).
• Across theoretical orientations, good
  interviewing draws heavily from the
  client-centered perspective.

3
Types of Clinical Interviews

• Initial assessment interview (intake)
• Interview during treatment (e.g., suicide
  assessment)
• Assessment interview

4
Structured vs. Unstructured Interviews

• Most clinical interviews are unstructured.
• Primary advantage is flexibility
• Structured interviews have many advantages
• Standardization permits high inter-rater
  reliability and facilitates research.
• Standardization guards against interviewer bias.

5
The Role of Assessment in Treatment

• Diagnosis
• Guiding Treatment
• What type of treatment?
• Is this treatment effective?
• What to expect from this client?
• Therapeutic Assessment
• Documenting Outcomes

6
Assessment in the Counseling M.S. and Ph.D.
Programs

• Role of This Course
• Role of Supervision
• Assessment in Practicum Courses
• Practicum I
• Practicum II
• Masters Internship
• Doctoral Training

7
The Assessment Interview Importance Goals

• Importance
• Included in every assessment
• Clients first contact with agency/professional
• Often serves to match client with provider
• Goals
• Building rapport
• Gathering information
• Providing information

8
Assessment Interview Outline

• Introduction
• Introduce yourself and note your
  status/credentials
• Outline the time and goals for this meeting
• Mention that you will be taking notes
• Review Limits to confidentiality
• Opening
• Provide the client with the opportunity to
  discuss his/her problem(s)
• Use counseling micro-skills to facilitate
  communication and convey empathic understanding

9
Assessment Interview Outline

• Body
• History of presenting problem(s)
• Mental health history
• Medical history and review of physical systems
• Coping social support
• Suicidal/homicidal ideation history
• Administer the MINI
• Personal social history

10
Assessment Interview Outline

• Closing
• Summarize important themes/issues and inform
  client of the next step in the process.

11
Strategies for Effective Interviewing

• Start with open questions.
• Remember, this isnt therapy.
• Dont be afraid to direct the interview.
• Strive for a balance of information-gathering and
  rapport-building.
• Observe behavior and mood.
• Take notes.
• Use an outline and/or structured interview.

12
The MINI International Neuropsychiatric Interview

• Brief, highly structured interview of primary
  DSM-IV Axis I disorders
• Requires approximately 15 minutes
• Minimal training is necessary (for persons who
  have already had basic training in clinical
  interviewing)
• Modular structure saves time

13
Effective Interviewing with the MINI

• Make sure you preface it with a disclaimer.
• The MINI is only as good as the person using it,
  so you must be prepared to insert follow-up
  questions as needed.
• Please give me an example.
• The MINI will produce many false positives in
  settings where malingering is likely.
• May want to supplement with malingering test