Dhuff Mattheus V.

Ortiz Saturday (8:00 AM- 6:00PM)

Clinical Psychology Dr. Hector Perez

WRITTEN REPORT: CLINICAL INTERVIEW

I. Reliability, Validity, and Clinical Utility
a. Reliability-the extent that it yields consistent, repeatable results. If its results
depend on when, where, or how the technique was administered, its reliability
might be questionable.
i. Test retest reliability
ii. Interrater reliability
iii. Split-half reliability
b. Validity-the extent that it measures what it claims to measure
i. Content Validity
ii. Convergent Validity
iii. Discriminant Validity
c. Clinical Utility- Usefulness of the test to the psychologist
II. General Skills of an Interviewer
a. Quieting yourself-does not simply mean that the interviewer should not talk
much during the interview (although rambling by the interviewer is usually not
a good idea). Rather than the interviewer’s speech, what should be quieted is
the interviewer’s internal, self-directed thinking pattern
b. Being self-aware-is another important skill for the clinical interviewer. This self
awareness should not be confused with the excessive self-consciousness. The
type of self-awareness that should be maximized is the interviewer’s ability to
know how he or she tends- to affect others interpersonally and how others
tend to relate to him or her
c. Developing positive working relationships in many clinical settings, an
interview client is likely to become a psychotherapy client, so a good start to
the working relationship benefits both parties
III. Specific behaviors
a. Listening may seem like a simple enough task, but it can be broken down into
even more fundamental building blocks of attending behaviors (many
described in Ivey, Ivey, & Zalaquett, 2010).
i. Eye contact. Perhaps it’s an obvious point, but interviewers must
realize the connection between attentive listening and eye contact.
Eye contact not only facilitates listening, it also communicates
listening
ii. Body language. As with eye contact, culture can shape the
connotations of body language. There are a few general rules for
the interviewer: face the client, appear attentive, minimize
restlessness, display appropriate facial expressions, and so on
iii. Vocal qualities. Skilled interviewers have mastered the subtleties
of the vocal qualities of language—not just the words but how those
words sound to the client’s ears. They use pitch, tone, volume, and
Dhuff Mattheus V. Ortiz Saturday (8:00 AM- 6:00PM)
Clinical Psychology Dr. Hector Perez
fluctuation in their own voices to let clients know that their words
and feelings are being deeply appreciated.
iv. Verbal tracking. Effective interviewers are able to repeat key
words and phrases back to their clients to ensure the clients that
they have been accurately heard. Interviewers don’t do this in a
mechanical way; instead, they weave the clients’ language into
their own.
v. Referring to the client by the proper name. It sounds simple
enough, but using the client’s name correctly is essential (Fontes,
2008). Inappropriately using nicknames or shortening names (e.g.,
calling Benjamin “Benji”), omitting a “middle” name that is in fact an
essential part of the first name (e.g., calling John Paul “John”), or
addressing a client by first name rather than a title followed by
surname (e.g., addressing Ms. Washington as “Latrice”) are
presumptuous mistakes that can jeopardize the client’s sense of
comfort with the interviewee
IV. Cultural Issues during Interview
a. Compared with traditional Western culture, Chinese culture tends to
feature far less eye contact, especially between members of the opposite
sex. Eye contact that falls within the normal range among Western
individuals may communicate rudeness or sexual desire among Chinese
people
b. Norms for physical touch also differ from one culture to another, with
Asian cultures typically incorporating less than European Americans.
Thus, a touch on the shoulder, intended and received as innocuous from
one European American to another, might be received as inappropriate by
an Asian individual
c. Individuals of Middle East and Latino/Latina cultures tend to stand or sit
closer together, whereas North American and British people tend to
maintain more space between themselves. Tendencies such as these
represent essential knowledge for the culturally competent interviewer
V. Components of the Interview
a. Rapport refers to a positive, comfortable relationship between interviewer
and client. When clients feel a strong sense of rapport with interviewers,
they feel that the interviewers have “connected” with them and that the
interviewers empathize with their issues.

However, there are some specific efforts interviewers can make to

enhance the client’s experience of rapport:

i. First, interviewers should make an effort to put the client at ease,

especially early in the interview session
Dhuff Mattheus V. Ortiz Saturday (8:00 AM- 6:00PM)
Clinical Psychology Dr. Hector Perez
ii. Second, interviewers can acknowledge the unique, unusual
situation of the clinical interview
iii. Third, interviewers can enhance rapport by noticing how the client
uses language and then following the client’s lead. Interviewers
should pick up on the client’s vocabulary and, as much as possible,
speak in similar terms (Othmer & Othmer, 1994).
b. Technique-is what an interviewer does with clients. These are the tools in
the interviewer’s toolbox, including questions, responses, and other
specific action
i. Questions:
1. Directive style get exactly the information they need by
asking clients specifically for it. Directive questions tend to
be targeted toward specific pieces of information, and client
responses are typically brief, sometimes as short as a single
word (e.g., “yes” or “no”).
2. Nondirective style allow the client to determine the course
of the interview. Without direction from the interviewer, a
client may choose to spend a lot of time on some topics and
none on others

****Certainly, both directive and nondirective approaches

play an important role in interviewing. Direct questioning can
provide crucial data that clients may not otherwise choose to
discuss. Indirect questioning, conversely, can provide crucial
information that interviewers may not otherwise know to
inquire about****

******Both directive and nondirective approaches have

shortcomings as well, especially when an interviewer relies
too heavily on either one. Sometimes, directive approaches
can sacrifice rapport in favor of information. In other words,
interviewers who are overly directive may leave clients
feeling as though they didn’t have a chance to express
themselves or explain what they thought was important.
Although nondirective interviewing can facilitate rapport, , it
can fall short in terms of gathering specific information.
Interviewers who are overly nondirective may finish an
interview without specific data that is necessary for a valid
diagnosis, conceptualization, or recommendation.*****
i. Responses:
1. Open-ended questions allow for individualized and
spontaneous responses from clients. These responses tend
to be relatively long, and although they may include a lot of
Dhuff Mattheus V. Ortiz Saturday (8:00 AM- 6:00PM)
Clinical Psychology Dr. Hector Perez
information relevant to the client, they may lack details that
are important to the clinical psychologist
2. Closed-ended questions allow for far less elaboration and
self-expression by the client but yield quick and precise
answers. Indeed, open-ended questions are the building
blocks of the nondirective interviewing style described
above, whereas the directive interviewing style typically
consists of closed-ended questions
3. Clarification The purpose of a clarification question is to
make sure the interviewer has an accurate understanding of
the client’s comments. Clarification questions not only
enhance the interviewer’s ability to “get it,” they also
communicate to the client that the interviewer is actively
listening and processing what the client says
4. Interviewers use confrontation when they notice
discrepancies or inconsistencies in a client’s comments.
Confrontations can be similar to clarifications, but they focus
on apparently contradictory information provided by clients
5. Paraphrasing is used simply to ensure clients that they are
being accurately heard. When interviewers paraphrase, they
typically restate the content of clients’ comments, using
similar language
6. Reflection of feeling echoes the client’s emotions.
Reflections of feeling are intended to make clients feel that
their emotions are recognized, even if their comments did
not explicitly include labels of their feelings
7. Summarizing usually involves tying together various topics
that may have been discussed, connecting statements that
may have been made at different points, and identifying
themes that have recurred during the interview.
8. The conclusion can take a number of different forms,
depending on the type of interview, the client’s problem, the
setting, or other factors. In some cases, the conclusion can
be essentially similar to a summarization
VI. Pragmatics of the Interview
a. Note Taking - are certainly more reliable than the interviewer’s memory.
Many clients will expect the interviewer to take notes and may feel as
though their words will soon be forgotten if the interviewer is not taking
notes
b. Audio or video recording - Unlike note taking, recording a client’s
interview requires that the interviewer obtain written permission from the
client. While obviously providing a full record of the entire session,
Dhuff Mattheus V. Ortiz Saturday (8:00 AM- 6:00PM)
Clinical Psychology Dr. Hector Perez
recordings can, with some clients, hinder openness and willingness to
disclose information
******As with note taking, an explanation of the rationale for the recording, as
well as its intended use (e.g., review by the interviewer or a supervisor) and a
date by which it will be erased or destroyed, is typically appreciated by the client

c. Interview Room - when choosing a room [for interviews], it is useful to

strike a balance between professional formality and casual comfort”
(Sommers-Flanagan & Sommers-Flanagan, 2009, p. 31
d. Confidentiality - Many people incorrectly assume that any session with a
psychologist is absolutely confidential (Miller & Thelen, 1986), when in fact
there are some situations that require the psychologist to break
confidentiality
VII. Types of Interviews
a. intake interview is essentially to determine whether to “intake” the client
to the setting where the interview is taking place. In other words, the
intake interview determines whether the client needs treatment; if so, what
form of treatment is needed (inpatient, outpatient, specialized provider,
etc.); and whether the current facility can provide that treatment or the
client should be referred to a more suitable facility.
b. diagnostic interview purpose is to diagnose. At the end of a well-
conducted diagnostic interview, the interviewer is able to confidently and
accurately assign Diagnostic and Statistical Manual of Mental Disorders
(DSM) diagnoses to the client’s problems. When an interview yields a
valid, specific diagnosis, the effectiveness of the recommendations and
subsequent treatment may be increased
i. A structured interview is a predetermined, planned sequence of
questions that an interviewer asks a client. Structured interviews
are constructed for particular purposes, usually diagnostic
1. Advantages of Structured Interview
a. Structured interviews produce a diagnosis based
explicitly on DSM criteria,
b. Structured interviews tend to be highly reliable,
c. Structured interviews are standardized and typically
uncomplicated in terms of administration
2. Disadvantages of Structured Interview
a. The format of structured interviews is usually rigid,
which can inhibit rapport and the client’s opportunity
to elaborate or explain as he or she wishes
b. Structured interviews typically don’t allow for inquiries
into important topics that may not be directly related
to DSM criteria
Dhuff Mattheus V. Ortiz Saturday (8:00 AM- 6:00PM)
Clinical Psychology Dr. Hector Perez
c. Structured interviews often require a more
comprehensive list of questions than is clinically
necessary, which lengthens the interview.

ii. Unstructured interview, in contrast, involves no predetermined or

planned questions. In unstructured interviews, interviewers
improvise: They determine their questions on the spot, seeking
information that they decide is relevant during the course of the
interview (Maruish, 2008)

c. Crisis Interview They are designed not only to assess a problem

demanding urgent attention (most often, clients actively considering
suicide or another act of harm toward self or others) but also to provide
immediate and effective intervention for that problem. Quickly establishing
rapport and expressing empathy for a client in crisis, especially a suicidal client,
are key components of the interview

Suicide prevention contracts. These contracts essentially require

the client to contact the interviewer before committing any act of
self-harm
1. When interviewing an actively suicidal person, five specific
issues should be assessed
a. How depressed is the client?
b. Does the client have suicidal thoughts?
c. Does the client have a suicide plan?
d. How much self-control does the client currently
appear to have?
e. Does the client have definite suicidal intentions?
VIII. Acknowledging Cultural Differences
When cultural differences exist between interviewer and client—which happens
quite frequently, especially if we define culture by ethnicity, gender, religion, age,
or a number of other variables—it is often wise for the interviewer to openly
acknowledge these differences. Open, respectful discussion of cultural variables
can enhance rapport, increase the client’s willingness to share information, and
help the interviewer gain a more accurate understanding of the client’s issues
Dhuff Mattheus V. Ortiz Saturday (8:00 AM- 6:00PM)
Clinical Psychology Dr. Hector Perez