Ch. 8 - Clinical Interview Flashcards

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1
Q

T or F? No other mental health professional incorporates assessment into their work as clinical psychologists do

A

True SISTAH!

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2
Q

Clinical interviews are the most…

A

frequent assessment tool, more than any specific test, used by the bast majority of practicing clinical psychologists

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3
Q

Validity

A

measures what it claims to measure

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4
Q

Content validity

A

has content appropriate for what is being measured

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5
Q

Convergent validity

A

correlates with other techniques to measure the same thing

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6
Q

Discriminant validity

A

does not correlate with techniques that measure something else

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7
Q

Reliability

A

yield consistent, repeatable results

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8
Q

Test-retest reliability

A

yields similar results across multiple administrations at different times

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9
Q

Interrater reliability

A

yield similar results across multiple administrators

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10
Q

Internal reliability

A

consists of items that are consistent with one another

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11
Q

Clinical utility

A

improves delivery of services or client outcome

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12
Q

General skills
 (3)

A

Quieting yourself
♣ Minimize excessive internal, self-directed thoughts that detract from listening
♣ “did I ask the right question?”
Being self-aware

♣ Know how you tend to affect others interpersonally, and how others tend to relate to you
♣ You don’t know how many triggers you have, but you have to deal with it so it doesn’t interfere with client
Develop positive working relationships
♣ Can segue into psychotherapy

♣ Respectful and caring attitude is key

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13
Q

What is the primary task of the interviewer (specific behaviour)

A

Listening - consists of numerous building blocks

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14
Q

What building blocks make up listening? (5)

A

♣ Eye contact (there is an appropriate amount)
♣ Body language (face client, appear attentive, appropriate facial expressions)
♣ Vocal qualities (changing the pitch, tone and volume)
♣ Verbal tracking (repeat key words and phrases back to the client, smoothly transition from one topic to another)
♣ Referring to client by proper name

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15
Q

What is a rapport?

A

Positive, comfortable relationship between interviewer and client
How an interviewer is with clients

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16
Q

What is a technique?

A

What an interviewer does with a client

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17
Q

What are 2 technique styles?

A

♣ Nondirective: not suggesting, or having client confront, letting client sit in their own thoughts, client dictates what topics are talked about and for how long
♣ Directive: too much goal oriented counselling can almost feel like bullying, too much too fast, ask pointed questions to get the answers they need

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18
Q

What are 5 components to active listening?

A
  1. Open/close ended/leading questions
  2. Paraphrasing
  3. Summary
  4. Reflection of feelings
  5. Clarification/Exploration
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19
Q

Distinguish between open/closed ended and leading questions

A

Open (allows client to elaborate and go where the client want to go)

Closed ended (used less often than open ended)

Leading questions (Never do this, suggesting the answer to the question – especially important in investigating child abuse cases)

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20
Q

What is paraphrasing? What is a poor and good example?

A

Act as mirror – allowing client to hear in a different way what they just said, also the client can correct you if you’re wrong
♣ Poor: suggesting feelings that obviously are not there
♣ Good: accurately reading the emotions

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21
Q

What is summary?

A

Kind of paraphrasing but a lot more info – helpful in the beginning to keep track of how therapy is going. Nice for client to get that overview to see how far they’ve come and a reminder of what they’ve talking about

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22
Q

What is reflection of feelings? What is a good and bad example?

A

therapist is reflecting how the client is feeling – ex: “you seem to feel out of control”

♣ Poor: suggesting feelings that obviously are not there
♣ Good: accurately reading the emotions

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23
Q

What is clarification/exploration?

A

Going further/beyond what the client is giving you, helping the client delve further into things. If the client says something that is a bit conflicting – trying to get more information to see if it is a conflict.
ex: “so the relationship seems to be over?”

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24
Q

What are the 5 stages of the interview?

A
  1. Relationship: establish rapport (3 V’s + B)
  2. Story: Draw out stories, concerns, problems or issues
  3. Goals (client’s goals): why are we here? what does the client want at the end of this?
  4. Working: how are we going to solve this (different if suicidal)? Explore alternatives. Confront. Re-story (reframing - changing perspective in a way that is helpful)
  5. Action/Termination: (usually have something that you or your client will be doing) empowering client to go forward and act/generalize on new stories
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25
Q

What is the hierarchy of interview skills (go from bottom to top)

A
  1. Attending behavior (if you don’t have this, you have nothing)
  2. Open & closed questions (might use close ended questions if the person tends to go off on a tangent)
  3. Client observation skills (have to be able to react to the feel of the interview; you may be able to pick up on if they’re feeling down)
  4. Encouraging, paraphrasing, summarizing, reflection of feelings
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26
Q

What is attending behaviour?

A
  • Orienting toward client (leaned forward and focused on the client)
  • Encourages person to talk
  • Let’s client know you’re listening
  • Conveys empathy (think of the blink blink guy who did not convey empathy)
  • Important for rapport
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27
Q

What are the three Vs + B of attending behaviour?

A
Visual eye contact 
Vocal qualities (lower voice) 
Verbal tracking 
Body 
o	Face other squarely 
o	Head nods
o	Open posture
o	Lean toward 
o	Relaxed
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28
Q

Give a good and bad example of attending behaviour

A

Poor Example:
- Fidgeting, uninterested, relaxed posture, more interested on the room than the person

Good Example:
- Actively listening, leaned in, nodding, validating, asking questions that keep her talking, client is giving more information and more open, paraphrasing what the client said instead of asking a question to get her to elaborate and focused.

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29
Q

What are 3 ways you can use encouragers? what does it indicate to the client?

A
Verbal 
o	Word or sounds to encourage client 
o	Ex: “yeah”, “uh huh”, “go on”, “oh” 
o	Used at natural break in speech 
Non-Verbal 
o	Eye contact, smile, head nod 
Restatement 
o	Repeat 2 or more of client’s exact words 

Indicates what client is saying is important

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30
Q

What is a good and bad example of an encourager?

A

Poor Example:
- No facial expression

Good Example:
- Repeating the last word of a lot of her sentences, leaned in, nodding,

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31
Q

What is the purpose of open ended questions? (4)

A

Begin interview
Encourage elaboration (should not be talking more than the client)
Elicit specific examples
Motivate communication

32
Q

What is the purpose of closed ended questions? (4)

A

Obtain specific information
Identify parameters of problem
Narrow topic of discussion
Interrupt an over talkative client

33
Q

What is a leading question? (3)

A

Frowned upon
Questions where client is guided to answer
Usually Judgemental
Ex: “You always check with your doctor before this right

34
Q

Paraphrasing

A

Rephrase the content of client’s message

35
Q

What is the purpose of paraphrasing? (4)

A

Conveys understanding
Help client simplify, focus on crystallize what is said
Encourage elaboration
Provide a check of accuracy of your perceptions

36
Q

When should we use paraphrasing? (3)

A
  • If you have hypothesis about what’s going on
  • When client is in a conflict
  • When client presented lots of material & you are confused
37
Q

What are the steps in rephrasing? (5)

A
  • Recall message & restate covertly
  • Identify key parts
  • Select a beginning, “Sounds like…”
  • Translate key content in own words
  • Confirm accuracy of paraphrase
38
Q

What is the purpose of a summary? (6)

A
  • Tie together multiple elements
  • Identify common theme/pattern
  • Interrupt excessive rambling
  • Pace a session
  • Review progress
  • Serve as a transition when changing topics
39
Q

When should you use summary?

A

At the start and end of a session

40
Q

What are the steps in summary?

A
  • Recall key content & affect messages
  • Identify patterns or themes
  • Use appropriate sentence stem “I sense…”
  • Summarize
  • Assess effectiveness
41
Q

What is rephrasing?

A

Rephrasing the affective/emotion aspect
Reflection of feeling
o Echo client’s emotions, even if not explicitly mentioned
- Ex: “you are feeling sad about this”

42
Q

What is the purpose of reflection? (4)

A
  • Feel understood
  • Express more feelings
  • Manage feelings
  • Discriminate among various feelings
43
Q

What are the steps in reflection? (7)

A
1. Listen closely & observe behavior 
o	Watch nonverbal 
o	Verbally reflect feelings back 
2. Identify feeling category 
3. Identify intensity 
4. Match feeling and intensity of word 
5. Feedback to client 
6. Add component using the form 
o	“you feel \_\_\_\_\_ because \_\_\_\_\_” 
7. Check accuracy
44
Q

What is the purpose of exploration/clarification ? (3)

A
  • Encourage client elaboration
  • Check accuracy of what you heard
  • To clear up vague messages
45
Q

What are the steps in clarification? (3)

A
  • Identify element want elaborated
  • Use stems such as “Do you mean that” or “are you saying”
  • Follow up if necessary
46
Q

What is empathy as Carl Roger’s said?

A

Client’s world as he/she sees it and experiences it

47
Q

What is empathy defined as?

A

Experience client’s world but remain separate

48
Q

How do you convey empathy? (2)

A

o Paraphrasing

o Reflection of feeling

49
Q

What is subtractive empathy?

A

Give back less than or distorts
o “That’s not a very nice way to talk; you should consider his feelings too!”
o Slightly: “Seems like you’ve just given up on him. You don’t want to try anymore.”

50
Q

What is Basic/Interchangeable empathy?

A

Interchangeable with that client says
Accurate use of the BLS = basic empathy
Not elaborating on it – not giving anything further
o “You’re discouraged and confused, you’ve worked over your issues with hum but he doesn’t seem to understand. You don’t really care”

51
Q

What is additive Empathy?

A

Adds something beyond what the client has said
Give client something to think about, maybe reframing
o Slightly: “You’ve gone over the problem with him and again to the point that you don’t really care right now. You’ve tried hard. What does this mean to you?

52
Q

What is confrontation for?

A

For discrepancies or inconsistencies in a client’s comments

53
Q

What is confrontation?

A
  • Not a direct harsh challenge
  • Not going against the client, but with the client
  • Is a supportive challenge
54
Q

What does confrontation act as?

A

A lever for the activation of human potential

55
Q

What are 6 strategies for change?

A
  1. interpretation/reframe
  2. logical consequences
  3. self-disclosure
  4. feedback
  5. information/advice/opinion/suggestion
  6. directive
56
Q

interpretation/reframe?

A
  • Re-story, guide the client to looks at the problem from a new perspective with a new frame of reference
57
Q

logical consequences?

A

Look at the possible results of alternative actions, anticipation of rewards/punishments

58
Q

Self disclosure?

A
  • Interview shares brief story, thoughts or experiences - I, Me, My, + verb (think, feel, have experienced) be genuine and cautious
  • Kept at a minimum
  • Should be related to specifically what they needed
59
Q

feedback?

A
  • See/hear ourselves as others see/hear us, be touches as others touch us
  • Focus on strengths, be concrete & specific, lean & precise, nonjudgmental, use check-point
60
Q

Information/advice/opinion/suggestions:

A
  • Attend to client, be clear specific & concrete and use check-out
  • Should not suggest “you should meditate” it’s too broad, the more specific the more likely they will come back
61
Q

Directive

A

Involve client as co-participation in strategy
Be clear & concrete, use check out
Need to make sure that the client is buying in or else they won’t do it

62
Q

Note-taking

A

o Little consensus about note-taking

o Provide a reliable written record, but can be distracting to client and interviewer

63
Q

Audio/Visual Recordings

A

o Also provide a reliable record, but can be inhibiting to clients
Must obtain permission

64
Q

Intake Interview

A

To determine whether to “intake” the client into the agency or refer elsewhere
♣ A risk if the client was suicidal or family unit was at risk

65
Q

Diagnostic Interview

A

To provide DSM diagnosis, Structured interviews often used
♣ Minimized subjectivity, enhanced reliability
♣ Semi-structured interviews include some structure but also some flexibility or opportunities to improvise

Makes it hard to form relationship since it feels robotic

66
Q

Mental Status exam

A

o Typically used in medical settings

o To quickly assess how a client is functioning at that time

67
Q

Crisis interview

A

o Assess problem and provide immediate intervention

o Clients are often considering suicide or other harmful act

68
Q

What are 3 types of bubbles?

A

o Social distance (boss)
o Personal distance (friends)
o Intimate distance (partner)

69
Q

What are 3 static features?

A
  • Orientation
  • Posture
  • Physical contact
70
Q

What are 5 dynamic facial expressions?

A
  • Smile
  • Frown
  • Raised Eyebrow
  • Yawn
  • Sneer
71
Q

What are 3 dynamic gestures?

A
  • Regulation
  • Emphasis
  • Soothing gestures
72
Q

What can the eye convey ?

A
  • Feelings
  • Interest
    Connections
73
Q

What is paralanguage?

A
How you say it 
o	Speed
o	Tone 
o	Pitch 
Interest 
Affect
74
Q

What is silence used for? (3)

A
  • Pausing for emphasis
  • Punishment
  • Uncertainty
75
Q

What are the cultural components to an interview?

A

Appreciating the cultural context
o Knowledge of the client’s culture, as well as the interviewer’s own culture
o For behaviour described or exhibited during interview

Acknowledging cultural differences
o Wise to discuss cultural differences rather than ignore
o Sensitive inquiry about a client’s cultural experiences can be helpful