Chapter 4: Interviewing & Observing Flashcards
Interview
Conversation with a purpose or goal
Useful in Clinical Situations
Easy means of communicating; convenient context for attempting to help them; inexpensive’ provide the clinician with simultaneous samples of clients’ veral and nonverbal behavior
Intake Interviews
Designed maily to establish the nature of the problem; used to develop broader descriptions of clients and the environmental context in which their behavior occurs; lays the groundwork for subsequent therapy efforts by establishing a productive working relationship and organizing the clinician’s hypotheses about origins and development of the client’s problems
Mental Status Examination (MSE)
Planned sequence of questions designed to assess a client’s basic mental functioning in a number of important areas; analogous to the physical examination that makes up part of the assessment of medical problems
Problem-Referral Interviews
Interviews conducted after a client is referred in order to answer a specific question; central goal is to address the referral question
Orientation Interviews
Special interviews to acquaint the client with the assessment, treatment, or research procedures to come
Termination Interview
Interview that occurs when it is time to terminate the clinical relationship; can help alleviate clients’ anxiety about the assessment enterprise by explaining the procedures and protections involved in transmission of privileged information and by providing a summary and interpretation of the assessment results
Debriefings
Terminations following clinical research
Crisis Interviews
Attempt to provide suppport, collect assessment data, and provide help, all in a very short time; ask relevant questions;
Nondirective Interviews
Uses direct questions sparingly and relies instead on responses designed to facilitate the client’s talking about his or her concerns
Semi-structured Interviews
An organized set of topics is explored in a way that gives the interviewer flexibility in wording questions, interpreting answers, and guiding decisions about what to address next
Structured Interviews
Do not outlaw open-ended questions or prohibit interviewers from formulating their own questions to clarify ambiguous responses, they do provide detailed rules (decision trees or branching rules) that tell the interviewer what to do in certain situations
Sources of Error in Clinical Interviewing
Patient Variance
Information Variance
Criterion Variance
Patient Variance
Occurs when the same patient provides different answers or displays different behaviors in response to the same questions asked by different clinicians
Information Variance
Refers to differences in the way clinicians ask questions or make observations
Criterion Variance
Refers to disagreements that occur if clinicians apply different standards of judgment to the same set of client responses
Stages in the Interview
Beginning the Interview
The Middle of the Interview
Closing the Interview
Important things to Consider
The Setting needs to be comfortalbe, private, and can aid rapport
The Opening - Important because clients may not be ready to talk candidly about personal matters
Frame Setting & Transition - Explain to the client the basic ground rules for theinteraction
Frame Setting
Frame refers to the norms and expectations that surround an interview, consultation, or therapy session; clarifies time boundaries for the interview session, expresses expectation about what will be covered and what basic roles participants will take, and briefly introduces the idea of a structure; provides assurances of confidentiality as well as its limits and conveys information about the interviewer’s commitment
Active listening
Involves responding to the client’s speech in ways that indicate understanding and encourage further elaboration
Paraphrasing
Clinicians restate what their clients say in order to show they are listening closely and give the clients a chance to correct the remark if it was misinterpreted
Reflection
Highlighting the client feelings
Repeated Scanning & Focusing
Interviewers first scan a topic nondirectively, then focus on it in more directive fashion
Closing the Interview
Provide valuable assessment data and opportunity to enhance rapport; Accomplish (1) impending conclusion of the interview is signaled (frame setting) (2) client is praised for cooperativeness and reassured that the clinician recognized how stressful the interview was (emotional support) (3) The suggested plan for the final minutes invites the client to ask questions or make comments that may be important but not had not been put into words
Communication in the Interview
Fundamental objective is to encode, transmit, and decode messages accurately;
Nonverbal Communication
Remains open even when the verbal channel shuts down; clinicians must be sensitive not only to incoming signals but also to those they transmit; must be coordinated with verbal behavior;
Channels of Nonverbal Communications
Physical Appearance Movements Posture Eye Contact Facial Expressions Emotional Arousal Speech Variables
Carl Rogers
Publish first transcripts from phonographic recordings of therapy interviews
Reliability of Interview Data
Examined the consistency of clients’ responses across repeated interview occasions; measures test-retest reliability; Degree to which different judges agree on the inferences (ratings, diagnoses, or personality trait descriptions) measures interrater reliability
Useful Research Strategy for Interview Data
Have several clinicians view videotaped interviews and then make ratings or draw other inferences from the tapes;
Test-Retest Reliability of Interviews
Tends to be highest when the interval between interviews is short and when adult clients are asked for innocuous information such as age and other demographic data
Validity of Interviews
Established by including all of the relevant aspects of a target domain (content validity), b comparing interview results with other valid measures of the same concept (concurrent validity), or by an interview’s ability to predict expected future outcomes (predictive validity)
External Criterion
Gold standard; used as the standard against which interview conclusions are measured
Convergent Validity
When instruments correlate with several conceptually similar indices
Discriminant Validity
When instruments are uncorrelated with measures of conceptually different phenomena
Probability of Error or Distortion
Increases when clients are mentally retarded, suffer from various brain disorders, or would prefer not to reveal the truth about their behavior problems, drug use, sexual behavior, criminal activity, or previous hospitalizations
Impression Management
The desire to present oneself in a particular light to a mental health professional
Observational Data
likely to provide more valid information in special situations;
Observational Methods
Defined as the selection, provocation, recording, and encoding of behaviors;
Naturalistic Observations
Hospital and Clinic Observations School Observations Home Observations Self-Observation Observation by Insiders
Controlled Observation (Analog Behavior Observation, Situation tests, and Contrived Observation)
Set up special circumstances under which clients can be observed as they react to planned, standardized events
Types of Controlled Observation
Performance Measures Role-Playing Tests Physiological Neaures Virtual Reality Assessment Behavioral Avoidance Tests
Factors Important to Interrater reliability
Task complexity
Rater Training
