Week 9: Assessment Interviews Flashcards
What is the single most important means of data collection which provides context for psychological evaluation?
The assessment interview
What valuable information may not be obtained outside of an assessment interview?
The uniqueness of a person
Behavioural observations
Idiosyncracies
The person’s response to their current life situation
How they respond to ambiguous or unexpected information
What can a skilled interviewer do whilst conducting an assessment interviewer?
Read between the lines
Observe body language and what is unsaid along with what is said
Tune into process, rather than only the content
What are the two main types of assessment interview?
Structured and unstructured
What are the benefits of structured/semi-structured interviews?
Better psychometric properties (validity and reliability)
Have quantifiable results
Ensures referral question is directly addressed
Less opportunities for interviewer bias
More efficient
Less reliant on interviewer experience
What are the benefits of unstructured interviews?
Better in terms of building rapport
Provide greater flexibility
Opportunities to deal with unexpected information
Can get more detail about person’s subjective experience
What are interviewers susceptible to in terms of bias
Halo effect
Confirmatory bias
What may interviewee’s do during an interviewee in terms of bias
Fake good
Fake bad
What is the halo effect in terms of interview bias
When the interviewer forms general impressions of a client and then attributes characteristics.
E.g. she has purple hair and tattoos, she must have issues with authority
What is confirmatory bias?
When the interviewer has an initial assumption that guides their interpretation of other information.
They only interpret/seek information which supports the assumption.
e.g. A client reportedly had forbidden items in her room, during the interview she doesn’t make eye contact and hesitated before answering questions, she must be untrustworthy.
What is faking good?
When a client overemphasises positive aspects of their behaviour and minimises negative aspects of behaviour.
E.g. overestimating the amount given to charity
What is faking bad?
When a client intentionally performs badly, exaggerates negative traits and emotions to come across in a particular way.
E.g. Overestimating the amount of time taken off from work
What does the reliability of an interview depend on?
The stability, dependability and consistency of results.
What does validity mean in terms of an interview?
The extent in which it accurately measures what it is supposed to measure
Without interview data, most psychological tests results are…
Meaningless
What is an intake form?
Gives personal information including relevant historical data
What are SADS and SCID used for?
Formally developed structured interviews
What were the common objectives of early interviews?
- Get a overall picture of the person.
- Conceptualize what is causing current issues
- Make a diagnosis
- Formulate a treatment plan
What is a major concern for unstructured interviews?
They lack reliability, validity and cost effectiveness
What happened during 1940s and 1950s in terms of assessment interviews?
Researchers and clinicians began conceptualizing and researching 5 critical dimensions of interviews.
What were the 5 critical dimensions of interviews?
- Content vs. process
- Goal orientation vs. expressive elements
- Level of directiveness
- Amount of structure
- Level of activity expressed by the client.
During the 1950s and 1960s, how were assessment on children primarily conducted?
Interviews with parents
Interviews with children were conducted for therapeutic reasons rather than for assessment.
What were mothers likely to report in structured interviews during 50s and 60s?
Overt behaviours which were a nuisance for adults (e.g. thumbsucking, temper tantrums)
What did a 1968 study find about interrator agreement for structured interviews for children?
That agreement was high for psychiatric issues, moderate for other overt behaviours and low for covert issues including depression and anxiety.
What did the BASIC-ID model cover in terms of assessments during the 70s?
Behaviours
Affect
Sensation
Imagery
Cognition
Interpersonal Relations
Drugs
What is a Mental Status Evaluation?
Or mental status exam.
Reviews major systems of psychiatric functioning in a brief, systematic manner.
Largely used in psychiatric settings and situations when there isn’t enough time to run psychological tests.
What were two defining features of psychology during 1990s?
Managed health care
Controversy over validity of repressed memories
What has research consistently indicated regarding client self-reports?
They are a reconstruction of events and are questionable
What method is used to measure reliability of interviews?
Interrater agreement
What helped to improve interrater agreement?
Training on interview strategies
Focusing on narrow areas
What factor creates bias in job applications?
Physical attractiveness
When are inaccuracies more likely to happen when clients are sharing information during an assessment?
Psychosocial information, such as family conflict, onset of depressive symptoms
What has been found to increase the validity of interviews?
Increase in structure of the interview
What has the highest validity in terms of interview study, based on research?
Panel interviews using consensus ratings
What factor can increase interview accuracy from the interviewee’s perspective?
Paying attention to how the interviewee reached decisions.
Focusing on their process.
Based on research, how should unstructured interviews be treated?
As hypotheses that need additional evidence to be supported
What is the primacy effect?
The tendency to remember first pieces of information and forget information provided later on.
What factors are the main reasons behind diagnostic disagreement?
Information variance
Criterion variance
What new method of interview is a way of dealing with time issues around interviews?
Computer administered interviews
What are DIS and DICA?
Instruments which can be administered by non-professionals, thus saving time and capacity.
What characteristics would be present in a client-centred interview?
Non-directive, unstructured questions
The goal is to build rapport to assist in creating change
What characteristics would be present in a behavioural interview?
Structured questions, directive
What is involved in a diagnostic interview?
Main goal is to develop a diagnosis for a client, mainly based on DSM-5.
Directive, considered criteria for different diagnoses in a psychiatric or general medical setting.
What key themes would be involved in questions in an unstructured interview?
Presenting Problem and its History
Family Background
Personal History
Miscellaneous
What despite having differing theoretical backgrounds, do most interviewers agree are essential to conducting a good interview?
Building rapport with the client
Being sincere, warm, understanding and having positive regard for the client.
What estimates did Mehrabian (1972) make in terms of nonverbal messages?
55% were dependent on facial expression
38% tone of voice
Only 7% on content
What level of notetaking is recommended during interviews?
An intermediate level
What are the key preliminary items that should be handled in the beginning or prior to an interview?
- Arrange the room appropriately
- Introductions
- Purpose of interview, process, and clarity
- How information from interview will be used
- Confidentiality
- Use of instruments or activities
- Ensure fees and payment details are understood
Which elements of the preliminary activities should be handled by the psychologist?
All but 7. Fees and payment details
What sorts of clients may benefit more from a directive, structured approach?
Clients who are withdrawn or extremely anxious
Seeing psychodynamic interviews and behavioural interviews as mutually exclusive is problematic.
Why?
Because each style can provide different types of information and compensate for the other’s weaknesses.
Using both approaches could increase interview validity and breadth.
What are benefits of open-ended questions?
Can provide significant and unsual information about a client.
Can generate hypotheses based on tone, fluency, speed, gestures, energy levels.
What are some issues around open-ended questions?
Can provide too much detail which may be vague and unrelated.
What interviewer responses are classified as intermediate in terms of levels of directiveness?
Facilitation
Clarification
Empathy
Confrontation
What is the purpose of confrontation during assessments?
Gather more indepth information about the client
What is a rough structure in terms of types of questions and responses during an assessment interview?
Open-ended questions
Intermediately structured responses (e.g. facilitation, clarification)
Closed/directive questions (to fill in the gaps)
Vary throughout the interview.
what is the basic focus of an assessment interview?
To define problem behaviour and its context
What is a helpful tool to ensure the interviewer covers off on all the important areas in an assessment interview?
A checklist
Why should you avoid ‘why’ questions during assessment interviews?
Why can lead to defensiveness or justifications.
Instead focus on how, or what.
What types of mental status exams are more widely accepted and used?
The structured and more focused examinations that focus on cognitive impairment.
What is receptive language?
How a client responds to directions or conversations
What is expressive language?
Client’s actual speech and use of language
What does orientated X3 mean in terms of a mental status exam?
This means the client is orientated in terms of who they are, where they are and what time it is.
What does sensorium mean?
How well are the client’s senses working/interacting with their surroundings?
e.g. any strange smells, hearing voices, strange sensations?
What information from the interview should be included in the final report?
Information which is supported by other material/tests and that relates to the referral question
What are the different ways of organising interview data in a report?
Around various domains
Through a coherent narrative of person’s life
Why has the reliability of structured assessment interviews varied greatly?
How specific and precise the rating or diagnosis is.
Global assessments (general presence or absence of psychopathology) have higher reliability than specific types of behaviours or syndromes
What do future studies around validity of interviews need to focus on?
Construct validity
Interaction between and implications of multiple criterion measures
What is the SCID?
Structured Clinical Interview for the DSM
What is the SADS?
A semi-structured interview tool used by professionals.
Schedule for Affective Disorders and Schizophrenia
Adult version and Child Version
What is the DIS?
A highly structured tool which nonprofessionals can use.
Diagnostic Interview Schedule.
Adult and Child Version.
What is the CFI?
DSM-5 Cultural Formulation Interview.
Why is it important to emphasise a client’s cultural strengths during an interview?
Such factors may contribute to a client’s resilience.
Culturally specific ways of coping
Participation in their culture
Extended family
What is SEWB?
Social and Emotional Wellbeing Assessment
A range of standard instruments which are used with Indigenous people to measure a culturally relevant version of mental health
What are different examples of SEWB’s?
The Aboriginal Resiliance and Recovery Questionnaire (ARRQ)
The Brief Wellbeing Screener
The Here and Now Aboriginal Assessment (HANAA)
Strong Souls: Social and Emotion Wellbeing Assessment Tool
