A clinical interview is called a face-to-face conversation with a purpose or goal. The clinical interviews are foundational to psychological treatment. These involve a professional relationship between a mental health provider and a client. The clinical interview includes an informed consent process. Its primary goals include initiating a therapeutic alliance, collecting assessment or diagnostic data, formulating the case, and implementing a psychological intervention.
Defining Characteristics of Clinical Interviews
The first is the different social roles of the two participants; the psychologist is in the role of a professional. A second distinction is the setting in which clinical interviews are conducted. The third one is in the flow of information. The skilled clinician can maintain a natural flow to the conversation. And, the fourth defining property of a clinical interview is that it has an objective or purpose
Techniques For Conducting Clinical Interviews
Clinicians must use the following effective techniques to meet the needs and goals of the interview:
Communication Strategies
Listening Skills
Communication strategies: Crucial for Psychological Interviews
Communication skills involve verbal and non-verbal strategies.
Verbal strategies. It is important to communicate in a manner that clients can understand. Clinicians ask some questions so that the client can provide a full range of answers. A skilled interviewer uses a combination of open and closed-ended questions.
Open-ended questions. Interviewers mostly use these questions during an initial interview. Open-ended questions typically start with words like what, how, where, etc. For example, an interviewer might ask, ‘Tell me about your relationship with your parents
Closed-ended questions. Closed questions help to narrow the topic area of discussion. These types of questions are useful in gathering specific information. Hence, excessive use of this method is regressive and stifles true communication.
Nonverbal strategies. Skilled clinicians read a client’s nonverbal behavior for clues about the client’s emotions, attitudes, and behavior. For example, the client who never makes eye contact with the clinician may be anxious and depressed. However, the clinician needs to take into consideration the client’s cultural background, for example, in some cultures, avoiding eye contact is a sign of respect.
SOLER. The acronym SOLER is a mnemonic device for recalling these skills. The ‘S’ stands for squarely facing the client. ‘O means open posture. ‘L’ is for lean towards the client. ‘E’ is for eye contact. ‘R’ stands for relax. A relaxed clinician helps the client to relax and open up in the interview.
Listening skills: A major component for effective clinical interviewing
Effective interviewing requires effective listening. When listening is an active process, the listener gains more information. Clinicians use the term ‘active listening’ to describe strategies that facilitate communication with clients by following four basic listening responses, which contribute to effective and active listening in clinical interviewing.
Clarification
Paraphrasing
Reflection
Summarization
Clarification. It refers to questioning that helps the clinician understand an ambiguous message. It encourages the client to elaborate.
Paraphrasing. It involves responding to the content of the client’s message.
Reflection. It is a rephrasing of the effective part of the client’s message. It includes responding to the client’s feelings.
Summarization. Two or more paraphrases or reflections that condense the client’s message. It helps in identifying a common theme or reviewing progress.
Types of Clinical Psychological Interviews
Types of clinical interviews are as follows:
Unstructured clinical interviews
In an unstructured interview, clinicians mostly ask open-ended questions. This flexible approach lets interviewers follow leads and explore relevant topics they couldn’t anticipate before the interview. However, unstructured interviews typically appeal to psychodynamic and humanistic clinicians
Structured interviews
In this type of interview, clinicians ask for specific information. Mostly, they use a standard set of questions designed for interviews. Structured interviews improve diagnostic reliability by standardizing the interview process. Structured interviews have advantages over unstructured interviews. Research studies suggest that rapport is not strongly affected by structured interviewing.
Other common types of clinical interviews are as follows:
Intake interview
The first meeting between a psychologist and a client is an intake interview. The main goal of this interview is to determine the nature of the client’s problem. The second purpose is to determine whether the psychologist, or the agency where he or she works, has the resources and competencies to help the individual.
Brief screening interviews
This type of interview is distinguished by its time-limited and focused, structured design to ask a specific question. For example, is the patient suicidal, or does the patient need to be hospitalized, etc?
Case history interviews
A case history is also called a psychosocial history. It is a detailed explanation of a client’s background. It helps the clinicians to understand how the current problems fit in the broader context of the client’s life
Typical information that is gathered in a case history interview includes:
Birth and development
Family of origin
Education
Employment
Recreation
Sexual history
Dating and marital
Alcohol and drugs
Physical health
Diagnostic interviews
The purpose of the diagnostic interview is to elicit the information necessary to arrive at a diagnostic formulation. In these types of interviews, a psychologist observes the client’s behavior, asks about his/her symptoms in detail, and collects personal and family history.
Steps of diagnostic interview. Othmer and Othmer (1994) propose five steps in diagnostic interviewing. In the first step, clinician looks for diagnostic clues in the client’s chief complaint. In the next step, the psychologist inquires about specific diagnostic criteria. And, in the third one, the clinician gets the psychiatric history. Here, a history of the disorder is gathered. The fourth step is diagnosis. The fifth step in the diagnostic process is to arrive at a prognosis for the client.
Crisis interviews
The purpose of the crisis interview is to resolve the problems immediately so that a catastrophic outcome is avoided. For some individuals, one or two interviews with a skilled clinician will resolve the crisis. For others, a crisis interview is the first step toward developing permanent solutions to long-standing problems. In crisis interviewing, the clinicians try to provide reassurance, assess the problems, and explore potential resources with the projection of a calm and confident manner.
Motivational interviews
Motivational interviewing is a set of techniques designed to help people recognize how their behavior creates problems for them and others. These types of interviews motivate them to do something about it. The strategies of motivational interviewing are more persuasive than coercive and more supportive than argumentative. There are five general principles of motivational interviewing.
The principles of motivational interviewing are as follows:
Express empathy
Develop discrepancy
Avoid argumentation
Roll with resistance
Support self-efficacy
Threats to Effective Psychological Interviewing
Some factors that may contribute as threats in clinical interviews and influence the results of the clinical interviews are bias, reliability and validity, and behavioral observations.
Biasness
Interviewers may be biased. Clinicians should keep in mind that every person is unique. We can’t be biased upon are personal judgment and personal personality orientation. Interviewers should not be biased in the appropriate assessment
Behavioral observations
Behavioral observations are another factor that influences the results of a clinical interview. Such as Seeing is believing. Psychologists or interviewers observe to identify the problems. A psychologist should carefully analyze his or her observations for an accurate assessment. Hence, behavioral observations give a lot of information, but this process also has some drawbacks. A clinical interview relies on much self-report information that may or may not be correct. People may minimize the intensity of the stress they are experiencing. Behavioral observation includes the selection of target behaviors. Moreover, it often becomes difficult to isolate the target behavior. Additionally, interviews are held in structured places. So, observing in a participant’s naturalistic environment is a more accurate method for collecting the appropriate information.
Conclusion
Whatever the types of clinical interviews, they are all helpful in gathering information regarding the client/their problems. Interviews contribute a lot to assessing the client. Their reliability and validity somehow improved by considering some important factors like effective communication skills, by considering the uniqueness of the client, and taking into account the cultural and ethical factors of the clients. Without clinical interviews, it is difficult to know about the parameters of the client’s problem. So, interviewers should conduct interviews appropriately to accurately assess and achieve the goal of effective intervention.”
