PSYC 4375: Interviews and Observations

• PSYC 4375 covers interviews and observations, presented by Stephen Rochefort.

Objectives

• Ethical issues like confidentiality are key
• Unstructured and semi-structured interviews are important
• Important to be aware of general issues in interviews
• Observations are key to the process
• Self-monitoring is crucial

Interviews

• Interviews provide a critical understanding of the client's problems, history, and context
• Effective interviews build trust and rapport for honest self-disclosure
• Interviews gather comprehensive information on symptoms, history, and functioning
• Interview info guides the selection of further assessment tools and strategies
• Interviews provide the context to interpret test results and understand the client's unique situation
• Psychologists use interviews to formulate initial hypotheses about the client's condition

Interviewer Skills

• General skills, quieting yourself enables focus on the client
• Being self-aware: knowing how you affect and relate to others
• Develop positive working relationships through attentive listening, empathy, respect, and cultural competence
• Listening is primary, building on attending behaviors

Attending

• Attending behaviors are the building blocks of attentive listening
• Eye contact facilitates and communicates listening
• Body language rules during client interactions, including appearing attentive and minimizing restlessness
• Vocal qualities such as pitch, tone, and volume will be observed by the client
• Verbal tracking focuses on the client's train of thought, enabling smooth topic shifts
• It is import to address clients by their preferred name

Rapport

• Rapport: cultivate a positive, comfortable interviewer-client relationship
• Enhance rapport by putting the client at ease early, acknowledging the clinical interview's unique nature
• Pay attention to client's language and follow their lead

Technique

• Technique: questions, responses, and actions used with clients
• Directive interviews are useful for obtaining specific historical information, presence/absence of specific symptoms, frequency of behaviors, and durations of problems
• Nondirective interviews let the client guide the discussion with the interviewer expanding on essential information
• Directive interviews sacrifice rapport and nondirective interviews gather less data
• The best strategy is a balance of both

Interview Responses: The Interviewer

• Open questions: enables elaborate responses, cannot be answered with yes/no
• Closed questions: these can be answered with a single word
• Clarification: ensures the interviewer accurately understands
• Confrontation: similar to clarification, focuses on contradictory client information
• Reflection of feeling: echoes the client's emotions to provide validation
• Summarizing: ties together various information into themes
• Conclusion: provides a summation

Ethical Considerations: Confidentiality

• Confidentiality: psychologists have an ethical and legal duty to protect clients' private information
• Limits of confidentiality: confidentiality is broken by disclosing client information to another person or agency
• Confidentiality can be broken if there is risk of harm to self or others, abuse/neglect of vulnerable people
• Confidentiality can also be broken due to legal requirements or client consent

Types Of Interviews

• Intake interviews: decides if treatment is needed and finds a suitable treatment or facility
• Diagnostic interviews: assigns diagnoses and recommends treatments
• Mental status exam: a snapshot of the client's functioning
• Crisis interview: to address problems demanding immediate attention

Clinical Assessment vs Therapy Inerviews

• Clinical assessment similarities include relationship building, respect, trust, gathering, verbal/nonverbal communication, providing structure, clients ask questions
• Assessment objectives include obtaining information to create diagnoses, developing case formulations, and determining treatment options
• Therapy goals guide behavioral, cognitive, and emotional change

Differences Between Clinical and Social Interviews

• Social: It can take place anywhere. It may be overheard. Their durations vary
• Clinical: It usually takes place in an office. It is private, lasting around 50mins to 1hr.
• Social: Details may be repeated in other conversations, and purpose is relationship maintenance -Clinical: It is confidential, gathers information and to establish a collaborative relationship.
• Social: It is free flowing, they are reciprocal, each person makes comments when an opening is available, and avoids painful topics.
• Clinical: it is goal directed, focused on the client, redirection happens, persistent questioning and clinicians raise painful topics.
• Social: The interview are not usually documented. There is no notes typically

Interviews: Structured, Unstructured and Diagnostic

• Unstructured Interview: conversation free form questions
• Advantage: The interviews are flexible and allows for in-depth explorations
• Disadvantage: key information is missed and hard to compare across
• Semi Structured Interview: Combination of predetermined questions to follow
• Advantages Covers the essential areas as well as allow for exploration
• Disadvantage: requires skill to maintain the unstructured elements
• Structured Interviews: Strictly adheres to questions in an order predetermined.
• Advantages: It covers topics with greater depth and accuracy
• Diagnostic interview: targets and diagnoses mental disorder and includes tools like DSM-5 and ICD-10

Features of Diagnostic Interviews

• Structured Clinical Interview for DSM-5 (SCID-5) has a broad coverage, takes 60 minutes to administer, and has alignment with DSM-5
• Anxiety Disorders Interview Schedule for DSM-5 (ADIS-5) has a medium coverage, takes 45-60 minutes to administer, and has alignment with DSM-5
• SCID-5 Personality Disorders (SCID-5-PD) has a medium coverage, takes 30-120 minutes to administer, and aligns well with DSM-5

General Issues

• Non-directive Listening Responses: Eye Contact, leaning forward etc enhance conversation with clients.
• Silence: Allows pressure to client to respond and considers the best response
• Paraphrasing: assure's the client the interviewer is listening.
• Clarification: Verifies the clarification made
• All these practices enhances the client.

General Issues:

• Assess interviews are critical for interviews to get demographic, development, childhood/adolescent educational, employment, all the hx of the client

Culture

• The text speaks of cultural norms and cultural sensitivity during interviewing. Areas like Respect, Authority, interpersonal distance, direct and indirect forms of communication

Interviewing:

• General Issues are about Language Differences. Language differences can affect the accuracy of what has been excahnged.

Defining problems

• Defining goals involve clients coming to doctors. To clarify, psychologist may ask a series of questions about the issue as how it arise, how and where what the meaning is etc.

Note Taking

There is little consensus among note taking among clinicians,

• Pros: More reliable, client is more heard.
• Cons Disctrations from both interviewer and client.

Recording Interviews

• Recording audio or video requires consent from the client, can hinder the client's willingness to disclose, used to explain rationale.

Interview Room and Telepsychology

• Interview Room: Strike between formality and casual comfort
• The tool should facilitate purpose and is well serve as it helps with the goals of the interview
• Telepsychology are clinical interviews facilitated with access to necessary technology. Non verbal conversations are limited. There ethics obligations and technical skills. Risk of videoconference fatigue and self care helps

Clinical Observation Skills

• Interviewing is observing
• Appearance: Grooming, clothing, hygiene, and physical condition.
• Motor Behaviour: Movement, coordination, restlessness.
• Speech: Rate, volume, fluency, coherence, and tone.
• Eye Contact: Frequency, duration.
• Posture and Body Language: Openness, defensiveness, relaxation, and tension.
• Behavioural indicators: Level of anxiety.
• Interaction and Personality: How the clients trust etc.
• Data and direct observations from clinical assessments are important

Direct Observations

• Remember that behaviour in an office setting and in clinic may not mean thats how the client behaves in person.
• Observations takes practice and is best done in the clinic at School as well as at Home.

Considerations

• Its best to be aware on types of behavior what occue frequently for setting up proper observations.
• Consider factor that lead to innacurate and invalid observations in these settings

Self monitoring

• Strategies to manage emotions or feelings or thoughts in an individual. They are designed a behaviour logging, mood tracking, symptoms log, sleep, and or execice routines.

Self monitoring

• There a several changes with clients not recording behavior and thought leading to incomplete biased data. The process can cause people to focus alot on the negative side effects and changes do occure.

Suicide Assessment

• Assessment: The thoughts, plans intentions, and past attempts and past accidents
• Risk factors and protective factors are crucial for determining the individual skills, strengths.
• Immediate safety plan is essential, including identifying coping startegies, emergency contacts, and removing any means of harm.
• Clinicians must navigate obligations in law as well

Question for Suicide Risk

• Assess the client with questions about their plans, method and means in a professional manner without expressing immediate shock and care

Interviewing Couples and Families

• Couples: couples can take a toll on you so take things with precaution as things with emotions is key. Ensure fairness. Keep the trust between the people.
• Families: The family needs to have confidentiality. And fairness

Interviewing Older and Younger Adults

• Older adults: There may be loss of hearing, cognitive decline, or lack of memory. Its best to build trust.
• Younger adults: Understand youth are easily influenced and manipulated so its key you focus to avoid that.

Helpful tips for interviewing youth

• Youth-friendly environment will make them more comfortable
• A supportive environment
• Building trust and rapport quickly
• Ground rules must happen ahead of time
• Avoid all suggestions
• Close by thanking the youth and having them ask questions
• Avoid certain words to avoid giving the youth the idea
• Do not criticize, offer praise because the youth will always look for the right answer.