Psychology: Types of Interviews

Types of Interviews

• Unstructured interviews: clinician interviews client based on a loose set of goals and questions
  • Open questions: allow and encourage client to answer in elaborate manner
  • Closed questions: Yes-or-no questions
• Semi-structured interviews: specific questions set by clinician (or treatment clinic) that allow some flexibility
• Structured diagnostic interviews: very specific format for asking questions and for determining follow-up questions
  • Examples: Structured Clinical Interview for Axis I Disorders (SCID), Structured Clinical Interview for DSM-5 (SCID-5)

Structured Clinical Interview for DSM-5 (SCID-5)

• Designed to cover DSM-5 disorders
• Administered by a clinician or trained mental health professional familiar with DSM-5 classification and diagnostic criteria
• Used to ensure major DSM-5 diagnoses are systematically evaluated
• Examples of uses: clinical intake procedures, comprehensive forensic diagnostic evaluation, selecting a study population

PHQ Depression Module

• A questionnaire used to assess depression symptoms
• Example questions: little interest or pleasure in doing things, feeling down, depressed, or hopeless, trouble falling or staying asleep, or sleeping too much

General Issues in Interviewing

• Attending skills: important components of active listening
  • Attention to body language: eye contact, leaning forward, head nods, etc.
  • Absence of verbal activity
  • Restating what the client said and checking if that was correct
  • Rephrasing/clarifying
  • Non-directional reflection of feeling
  • Summarizing
• Focus on the client: clinician does not self-disclose or convey things they are struggling with
• Respectful and non-judgmental
• Non-blaming stance
• Cultural sensitivity
  • Knowledge of self and own culture
  • Knowledge of others and differences
  • 'Cultural humility' – openness to differences (without pathologizing)

Importance of Defining the Problem

• Clients are often vague about presenting problems
• Clinician must know what is normative behavior
• Questions about the frequency, duration, and intensity of the problem
• Questions about the meaning of the problem

Importance of Defining the Goals for Treatment

• Clients often do not know what therapy can do
• Goals must be important to the client
• Goals must be expressed in terms of the ways people behave
• Goals must be small, simple, and achievable
• Goals must be in positive terms (e.g., "how would you know if therapy worked?")

Suicide Assessment

• Importance of asking direct questions
• Specific thoughts about suicide
• Past attempts
• Plans for committing suicide (obtaining means)
• Ever cut yourself intentionally?
• What are the reasons for committing suicide
• Friendship or support system in place?

Interviewing Special Populations

• Interviewing couples: importance of flexibility and interpersonal skills of the clinician
• Interviewing families: similar challenges as with couples – but with the difficulty of establishing rapport with many individuals at once
• Interviewing older adults: knowledge of life span issues without stereotyping
  • Possible concerns: declining health, loss of autonomy, bereavement, mortality
• Interviewing children and adolescents: using age-appropriate behavior and language
  • Not leading the child to an answer or response
  • Less eye contact is often helpful
  • Knowledge of current media/toys/games

Observations

• Attention to many facets of the client during the interview: e.g., client activity level, attention span, impulsivity, tone of voice, self-reflectiveness, etc.
• Direct observations: observing the client in different environments if possible (e.g., child with ADHD at school)

Self-Monitoring

• Strategy for clients to write down/log information throughout the day on a particular behavior (e.g., smoking, food intake, headache, interpersonal interaction)
• Helps decrease memory errors
• Provides additional information about context
• Reactivity: how self-monitoring can affect the behavior being evaluated

Ecological Momentary Assessment

• Gathering data about emotions, thoughts, behaviors, or experiences through the use of a smartphone, tablet, or other device that prompts the user randomly throughout the day
• Aims to minimize recall bias, maximize ecological validity, and allow study of microprocesses that influence behavior in real-world contexts