Chapter 8

The Clinical Interview

 The Clinical Interview
• Assessment is closely linked with the identity of
clinical psychologists
– No other mental health profession incorporates
assessment into their work as clinical psychologists do
• Clinical interviews are the most frequent assessment
tool
– More than any specific test
– Vast majority of practicing clinical psychologists use
interviews
 Essential Qualities of Assessment
Techniques
• All assessment techniques (including
interviews) should have adequate:
– Validity—measures what it claims to measure
– Reliability—yields consistent, repeatable results
– Clinical utility—benefits the clinician and
ultimately the client
 Validity, Reliability,
and Clinical Utility

Validity measures what it claims to measure.

Content validity has content appropriate for what is being measured.
Convergent validity correlates with other techniques that measure the same thing.
Discriminant validity does not correlate with techniques that measure something else.
Reliability yields consistent, repeatable results.
Test-retest reliability yields similar results across multiple administrations at different times.
Interrater reliability yields similar results across different administrators.
Internal reliability consists of items that are consistent with one another.
Clinical utility improves delivery of services or client outcome.
 Feedback
• Common to all kinds of psychological
assessment
• Provide results of tests or interviews
• May be face-to-face, a report, etc.
 The Interviewer
• General skills
– Quieting yourself
• Minimize excessive internal, self-directed thoughts that detract
from listening
– Being self-aware
• Know how you tend to affect others interpersonally, and how
others tend to relate to you
– Develop positive working relationships
• Can segue into psychotherapy
• Respectful and caring attitude is key
 The Interviewer (cont.)
• Specific behaviors
– Listening—the primary task of the interviewer,
consisting of numerous building blocks
• Eye contact
• Body language
• Vocal qualities
• Verbal tracking
• Referring to client by proper name
 Components of the Interview
• Rapport
– Positive, comfortable relationship between interviewer
and client
– How an interviewer is with clients
• Technique
– What an interviewer does with clients
– Directive vs. nondirective styles
 Specific Interviewer Responses
• Open-ended and closed-ended questions
– Open-ended questions
• Allow individualized and spontaneous responses from
clients
• Elicit long answers that may or may not provide
necessary info
– Closed-ended questions
• Allow less elaboration and self-expression by the client
• Yield quick and precise answers
 Specific Interviewer Responses (cont.)
• Clarification
– Question to make sure the interviewer accurately
understands the client’s comments
• Confrontation
– For discrepancies or inconsistencies in a client’s comments
• Paraphrasing
– Restatement of client’s comments to show they have been
heard
 Specific Interviewer Responses (cont.)
• Reflection of feeling
– Echo client’s emotions, even if not explicitly mentioned
• Summarizing
– Tie together various topics, connect statements that may
have been made at different points, and identify themes
 Pragmatics of the Interview
• Note-taking
– Little consensus about note-taking
– Provide a reliable written record, but can be distracting to
client and interviewer
• Audio- and Video-recording
– Also provide a reliable record, but can be inhibiting to
clients
– Must obtain permission
 Pragmatics of the Interview (cont.)
• The Interview Room
– Professional yet comfortable
• Confidentiality
– Explain confidentiality and its limits to clients (e.g.,
child abuse, intention to harm)
 Types of Interviews
• Intake interviews
– To determine whether to “intake” the client into the
agency or refer elsewhere
 Types of Interviews (cont.)
• Diagnostic interviews
– To provide DSM diagnosis
– Structured interviews often used
• Minimize subjectivity, enhance reliability
• SCID is an example
– Currently being revised for DSM-5
• Semi-structured interviews include some structure but
also some flexibility or opportunities to improvise
 Types of Interviews (cont.)
• Mental status exam
– Typically used in medical settings
– To quickly assess how a client is functioning at that
time
• Crisis interviews
– Assess problem and provide immediate
intervention
– Clients are often considering suicide or other
harmful act
 Cultural Components
• Appreciating the cultural context
– Knowledge of the client’s culture, as well as the
interviewer’s own culture
– For behavior described or exhibited during interview
• Acknowledging cultural differences
– Wise to discuss cultural differences rather than ignore
– Sensitive inquiry about a client’s cultural experiences can
be helpful