Clinical Assessment (I) : The

Assessment Interview
Aska Primardi
 Clinical assessment

• An evaluation of an individual's strengths and

weakness
• A conceptualization of the problem at hand (as well
as possible etiological factors)
• Some prescription for alleviating the problem
• Lead us to a better understanding of the client
• Assessment is not something that is done once
and then is forever finished, it's ongoing process
• Whether the clinician is making decisions or
solving problems, clinical assesssment is the
means to the end
 The Referral

• The assessment process begin with a referral

• Someone (parent, teacher, psychiatrist, judge,
psychologist) poses a question about the patient

what influences how the clinician addresses the referral

question?

answer : influenced by the clinician's theoretical

commitments (pychodynamic, behavioral, cognitive-
behavior. etc)
 The interview
The assessment interview is at once the most basic and the
most serviceable technique used by clinical psychologist

General characteristic of interviews :

1. An Interaction
2. Interviews versus tests : interviews are more purposeful and
organized than conversation but sometimes less formalized
or standardized then psychological test
3. The art of interviewing

computer-assisted interview assessment : many nonverbal

cues, only clinicians are able to apply "clinical judgment", only
clinicians can encode & process information
Interviewing essentials and techniques

• The physical arrangements

Few patients are likely to be open and responsive if
: Take place anywhere that 2 people can meet and
interact, & Privacy and protection from interruptions

• Note-Taking & recording

To recall much from the earlier interviews
 Rapport

Definition : the relationship between patient and

clinician. Rapport involves a comfortable
atmosphere and a mutual understanding of the
purpose of interview

Characteristics :
1. Patients realize that the clinician is trying to
understand their problems in order to help them
2. Patients accepts the clinician’s ultimate goal of
helping.
3. Patients recognize that the clinician is not
seeking a personal satisfaction in the interview
 Communication

1.Beginning a session
2.Language
3.The use of question
4.Silence
5.Listening
6.Gratification of self
7.Impact of the clinician
8.The clinician's values and background
 Five type of interview questions

1. Open-ended : gives patient responsibility and latitude for

responding. Ex : "would you tell me about your experiences
in the army"
2. Facilitative : encourage patient's flow of conversation. Ex:
"Can you tell me a little more about that?"
3. Clarifying : encourages clarity of amplification. Ex: "i guess
this means you felt like....?"
4. Confronting : challenges inconsistencies or contradiction. Ex
: "before, when you said....?"
5. Direct : once rapport has been established and the patient is
taking responsibility. Ex : "what did you say to your father
when he criticized your choice?"
 Varieties of interviews (1)

• The intake-admission interview

Purpose : to determine why the patient has come to the
clinic or hospital, & to judge weather the agency’s
facilities, policies, and services will meet the needs and
expectations of the patients

• The case-history interview

Purpose : to provide a board background and context in
which both the patient and the problem can be placed
 Varieties of interviews (2)
• The mental status examination interview
Purpose : to assess the presence of
cognitive, emotional, or behavioral problems

• The crisis interview

Purpose : to meet problems as they occur
and to provide an immediate resource
 Varieties of interviews (3)
• The diagnostic interview
o Consists of a standard set of questions and follow-up
probes that are asked in a specified sequence
o Clinical psychologists evaluate patients according to
DSM-IV criteria (ex : specific phobia section of the
structured clinical interview for Axis I)
o All patients or subjects are asked the same question
o Interrater reliability : two clinicians who evaluate
the same patient will arrive at the same diagnostic
formulation
 Reliability of interviews

• Interrater / interjudge reliability : index of the

degree of agreement between 2 or more raters of
judges as to the level of a trait that is present or
the presence/absence of a feature or diagnosis

• Test-retest reliability : index of the consistency of

interview scores across some period of time
 Validity of interviews (1)

• Content Validity : refers to the measure’s

comprehensiveness in assessing the variable of
interest (ex : measuring depression. Give
multiple questions assessing various emotional,
cognitive, & physiological aspects of depression)
• Predictive validity : the degree to which
interview scores can predict (correlate with)
behavior or test score that are observed or
obtained at the same point in the future
 Validity of interviews (2)

• Concurrent validity : the extent to which

interview scores are correlated with a related, but
independent, set of test/interview scores or
behaviors
• Construct validity : the extent to which interview
score are correlated with other measures or
behaviors in a logical and theoretically consistent
way.