Chapter 6 –
Assessment:
Interviewing and
Observation
Copyright © 2014 John Wiley & Sons, Inc. All
rights reserved.
Introduction to Interviews



Interviews and observations are the most
commonly used assessment strategies
Interviews help gather information for
diagnosis, but also used to obtain
background information for caseformulation, problem-definition, and goalsetting for the intervention.
The way questions are asked can result in
yes or no answers or in more elaboration.
Copyright © 2014 John Wiley & Sons, Inc. All
rights reserved.
Interviews (cont-d)


Interviews are differ from mere
conversation; they require listening
skills, in both verbal and non-verbal
forms, conveying that the psychologist
is attentive.
Interviewing skills must be adapted
along differing clients and also
different purposes.
Copyright © 2014 John Wiley & Sons, Inc. All
rights reserved.
Types of Interviews




Interviews differ in their degree of structure,
depending on the purpose.
In unstructured interviews the questions are
open-ended; The psychologist asks the
questions but is led by the responses given
In semi-structured interviews there is some
flexibility but a pre-determined direction
Structured interviews follow a precise
directions of asking the questions
Copyright © 2014 John Wiley & Sons, Inc. All
rights reserved.
Interviewing and Ethics


Confidentiality: A cornerstone of
psychotherapy – all information must
remain private between the therapist
and client
Limits on confidentiality:
– Danger to self
– Danger to others
– Harm to children/elders
– Judge superseding confidentiality
(privledge)
Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
Type of Interviews

Unstructured interviews: Clinician
interviews the 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 in how
and what the clinician asks
Copyright © 2014 John Wiley & Sons, Inc. All
rights reserved.
Type of Interviews

Structured diagnostic interviews:
Very specific format for asking
questions and for determining follow up
questions
– Structured Clinical Interview for Axis
I Disorders (SCID): Designed to cover
DSM disorders
SCID-I: More comprehensive – covers all DSM
disrders
 SCID-CV: Only most common disorders

Copyright © 2014 John Wiley & Sons, Inc. All
rights reserved.
Type of Interviews

Structured diagnostic interviews
(cont):
– Anxiety Disorders Interview Schedule
(ADIS-IV): Designed to cover in more
depth DSM anxiety disorders and common
co-morbid disorders
– Primary Care Evaluation of Mental
Disorders (PRIME-MD): Brief measure
used in primary care to screen for mental
disorders (brevity makes it less reliable)
Copyright © 2014 John Wiley & Sons, Inc. All
rights reserved.
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-direction reflection of feeling
– Summarizing
Copyright © 2014 John Wiley & Sons, Inc. All
rights reserved.
General Issues in Interviewing




Focus is on the client: Clinician does not
self-disclose or convey things that 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)
Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
General Issues in Interviewing

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

E.g., Tell me what you mean by “depressed”
Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
General Issues in Interviewing

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?”)
Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
General Issues in Interviewing

Suicide assessment: Importance of
asking direct questions (for ex.)
– 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?
Copyright © 2014 John Wiley & Sons, Inc. All
rights reserved.
General Issues in Interviewing


Interviewing couples: Importance of
flexibility and interpersonal skills of the
clinician to deal with two individuals;
also importance of structuring and
directing the interview
Interviewing families: Similar challenges
as with couples – but with the difficulty
of establishing rapport with many
individuals at once
Copyright © 2014 John Wiley & Sons, Inc. All
rights reserved.
General Issues in Interviewing


Interviewing older adults: Knowledge of
life span issues without stereotyping
(possible concerns with 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
Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
Observations


Attention to many facets of the
client during the interview: E.g.,
client activity level, attention span,
impulsivity, tone of voice, selfreflectiveness, etc.
Direct observations: observing the
client in different environments if
possible (e.g., child with ADHD at
school)
Copyright © 2014 John Wiley & Sons, Inc. All
rights reserved.
Copyright © 2014 John Wiley & Sons, Inc. All rights reserved.
Observations: Self-Monitoring

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
effect the behavior being evaluated
Observations: Self-Monitoring

Ecological Momentary Assessment:
(aka experience sampling) gathering
data about emotions, thoughts,
behaviors or experiences through the
use of a smartphone, tablet, or other
device that prompts the user randomly
through the day
– Used in both research as well as
assessment and treatment
Copyright © 2014 John Wiley & Sons, Inc. All
rights reserved.