Chapter 6: Assessment: Interviewing and Observation
Chapter 6 – Assessment: Interviewing and
Observation
Chapter Overview
Chapter 6 explores the many facets of interviewing and observation. Notably,
unstructured and structured interviews are examined, with a reemphasis given to
confidentiality. Students are introduced to proper interviewing skills across
cultures and populations. The importance of solid interviewing skills may mean
the difference between life and death for a suicidal or homicidal patient. A
diagnostic assessment should neither be rushed nor should a clinician infer
anything about their patients until they have completed a thorough assessment.
One should also emphasize the need for careful administration of the
assessments discussed in the chapter as improper administration not only
weakens the rapport and invalidates the findings, but also does a disservice to
the entire assessment process. This chapter may also serve as a reference
chapter for next three chapters on the various assessment tools.
Chapter Contents

Introduction

Ethical Issues: Limits of Confidentiality

Unstructured Assessment Interviews

Structured Diagnostic Interviews

General Issues in Interviewing

Attending Skills

Contextual Information

Culturally Sensitive Interviewing

Defining Problems and Goals

Assessing Suicide Risk

Interviewing Couples

Interviewing Families

Interviewing Children and Adolescents
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Chapter 6: Assessment: Interviewing and Observation

Observations

Self-Monitoring

Summary and Conclusions
Learning Objectives
1. What is the difference between a conversation and a clinical assessment
interview?
2. Discuss the limits of confidentiality and when confidentiality can be
broken?
3. What are unstructured assessment interviews?
4. What is the difference between open- and closed-ended questions?
5. What is the purpose of a structured diagnostic interview?
6. Discuss the importance of listening skills.
7. How does contextual information play a role in assessment?
8. How can culture affect assessment of the patient?
9. What are the empirically supported suicide risk assessment questions?
10. Discuss the challenges to interviewing couples?
11. Discuss the challenges to interviewing older adults?
12. How is interviewing a child or an adolescent different from an interview
with an adult?
13. What are the challenges faced by psychologists when interviewing
children and adolescents?
14. How do observations sometimes provide more information than direct
interviewing?
15. How can self-monitoring be beneficial to a patient’s overall therapy?
Up for Discussion
1. What are the limits of confidentiality for a psychologist? When can he or
she break confidentiality?
2. Why are unstructured interviews susceptible to clinician bias?
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Chapter 6: Assessment: Interviewing and Observation
3. Discuss the rationale for including both open- and closed-ended
questions during an assessment?
4. How do closed-ended questions limit the interview?
5. What is the most common mistake clinician’s make when conducting
structured diagnostic interviews?
6. Can a structured diagnostic interview replace a formal psychiatric
assessment?
7. Why is it important to paraphrase what your patient is saying?
8. Is silence, while awkward, beneficial during therapy?
9. What are the challenges for a clinician whose patients come from various
cultures?
10. When is the risk of suicide in depression at the highest potential for
lethality?
11. Have two students conduct a mock suicide assessment. One student
would be the patient, the other the clinician. Ask the class to critique the
mock interview, noting the questions and the verbal and non-verbal
responses.
12. How can a therapist remain neutral when interviewing couples?
13. What are the dynamics of working with children, adolescents, and their
parents?
14. How does non-verbal communication provide a wealth of information to
the clinician?
15. What are the challenges to having patients complete self-report
measures as well as self-report monitoring?
Out-of-Class Activities
1. Have students write up the various verbal and non-verbal ways a clinical
interview can capture information. Have students bring this to their next
class to discuss. This assignment may tie in nicely with a mock
demonstration of the difference between verbal and non-verbal
communication.
2. Have students research the various structured and semi-structured
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Chapter 6: Assessment: Interviewing and Observation
assessment tool that exist in the field. Students should focus on one
particular area such as diagnostics, depression, anxiety, bipolar etc.
Students should provide a write up of the assessment(s) highlighting the
assessment’s utility, administration time, who can administer it, and
reliability and validity data.
3. Divide students into three to five teams, depending on your class size.
You may also assign individually. Each of the teams or the individual
should be given two weeks to work on this assignment. Students are to
create a series of both open-ended and closed-ended questions for a
particular disorder. They then will present to the class or provide a write up
of the questions. Students should focus on cultural sensitivity and overall
feasibility of the questions.
4. Have students pair up inside of class or pair up with a friend outside of
class and have a normal discussion with that person, noting the nonverbal communication throughout the conversation. Have the students
write up their reactions and findings. Use this exercise to stimulate more
discussion in class.
5. Have students look up the following suicide risk assessments and provide
a critique of them: Columbia Suicide Severity Rating Scale (C-SSRS) and
the Beck Scale for Suicide Ideation (BSS).
6. Have students self-monitor there eating, drinking, smoking, or exercising
habits for two weeks. Have them record their findings and write up the
challenges, difficulties, and then have them apply their understanding to
how their experiences are similar to what patients face.
Web Links
You can find information about the SCID here:
http://www.scid4.org/
You can find information about the Dominic Interview here:
www.dominicinteractive.com
The National Institute of Mental Health site devoted to facts, research, and
statistics about suicide.
http://www.nimh.nih.gov/health/publications/suicide-in-the-us-statistics-andprevention/index.shtml
The American Foundation for Suicide Prevention (AFSP) is the only national notfor-profit organization exclusively dedicated to funding research, developing
prevention initiatives and offering educational programs and conferences for
survivors, mental health professionals, physicians and the public.
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Chapter 6: Assessment: Interviewing and Observation
http://www.afsp.org/index-1.htm
For information on risks for suicide and understanding more about suicide
prevention:
http://www.livingworks.net/
http://www.sprc.org/
The National Institute of Neurological Disorders and Stroke provides a wonderful
overview of the various diagnostic tests and procedures used in clinical and
research practice.
http://www.ninds.nih.gov/disorders/misc/diagnostic_tests.htm#tests
This is the Web site for Pearson Assessments owners of the Beck series of
assessments, including the Beck Scale for Suicide Ideation (BSS).
http://www.pearsonassessments.com/
Video Suggestions
Assessment (Video, color, 22 min.) Reviews the addiction assessment process.
Examines adult and adolescent assessment tools such as the addiction severity
index, the problem-oriented screening instrument, the adolescent problem
severity index, and the personal experience inventory. 1994. Issembert
Productions: a presentation of CSR, Incorporated.
Suicide (Video, color, 23 min). Explains why some people are more prone to
suicidal tendencies than others. Presents various theories about what causes a
person to take his or her own life, and teaches how to recognize pre-suicidal
behavior and seek help. 2001. Educational Video Network, Inc.
Emotional intelligence (Video, color, 70 min.) Discusses the five basic emotional
competencies - self-awareness, managing emotions, motivation, empathy and
social skills. Explains how to have more success in life as a partner, a parent and
on the job. WETA, Washington, DC, produced in association with the Consortium
for Research on Emotional Intelligence in Organizations, Rutgers University; PBS
home video 1998.
Suggested Readings
Hersen, M., & Turner, S. M. (Eds). (2003). Diagnostic interviewing (3rd ed.). New
York: Kluwer Publishers.
Sattler, J. M. (1998). Clinical and forensic interviewing of children and families. San
Diego, CA: Jerome Sattler.
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Chapter 6: Assessment: Interviewing and Observation
Sue, D. W., & Sue, D. (2008). Counseling the culturally different: Theory and
practice (5th ed.). New York: John Wiley & Sons.
Sommers-Flanagan, J., & Sommers-Flanagan, R. (2003). Clinical interviewing
(3rd ed). New York: John Wiley & Sons.
Barnett, J. E., & Johnson, W. B. (2008). Ethics desk reference for psychologists.
Washington, DC: American Psychological Association.
Schroeder, C. S. & Gordon, B. N. (2002). Assessment and Treatment of
Childhood Problems: 2nd Edition: A Clinician’s Guide. The Guilford Press.
Vingerhoets, A (2001). Assessment in Behavioral Medicine. Routledge.
White, A. (1999). How to Identify Suicidal People: A Systematic Approach to
Risk Assessment, Charles Press Publishers
Groth-Marnat, G. (2003). Handbook of psychological assessment (4th ed.).
Hoboken, NJ: John Wiley & Sons.
Hersen, M. (Ed.). (2004). The comprehensive handbook of psychological
assessment (Vols. 1–4). New York: John Wiley & Sons.
Hogan, T. P. (2007). Psychological testing: A practical introduction (2nd ed.).
Hoboken, NJ: John Wiley & Sons.
Hunsley, J., & Mash, E. J. (Eds.). (2008). A guide to assessments that work. New
York: Oxford University Press.
Rush, A.J., First, M.B., Blacker, B. (2008). Handbook of Psychiatric Measures:
2nd Edition. American Psychiatric Publishing.
Sajatovic, M. & Ramirez, L.F. (2003). Rating Scales in Mental Health: 2nd
Edition. LexiComp.
Loewenthal, K.M. (2001). An Introduction to Psychological Tests and Scales: 2nd
Edition. Psychology Press, Taylor and Francis Group.
Suzuki, L.A., Ponterotto, J.G., and Meller, P.J. (2001). Handbook of Multicultural
Assessment: Clinical, Psychological, and Educational Applications, 2 nd Ed.,
Jossey-Bass.
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