Feeling Validation

Reflection of feeling is often confused with a technique referred to as feeling validation. Beginning textbooks normally do not distinguish between these two different responses (A. Ivey & Ivey, 1999 Meier & Davis, 2001). Feeling validation occurs when an interviewer acknowledges and approves of a client's stated feelings. The purpose of feeling validation is to help clients accept their feelings as a natural and normal part of being human. Feeling validation can serve as an ego boost...

User Friendly Assessment and Information Gathering Strategies

The purpose of formal assessment or evaluation procedures is to obtain information about client functioning that may be used to make diagnoses and treatment recommendations and or facilitate therapy (Peterson & Nisenholz, 1987). While many mental health professionals use traditional, formal assessment procedures (e.g., intellectual and personality testing, questionnaires) when interviewing children, many do not. Those who do not sometimes have negative attitudes toward assessment or view...

Reliability Judgment and Insight

Reliability refers to a client's credibility and trustworthiness. A reliable informant is one who is careful to present his or her life history and current personal information honestly and accurately. In contrast, some clients may be highly unreliable for one reason or another, they distort, confabulate, or blatantly lie about their life circumstances and personal history. It is often difficult to determine when a client is being untruthful during an interview. Even experienced interviewers...

Current Situation and Functioning

This section of the intake report focuses on three main topics (a) usual daily activities, (b) client self-perception of personal strengths, and (c) apparent ability to adequately perform usual age-appropriate activities of daily living. Depending on your setting and preference, it is also possible to expand on this section by including a description of the client's psychological functioning, cognitive functioning, emotional functioning, or personality functioning. This provides the interviewer...

Exploring Your Personal Attitudes Toward Substances

In one way or another, everyone has a personal substance use or abuse history and an attitude toward alcohol and drug use worth examining. Whether you grew up in a family with strong prohibitions against drinking alcohol or a family with members suffering from cocaine addiction, your family experiences undoubtedly shaped how you think about people who use (or do not use) alcohol, cocaine, and other drugs. To become more effective in working with substance-abusing clients, you should reflect on...

Identifying Evaluating and Exploring Client Problems and Goals

Your first, and perhaps primary, objective is to find out about your client's distress. As an interviewer, your exploration of a client's chief complaint begins with your opening statement (e.g., What brings you here or How can I be of help see Chapter 6). After the opening statement, at least 5 to 15 minutes should be spent tracking the client and trying to understand exactly why he or she has come to see you (Shea, 1998). In some cases, clients clearly identify their reasons for seeking...

Attending Behavior

Ivey and Ivey 1999 consider attending behavior the foundation of interviewing. They define attending behavior as culturally and individually appropriate . . . eye contact, body language, vocal qualities, and verbal tracking p. 15 . To succeed, interviewers must pay attention to their clients in culturally and individually appropriate ways. If interviewers fail to look, sound, and act attentive, they will not have many clients. Most clients quit going to counseling if they think their...

Interviewing Trauma Survivors

Many clients come to therapy because they are struggling with an experience of trauma. When individuals are exposed to traumatic events, such as natural disasters, school or workplace shootings, sexual assault, or war-related violence, they often experience immediate and longer term emotional and psychological symptoms. In this section, we briefly review issues associated with interviewing trauma survivors. In 1980, when posttraumatic stress disorder was first included in the DSM, trauma was...

Assessment of Current Functioning

After inquiring and exploring historical and interpersonal issues, interviewers should make one more major shift and focus on current functioning. Not only is it important to assess current functioning, but also it is equally important not to end an interview focused on the past. The shift to current functioning provides both a symbolic and a concrete return to the present. The end of the interview is also a time to encourage clients to focus on personal strengths and environmental resources,...

Motivational Interviewing A Contemporary Approach to Substance Abuse Interviewing

Over the past 20 plus years, the most well-respected and empirically validated approach to interviewing clients about substance use is largely, and perhaps surprisingly, non-confrontational. Drawing from his experiences treating problem drinkers, William Miller 1983 began writing about his beliefs and practices, calling his methodology motivational interviewing. He and his colleague Stephen Rollnick published a book by that name in 1991 a second edition in 2002 , and published a number of...

Using a Comprehensive Checklist for a Thorough Suicide Assessment

After practicing and gaining familiarity with risk factors, the following checklist can be used in practice sessions and role plays to help you conduct a thorough suicide assessment in almost any circumstance. It is important to practice actually obtaining the information from different types of clients because the energy, setting, time allotted, and so forth, can make for interesting challenges when it comes to getting this information. Either in pairs in class or with a willing friend or...

Speech and Thought

In mental status exam formulations, speech and thought are intimately linked. It is primarily through speech that mental status examiners observe and evaluate thought process and content. There are, however, other ways for interviewers to observe and evaluate thought processes. Nonverbal behavior, sign language in deaf clients , and writing also provide valuable information about client thinking processes. In a mental status exam, speech and thought are evaluated both separately and together....

Resistance

At times, we are at odds with our clients. We want them to talk about their life history, and they want to talk about their last trip to the mall, the Olympic games, or some other matter that seems distant or irrelevant. If clients are avoiding important topics, yet at the same time wanting the benefits of therapy, it is likely that resistance is occurring. Some of the best examples of resistance come from the medical world. We avoid the dentist even though our tooth aches because we do not...

Cultural Background and Personal Space

You should be sensitive to cultural differences in eye contact, body language, vocal qualities, and verbal tracking. Although most Whites in North America interpret eye contact as a positive sign of interest, people from other cultures e.g., Asian and Native American tend to prefer less direct eye contact and may view excessive eye contact as disrespectful or invasive. During a visit to Europe and North Africa, we became acutely aware of cultural differences in body language. We had a limited...

Affect and Mood

Affect is defined as the prevailing emotional tone observed by the interviewer during a mental status examination. In contrast, mood is the client's self-reported mood state. Affect is usually described in terms of its a content or type, b range and duration also known as variability and duration , c appropriateness, and d depth or intensity. Each of these descriptive terms is discussed further. Affect Content To begin, you should identify what affective state you observe in the client. Is it...

Coping with Countertransference

Countertransference is defined as therapist emotional and behavioral reactions to clients. As an example, imagine an interviewer who lost his mother to cancer when he was a child. His father's grief was very severe. As a consequence, little emotional support was available when the interviewer was a child. The situation eventually improved, his father recovered, and the interviewer's conscious memory consists of a general sense that losing his mother was very difficult. Now, years later, he's a...

Open and Closed Questions

The four sets of questions that follow are designed to obtain information pertaining to the same topic. Imagine how you might answer these questions, and then compare your imagined responses. 1. Open How are you feeling about being in psychotherapy Closed Are you feeling okay about being in psychotherapy 2. Open What happened next, after you walked onto the subway and you felt your heart begin to pound Closed Did you feel lightheaded or dizzy after you walked onto the subway 3. Open What was it...