clinical assessment interview

1. Clinical Assessment (I) : The
Assessment Interview
Aska Primardi

2. 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

3. 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)

4. 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

5. 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

6. 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

7. 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

8. 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?"

9. 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

10. 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

11. 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

12. 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

13. 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

14. 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.