interviewing skills

Question	Answer
what happens in the assessment interview?	Patients often present themselves with an undifferentiated array of problems and the therapist aims to help them clarify these into manageable proportions such that the patient begins to have hope that resolution to their problems is actually possible. The assessment emphasises the possibility of change. Another very important part of assessment is to establish RISK
The environment in which the interview takes place is important. Describe an appropriate environment?	Comfortable and confidential environment Few distractions Try and put the patient at their ease Warmth and empathy Genuine, supportive and non-judgemental in your attitudes Show an interest in the patient as a person and not just a clinical case
The degree to which an assessment interview is structured varies depending on ...?	the task in hand and the preferred style of the therapist. The style will also need to be altered depending on how talkative the patient is. Also the purpose of the interview. Choose the style which best meets the task in hand In reality the therapist needs to be able to conduct both types of interview This may involve altering your style for certain kinds of patient and/or tasks
What information needs to be gathered?	Reason for referral The patients own description of their presenting problems Why they came for help now? Chronological history of mental health problems Personal history of patient Current situation Patient’s appearance and behaviour during interview Biological functioning Cognitive–intellectual functioning Abnormal experiences Risk – of harm to self/ others Psychological mindedness;
describe psychological mindedness?	How much the patient acknowledges they have an emotional life The ability to make links between thoughts, feelings, and behaviours Motivation & willingness to accept responsibility for themselves That psychological factors can exert an influence on physical symptoms Ability to work collaboratively
at first contact with patients, how is rapport established?	Best not to be too formal The therapist needs to take the lead The sentences you start with and your non-verbal communication (posture, eye contact etc) should show the patient that you are ready to listen to them Clarify how much time you have available Make reference to the referral sources Avoid ‘minimising’ expressions Be inviting, friendly and clear, but not too informal
what is attending behavior?	the term attending behaviour is used to make listening specific and observable. The key aspects are eye contact, body language and verbal following Eye contact look at the person breaks in eye contact Body language 80-85% of our communication is non-verbal posture proximity & personal space Verbal following This means responding to whatever the patient has just said or said earlier in the session avoid doing too much of the talking tone of voice
summarise appropriate attending behavior?	Use varied eye contact to communicate, adopt a relaxed natural posture and gestures and stay with the patient’s topics. If you are attending well you will also be able to pick up information about your patient through their own eye contact, posture, tone of voice, facial expressions, physical movements and gestures.
what are minimal encouragers?	small indicators to another person that you are attending to them and are with them. These may be; non-verbal encouragers verbal encouragers
why is an open invitation for the client to talk used in the assessment interview?	help begin an interview help a patient elaborate on a point help elicit specific information can help focus the patient on to his or her feelings
during the assessment interview, what questions should be avoided?	Try to avoid closed questions They can usually be answered in a few words or with a simple ‘yes’ or ‘no’ answer. Closed questions often emphasise factual content rather than an interest in the persons feelings. Avoid questions beginning with ‘Why?’ can feel threatening to a patient/force into giving reason fail to give further room for exploration
Outline some skills which give the therapist more influence on the conversation (selective listening)?	Paraphrasing Reflecting Feelings Concreteness Summarisation
describe paraphrasing?	A type of attending to another person which demonstrates the ability to ‘give back’ in one’s own words ‘pieces’ of content information to that person. Can serve several purposes convey to the client that you are with them crystallize a client’s comment by making it more concise provide a check on the accuracy of the perceptions of the interviewer give a direction to the interview A paraphrase gives a “translation” of the essence of what is said rather than simple mirroring of words.
outline reflecting of feelings?	paraphrasing by the therapist emphasises the content of what the patient says, By means of paraphrasing, the therapist tries to understand what the patient’s situation looks like, and an accurate reflection of feeling is especially important …. As a result, the patient notices that their feelings are accepted and are receiving attention, and they are stimulated to disclose more of their feelings. A reflection of feeling shows that the therapist tries to understand what the patient experiences emotionally in their situation Is especially important when patients have mixed feelings which inhibit them from getting a clear picture In order to reflect feelings the therapist must, recognise the feelings use affective words non-verbal aspects Important that the reflection has the right intensity of feeling, not stronger or weaker than the feeling the patient uttered.
outline concreteness?	When we listen critically to the story of a patient it often appears to be rather vague. The patient may try to evade the painful problems by talking in generalities, s/he might not be conscious of what is really bothering them in precise detail. Means having the patient talk as specifically and clearly as possible about their problems. It is important to both the therapist and the patient to discuss the problems in more concrete terms. Skills such as listening, encouraging, asking open questions, paraphrasing, reflecting and immediacy can all add up to a more concrete conversation. Concreteness can be directed to behaviour, thoughts and feelings. The therapist can stimulate the patient to be more concrete in several ways: can ask for clarification by means of concrete open questions (What happened exactly?) be as concrete as possible in his responses can interpret long, vague stories with clarifying questions, concrete paraphrases and reflections split up the problems in order to gather information per “problem area”
outline summarization?	Summarisation is an attempt to recapitulate, condense or crystallise the essence of what has been said. The key purpose is to help another individual pull their thinking together. A secondary purpose is to check whether or not you as a therapist have understood things correctly. The therapist attends to the patient’s verbal and non-verbal statements over a period of time; then selects out critical dimensions of the statements and behaviour and restates them as accurately as possible, thus helping the patient to see the situation more clearly. Important to state your summary in a tentative way, so that your patient has the opportunity to correct you. It can help move the interview from exploration to action and problem-solving.
Clarity of role is an important concept in the therapeutic relationship, but sometimes this can be severely tested. A patient can have expectations of the therapist which the therapist cannot or does not want to meet . What should a therapist do in this situation?	In such a situation a therapist should discuss the ongoing conversation itself with the patient. This can be seen as a meta-conversation. Therapist and patient talk about their conversation. situations in which the above mentioned skill can be of help a patient is very much interested in the personal life of the therapist a patient is interested in the feelings of the therapist towards him and his problems a patient is dissatisfied with the therapist a patient asks the therapist to be on his side of a personal conflict with others
HOw should the interview be ended?	Start the termination phase on time; It is important that your closing sentences are clear, these should clearly indicate the end of the meeting; Don’t introduce new subjects; Have your patient repeat the agreements; Some conversations need not last a long time. Don’t be afraid to terminate a conversation if there is nothing left to talk about.
The therapist will commonly meet with reluctance and/ or resistance to disclosing information by a patient. There are a number of possible reasons why this may happen. Some examples include?	The patient may see no reason for attending in the first place They are fearful of therapy have difficulties with relationships anyway see therapists as ‘authority figures’ are suspicious about therapists an admission of weakness no payoff/ gains to change or even loss of benefits they may have some shame/guilt about what they are taking about
If a patient is reluctant to disclose information, what is crucial in gaining compliance?	the therapist’s attitude
Obviously becoming impatient or even hostile, engaging in power struggles, allowing the patient to become abusive, ignoring the situation or blaming the patient are unacceptable and will most likely result in the session being terminated early either by the patient or the therapist. Name some better approaches?	See some resistance as avoidance by the patient which needs to be worked through with the patient. Try to see things from the patient’s perspective a bit more. Examine the quality of your own interventions and be willing to reflect upon and learn from these. Address the Immediacy of the situation rather than ignoring it, and explore this with the patient. Don’t ignore it or tolerate abuse. Deal with this in an assertive way and with respect for the patient. Don’t get entrenched with your power struggles but rather try to stand back a little and understand the dynamics of what is going on. Remember the patient is usually not attacking you as a person but what you ‘represent’ to them. In this way you will be able to deal with the situation more calmly and rationally. Be prepared to explore your own resistance and distortions. Don’t be thrown off course by it. Point out the patient’s responsibility for their own problems. Point out the importance of working collaboratively. Emphasise the confidentiality of the interview if this is an issue.
What should therapists avoid in order to have a good therapeutic attitude?	Don’t talk down to patients. Don’t relate to the patients in a disapproving way. Avoid sarcasm or excessive use of humour. Avoid ‘prejudice’. Keep a professional distance.
Give a reference for active listening	Rogers and Farson, 1957
When people are listened to actively, what happens?	They listen to themselves with more care and to make clear what they are thinking
Outline Woody (1980)'s statement about clinical assessment?	Clinical assessment is individually oriented, but it always considers social existence; the objective is usually to help a person solve problems'
Clinical psychologists and other mental health practitioners have traditionally focused on what “goes wrong” for clients and how to treat it (Cowen, 1999). More recently, the field has seen a growing emphasis on...?	Wellness enhancement (Tedeschi and Kilmer, 2005)
The traditional problem focused approach to clinical assessment reduces what?	the range of information sought and considered, limiting the clarity of the picture painted by the evaluation and emphasizing negative aspects of individuals and situations (Tedeschi and Kilmer, 2005)
when assets and risks are both assessed, clients are more likely to...?	experience the intervention as affirming and empowering, even motivating (Tedeschi and Kilmer, 2005)
According to Sommers-Flanagan and Sommers-Flanagan (2012) what is the minimum requirement for the setting of an assessment interview?	minimum requirement= privacy A degree of professional décor is also important
According to Rogers and Farson (1957) what should be avoided when practicing active listening?	Advice and information are usually seen as efforts to change a person, thus serving as barriers to self-expression and development of a creative relationship Passing judgment (even when the speaker asks whether the listener agrees) as this makes free expression difficult trying to change the speakers' way of looking at things, as this stops the listener actually engaging and understanding the way the speaker feels
OUtline Morland, Ivey and Phillips (1973)	Assigned 24 male 2nd-yr medical students to 1 of 2 interviewing training groups. The 12 microcounseling Ss received training in the use of attending behavior, open-ended questions, minimal activity responses, paraphrases, reflections of feeling, and summarization through the use of the microcounseling paradigm. The 12 comparison Ss received equivalent interview training. Pretraining and posttraining interviews with real patients were videotaped for each S. Data analysis reveals that both groups of Ss became better interviewers, but those receiving microcounseling training improved more than the comparison Ss
Outline Weger, Castle and Emmett (2010)	Perhaps no communication skill is identified as regularly as active listening in training programs across a variety of disciplines and activities. Yet little empirical research has examined specific elements of active listening responses in terms of their effectiveness in achieving desired interpersonal outcomes. This study reports an experiment designed to test the influence of a specific element of active listening responses, namely, the message paraphrase. One hundred and eighty undergraduate students participated in peer interviews in which they received either a paraphrased reflection or a simple acknowledgement in response to their expressed opinions regarding comprehensive examinations. The results of data analysis indicated that message paraphrases were associated with the social attractiveness of the listener but were not associated with participants' conversational satisfaction or perceptions of feeling understood by the listener. As people are more likely to tell people who they like more intimate things, paraphrasing is useful in this way.
outline the findings of Levitt (2001)	beginning counseling students receiving specific micro-skill training in active listening considered themselves more effective as counselors and received higher ratings from their supervisors in a variety of counseling skills
What was found in several 'last sessions before drop out' by Piper et al (1999) (who compared 22 dropouts with a sample of 22 matched completers)	Persistent use of transference interpretations on the therapist's part was not successful in resolving the impasse. The therapist was often unable to avoid countertransferential reactions.

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	Created by Jo Gledhill about 9 years ago