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    Clinical Interviewing Skills

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    aananyaa2020
    Here are some techniques you can use if the patient doesn't respond verbally: - Use open-ended gestures like head nods to encourage non-verbal responses - Observe facial expressions, body language, eye contact for clues - Ask simple yes/no questions to check understanding - Paraphrase what you've observed to check your interpretation - Allow silence without pressure to fill it in - Validate their feelings through reflective statements - Shift topics to find something they may engage with more - Assess for physical needs, pain, or other barriers to responding - Reassure them you're there to understand and help at their pace The key is to keep the communication channel open through observation, validation

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    Clinical Interviewing Skills

    Uploaded by

    aananyaa2020
    24 views28 pages
    Here are some techniques you can use if the patient doesn't respond verbally: - Use open-ended gestures like head nods to encourage non-verbal responses - Observe facial expressions, body language, eye contact for clues - Ask simple yes/no questions to check understanding - Paraphrase what you've observed to check your interpretation - Allow silence without pressure to fill it in - Validate their feelings through reflective statements - Shift topics to find something they may engage with more - Assess for physical needs, pain, or other barriers to responding - Reassure them you're there to understand and help at their pace The key is to keep the communication channel open through observation, validation

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    Here are some techniques you can use if the patient doesn't respond verbally: - Use open-ended gestures like head nods to encourage non-verbal responses - Observe facial expressions, body language, eye contact for clues - Ask simple yes/no questions to check understanding - Paraphrase what you've observed to check your interpretation - Allow silence without pressure to fill it in - Validate their feelings through reflective statements - Shift topics to find something they may engage with more - Assess for physical needs, pain, or other barriers to responding - Reassure them you're there to understand and help at their pace The key is to keep the communication channel open through observation, validation

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    24 views28 pages

    Clinical Interviewing Skills

    Uploaded by

    aananyaa2020
    Here are some techniques you can use if the patient doesn't respond verbally: - Use open-ended gestures like head nods to encourage non-verbal responses - Observe facial expressions, body language, eye contact for clues - Ask simple yes/no questions to check understanding - Paraphrase what you've observed to check your interpretation - Allow silence without pressure to fill it in - Validate their feelings through reflective statements - Shift topics to find something they may engage with more - Assess for physical needs, pain, or other barriers to responding - Reassure them you're there to understand and help at their pace The key is to keep the communication channel open through observation, validation

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 28

    Interviewing Skills in Clinical settings

    By-
    Ms.Chetna Luthra
    Clinical Psychologist “A conversation
    & Psychotherapist with a purpose”

    5+ years of work
    experience
    What do you understand by

    “A conversation with a purpose”


    What is a CLINICAL INTERVIEW?
    In simple words, A clinical interview is a dialogue between
    psychologist & patient that is designed to help the
    psychologist diagnose and plan treatment for the
    patient.
    Why is it used??
     Most Important diagnostic tool
     Used for assessment and treatment
     Used to gather information for clinical
    evaluation and psychotherapeutic treatment,
    can also prepare the patient for therapy
     May provide some relief
    Amount of time devoted –

    May vary due to the interview, the setting and the


    purposes but the features of an effective clinical
    interview remain the same

    Performed in different settings–

    emergency
    Private psychiatric
    Outpatient Prison or medical
    practice hospital
    hospital
    INTERVIEW CLINICAL INTERVIEW
     Establish a diagnosis, evaluate  Clinician inquires directly & in
    mental status & historical data that focused manner about the patient’s
    impact an individual development, adaptation and
    current difficulties
     Provide full understanding of the  To prepare the patient for the
    importance of personality, biological clinical interventions
    and environmental variables that
    brought the person to this point.
     Interview helps in building the
    rapport , provide a sense of
     Formal or informal evaluation professional intimacy and a feeling of
    compassion and interest in patient’s
    well-being
     Necessary adjunct to the data
    gathered from other assessment  Prepares the responded for a
    procedures beneficial outcome
    CLINICAL INTERVIEW
     Must cover the important aspects
     Introduction/purpose of the interview
     Credentials/role of the interviewer
     Confidentiality and ethical considerations
     Presenting problems ( Open ended)
     Explore mood/anxiety symptoms
     Impulse control and risk evaluation
     Current functioning in all areas of life
     Assess social support
     Environmental factors
     Developmental factors
     Family history
     Substance use
     Legal history
    Points to always keep in mind
     Obtaining information is easy
     Quality of information obtained is important

     Empathy – subtle signs , overt communication,


    usage of words (Entering someone’s world) , to resonate
    with the client , respond that eases the flow of information

     Focus point – not just attune to overt or visible behavior


    but also underlying feelings and meaning

     Be aware of your own biases, values that can impact – use practice
    and supervision

     Sensitivity to wording and follow up questions


     Introspection, acceptance & confrontation with own beliefs necessary
    How to START?
     Plan out the introduction & opening of interview – open ended
    questions
     Give time to explain the respondent about the history
     Give opportunity and insight into client’s thought process
     Make general observations about the behavior

    ••Question
    Question––
    “Please tell me the things that are concerning
    concerning you
    you right
    right now”
    now”

     Amount dependent on intellectual ability and verbal capacity


     May encounter resistance in disclosure
     Identify and decide the responses
     Identify cognitive distortions and act accordingly
    Clinical interviewing skills

    • To be able to plan – develop questions


    • Allocate time to appropriate topics
    • Evaluate probing questions –
    clarify, elaborate, check
    • Consistency and revising
    • Sensitivity to understand what can be
    threatening
    • Recognize communication styles & adjust
    • Understanding non –verbal cues
    • Maximize empathy
    Rapport Formation
    Rapport is important because it creates trust, which leads to
    a more open and honest discussion.

    METHODS OF BUILDING RAPPORT

     Commonality
     Emotional Mirroring
     Posture Mirroring
     Tone and Tempo Mirroring
     Non judgmental attitude
     Inviting Behavior
    ACTIVE LISTENING
    Communication technique requires the listener to understand,
    interpret and evaluate what they hear

    Listen attentively , focus attention on the speaker , suspending


    one’s frame of reference, suspending judgment and avoid
    internal mental activities

    Levels of Listening

    • LEVEL I – NON-LISTENING
    • LEVEL II – PASSIVE LISTENING
    • LEVEL III- ACTIVE LISTENING
    DEFRAMING
    It is an attempt of the interviewer to challenge certain negative
    beliefs of the client without being preachy. It can be a powerful
    tool for influencing the client when dealing with a client’s
    dysfunctional and useless beliefs.

    Questions -
    - How do you know that to be so?
    - What makes you say that?
    - How is that so?
    - Where did you get that idea?
    - What makes you so sure?
    - On what basis have you reached that
    conclusion?
    Other important skills/techniques

    Reflecting Paraphrasing Summarizing


    Verbal response to Choose important details and Summarization is taking a
    respondent’s emotion reflect back large amount of
    information and
    This technique will show clients condensing it so that the
    This technique is used that the counselor is listening to
    to show the clients that main points are covered
    their information and
    we’re are fully aware of but there is a reduced
    processing what they have
    the feelings that the been telling them. amount of statements.
    client is experiencing.
    Paraphrasing is also good to Restating them for the
    reiterate or clarify any client as accurately as
    misinformation that might possible.
    have occurred.
    During clinical interview
    ’
     Make sure an alliance has been built
     The focus shifts to other aspects after rapport building
     Draw from your existing knowledge about psychopathology
    to understand the development and build relevant questions
     Notes making both objective and subjective
     Identify primary strengths , resources and abilities
     Use the framework around the presenting problem
     Attend to the subtle changes in both the client and yourself
     be able to identify lingering questions
     Focus on problems , questions and possible solutions
     Try to identify and follow leads
     Use numbers to discuss the level of symptoms
     Allow proper closure and heading towards closing the
    interview
     Don’tstart with questions as soon as the patient comes
     Don’t ask excessive questions
     Avoid ‘WHY’ questions
     Not focusing on the client
     Don’t Look distracted, lose attention, interrupt
     Don’t Shift attention to oneself
     Don’t Criticise the client
     Don’t Share personal opinion (giving approval or disapproval)
     Don't be overly familiar, even if the person is
     Don’t disregard the natural flow of conversation
     Avoid distressing topics ( sexual , racial. Substance use)
     Don’t rush but skillfully close the interview
     Avoid prejudices and bias
    Important!!

     Don’t Expect to Accurately Diagnose Clients after a Single


    Interview

    • It’s good to have lofty goals, but in many cases, you won’t be able
    to assign an accurate diagnosis to a client after a single interview.
    In fact, you may leave the first interview more confused than when
    you began. Fear not. The ICD-10-CM and DSM-5 provide
    practitioners with procedures for handling diagnostic uncertainty.

     These include the following:


    V codes (DSM-5) and Z codes (ICD-10-CM): V codes and Z codes
    are used to indicate that treatment is focusing on a problem that
    doesn’t meet diagnostic criteria for a mental disorder.
    Do you what code F99 refers to?
    Answer in chat box!!
    Code F99 refers to-

    F99: This code refers to Unspecified Mental


    Disorder. It’s used when the clinician determines that
    symptoms are present, but full criteria for a specific
    mental disorder are not met.
    But what to do if the patient
    doesn’t respond?
    Can you suggest some techniques?
    in the chat box!!
    what to do if the patient doesn’t respond?
    Firstly its very important to understand why the patient is not responding,
    Maybe due to-
    Due to low energy
    Negative mood, tone and affect
    Disorganized attention
    Concentration disturbed
    WHAT YOU CAN DO-
    • Observation is the key!
    • Focus on observation , look for specific behaviors
    • Use simple questions and language if only head nodding
    • Assess levels of consciousness and orientation
    • Identify hopelessness and include aspects in interventions
    • Non-verbal cues- very important
    • Notice facial expressions, body posture, eye contact, overall
    appearance & behavior
    Can you name some disorders in which
    problem with speech can be observed?

    Use chat box!!


    Common mistakes made by beginner therapists
    Interrogating rather than interviewing by asking questions in rapid, disjointed
    manner.
    Attempting to cheer up the other person- “Everything will be ok. Don’t worry.”
    Frequently interrupting with a comment or question.
    Talking frequently about yourself and how you solved this or that problem;
    prematurely disclosing your own feelings and opinions. Don’t automatically
    compare the client’s experience with your own.
    Offering suggestions or solutions too early in the process. Immediately providing
    or seeking a solution for the problem.
    Suggesting that the problem is in the client’s imagination. Don’t invalidate the
    client’s feelings.
    Interviewing in an environment not conducive to listening.
     Sarcasm, blaming or moralising.
     Anticipating responses or hearing what you want to,completing client’s sentence
    Reliability in Clinical Interview
     Assess the reliability

    Factors that may affect –

    Lack of
    Cognitive Inadequate understanding of
    functioning memory recall the questions being
    asked

     Look for clues for wrong information


     Cross reference information later from sources
     May want to include a caregiver in the session
    We sincerely do hope you found
    this workshop meaningful and
    were able to take some insights
    from the session.

    But this is just the starting, if


    you’re interested to go beyond
    books & learn in-depth about the
    most important clinical skills
    which every psychologist should
    know from Ms. Chetna, then do
    join us

    LIMITED SEATS
    AVAILABLE!!!

    Register Now

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