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Clinical Assessment

Interviewing

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Psychological Assessment

Key activity in clinical psychology

(historically)

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Psychological Assessment:

Overall ProcessI. Planning the assessment

II. Data collection** (our focus)

IV. Data processing

V. Communicating findings

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I. Planning the Assessment

Why is the person being assessed? (referral

question)

The goal of the psychological assessment

follows from the referral question.

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Goals of Psychological Assessment

Classification (diagnoses)

Description

Prediction (true positive, false positive)

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II. Data Collection**

Methods

Clinical interview

Tests

Observations

Informal assessment Examination of life records

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III. Data Processing

Organization and interpretation of data

Clinical judgment vs. statistical prediction

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IV. Communicating Findings

Typical Report Identifying Information

Reason for Referral Background Information Behavioral Observations Assessment Results

Diagnosis Interpretation Summary and Recommendations

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Clinical Interviewing

Clinical Interview vs. Social Conversation

Different social roles of the two

participants

Interview usually takes place in a

professional setting

Interview is usually one-sided

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Types of Interviews

Intake interview

Case history

Diagnostic interview

Mental status exam

Crisis interview

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Intake Interviews

For the Clinician Determine the nature of the

client’s problems

Determine the appropriatenessof services offered Define problems to be worked

on and establish goals Balance gathering information

with establishing rapport

For the Client Determine appropriateness of 

services

Find out about psychologist’sfees, procedures and policies

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Case History or Psychosocial

HistoryDetailed description of the client’s background which usually includes: Birth and development Family of origin Education Employment Recreation/Leisure Sexual history Dating and Marital Alcohol and drugs Physical health

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Structured Diagnostic Interviews

Structured Interviews specify:

Symptoms and disorders to be assessed

Interview format Order of questions

Wording of questions

Guidelines for additional questions

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Structured Diagnostic Interviews

Professionals

Schedule for Affective

Disorders andSchizophrenia (SADS)

(semi-structured)

Structured Clinical

Interview for DSM-IV(SCID)

Lay Persons

Diagnostic Interview

Schedule (DIS)

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Mental Status Exam

General appearance andbehavior 

Speech and thought

ConsciousnessPerception

Obsession and Compulsions

Orientation

Memory

Attention and concentrationGeneral information

Intelligence

Insight and judgment

Higher cognitive functioning

Intelligence

Insight and judgment

Higher cognitive functioning

Speech

Orientation

Mood and AffectForm of Though

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Crisis Interview

Goal: Resolve the problem to avoid catastrophic outcome

Tasks: Provide reassurance Assess the problem Explore potential resources

Method: Convey understanding Projecting a calm and confident manner 

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Essential Elements of Clinical

Interview Rapport

Effective communication strategies

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Rapport

The sense of mutual trust and harmony that 

characterizes a good relationship

Rapport involves a comfortable atmosphereand a mutual understanding of the

 purpose of the interview.

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Establishing Rapport

Conveying acceptance, understanding

and respect for the patient

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Effective Communication:

Verbal StrategiesOpen Questions

What did you think of the

movie?

How would you describe

your relationship with

your parents?

Closed Questions

Did you like the movie?

Do you have a good

relationship with your parents?

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Questions

Open Questions

Elicit information

Closed Questions

Gather specific

information

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How would you describe your marriage?

What do you enjoy about the relationship?

What are these arguments like?

Have you and your husband

ever separated?

How long have you been

married?

Combining Open and Closed

Questions

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Listening Skills

Four Types of Responses that Convey

Listening

Clarification Paraphrase

Reflection

Summarization

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Clarification

Definition

Questioning that

helps the clinicianunderstand an

ambiguous message

Confirms the accuracy of 

the clinician’s perception

Example

Are you saying that….

Could you describe for me…

Say what you mean

by…

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Clarification: Purpose

To encourage elaboration

To check accuracy of what you heard

To clear up vague messages

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Distinguishing Content vs. Emotion:

An ExerciseWhat thoughts are you

having about being in

class today?

What are the feelings

that go along with

these thoughts?

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Paraphrasing

Definition: Describing the content/thoughts of 

the client’s message

Provides an opportunity for client to clarify Encourages client to say more about a topic

Provides an opportunity to redirect client to

central topic

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Paraphrasing

Example

Client: School has always been really difficult for me. Ireally have to work hard to do well. My grades have

always been good but it hasn’t been easy. Not likemy sister. Megan has always just waltzed rightthrough school. She just reads a chapter once and itsall there for her when test time comes.

Therapist: So while you’ve done well in school, you’ve

had to work very hard.

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Paraphrasing: Purpose

To help the client focus on the content of 

their message

To highlight content when attention tofeelings is premature

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Reflection

Definition

Describing the feelings of the client’s message.

Example:

Client: Since I have had the baby, my husband isalways busy at work and I have to do everythingby myself and it is hard to keep up.

Therapist: You are feeling overwhelmed bybecoming a new mother?

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Reflection: Purpose

To encourage the client to express more of his

or her feelings

To have the client experience feelings moreintensely

To help the client become more aware of their 

feelings

To help the client discriminate accurately

among feelings

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Paraphrasing and Reflection

Client: Everything is humdrum. There’s nothing newgoing on, nothing exciting. All my friends are away. Iwish I had money to do something different.

Paraphrase: With your friends gone and no moneyaround, there is nothing for you to do right now.

Reflection: You feel bored with the way things are for you right now.

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Summarizing

Definition: 

Two or more paraphrases or reflections that

condense the client’s message or thesession.

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Summarizing: Purpose

To tie together multiple elements of the

client’s message

To identify a common theme To interrupt excessive talking

To review progress

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Overview Psychological

AssessmentPlanning the assessment (why is person

being assessed?)

Data collection (interviews, tests,observations etc)

Data processing (clinical vs. statistical

prediction)

Communicating findings (written reports)