Clinical Interviewing

Preface................................... xiii 
About the Authors ............................ xxi
Part One: Foundations of Clinical Interviewing . . . . . . . . . . . . . . 1 
Chapter 1: An Introduction to the Clinical Interview . . . . . . . . . . . 3
Learning Objectives............................ 3 
Chapter Orientation ........................... 3 
Welcome to the Journey ......................... 3 
What Is a Clinical Interview?...................... 5 
Clinical Interviewing versus Counseling and Psychotherapy . . . . 7 
A Learning Model for Clinical Interviewing . . . . . . . . . . . . . 13 
Multicultural Competencies ...................... 17 
Multicultural Humility ......................... 25 
Summary.................................. 28 
Suggested Readings and Resources................... 29
Chapter 2: Preparation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Learning Objectives............................ 31 
Chapter Orientation ........................... 31 
The Physical Setting ........................... 31 
Professional and Ethical Issues ..................... 38 
Multicultural Preparation........................ 55 
Stress Management and Self-Care ................... 65 
Summary.................................. 68 
Suggested Readings and Resources................... 68
Chapter 3: An Overview of the Interview Process . . . . . . . . . . . . . 71
Learning Objectives............................ 71 
ChapterOrientation ........................... 71 
StagesofaClinicalInterview ...................... 71 
TheIntroduction ............................. 73 
TheOpening................................ 84 
TheBody.................................. 90 
TheClosing ................................ 95
 vi
Contents
 EndingtheSession(Termination) ................... 104 
Summary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107 SuggestedReadingsandResources................... 109
Part Two: Listening and Relationship Development . . . . . . . . . . . 111 
Chapter4:NondirectiveListeningSkills. . . . . . . . . . . . . . . . . . . 113
LearningObjectives............................ 113 
ChapterOrientation ........................... 113 
ListeningSkills .............................. 113 
Adopting a Therapeutic Attitude.................... 114 
Why Nondirective Listening Is Also Directive . . . . . . . . . . . . 123 
The Listening Continuum in Three Parts . . . . . . . . . . . . . . . 125 
Nondirective Listening Behaviors: Skills for Encouraging Client Talk .................. 126 
Ethical and Multicultural Considerations . . . . . . . . . . . . . . . 142 
Not Knowing What to Say........................ 145 
Summary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 146 
Suggested Readings and Resources................... 147
Chapter 5: Directive Listening Skills .....................149
Learning Objectives............................ 149 
Chapter Orientation ........................... 149 
Directive Listening Behaviors: Skills for Encouraging Insight..................... 150 
Ethical and Multicultural Considerations
When Using Directive Listening Skills . . . . . . . . . . . . . . . 175 
Summary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 178 
Suggested Readings and Resources................... 179
Chapter 6: Skills for Directing Clients Toward Action . . . . . . . . . . . 181
Learning Objectives............................ 181 
Chapter Orientation ........................... 181 
Readiness to Change . . . . . . . . . . . . . . . . . . . . . . . . . . . 181 
Skills for Encouraging Action: Using Questions . . . . . . . . . . . 184 
Using Educational and Directive Techniques . . . . . . . . . . . . . 192 
Ethical and Multicultural Considerations
When Encouraging Client Action ..................204 
Summary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 215 
Suggested Readings and Resources................... 216
Chapter 7: Evidence-Based Relationships. . . . . . . . . . . . . . . . . . 217
Learning Objectives............................ 217  
Chapter Orientation ........................... 217
The Great Psychotherapy Debate.................... 217
Carl Rogers’s Core Conditions......................218
Other Evidence-Based Relationship Concepts Evidence-Based Multicultural Relationships . 233
Summary. . . . . . . . . . . . . . . . . . . . . . 250
Suggested Readings and Resources . . . . . . . 254
Part Three: Structuring and Assessment ..... 
Chapter 8: Intake Interviewing and Report Writing
Learning Objectives............................ 257 
Chapter Orientation ........................... 257 
What’s an Intake Interview?....................... 257 
Identifying, Evaluating, and Exploring Client Problems and Goals . 259 
Obtaining Background and Historical Information . . . . . . . . . 267 
Assessment of Current Functioning .................. 276 
Brief Intake Interviewing ........................280 
The Intake Report............................. 282 
Do’s and Don’ts of Intake Interviews with Diverse Clients. . . . . . 298 
Summary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 300 
Suggested Readings and Resources................... 301
Chapter 9: The Mental Status Examination . . . . . . . . . . . . . . . . .303
Learning Objectives. . . . . . . . . . . . . . . . . . . . . . . . . . . . 303 
Chapter Orientation ...........................303 
What Is a Mental Status Examination? ................303 
Individual and Cultural Considerations . . . . . . . . . . . . . . . . 305 
The Generic Mental Status Examination . . . . . . . . . . . . . . . 308 
When to Use Mental Status Examinations . . . . . . . . . . . . . . 340 
Summary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 342 
Suggested Readings and Resources . . . . . . . . . . . . . . . . . . . 342
Chapter 10: Suicide Assessment . . . . . . . . . . . . . . . . . . . . . . . . 345
Learning Objectives. . . . . . . . . . . . . . . . . . . . . . . . . . . . 345 
Chapter Orientation ...........................345 
Facing the Suicide Situation . . . . . . . . . . . . . . . . . . . . . . . 345 
Suicide Risk Factors, Protective Factors, and Warning Signs . . . . 348 
Building a Theoretical and Research-Based Foundation . . . . . . . 356 
Suicide Assessment Interviewing . . . . . . . . . . . . . . . . . . . . 360 
Suicide Interventions . . . . . . . . . . . . . . . . . . . . . . . . . . . 380 
Ethical and Professional Issues ..................... 385 
Summary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 389 
Suggested Readings and Resources................... 390
Chapter 11: Diagnosis and Treatment Planning . . . . . . . . . . . . . .393
Learning Objectives............................ 393 
Chapter Orientation ........................... 393 
Modern Diagnostic Classification Systems . . . . . . . . . . . . . . 393 
Defining Mental Disorders........................ 396 
Diagnostic Interviewing . . . . . . . . . . . . . . . . . . . . . . . . . 404 
The Science of Clinical Interviewing:
Diagnostic Reliability and Validity . . . . . . . . . . . . . . . . . . 406 
Less Structured Diagnostic Clinical Interviews . . . . . . . . . . . 409 
Treatment Planning ........................... 415 
Case Formulation and Treatment Planning:
A Cognitive-Behavioral Example . . . . . . . . . . . . . . . . . . . 423 
Additional Cultural Modifications and Adaptations . . . . . . . . . 427 
Summary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 428 
Suggested Readings and Resources . . . . . . . . . . . . . . . . . . . 430
Part Four: Special Populations and Situations . . . . . . . . . . . . . . .431 
Chapter 12: Challenging Clients and Demanding Situations . . . . . . 433
Learning Objectives............................ 433 
Chapter Orientation ........................... 433 
Challenging Clients ........................... 433 
Motivational Interviewing and Other Strategies for Working Through Resistance . . . . . . . . . . . . . . 436 
Assessment and Prediction of Violence and Dangerousness . . . . 451 
Demanding Situations: Crisis and Trauma . . . . . . . . . . . . . . 456 
Cultural Competencies in Disaster Mental Health . . . . . . . . . . 468 
Summary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 470 
Suggested Readings and Resources................... 471
Chapter 13: Interviewing Young Clients. . . . . . . . . . . . . . . . . . .473
Learning Objectives............................ 473 
Chapter Orientation ........................... 473 
Considerations in Working With Young Clients . . . . . . . . . . . 473 
The Introduction ............................. 475 
The Opening . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 479 
The Body of the Interview . . . . . . . . . . . . . . . . . . . . . . . . 490 
Closing and Termination ........................503 
Culture in Young Client Interviews ..................506 
Summary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 508 
Suggested Readings and Resources . . . . . . . . . . . . . . . . . . . 508
Chapter 14: Interviewing Couples and Families . . . . . . . . . . . . . . 511
Learning Objectives............................ 511 
Chapter Orientation ........................... 511 
Challenges and Ironies of Interviewing Couples and Families . . . 511 
The Introduction ............................. 514 
The Opening . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 522 
The Body . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 528 
Closing and Termination. . . . . . . . . . . . . . . . . . . . . . . . . 540 
Special Considerations.......................... 541 
Diversity Issues ..............................546 
Summary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 549 
Suggested Readings and Resources................... 550
Chapter 15: Electronic and Telephonic Interviewing . . . . . . . . . . . 553
Learning Objectives............................ 533 
Chapter Orientation ........................... 553 
Technology as an Extension of the Self ................554
Definition of Terms and Communication Modalities . . . . . . . . 557 
Non-FtF Assessment and Intervention Research . . . . . . . . . . . 561
Ethical and Practical Issues: Problems and Solutions . . . . . . . . 565  
Conducting Online or Non-FtF Interviews . . . . . . . . . . . . . . 573
Multicultural Issues: Culture and Online Culture . . . . . . . . . . 575
Summary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 576
Suggested Online Training Resources . . . . . . . . . . . . . . . .. 577  
Appendix: Extended Mental Status Examination Interview Protocol References .....................................589 Author Index . . . . . . . . . . . . . . . . . . . . 639 
SubjectIndex. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .655