The psychological interview is the most used evaluation technique in psychology, specifically in the clinical field. Its use is justified by its effectiveness both to investigate non-observable contents and to serve as a guide and guidance on what content should be evaluated with other procedures.
Through psychological evaluation, the behavior of an adult or child is explored and analyzed based on different objectives:
If we want to make a description of the subject in relation to their behavior.
If we want to make a diagnosis of the person.
If we want to choose a person for a particular job, selection and prediction.
If we want to give some explanation to some behavior or way of being of a person.
If we need to observe if there have been changes in a person and if, therefore, the treatment has been effective …
All these aspects are covered by the psychological clinical interview, an instrument that we can classify within the general category of self-reports, and through which we obtain information, prior to diagnosis and even to any type of intervention.
The interview is usually given at the beginning of the evaluation and when communicating the results, what is known as a return interview.
Functions of the interviews
The interview is a conversation and / or interpersonal relationship between two or more people, with certain objectives, that is, with a purpose, in lav that someone asks for help and another offers it.
This assumes that there is a difference of roles in the participants. In addition, an asymmetric relationship can be seen , since one is the expert, the professional, and the other the one who needs help.
Its main functions are:
- Motivating function : since through the interview a relationship that stimulates change is stimulated.
- Clarifying function : the exposure of the problems by the patient and ordering them, helps the subject to clarify them.
- Therapeutic function : it occurs when verbalizing, because the psychologist gives alternatives.
Objectives of the interview
Among the objectives that are intended to be achieved when it is decided to use an interview to clarify the person’s demand, we find the following:
Establish a good climate of trust appropriate to promote patient communication.
Perceive the patient’s total behavior, both verbal and non-verbal.
Maintain active listening with the patient and observe.
Stimulate verbal expression.
Define the problem in an operative way, taking into account the observable and definable characteristics.
Identify background and consequences that may be influencing the demand posed by the subject.
Know attempts of solution put into practice by the subject and develop hypotheses.
Plan the process of psychological evaluation, and develop an integrative conceptual map.
Characteristics of the interviews
Next, I will cite the main characteristics of this means of evaluation:
- It is an evaluation that is carried out through a conversation with a purpose. It is intended to collect data through the self-report of the evaluated subject, and to collect information from a third party.
- It includes the respondent’s demand, that is, all that information of a broad, general, specific and concrete nature. The psychologist must identify and clarify the demand.
- The interview takes place in a pre-established space and time. It is usually in the psychologist’s office.
- There is a reciprocal influence between the individuals involved, this influence is bidirectional.
- The relationship between interviewer and interviewee starts from mutual ignorance, however, the task of the interviewer will be to gather information to achieve a good knowledge of the patient and their environment in a short period of time (around 40-50 minutes) .
- The relationship that occurs in an interview works as a Gestalt, as a whole.
Despite all the advantageous characteristics of the interview, there are 2 sources of problems: the information obtained is based on the report of the subject and there is a high difficulty in separating the execution of the technique from the usual ways in which the people behave in an interactive situation.
That is, it is difficult to discern among themselves what the interviewee responds to is how the subject behaves habitually, or if, on the contrary, he is responding in a different way to the knowledge being evaluated.
Stages of the interviews
During the development of psychological interviews we can refer to three basic sections present, on the one hand, the pre-interview, on the other the interview, and finally the post-interview. In each stage different tasks and characteristics of house one are carried out.
The professionals do not usually receive a patient directly, but there is another who receives the request for consultation of the patient. In this stage, the person in charge must collect information about the patient (who calls, how old he / she is and contact information); about the reason for consultation, which will be collected briefly so as not to interfere with the work of the clinician, and what is said and how it is said will be recorded verbatim. And, finally, the referent will be noted (if it is derived or on its own initiative).
In this stage we can distinguish different sub-stages:
- Basic knowledge phase: in this one there are three aspects to consider; physical contact, social greetings and attempts of mutual knowledge. There is no stipulated way to receive the patient, it is advised to take care of empathic and warm attitude with care, as well as non-verbal communication. The interview is opened by clarifying the objectives that are pursued with the evaluation, the time of intervention and the knowledge we have of their demand.
- Phase of exploration and identification of the problem : it is the body of the interview and lasts approximately 40 minutes. An analysis of the demands, complaints and goals of the patient is carried out. The psychologist must make clear what their role is, guide the interviewee and use their knowledge and experiences to understand the problem, develop hypotheses, analyze the background and consequent, and explore the previous solutions. Before going on to the next phase, the psychologist should make a synthesis of the problems raised and a summary will be formulated to the patient of what we have obtained with the interview, in order to obtain a feedback of their part.
- Farewell phase : in this phase the patient is dismissed. Previously, the working method to be followed will be clarified in the next sessions and a new appointment will be made. There are patients that when they reach this stage they refuse to leave, they cry or they feel bad because they just remember something important that they had to communicate … In these cases the patient will be told that they will be able to discuss it in the next session, so do not worry .
In this phase the psychologist will complete notes that he has taken during the interview, write down his impressions and formulate a map about the problems that have consulted him.
Types of interviews
There are many different interviews. Next, different classifications will be presented according to the structure, purpose, temporality and age.
According to the structuring
- Structured : has an established and generally standardized script. Two modalities: the mechanized, in which the patient is placed in front of a computer to answer some questions and the questionnaire guided by the examiner, where the patient responds to the interrogation of the examiner, or he answers by himself.
- Semi-structured : preliminary script that can be altered during the interview (altering the order, the formulation …).
- Free : it allows the interviewee to speak according to their needs, through multiple open-ended, wide-ranging questions.
According to the purpose
- Diagnosis : it is usually followed by other instruments that allow contrasting what was collected in the interview.
- Consultative : it tries to give answer to a specific subject, the final aim is not destined to continue with a later clinical work.
- Of vocational orientation: its objective is to guide people in relation to which studies to choose or which is the ideal professional field.
- Therapeutics and advice : they aim at a change agreed upon by both parties.
- Of investigation : to determine according to previously defined criteria the ascription or not of a subject to the own investigation.
According to the temporality
- Initial : opens the relational process and identifies the object and objectives.
- Interview of complementary information : useful to know more data (relatives, external professionals …).
- Biographical interviews or anamnesis : used in child psychology and is essential for diagnosis. They go through evolutionary milestones , early development, autonomy, the acquisition of basic functions (questions are asked about pregnancy, childbirth, if you had problems eating, when you started talking …).
- Return interview : the psychologist offers information on diagnosis, prognosis and silver therapeutic strategies. At stake is the understanding of the problem, motivation for change and adaptation strategies proposed. This interview is also known as a verbal report.
- High clinic interview, physical and administrative farewell : useful to physically and administratively dismiss the patient and close the case, ends because the objective has been met, or because there has been an successful response to the problem.
According to age
- Interview to children and adolescents : in general they do not ask for help by themselves (only 5% do it), but the demand comes from adults, and these are usually involved in the problem and the resolution. A very personalized adaptation must be made and the knowledge of the evolutionary characteristics is essential.
In children between 0 and 5 years, the game and the graphic and plastic expressions are usually used (it must be taken into account that from 0 to 3 years the presence of mothers is important ).
In children between 6 and 11 years old, between six and eight drawings and games are used. And then the use of language is evaluated.
- Interview with adults : interviews with the elderly and people with impairment require special training for the type of relationship, the language, the way of asking, the objectives of the change, the economic, social and emotional support.
Fundamental aspects to be a good interviewer
When carrying out a psychological interview with a patient, it is necessary to take into account a series of aspects that will facilitate the obtaining of congruent and valuable information. These refer to attitudes, listening skills and communication skills.
The empathy is the ability to understand the patient to cognitive and emotional level, and convey that understanding. Bleguer called it “instrumental dissociation “, that is, dissociation that the professional experiences, which on the one hand must show an attitude of emotional closeness, and on the other, remains distant. Three basic conditions must be met: congruence with oneself, unconditional acceptance of the other and putting oneself in the place of the other without ceasing to be oneself.
Being empathetic means understanding the other’s problems, grasping their feelings, putting themselves in their place, trusting in their capacity to get ahead, respecting their freedom and intimacy, not judging them, accepting them as they are and how they want to be, and seeing the other from itself.
The warmth refers to the positive acceptance of the patient, manifested by physical proximity, gestures, verbal reinforcements …
The therapist must demonstrate his experience and ability to propose solutions to the patient. It is very useful to anticipate what the patient is going to say, if he knows him well, because it makes him see that the therapist is competent and knows what he is talking about. In case the psychologist considers that the case exceeds its own limitations, it should refer to another professional.
Flexibility and tolerance
It implies for the psychologist to know how to respond to unforeseen situations, without losing the objective pursued. The professional has to be flexible to adapt to the diversity of people with whom he works.
Honesty and professional ethics
The psychologist will work being consistent with its principles, values, its theoretical model, this translates into acting with sincerity, honesty and open attitude, respecting the informed consent of the patient, confidentiality and protection of information.
Within this category we find aspects such as maintaining eye contact, physical proximity, gestures …
The attitude of the psychologist must be receptive and must stop talking. This can be achieved through the following actions:
- Show the patient the interest of listening.
- Avoid distractions
- Give the patient time to express himself and not get ahead.
- Control the impulses.
- Do not make judgments of what the patient says.
- Offer a stimulating presence
- Keep the silences (favor listening and encourage to speak).
- Do not interrupt
- Take time to respond (it has been seen that if you wait for about 6 seconds, the interviewee is encouraged to continue speaking).
- To give help.
- Rectify cognitive errors as distortions or generalizations.
- Clarify the expressed emotions.
- Guide the patient to understand their discomfort and propose changes.
A) Strategies to elicit or maintain communication
Within these strategies we find the specular technique, consisting of repeating the last thing the patient said or making the gesture; give the word; make confirmatory comments or express approval.
You can also use the feedback of the facts, for example, make sure you have not misunderstood by expressing the subject “if I have misunderstood …” and / or behavior, for example, we say to a teenager “when you turn your eyes away” , the teachers feel that they are not being taken care of “.
It also uses pointing or underlining when we want to show a problem. Or interpretation, when we want to establish causes and effects. Finally, psychologists when they observe that a patient is trying to avoid a topic uses the parachute landing to approach it, in a surprising and direct way.
B) Strategies to ask questions
Psychologists use a multitude of types of questions. Among them we find open, closed questions, facilitating questions (not ambiguous), p. clarifiers (intended to clarify an ambiguous aspect), p. with heading, p. guided (or with an induced response, the question implies a monosyllabic response) and p. of confrontation (be cautious, usually enunciate to answer yes or no). The return of questions is also used , with the objective that the patient searches for the answers themselves.
On the other hand, they use pressure techniques, direct confrontation techniques (so that they are aware of their contradictions and techniques of remembering limits such as time pressure, focusing the problem and reviewing symptoms.
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The interview is one of the most used evaluation techniques nowadays because it allows to collect a wide variety of fundamental aspects when evaluating a person, in a short period of time and greatly facilitating the subsequent planning, both evaluative and therapeutic.