Mental Disorder

The Psychological Interview The Best Evaluation Method?

Posted by Mike Robinson

Last Updated on March 13, 2023 by Mike Robinson

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, we use 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 again when communicating the results, which 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 which someone asks for help and another offers it.

This assumes that there is a difference in roles among the participants. In addition, an asymmetric relationship can be seen since one is the expert, the professional, and the other is 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.
The Psychological Interview the Best Evaluation Method?
Young man going through a psychological interview.

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 operational way, taking into account the observable and definable characteristics.

  • Identify the background and consequences that may be influencing the demand posed by the subject.

  • Know attempts at solutions put into practice by the subject and develop hypotheses.

  • Plan the process of psychological evaluation and develop an integrative conceptual map.

Characteristics of the psychological interview

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 whole.

Despite all the advantageous characteristics of the interview, there are two sources of problems: the information obtained is based on the report  of the subject, and it is difficult to separate the execution of the technique from the usual ways in which people behave in an  interactive situation.

That is, it is difficult to discern among themselves whether 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 interview

During the development of psychological interviews, we can refer to three basic sections: 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.

Pre-interview

The professionals do not usually receive a patient directly, but there is another who receives the patient’s request for consultation. In  this stage, the person in charge must collect information about the patient (who calls, how old he or 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 about what is said and how it is said, which will be recorded verbatim. And, finally, the referent will be noted  (if it is derived or on its own initiative).

Interview

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 at mutual  knowledge. There is no stipulated way to receive the patient, but it is advised to take care to maintain an 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 : this 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 consequents, 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, refuse to leave, cry, or 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 .

Post interview

In this phase, the psychologist will complete the notes that he has taken during the interview, write down his impressions, and formulate a map about the problems that  have been brought to his attention.

Types of interviews

There are many different interviews. Next, different classifications will be presented according to the structure, purpose, temporality, and age of the document.

Type of structuring

  • Structured: has an established and generally standardized script. There are two modalities: the mechanized, in which the patient is placed in front of a computer to answer some questions, and the guided questionnaire, where the patient responds to the interrogation of the examiner or answers by himself.
  • Semi-structured: a preliminary script that can be altered during the interview (altering the order, the formulation, etc.).
  • Free: It allows the interviewee to speak according to their needs through multiple open-ended, wide-ranging questions.

Psychological interview purpose

  • Diagnosis: it is usually followed by other instruments that allow contrasting what was collected in the interview.
  • Consultative : it tries to give an 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 one’s own investigation.

Stage of the interviewing process

  • Initial : opens the relational process and identifies the object and objectives.
  • Interview of complementary information: it is useful to know more data (relatives, external professionals, etc.).
  • Biographical interviews, or anamnesis, are used in child psychology and are 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, etc.).
  • Return interview : The psychologist offers information on diagnosis, prognosis, and silver therapeutic strategies. At stake are the  understanding of the problem, the motivation for change, and the 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 a successful response to the problem.

Age considerations

  • Interview with 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 knowledge of the evolutionary characteristics is essential.

In children between 0 and 5 years, games and 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 impairments require special training for the type of relationship, the language, the  way of asking, the objectives of the change, and the economic, social, and emotional support.

Fundamental aspects of being a good interviewer

While conducting a psychological interview with a patient, several factors must be considered to acquire accurate and useful information. These refer to attitudes, listening skills, and communication skills.

Attitudinal characteristics
Empathy

During a psychological interview, empathy is the ability to understand the patient on a cognitive and emotional level and convey that understanding. Bleguer called it “instrumental dissociation “, that is, dissociation that the professional experiences. On one hand he 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.

Empathy means understanding the other’s problems, grasping their feelings, and putting yourself in their place. It also means trusting in their capacity to get ahead, respecting their freedom and intimacy and not judging them. 

Warmth

The warmth refers to the positive acceptance of the patient, manifested by physical proximity, gestures, verbal reinforcements, etc.

Competition

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 be referred to another professional.

Flexibility and tolerance

It implies that the psychologist knows how to respond to unforeseen situations without losing sight of 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, and theoretical model; this translates into acting with  sincerity, honesty, and an open attitude, respecting the informed consent of the patient, maintaining confidentiality, and protecting information.

Listening skills

Within this category, we find aspects such as maintaining eye contact, physical proximity, gestures …

The attitude of the psychologist must be receptive, and she must stop talking. This can be achieved through the following actions:

  • Show the  patient your interest in listening.
  • Avoid distractions
  • Give the patient time to express himself without getting ahead.
  • Control the impulses.
  • Do not make  judgments based on what the patient says.
  • Offer a stimulating presence.
  • Keep the silences (favor listening and encourage others 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.

Communication skills

A) Strategies to elicit or maintain communication

Within these strategies, we find the specular technique, consisting of repeating the last thing the person said. This occurs by making the gesture; giving the word; making confirmatory comments; or expressing approval.

You can also repeat the facts, for example, to make sure you have not misunderstood.  

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, use 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 questions, 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.

They also use pressure techniques and direct confrontation techniques (so that they are aware of their contradictions). Also, techniques of remembering limits such as time pressure, focusing the problem, and reviewing symptoms.

Also read: What are nervous tics?

Conclusion

The interview is one of the most commonly used evaluation techniques nowadays. It allows for the collection of a wide variety of fundamental aspects when evaluating a person in a short period of time. It also greatly facilitating the subsequent planning, both evaluative and therapeutic.

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