Client Interviews

Client Interviews

Clinical interviewing is the most commonly used assessment technique in counseling. Interviewing refers to the process by which a professional counselor uses clinical skills to obtain client information that will facilitate the course of counseling. Typically, clinical interviews are used to gather information concerning a client’s demographic characteristics, presenting problems, current life situation, family, educational status, occupational background, physical health, and mental health history. Many different types of interviews exist, and they can all be classified as structured, semistructured, or unstructured.

• Structured interviews use a series of pre-established questions that the professional counselor presents in the same order during each interview. The structured interview tends to be detailed and exhaustive as it covers a broad area of topics. Because the questions are predetermined and asked in a sequential manner, structured interviews provide consistency across different clients, counselors, and time periods. However, they do not provide the flexibility to ask follow-up questions or explore client issues more in depth. 
• Semi-structured interviews use pre-established questions and topic areas to be addressed; however, the professional counselor can customize the interview by modifying questions, altering the interview sequence, or adding follow-up questions. Although semistructured interviews allow for more flexibility, they are more prone to interviewer error and bias. Therefore, the results are considered less reliable than structured interviews.
• Unstructured interviews do not use pre-established questions and tend to rely on the client’s lead to determine a focus for the interview. Typically, professional counselors rely on open-ended questioning and reflective skills when conducting an unstructured interview. This type of interview provides the most flexibility and adaptability, but the results are the least reliable and most subject to interviewer error.

Here are some steps and considerations for conducting a clinical interview:

1. Preparation

Review the client’s background information, including any relevant medical or mental health records.

Familiarize yourself with the specific reason for the interview and the goals you aim to achieve during the session.

2. Establish Rapport

Create a safe and supportive environment to help the client feel comfortable sharing their experiences.

Begin by introducing yourself, explaining the purpose of the interview, and ensuring confidentiality. 

Use active listening skills, empathy, and non-verbal cues to convey your genuine interest and understanding.

3. Structuring the Interview

Depending on the nature and goals of the interview, you can choose between a structured or semi-structured approach. A structured interview follows a predetermined set of questions, while a semi-structured interview allows for flexibility and exploration based on the individual’s responses. 

Consider using open-ended questions to encourage the person to provide detailed information and share their perspective.

4. Gathering Information

Collect information about the client’s current concerns, symptoms, and their impact on daily life.

Explore their personal and family history, medical history, and any previous treatment experiences.

Inquire about their emotional experiences, thought patterns, behavioral patterns, and any precipitating or maintaining factors related to their anxiety or depression.

Use probing questions to gain a deeper understanding of their experiences and perspectives.

5. Assessing Severity

Assess the severity and duration of symptoms to determine the impact on the individual’s functioning.

Ask about the frequency, intensity, and duration of specific symptoms related to anxiety or depression.

Use rating scales or standardized measures, if appropriate, to gather more objective data.

6. Providing Psychoeducation

Educate the client about anxiety and depression, explaining common symptoms, potential causes, and treatment options.

Help them understand the nature of their difficulties within a clinical framework, reducing stigma and fostering self-awareness.

7. Formulating Impressions

Formulate a preliminary understanding of the individual’s condition based on the information gathered.

Consider any differential diagnoses or potential comorbidities. Note any strengths, resilience, or protective factors that may contribute to their well-being.

8. Collaborative Goal-Setting

Engage the client in developing treatment goals and exploring their expectations from therapy. 

Collaborate on an appropriate treatment plan, considering evidence-based interventions and the client’s preferences and resources.

9. Summarizing and Closing

Summarize the main points discussed during the interview, ensuring that the client feels heard and understood.

Provide an opportunity for them to ask questions or seek clarification.

Discuss next steps, such as follow-up appointments or referrals, if necessary.

Express appreciation for their participation and reaffirm your commitment to supporting their well-being.

Remember to adhere to ethical guidelines, maintain cultural sensitivity, and adapt your approach based on the client’s unique needs and circumstances. Clinical interviewing requires ongoing practice and refinement to develop effective communication skills and build a therapeutic alliance with the client.