COMP (2025) - Clinical Interviewing

Clinical Interview

A flexible, multidimensional process for assessment and helping

Two Goals of Clinical Interviewing

Assessment and helping

Clinical Interview vs. Psychotherapy

Interviewing is short-term and diagnostic; psychotherapy is ongoing and change-focused

Four Multicultural Competencies

Cultural self-awareness, multicultural knowledge, culture-specific expertise, culture-sensitive advocacy

Multicultural Humility

Respect for other cultures, lack of superiority, and lifelong learning

Intersectionality

The interaction of overlapping identities that shapes experience

Three Core Conditions (Rogers)

Congruence, Unconditional Positive Regard, Accurate Empathy

Working Alliance Components

Goals, tasks, emotional bond

Interview Process Stages (Shea)

Introduction, Opening, Body, Closing, Termination

Role Induction

Explaining what to expect in therapy and the client's role

First Contact Tasks

Create comfort, explain roles, confidentiality, and structure

Importance of Time Boundaries

Sessions should start/end on time and respect cultural time perspectives

SOAP Note Format

Subjective, Objective, Assessment, Plan

Telehealth Considerations

Adjust setting and expectations, ensure privacy

Three Goals of Intake

Explore presenting problem, gather history, assess functioning

Paraphrase

Rephrasing the client's content in your own words

Reflection of Feeling

Echoing the client's emotional state

Clarification

Checking for understanding through tentative restatement

Summary

Recap of content and affect to guide session closure

Attending Behavior Components

Eye contact, body posture, vocal tone, verbal tracking

Behavioral ABCs

Antecedent, Behavior, Consequence

Feeling Validation

Acknowledging and normalizing the client's emotions

Interpretive Reflection

Uncovering deeper or hidden emotions (advanced empathy)

Interpretation

Connecting current behaviors to underlying causes

Reframing

Offering a new, constructive view of a situation

Confrontation

Pointing out discrepancies in client behavior/thinking

Immediacy

Addressing the here-and-now relationship between client and therapist

Types of Questions

Open, closed, swing, implied, projective

Therapeutic Question Example

"What would be different if you were well?"

CAGE Questions

Cut down, Annoyed, Guilty, Eye-opener

IS PATH WARM

Suicide warning signs acronym

SLAP Model

Specificity, Lethality, Availability, Proximity

SAD PERSONS

Suicide risk checklist (Sex, Age, Depression, etc.)

Joiner's Theory of Suicide

Thwarted belongingness + Perceived burdensomeness

Shneidman's Concept

Psychache: unbearable psychological pain

Sexual Abuse Follow-up Questions

What happened? Who? When? How many times?

Substance Use Exploration

Ask about OTC, prescription, street drugs, and effects

Purpose of MSE

Assess current cognitive, emotional, and behavioral functioning

Orientation x4

Person, Place, Time, Situation

Mood vs. Affect

Mood is self-reported; Affect is observed

Thought Process Issues

Tangentiality, circumstantiality, flight of ideas, word salad

Thought Content

Delusions, obsessions, SI/HI

Reliability

Consistency and believability of client's report

Insight Levels

Absent, Partial, Good

Judgment Assessment

Decision-making ability in real or hypothetical situations

Resistance

Client's unconscious avoidance or defense

Motivational Interviewing Phrase

"What would make this a helpful visit?"

Managing Vague Clients

Ask specific questions, help develop emotional vocabulary

PFA Core Actions

Safety, comfort, stabilization, info, support, coping, referrals

Interviewing Children - Five Stages

Introduction, Opening, Body, Closing, Termination

Child Assent vs. Consent

Consent from caregiver, assent from child

Play-Based Tools

Kinetic Family Drawing, HTP, storytelling

DSM-5-TR Definition

Clinically significant distress or impairment, not due to substance or medical issue

Differential Diagnosis

Ruling out other conditions before final diagnosis

Case Formulation

Synthesized summary of client's issues, causes, and treatment needs

Structured vs. Unstructured Interviews

Structured are reliable but inflexible; unstructured are flexible but need skill

Treatment Planning Steps

Problem selection, goal setting, intervention creation

Client Involvement in Feedback

Helps clarify, builds trust, improves accuracy and motivation

Feedback Best Practices

Avoid jargon, monitor reaction, emphasize strengths, offer hope

Empirically Supported Treatment Match

Align interventions with diagnosis and client preferences

Cultural Formulation Interview Use

Helps gather client's cultural perspective to inform diagnosis and planning

Role of Informants

Family, caregivers, or others who can offer additional insight into client's symptoms or behavior