Lec 4.3 - Facilitating Interviews

Interview

• Situation in which two or more people verbally communicate with each other about a particular subject matter for a specific purpose

• A shared verbal experience between the interviewer and the interviewee, organized around the asking and answering of questions

• Focus on:

  • Discovering the needs, concerns, and aspirations of the client

  • Determining how to best help or benefit the client

Interview as Evaluation

• Frequently occurs at the beginning of the therapist’s work with a client

  • Understand the client’s story

  • Begin to form a collaborative relationship with the client

Interview as part of the intervention

• Involves reviewing what has happened during the course of therapy, thus anticipating and planning for any modification of what was agreed upon during the initial interaction 

Structured Interview

• According to Structure

• Standardized interviews

• With predetermined questions and fixed responses

Semi-structured Interview

• According to Structure

• With predetermined questions, but the interviewer may ask questions to probe and clarify

• General outline is used for the flow

Unstructured Interview

• According to Structure

• Interviewer explores whatever seems to be essential, useful, and pertinent to the interest of the interviewee

• No predetermined questions

• Requires great skill and sensitivity to the client and the interview process

Initial Interview

• According to Initial-Terminal Continuum

• Beginning basis for what needs to be evaluated in the succeeding interviews

• Facilitates establishment of rapport

• Includes client’s demographic data, chief complaint, goals for treatment, pre-morbid personality, and medical history

On-going Interview

• According to Initial-Terminal Continuum

• Occur over an extended period of time

• Focus on single or specified issues, which have been mutually agreed upon

• E.g., interview during re-evaluation

Terminal Interview

• According to Initial-Terminal Continuum

• Conclusion of the treatment

• Review the findings and general assessment statement of the interviewee’s problems, strengths, and concerns

• Discuss recommendations, suggestions, anticipated difficulties, and future plans

Consultations

• According to Function in the OT Process

• Assess:

  • individual's level of functioning with a particular area of occupational performance

  • Potential for occupational therapy treatment

Referrals

• According to Function in the OT Process

• Made when the facility cannot provide the service needed by the client

• Referring person explains the services that the other facility can offer and the reason of the referral

School Setting Interview

• OT Interviews for Children and Adolescents

• Appropriate for students from about age 9 through high school,  requires about 40 minutes to administer. 

• Collaborative interview that allows children and adolescents to describe the impact of environment on their functioning in multiple school settings and to identify any need for accommodations

Adolescent Role Assessment

• OT Interviews for Children and Adolescents

• Yields information on childhood play, socialization with family, peers, and at school, as well as occupational choice and work

Occupational Role History

• OT Interviews for Adolescents and Adults

• For short-term acutely ill adult psychiatric patients

• It gathers information on role status, and balance of leisure and role activities

Worker Role Interview

• OT Interviews for Adolescents and Adults

• A semi structured interview 

• Appropriate to use with individuals whose disability has had an impact on his or her participation to work

Work Environment Impact Scale

• OT Interviews for Adolescents and Adults

• Semi-structured interview and rating scale 

• For individuals who are actively anticipating returning to a specific job or type of work. 

• Describes the extent to which environmental factors affect performance, satisfaction, and the physical, social, and emotional well-being of the worker.

Canadian Occupational Performance Measure

• OT Interviews for Adolescents and Adults

• Measures perceived performance and level of satisfaction

Occupational Self-Assessment

• Questionnaires

• Gather client’s perceptions of their occupational competence and impact of the environment in their functioning

Occupational Questionnaire

• Questionnaires

• Client-centered semi-structured interview 

• Measure clients’ perceptions of their functioning in the areas of self-care, productivity, and leisure over time

Leisure Satisfaction Index

• Anchored Rating Scales

• Developed to evaluate extent to which people perceive certain needs as satisfied through leisure activities. 

• It focuses on psychological, educational, social, relaxational, physiologic, and aesthetic needs

Life Attitude Profile

• Anchored Rating Scales

• Assess attitudes toward life.

• It provides information on three major areas: degree of existential meaning and purpose of life, strength of motivation to find meaning, and acceptance in the present of future potential 

Self-Awareness

• Qualities of a good interviewer

• Being aware of one’s own attitudes and how these may potentially influence other’s behavior positively or negatively

• The more the interviewer knows themself, the better they will evaluate, understand, and control their own behavior

Cultural Awareness

• Qualities of a good interviewer

• Aware of the cultural differences and biases that could affect the interview process

• The behavior is inexplicably culturally-derived

  • Understanding of the client’s culture = understanding of the client’s narrative

Humanness and Self-Acceptance

• Qualities of a good interviewer

• The interviewer must first accept themself as a human being

• Allows one to treat and accept others as an equal, deserving of respect as another human being with their own attitudes, values and beliefs

Trustworthiness

• Qualities of a good interviewer

• Important as answering questions during the interview involves a fair amount of risk in the part of the client

• Makes it easier for the client to share his thoughts and feelings

Genuineness

• Qualities of a good interviewer

• Becoming real and honest clients

• Assures the client that you are direct and truthful while being careful not to blame or condemn him

Sincerity

• Qualities of a good interviewer

• Being forthright, candid, and truthful

• Involves attributes aforementioned as well as creating an atmosphere that is free from hypocrisy

Warmth and Caring

• Qualities of a good interviewer

• Expresses care and concern

• Expresses a liking a regard for others and communicates a watchfulness that may indicate the problem and the possible solution

Sympathy and Empathy

• Qualities of a good interviewer

• Respond to the emotional state of others, acknowledging the feelings expressed 

• Ability to assume another’s private world as if it were your own

Respect

• Qualities of a good interviewer

• Interviewer’s ethical responsibility

• Critical to the success of the interview

• Accepting the diversity of our clients, particularly those that oppose the our own and seeing them as unique beings with their own goals, deserving of help

Objectivity

• Qualities of a good interviewer

• Being as free from expectations as possible

• Awareness of one’s tendencies and biases allows an objective assessment of any conclusions

• Not over- or underestimate the other person, or expect certain behaviors from them

Children and Younger Adolescents

• Would describe themselves in more observable terms

• Would differentiate themselves from other through observable traits than on internal states

• Factors affecting children and adolescents in responding to interviews:

  • Inherent power imbalance between a child and the adult

  • Age-appropriate communication, short, simple, direct, concrete questions

  • Involvement of people in the child’s environment 

Older Adolescents and Adults

• Able to describe themselves in an abstract, psychological and interpersonal terms, rather than concrete and observable terms

• Describe and evaluate their feelings, thoughts, and behavior and learn to analyze other’s reactions to their behavior

• Best to have one or both parents present for the initial meeting but make time for separate, private discussions. 

Older Persons

• Ability to perveive and understand declines with age.

• Interviewer must be conscious of the tone, pitch, rate, and loudness of their voice.

• Biases and prejudices against older people, such as them being “weak, dependent, out of touch, talkative, and close-minded”. 

• They are treasure troves of wisdom and rich experiences.