[OT 124]: Lec. 4.3 - Facilitating Interviews

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

interview

Definitions of interview

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

• more structured due to its goal-based nature, interviewers have professional boundaries

• It is imperative to focus on the following concepts as you begin to conduct an interview

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

  • determining how to best help them

Interview Purposes

1. To gather and understand information or client’s story

2. To build the Therapeutic Alliance

3. To develop the Occupational Profile

4. To observe behavior

5. To identify problems

6. To clarify your role in the setting

7. To set goals

To gather and understand information or client’s story

• to uncover the specifics and understand the story, concerns, goals, aspirations

• understand the meaning that a person ascribes to an occupation and his/her perception of their performance

To build the Therapeutic Alliance

• provides opportunity to let the client know you care about what’s important to them

• facilitates mutual trust

To develop the Occupational Profile

• includes client’s daily use of time, roles, play, and leisure participation; and values, goals, and sense of competence relative to occupations

• includes client’s environment and occupational challenges

• helps determine client’s level of participation

To observe behavior

• client’s energy level, stamina, affect, comprehension, memory, concentration, thought organization, physical appearance, and interpersonal behavior

• informs how the client will respond to interventions

To identify problems

• aids in the formulation of an initial sense of a client’s strengths or assets

• helps in recognizing potential problems that might be addressed by OT interventions

To clarify your role in the setting

• facilitates clarification and elaboration of therapist’s role as well as the work he/she and the client may do together 

• therapists may explain what OT is, what services it offers, what options are available to the client, and possible recommendations 

To set goals

• goal setting: a mutual process in which the interviewer and the client collaborate and agree upon

• facilitate a client-centered approach in prioritizing problems identified and agreed upon by both parties

Types of Interview Schedules

1. Interview as Evaluation

2. Interview as (part of) Intervention

Interview as Evaluation

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

  • to understand the client’s story

  • to begin to form a collaborative relationship with the client

Interview as (part of) Intervention

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

Interview Types: According to structure

1. Structured interview

2. Semi-structured interview

3. Unstructured or Unstandardized interview

• standardized interviews

• with predetermined questions and fixated responses

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structured

• with predetermined questions but interviewer is free to ask other questions to probe and clarify interviewee’s responses

• a general outline is usually used to guide the questioning flow

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semi-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

unstructured/unstandardized

Interview types: According to Initial-Terminal Continuum (OT Process)

1. Initial Interview

2. On-going interviews

3. Terminal interviews

• provides a beginning basis for what needs to be evaluated in the next interviews

• facilitates establishment of rapport

• includes client’s demographics, chief complaint, goals med history

initial interview

• occur over an extended period of time

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

• interview during re-eval

on-going interviews

• occur at the conclusion of treatment

• focus is to review the findings and general assessment statement of the interviewee and to discuss recommendations, suggestions, anticipated difficulties, and future plans

terminal interviews

Interview types: According to function in the OT Process

1. Consultations

2. Referrals

Consultations

• done to assess:

  • individual’s level of functioning within a particular area of occupational performance

  • individual’s potential for OT treatment

Referrals

• made when facility cannot provide the services the client needs

• referring persons explain the services that the other facility can offer and the reason of referral

OT Interview Tools

1. OT For Children and Adolescents

2. OT Interviews for Adolescents and Adults

3. Questionnaires

4. Anchored Rating Scales

OT For Children and Adolescents

• SSI: School Setting Interview

• ARA: Adolescent Role Assessment

SSI

• school setting interview

• for students from 9 to high school

• around 40 minutes to administer

• collaborative interview: interviewees describe the impact of environment on their functioning and identify needs for accommodation

ARA

• adolescent role assessment

• provides info on childhood play, family/peer/school socialization, occupational choice, and work

OT Interviews for Adolescents and Adults

• ORH: Occupational Role History

• WRI: Worker Role Interview

• WEIS: Work Environment Impact Scale

• COPM: Canadian Occupational Measure

ORH

• occupational role history

• for use of short-term acutely ill adult psychiatric patients

• gathers info on role status and balance of leisure and role activities

WRI

• worker role interview

• semi-structured interview 

• for individuals whose disability impacts work participation

WEIS

• work environment impact scale

• semi-structured interview and rating scale

• for individuals actively anticipating to return to work

• describes extent to which environmental factors influence performance, satisfaction, and physical/social/emotional well-being of the worker

COPM

• canadian occupational performance measure

• measures perceived performance and level of satisfaction

Questionnaires

• OSA: Occupational Self-Assessment

• OQ: Occupational Questionnaire

OSA

• occupational self-assessment

• gathers a client’s perceptions of their occupational competence and the impact of the environment on their functioning

OQ

• occupational questionnaire

• client-centered semi-structured interview

• Measures a client’s perception of their functioning in self-care, productivity, and leisure over time

Anchored Rating Scales

• LSI: Leisure Satisfaction Index

• LAP: Life Attitude Profile

LSI

• leisure satisfaction index

• evaluates extent to which people perceive certain needs as satisfied through leisure activities

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

LAP

• life attitude profile

• assess attitudes toward life

• provides info in these three major areas:

  • degree of existential meaning and purpose in life

  • strength of motivation to find meaning

  • acceptance of present and future potential

Qualities of a Good Interviewer

1. Self-awareness

2. Cultural awareness

3. Humanness and Self-acceptance

4. Trustworthiness

5. Genuineness

6. Sincerity

7. Warmth/Caring

8. Sympathy/Empathy

9. Respect

10. Objectivity

• being aware of one’s own attitudes and how these may influence others’ behavior

• the more the interviewer knows himself, the better they will evaluate, understand, and control his behavior

self-awareness

• The interviewer needs to be aware of their cultural differences and biases that could potentially affect the interview process.

• The interviewee’s behaviors are also inexplicably culturally-derived; a good understanding of the client’s culture allows better understanding of the client’s narrative.

cultural awareness

• Interviewer must first accept themself as a human being

• Self-acceptance allows one to treat and accept others as an equal, deserving of respect as another human being who has their own attitudes, values, and beliefs

• To respect the client is to accept their humanity

humanness and self-acceptance

• Establishing an atmosphere of trust is important as answering questions during interviews involves a fair amount of risk in the part of the client

• Nurturing mutual trust make it easier for the client to share his thoughts and feelings

trustworthiness

• Becoming real and honest to clients

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

genuineness

• Being forthright, candid, and truthful

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

sincerity

Warmth/Caring

Warmth: attitude expressing care and concern

Caring: expressing liking or regard for others, communicating a watchfulness that may indicate the problem and solution

Sympathy/Empathy

Sympathy: responding to the emotional state of others, acknowledging feelings

Empathy: ability to assume another’s private world

• Considered as the interviewer’s ethical responsibility

• Critical to the success of the interview

• Accepting the diversity of our clients, particularly the characteristics that are opposite those we possess, and seeing them as unique beings with their own goals, deserving help

respect

• striving for objectivity means being free from expectations as possible

• awareness of one’s tendencies and biases allows a more objective assessment of any conclusions derived from the interview

• important not to over- or under-estimate the other person, or to expect them to behave in a certain way

objectivity

Interviewing different age groups: Children and Younger Adolescents

• Children would describe themselves in more observable terms and would differentiate themselves from others through observable traits rather than on internal states.

• Factors which affect children, as well as adolescents, in responding to interviews:

  • inherent power imbalance in the relationship between a child and the adult

    interviewer

  • age-appropriate communication – with younger children, short, simple and direct and concrete questions

  • involvement of people in the child’s environment

Guidelines in Interviewing Children

Interviewing different age groups: Older Adolescents and Adults

• They have already acquired the capacity to describe themselves in an abstract, psychological and interpersonal terms, rather than concrete and observable terms.

• They also describe and evaluate their feelings, thoughts, and behavior and learn to analyze others’ reactions to their behavior.

• For older adolescent interviewees, it is often best to have one or both parents present during the initial meeting but make time available for separate, private discussions.

Guidelines in Interviewing Adolescents

Guidelines in Interviewing Adults

Interviewing different age groups: Older Persons

• The ability to perceive and understand speech declines with age; thus, it is essential for the interviewer to be conscious of the tone, pitch, rate and loudness of his or her voice.

• Biases and prejudices against older people in society. People think of older persons as “weak, dependent, talkative, out of touch, and closed- minded.” Older persons, in reality, are treasure troves of wisdom and rich experiences.

Guidelines in Interviewing Older Persons