Interviewing And Diagnostic Exercises For Clinical And Counseling Skills Building

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Format: Paperback
Pub. Date: 2004-11-05
Publisher(s): Lawrence Erlbau
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Summary

This book, specifically designed to meet the needs of those teaching and learning interviewing and diagnostic skills in clinical, counseling and school psychology, counselor education, and other programs preparing mental health professionals, offers a rich array of practical, hands-on, class- and workshop-tested role-playing and didactic exercises. The authors, who bring to their task a combined 31 years of practice and 24 years of teaching these skills, present 20 complex profiles of a broad range of clients--adults, teens, and children; differing in ethnicity, gender, religion, socioeconomic status, presenting problems, and problem severity. The profiles provide students/trainees with a wealth of information about each client's feelings, thoughts, actions, and relationship patterns on which to draw as they proceed through the different phases of the intake/initial interview, one playing the client and one the interviewer. Each client profile is followed by exercises, which can also be assigned to students not participating in role-playing who have simply read the profile. The profiles are detailed enough to support a focus on whatever interviewing skills an instructor particularly values. However, the exercises highlight attending, asking open and closed questions, engaging in reflective listening, responding to nonverbal behavior, making empathetic comments, summarizing, redirecting, supportively confronting, and commenting on process. The authors' approach to DSM-IV diagnoses encourages students to develop their diagnostic choices from Axis I to Axis V and then thoughtfully review them in reverse order from Axis V to Axis I to ensure that the impacts of individual, situational, and biological factors are all accurately reflected in the final diagnoses. Throughout, the authors emphasize the importance of understanding diversity and respecting the client's perceptions--and of reflecting on the ways in which the interviewer's own identity influences both the process of interviewing and that of diagnosis. Interviewing and Diagnostic Exercises for Clinical and Counseling Skills Buildingwill be welcomed as a invaluable new resource by instructors, students, and trainees alike.

Table of Contents

Acknowledgments xi
Preface for Instructors/Supervisors xiii
Preface for Students/Trainees xix
Types of Interviewing Skills Indexed by Chapter: Table 1 xxiii
Diagnoses Indexed by Chapter: Table 2 xxiv
Conceptual Issues Indexed by Chapter: Table 3 xxv
PART I: INTRODUCTION
Interviewing Skills Highlighted in the Text
3(15)
Why Were Certain Skills Selected?
3(1)
What Is Attending Behavior?
3(2)
What Is Verbal Attending?
4(1)
What Is Nonverbal Attending?
4(1)
Responding to Nonverbal Behavior
5(1)
Identifying Nonverbal Behavior
5(1)
Identifying Feelings
6(1)
What Are Open-Ended and Closed Questions?
6(2)
Using Open-Ended Questions
7(1)
Using Closed Questions
7(1)
Further Examples of Open-Ended and Closed Questions
7(1)
What Are Reflective Listening Comments?
8(1)
Examples of Reflective Listening
8(1)
What Is an Empathetic Comment?
8(2)
Empathetic Comments That Show Clients You Understand Them
9(1)
Empathetic Comments That Validate Clients' Experiences
9(1)
Empathetic Comments to Support Emotional Control
9(1)
Further Examples of Empathetic Comments in Response to Client Information
10(1)
What Is Summarizing?
10(1)
Summarizing to Demonstrate Listening
11(1)
Summarizing to Highlight Themes
11(1)
Summarizing as a Transition
11(1)
Summarizing to Decrease Emotional Intensity
11(1)
What Is Redirecting?
11(2)
Redirecting for Clarity
12(1)
Redirecting to Prevent Avoidance
12(1)
Redirecting to Change the Subject
12(1)
What Is Supportive Confrontation?
13(2)
When Do You Make a Supportive Confrontation?
13(1)
How Do You Make a Supportive Confrontation?
14(1)
What Is a Process Comment?
15(1)
Describing a Client's Interpersonal Pattern Across Relationships
15(1)
Describing the Interpersonal Process Between Client and Interviewer
15(1)
Issues in Human Diversity During Interviewing
16(2)
Highlighted Diagnostic Practice
18(11)
Start the Diagnostic Process With a Thorough Intake Interview
18(2)
Be Aware of the Limited Nature of Your Information
19(1)
Ask Questions That Would Rule Out Diagnoses
19(1)
Consider Your Diagnostic Choices
20(2)
Be Stringent in Your Use of Diagnostic Criteria
20(1)
Axis I
21(1)
Axis II
21(1)
Axis III
22(1)
Axis IV
22(1)
Axis V
22(1)
Double-Check Your Clinical Judgment
22(2)
Conclusion
24(3)
PART II: ADULT PROFILES FOR USE IN INDIVIDUAL SESSIONS
Preface to Part II
27(1)
Taking the Client Role
27(1)
Taking the Interviewer Role
27(1)
What Will Be Kept Confidential?
28(1)
Does the Client Differ From You in Important Ways?
28(1)
Case of Monisha: Presenting Issues---College Adjustment, Academic Pressure
29(10)
Monisha, African-American (age 18) role-play material
29(4)
Exercises for developing a multiaxial diagnosis for Monisha with a highlighted diagnosis of Adjustment Disorder
33(2)
Exercises for deepening the interview with Monisha, highlighting the skills of responding to nonverbal behavior and open-ended and closed questions
35(2)
Exercises for thinking about Monisha from the interviewer's perspective, highlighting the decision to take a narrow versus wide focus to treatment
37(2)
Case of Jie: Presenting Issues---School Performance, Culture
39(12)
Jie. Taiwanese (age 18) role-play material
39(6)
Exercises for developing a multiaxial diagnosis for Jie with a highlighted comparison between Anxiety Disorder and Adjustment Disorder
45(2)
Exercises for deepening the interview with Jie, highlighting the skills of nonverbal attending, responding to nonverbal behavior, and summarizing
47(2)
Exercises for thinking about Jie from the interviewer's perspective, highlighting cultural issues in developing rapport and developing a treatment plan
49(2)
Case of Brenda: Issues---Parenting Young Children, Identity Shift
51(12)
Brenda, European-American (age 30) role-play material
51(6)
Exercises for developing a multiaxial diagnosis for Brenda with a highlighted diagnosis of Major Depressive Disorder
57(2)
Exercises for deepening the interview with Brenda, highlighting the skills of summarizing and reflective listening
59(2)
Exercises for thinking about Brenda from the interviewer's perspective, highlighting the areas of development, gender, and medication
61(2)
Case of Aaron: Presenting Issues---Hallucinations, Substance Abuse
63(10)
Aaron, African-American (age 25) role-play material
63(4)
Exercises for developing a multiaxial diagnosis for Aaron with a highlighted comparison of Schizophrenia and Substance-Related Disorders
67(2)
Exercises for deepening the interview with Aaron, highlighting the skills of nonverbal attending, open-ended and closed questions, reflective listening, and empathetic comments
69(2)
Exercises for thinking about Aaron from the interviewer's perspective, focusing on reactions to psychotic thinking
71(2)
Case of Mary: Presenting Issues---Depression, Anxiety
73(10)
Mary, European-American (age 55) role-play material
73(4)
Exercises for developing a multiaxial diagnosis for Mary with a highlighted comparison between Major Depressive Disorder and Bereavement
77(2)
Exercises for deepening the interview with Mary, highlighting the skills of nonverbal attending, open-ended and closed questions, reflective listening, and empathetic comments
79(2)
Exercises for thinking about Mary from the interviewer's perspective, focusing on sexual orientation, suicide, and religion as a cultural influence
81(2)
Case of Mark: Issues---Survival Guilt, Career Confusion
83(12)
Mark, European-American (age 18) role-play material
83(6)
Exercises for developing a multiaxial diagnosis for Mark with a highlighted diagnosis of Posttraumatic Stress Disorder
89(2)
Exercises for deepening the interview with Mark, highlighting the skills of reflective listening, empathetic comments, and redirecting
91(2)
Exercises for thinking about Mark from the interviewer's perspective, focusing on reactions to trauma
93(2)
Case of Sarah: Issues---Husband With Alzheimer's Disease, Family Pressure
95(10)
Sarah, European-American (age 70) role-play material
95(4)
Exercises for developing a multiaxial diagnosis for Sarah with a highlighted diagnosis of Adjustment Disorder
99(2)
Exercises for deepening the interview with Sarah, highlighting the skills of redirecting and responding to nonverbal behavior
101(2)
Exercises for thinking about Sarah from the interviewer's perspective, with emphasis on personal boundaries and health
103(2)
Case of David: Presenting Issues---Substance Abuse, Employment
105(10)
David, European-American (age 34) role-play material
105(4)
Exercises for developing a multiaxial diagnosis for David with a highlighted diagnosis of Substance-Related Disorders
109(2)
Exercises for deepening the interview with David, highlighting the skills of open-ended and closed questions, supportive confrontation, and redirecting
111(2)
Exercises for thinking about David from the interviewer's perspective, with emphases on client sexual overtures and substance use
113(2)
Case of Lisa: Presenting Issues---Marital Difficulties, Life Changes
115(12)
Lisa, European-American (age 45) role-play material
115(4)
Exercises for developing a multiaxial diagnosis for Lisa with highlighted diagnoses of Adjustment Disorder and Phase of Life Problem
119(2)
Exercises for deepening the interview with Lisa, highlighting the skills of summarizing and process comments
121(4)
Exercises for thinking about Lisa from the interviewer's perspective, focusing on gender roles and health issues
125(2)
Case of Gary: Presenting Issues---Aggression, Substance Abuse
127(16)
Gary, European-American (age 24) role-play material
127(4)
Exercises for developing a multiaxial diagnosis for Gary, with a highlighted comparison of Intermittent Explosive Disorder and Substance-Related Disorders
131(2)
Exercises for deepening the interview with Gary, highlighting the skills of nonverbal attending, empathetic comments, supportive confrontation, and process comments
133(2)
Exercises for thinking about Gary from the interviewer's perspective, with the focuses being danger to others and substance abuse
135(4)
PART III: CHILD AND TEEN PROFILES FOR USE IN INDIVIDUAL SESSIONS
Preface to Part III
139(1)
Taking the Client Role
139(1)
Taking the Interviewer Role
139(1)
What Will Be Kept Confidential?
140(1)
What Do Children Understand?
140(2)
Use Simple Language
141(1)
Use Directed and Concretely Focused Questions
141(1)
Focus on One Clear Issue at a Time
141(1)
How Are Children and Teens Going to Communicate With You?
142(1)
Does the Client Differ From You in Important Ways?
142(1)
Case of Cynthia: Issues---Eating Disorder, Emerging Sexuality
143(10)
Cynthia, European-American (age 13) role-play material
143(4)
Exercises for developing a multiaxial diagnosis for Cynthia, with a highlighted comparison of Bulimia Nervosa and Eating Disorder NOS
147(2)
Exercises for deepening the interview with Cynthia, highlighting the skills of empathetic comments, summarizing, and open-ended and closed questions
149(2)
Exercises for thinking about Cynthia from the interviewer's perspective, highlighting the areas of development, absent father, and culture
151(2)
Case of Jeffrey: Issues---Social Alienation, School Failure
153(10)
Jeffrey, European-American (age 16) role-play material
153(4)
Exercises for developing a multiaxial diagnosis for Jeffrey, with a highlighted comparison of Major Depressive Disorder and Oppositional Defiant Disorder
157(2)
Exercises for deepening the interview with Jeffrey, highlighting the skills of responding to nonverbal behavior, empathetic comments, and reflective listening
159(2)
Exercises for thinking about Jeffrey from the interviewer's perspective, focusing on the issues of suicide and violence
161(2)
Case of Melissa: Presenting Issues---Divorce, Shared Custody
163(12)
Melissa, European-American (age 10) role-play material
163(4)
Exercises for developing a multiaxial diagnosis for Melissa, with a highlighted diagnosis of Adjustment Disorder
167(2)
Exercises for deepening the interview with Melissa, highlighting the skills of responding to nonverbal behavior, reflective listening, empathetic comments, and open-ended and closed questions
169(4)
Exercises for thinking about Melissa from the interviewer's perspective, emphasizing issues of custody, confidentiality, and individual versus family treatment
173(2)
Case of Edward: Presenting Issues---Single-Parent Family, Acculturation
175(10)
Edward, African-American (age 12) role-play material
175(4)
Exercises for developing a multiaxial diagnosis for Edward, with a highlighted diagnosis of Learning Disorder
179(2)
Exercises for deepening the interview with Edward, highlighting the skills of responding to nonverbal behavior and open-ended and closed questions
181(2)
Exercises for thinking about Edward from the interviewer's perspective, focusing on single-parent family, culture, and poverty
183(2)
Case of Raoul: Presenting Issues---Racial Prejudice, Substance Use
185(10)
Raoul, Mexican-American (age 17) role-play material
185(4)
Exercises for developing a multiaxial diagnosis for Raoul, with a highlighted comparison between Conduct Disorder and Substance-Related Disorders
189(2)
Exercises for deepening the interview with Raoul, highlighting the skills of reflective listening, empathetic comments, supportive confrontation, and process comments
191(2)
Exercises for thinking about Raoul from the interviewer's perspective, with emphases on racism, poverty, and confidentiality
193(2)
Case of Erica: Presenting Issues---Bereavement, Behavior Problems
195(10)
Erica, European-American (age 7) role-play material
195(4)
Exercises for developing a multiaxial diagnosis for Erica, with a highlighted comparison between Adjustment Disorder and Bereavement
199(2)
Exercises for deepening the interview with Erica, highlighting the skills of nonverbal attending, responding to nonverbal behavior, open-ended questioning, and redirecting
201(2)
Exercises for thinking about Erica from the interviewer's perspective, focusing on development, religion, and personal boundaries
203(2)
Case of Joseph: Presenting Issues---Abandonment, Aggression
205(12)
Joseph, biracial Puerto Rican/Caucasian (age 10) role-play material
205(6)
Exercises for developing a multiaxial diagnosis for Joseph, with a highlighted comparison between Conduct Disorder and Separation Anxiety Disorder
211(2)
Exercises for deepening the interview with Joseph, highlighting the skills of responding to nonverbal behavior, empathetic comments, reflective listening, and supportive confrontation
213(2)
Exercises for thinking about Joseph from the interviewer's perspective, highlighting custody, poverty, and biracial identity development
215(2)
Case of Sabina: Issues---Acculturation Conflicts, Emancipation
217(12)
Sabina, Bangladeshi-American (age 16) role-play material
217(6)
Exercises for developing a multiaxial diagnosis for Sabina, with a highlighted comparison between Identity Problem and Child or Adolescent Antisocial Disorder
223(2)
Exercises for deepening the interview with Sabina, highlighting the skills of nonverbal attending, empathetic comments, reflective listening, open-ended and closed questions, and process comments
225(2)
Exercises for thinking about Sabina from the interviewer's perspective, with highlighted areas being culture and religion
227(2)
Case of Alex: Presenting Issues---Neglect, Behavior Problems
229(10)
Alex, European-American (age 8) role-play material
229(4)
Exercises for developing a multiaxial diagnosis for Alex, with a highlighted comparison between Oppositional Defiant Disorder and Parent-Child Relational Problem
233(2)
Exercises for deepening the interview with Alex, highlighting the skills of responding to nonverbal behavior, summarization, and redirecting
235(2)
Exercises for thinking about Alex from the interviewer's perspective, with focus on responding to aggression
237(2)
Case of Cathy: Presenting Issues---Sexual Abuse, Abandonment
239(10)
Cathy, European-American (age 11) role-play material
239(4)
Exercises for developing a multiaxial diagnosis for Cathy, with a highlighted comparison between Posttraumatic Stress Disorder and Sexual Abuse of Child
243(2)
Exercises for deepening the interview with Cathy, highlighting the skills of empathetic comments, summarization, and process comments
245(2)
Exercises for thinking about Cathy from the interviewer's perspective, with highlighted areas being sexual orientation and sexual overtures from clients
247(2)
References 249(2)
Suggestions for Further Reading 251(2)
Supervisory Feedback Worksheet 253(4)
Appendix: Interviewing Skills Worksheets 257

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