Initial Intake Process:

Clinical Interview Training

McKay Sohlberg
Jaime Lee

February 2010
*note: refer to Initial Consult forms
Purpose of Consultation

 Identify impact of cognitive impairments

on daily functioning
 Identify whether cognitive rehab would
be beneficial
 Identify and select treatment
approaches
Prior to the Initial Evaluation…

 Review available records

– Diagnoses
– Background information (family, education,
vocational, military history)
– Events thought to cause neurological
impairment
– Primary deficit areas
– Co-occurring conditions
 Interview Introduction

 Orient client to the clinic

 Inquire about special needs for comfort
(seating preference, noise, lighting)
 Describe purpose of visit
 Complete initial paperwork (including
permission to videotape)
Watch the following clip of an introduction from an initial
consultation and then answer the questions.
Questions
 How does the interviewer explain the purpose
of the visit?
 How would you explain cognitive rehab to
someone who was not familiar with our
services?
 What special needs might be an issue for
Jeremy if he chooses to participate in
therapy?

Note that Jeremy starts to describe his problems with

memory during the orientation. INTERVIEW TIP: Do
not follow a strict script. An interviewer should
respond naturally to the client and gather information
as it comes.
Clinical Interview Features
 Review of what is in
records; Supplemental
history
 Current living situation
 Current job;
Avocational activites
 Typical day
 Enjoyable
activites/ways to spend
time
Watch the next clip and answer the following questions.
 Current cognitive
concerns
 Strategies
 Previous therapies
 Supports
 Impact of cognitive
concerns (school,
home, work)
 Hope for therapy
Questions
 Why did the interviewer probe about possible
“issues” with the forestry job? (What
hypothesis might she have been testing?)
 Give an example of an open-ended question
from the clip.
 How does the interviewer begin to build
rapport with Jeremy?
 Describe one of the strategies Jeremy has
discovered.
Clinical Interview Principles
(from Sohlberg & Mateer, Ch. 13)
 Simultaneously Mindful of three levels:
– Words/message
– Perceptions/feelings behind the words
– Time restraints
 Questioning:
– Use open, closed questions as needed
 Listening Skills
– Active
– Check for understanding
– Natural
 Rapport/Comfort
– Read your client
– Adjust according to client response
 Watch next series of video clips for
examples of the clinical interview
principles on the previous slide.
 Each video is followed by a set of
comments or questions.
Question

 How has the interviewer matched the

demeanor of the client up to this point?
 Does he appear comfortable?
 How can you tell?
 Was her joke (at the end of the clip)
successful?
Comments/Questions

 Interviewer gathers more information

about children/family life/routines
 Interviewer integrates information from
chart review for follow-up questions
 What might account for Jeremy’s
difficulty with anger management and
occasional outbursts?
Questions
 Why is clinically relevant to gather
information about a client’s substance
use?
 In this clip, the interviewer provides
education about TBI and alcohol
use/abuse. What responsibilities do
clinicians have in this area?
Questions
 In this clip, the interviewer completes the
Compensation Techniques with the client
which can provide additional useful information
 What cognitive issue that Jeremy experiences
frequently does the interviewer inquire further
about?
 How many calendars does Jeremy have?
Why might this be useful clinical information?
 What type of aid would Jeremy’s filing system
be considered?
Comments

 As interviewer completes the inventory,

she summarizes/reviews the
information he has provided,
demonstrating active listening
 In the next video, the interviewer
continues to administer questionnaires.
 This one is focused on identifying
frequency of occurrence of different
types of attention problems in the
client’s day to day life.
Administering the APT-II Questionnaire
 In the next few slides you’ll see the
interviewer describe different options for
therapy.
 It is important to involve the client in the
selection of therapy goals and treatment
approaches. This is called “Collaborative
Goal Setting.”
 The interviewer only reviews options that she
feels would be appropriate based on the
information gathered in the interview.
Description of Attention Training and External Aid Therapy
Thoughts
 The veterans are a unique ABI population
with complicated medical and psychological
histories in addition to their neurological
deficits
 In working with veterans, it’s important to
demonstrate sensitivity and understanding.
 Note how Jeremy appreciates the
interviewers expression of gratitude for his
service. He says: “You don’t hear that very
often.”
In Summary
 An effective clinical interview:
– provides the clinician with needed information to
select appropriate therapy options
– Establishes a working therapeutic alliance with the
client

Note: this client’s interview was followed by an

interview with his fiance. A reminder that it is
important to involve natural supports in the therapy
process.