Advanced Advanced Interviewing: Interviewing: Difficult Difficult

Interviews, Interviews, Interviewing Children, Interviewing Children, Parents, & Teachers, Parents, & Teachers, Issues of Diversity Issues of Diversity

September 27, 2004September 27, 2004

Examples of Difficult Behavior Examples of Difficult Behavior During Clinical InterviewDuring Clinical Interview

• Clients who try and take control (i.e., Clients who try and take control (i.e., talk too much!)talk too much!)

• Clients who cryClients who cry• Clients who do not talkClients who do not talk• Clients who become verbally or Clients who become verbally or

physically aggressivephysically aggressive• Clients who talk about disconcerting Clients who talk about disconcerting

topics topics • Non-emotive clientsNon-emotive clients

Motor DevelopmentMotor DevelopmentAge Norms (In Months)Age Norms (In Months)

SKILLSKILL 50% 50% 90%90%

• Rolls overRolls over 2.82.8 4.74.7• Sits aloneSits alone 5.55.5 7.87.8• Walks aloneWalks alone 12.112.1 14.314.3• Stairs with helpStairs with help 17.017.0 22.022.0

Language Development:Language Development:Average Age in MonthsAverage Age in Months

SKILLSKILL AVERAGEAVERAGE• Babbling Babbling 6-10 months6-10 months• ComprehensionComprehension 10-12 months10-12 months• First WordFirst Word 13 months13 months• First 50 WordsFirst 50 Words 13-18 13-18

monthsmonths• Vocabulary SpurtVocabulary Spurt 18 months18 months• Two-Word SentencesTwo-Word Sentences 21 months21 months

Explaining Psychology to Explaining Psychology to ChildrenChildren

• Most children will view the clinic as a Most children will view the clinic as a doctor’s office.doctor’s office.

• I am not the kind of doctor who gives I am not the kind of doctor who gives shots! I am the kind of doctor who:shots! I am the kind of doctor who:

1.1. talks to kids about problems they are having talks to kids about problems they are having at home or school.at home or school.

2.2. helps kids figure out why they are having helps kids figure out why they are having trouble getting their work done (paying trouble getting their work done (paying attention) in school.attention) in school.

3.3. talks to kids about things that are worrying talks to kids about things that are worrying them (making them sad) and we try to figure them (making them sad) and we try to figure out how to make them feel better.out how to make them feel better.

Use of Play During a Child Use of Play During a Child InterviewInterview

• Develop rapport by knowing age appropriate Develop rapport by knowing age appropriate interests. (Pokemon is out, Yu Gi Oh is in!)interests. (Pokemon is out, Yu Gi Oh is in!)

• Use play as a mechanism for “interviewing”:Use play as a mechanism for “interviewing”:1.1. Allow the child to play while he/she talksAllow the child to play while he/she talks2.2. Use toys that provide an opportunity for the Use toys that provide an opportunity for the

child to share his/her thoughts (example on p. child to share his/her thoughts (example on p. 43).43).

3.3. Allow the child to draw to show you his/her Allow the child to draw to show you his/her feelings.feelings.

• Ask the child to draw a picture of him/herself. Ask the child to draw a picture of him/herself. • Ask the child to draw a picture of his/her family Ask the child to draw a picture of his/her family

doing something together. doing something together.

Avoiding Leading Avoiding Leading QuestionsQuestions

• Leading Question:Leading Question: Do you get mad Do you get mad when your mother yells at you? when your mother yells at you?

• Open Ended Question:Open Ended Question: How do you How do you feel when your mother yells at you?feel when your mother yells at you?

• Alternative Question:Alternative Question: When your When your mother yells at you, do you feel mad, mother yells at you, do you feel mad, sad, or happy?sad, or happy?

• Be careful to use a calm manner and Be careful to use a calm manner and tone of voice that does not reveal your tone of voice that does not reveal your feelings or personal biases!feelings or personal biases!

Interviewing Children about Interviewing Children about EmotionsEmotions

• Draw a body shape and have child show Draw a body shape and have child show where they feel different emotions.where they feel different emotions.

• Use line drawings of faces (happy, sad, Use line drawings of faces (happy, sad, mad) and ask children to point to the face mad) and ask children to point to the face that shows how they would feel in a that shows how they would feel in a specific situation.specific situation.

• Take the initial focus off of the child:Take the initial focus off of the child:• Some kids feel like sad when they have to go to Some kids feel like sad when they have to go to

time out and other kids feel mad. How do you feel?time out and other kids feel mad. How do you feel?• Let’s pretend that there is a 5 year old girl who gets Let’s pretend that there is a 5 year old girl who gets

in trouble. What do you think she did to get in in trouble. What do you think she did to get in trouble?trouble?

Behavioral Observations Behavioral Observations During InterviewDuring Interview

• Child’s ability to interact/relate to you.Child’s ability to interact/relate to you.• Child’s language level (vocabulary, Child’s language level (vocabulary,

articulation, sentence structure).articulation, sentence structure).• Child’s nonverbal communication (eye contact, Child’s nonverbal communication (eye contact,

gestures).gestures).• Child’s emotions (facial expressions, behaviors, Child’s emotions (facial expressions, behaviors,

tone of voice).tone of voice).• Child’s play (any themes, age appropriate Child’s play (any themes, age appropriate

topics?).topics?).• Child’s cognitive abilities/though processes Child’s cognitive abilities/though processes

(child’s knowledge, ability to coherently convey (child’s knowledge, ability to coherently convey experiences).experiences).

Interviewing Parents – Interviewing Parents – Developmental HistoryDevelopmental History

• Pregnancy/childbirth historyPregnancy/childbirth history• Developmental milestonesDevelopmental milestones

– LanguageLanguage– MotorMotor– SocialSocial

• Follow the same interview outline that Follow the same interview outline that I gave you in the basic interviewing I gave you in the basic interviewing lecture! lecture! – Sample interviewSample interview

Hints for Interviewing Hints for Interviewing ParentsParents

• Take the parent’s perspective (they may feel Take the parent’s perspective (they may feel guilty, angry at the child or themselves, scared, guilty, angry at the child or themselves, scared, or be in denial). Don’t blame the parent!or be in denial). Don’t blame the parent!

• Normalize therapy! They may think that bringing Normalize therapy! They may think that bringing their child to the clinic is a reflection of their poor their child to the clinic is a reflection of their poor parenting skills or a suggestion that their child is parenting skills or a suggestion that their child is “crazy.” “crazy.”

• Parents want to know how to help their children. Parents want to know how to help their children. Tell them how your assessment will do this.Tell them how your assessment will do this.– Once you make a diagnosis, you will know what Once you make a diagnosis, you will know what

therapy techniques will help.therapy techniques will help.– Diagnosis will qualify child for school services.Diagnosis will qualify child for school services.

Hints for Interviewing Hints for Interviewing Parents (cont.)Parents (cont.)

• Help parents remember the child’s Help parents remember the child’s developmental history by using developmental history by using landmarks (first birthday party, trip landmarks (first birthday party, trip to the beach at 2, etc.).to the beach at 2, etc.).

Taking a Cultural Taking a Cultural PerspectivePerspective

• Use language that is appropriate to the parent or Use language that is appropriate to the parent or child’s cultural background (i.e., are you using child’s cultural background (i.e., are you using slang that is not appropriate for the client’s slang that is not appropriate for the client’s culture?). culture?).

• Match the speed of your interaction to the client’s Match the speed of your interaction to the client’s cultural background (i.e., are you talking too cultural background (i.e., are you talking too fast?)fast?)

• Match your expectations to the family. Are there Match your expectations to the family. Are there other family members that need to be other family members that need to be interviewed? Who is the family leader in this interviewed? Who is the family leader in this particular family (grandmother, aunt, father, particular family (grandmother, aunt, father, etc.).etc.).

• How does your appearance fit with the family How does your appearance fit with the family culture? (Example of wearing a religious culture? (Example of wearing a religious necklace). necklace).

Taking a Cultural Taking a Cultural Perspective (cont.)Perspective (cont.)

• Recognize that developmental Recognize that developmental expectations differ across cultures.expectations differ across cultures.

1.1. Cultural beliefs about where children should Cultural beliefs about where children should sleep.sleep.

2.2. Cultural beliefs about adolescent autonomy Cultural beliefs about adolescent autonomy – “normal enmeshment.”– “normal enmeshment.”

3.3. Cultural beliefs/success of different Cultural beliefs/success of different parenting styles.parenting styles.

• Use culturally sensitive toys in a play Use culturally sensitive toys in a play interview.interview.

Interviewing TeachersInterviewing Teachers

• Work as a collaborator with the teacher (i.e., Work as a collaborator with the teacher (i.e., do not take an authoritarian role!).do not take an authoritarian role!).

• Ask the teacher’s opinion about the function Ask the teacher’s opinion about the function or role of the child’s behavior.or role of the child’s behavior.– What happens before the behavior.What happens before the behavior.– What happens after the behavior.What happens after the behavior.

• Ask the teacher to fill out rating scales and/or Ask the teacher to fill out rating scales and/or behavioral charts describing the child’s behavioral charts describing the child’s behavior.behavior.

• NEVER give advice until you have all of the NEVER give advice until you have all of the data!data!