JOHN SOMMERS-FLANAGAN, PHD, is a clinical psychologist and professor of counselor education at the University of Montana. He is a long-time member of both the American Counseling Association (ACA) and the American Psychological Association (APA).

RITA SOMMERS-FLANAGAN, PHD, is professor emeritus at the University of Montana. As a clinical psychologist, she has worked with youth, families, couples, and women for many years.

Preface xiii

About The Authors xxi

Part One: Foundations of Clinical Interviewing 1

Chapter 1: An Introduction to The Clinical Interview 3

Learning Objectives 3

Chapter Orientation 3

Welcome to The Journey 3

What Is a Clinical Interview? 5

Clinical Interviewing versus Counseling and Psychotherapy 7

A Learning Model for Clinical Interviewing 13

Multicultural Competencies 17

Multicultural Humility 25

Summary 28

Suggested Readings and Resources 29

Chapter 2: Preparation 31

Learning Objectives 31

Chapter Orientation 31

The Physical Setting 31

Professional and Ethical Issues 38

Multicultural Preparation 55

Stress Management and Self-Care 65

Summary 68

Suggested Readings and Resources 68

Chapter 3: An Overview of the Interview Process 71

Learning Objectives 71

Chapter Orientation 71

Stages of a Clinical Interview 71

The Introduction 73

The Opening 84

The Body 90

The Closing 95

Ending The Session (Termination) 104

Summary 107

Suggested Readings and Resources 109

Part Two: Listening and Relationship Development 111

Chapter 4: Nondirective Listening Skills 113

Learning Objectives 113

Chapter Orientation 113

Listening Skills 113

Adopting a Therapeutic Attitude 114

Why Nondirective Listening Is Also Directive 123

The Listening Continuum in Three Parts 125

Nondirective Listening Behaviors: Skills for Encouraging Client Talk 126

Ethical and Multicultural Considerations 142

Not Knowing What to Say 145

Summary 146

Suggested Readings and Resources 147

Chapter 5: Directive Listening Skills 149

Learning Objectives 149

Chapter Orientation 149

Directive Listening Behaviors: Skills for Encouraging Insight 150

Ethical and Multicultural Considerations When Using Directive Listening Skills 175

Summary 178

Suggested Readings and Resources 179

Chapter 6: Skills for Directing Clients Toward Action 181

Learning Objectives 181

Chapter Orientation 181

Readiness to Change 181

Skills for Encouraging Action: Using Questions 184

Using Educational and Directive Techniques 192

Ethical and Multicultural Considerations When Encouraging Client Action 204

Summary 215

Suggested Readings and Resources 216

Chapter 7: Evidence-Based Relationships 217

Learning Objectives 217

Chapter Orientation 217

The Great Psychotherapy Debate 217

Carl Rogers’s Core Conditions 218

Other Evidence-Based Relationship Concepts 233

Evidence-Based Multicultural Relationships 250

Summary 253

Suggested Readings and Resources 254

Part Three: Structuring and Assessment 255

Chapter 8: Intake Interviewing and Report Writing 257

Learning Objectives 257

Chapter Orientation 257

What’s an Intake Interview? 257

Identifying, Evaluating, and Exploring Client Problems and Goals 259

Obtaining Background and Historical Information 267

Assessment of Current Functioning 276

Brief Intake Interviewing 280

The Intake Report 282

Do’s and Don’ts of Intake Interviews with Diverse Clients 298

Summary 300

Suggested Readings and Resources 301

Chapter 9: The Mental Status Examination 303

Learning Objectives 303

Chapter Orientation 303

What Is a Mental Status Examination? 303

Individual and Cultural Considerations 305

The Generic Mental Status Examination 308

When to Use Mental Status Examinations 340

Summary 342

Suggested Readings and Resources 342

Chapter 10: Suicide Assessment 345

Learning Objectives 345

Chapter Orientation 345

Facing The Suicide Situation 345

Suicide Risk Factors, Protective Factors, and Warning Signs 348

Building a Theoretical and Research-Based Foundation 356

Suicide Assessment Interviewing 360

Suicide Interventions 380

Ethical and Professional Issues 385

Summary 389

Suggested Readings and Resources 390

Chapter 11: Diagnosis and Treatment Planning 393

Learning Objectives 393

Chapter Orientation 393

Modern Diagnostic Classification Systems 393

Defining Mental Disorders 396

Diagnostic Interviewing 404

The Science of Clinical Interviewing: Diagnostic Reliability and Validity 406

Less Structured Diagnostic Clinical Interviews 409

Treatment Planning 415

Case Formulation and Treatment Planning: A Cognitive-Behavioral Example 423

Additional Cultural Modifications and Adaptations 427

Summary 428

Suggested Readings and Resources 430

Part Four: Special Populations and Situations 431

Chapter 12: Challenging Clients and Demanding Situations 433

Learning Objectives 433

Chapter Orientation 433

Challenging Clients 433

Motivational Interviewing and Other Strategies for Working Through Resistance 436

Assessment and Prediction of Violence and Dangerousness 451

Demanding Situations: Crisis and Trauma 456

Cultural Competencies in Disaster Mental Health 468

Summary 470

Suggested Readings and Resources 471

Chapter 13: Interviewing Young Clients 473

Learning Objectives 473

Chapter Orientation 473

Considerations in Working with Young Clients 473

The Introduction 475

The Opening 479

The Body of the Interview 490

Closing and Termination 503

Culture in Young Client Interviews 506

Summary 508

Suggested Readings and Resources 508

Chapter 14: Interviewing Couples and Families 511

Learning Objectives 511

Chapter Orientation 511

Challenges and Ironies of Interviewing Couples and Families 511

The Introduction 514

The Opening 522

The Body 528

Closing and Termination 540

Special Considerations 541

Diversity Issues 546

Summary 549

Suggested Readings and Resources 550

Chapter 15: Electronic and Telephonic Interviewing 553

Learning Objectives 533

Chapter Orientation 553

Technology as an Extension of the Self 554

Definition of Terms and Communication Modalities 557

Non-FtF Assessment and Intervention Research 561

Ethical and Practical Issues: Problems and Solutions 565

Conducting Online or Non-FtF Interviews 573

Multicultural Issues: Culture and Online Culture 575

Summary 576

Suggested Online Training Resources 577

Appendix: Extended Mental Status Examination Interview Protocol 579

References 589

Author Index 639

Subject Index 655

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