with every patient. Several factors or skills,
however, can increase the likelihood that inter-
views will be productive. Training and supervised
experience in interviewing are very important.
Techniques that work well for one interviewer
can be notably less effective for another; there is
a crucial interaction between technique and inter-
viewer. This is why gaining experience in a super-
vised setting is so important; it enables the
interviewer to achieve some awareness of the
nature of this interaction.
Training, then, involves not just a simple mem-
orization of rules, but, rather, a growing knowledge
of the relationships among rules, the concrete situ-
ation being confronted, and one’s own impact in
interview situations.
The Physical Arrangements. An interview can
be conducted anywhere that two people can meet
and interact. On some occasions, this happens by
chance—an encounter with a patient on the street,
for example. Usually, the clinician does not choose
such a setting. But the needs of the patient, the
degree of urgency in the situation, or even, in
some instances, sheer coincidence may make an
interview of sorts inevitable.
Obviously, certain physical arrangements are
especially desirable for an interview. Two of the
most important considerations are privacy and protec-
tion from interruptions. Nothing is more damaging to
the continuity of an interview than a phone that rings
relentlessly, an administrative assistant’squery,oran
imperative knock on the door. Such interruptions are
extremely disruptive. But even more important is the
message they subtly convey—that the patient and his
or her problems are of secondary importance. After
all, administrative assistants do not knock on the door
or put through a call if they have been instructed
otherwise.
Because lack of privacy can lead to many delete-
rious outcomes, soundproofing is also very important.
If noise from a hallway or an adjacent office intrudes,
patients will probably assume that their own voices
can also be heard outside. Few patients are likely to be
open and responsive under such conditions.
The office or its furnishings can be as distract-
ing as loud noises and external clamor. There are
few rules in this area, and much depends on indi-
vidual taste. However, many clinicians prefer offices
that are fairly neutral, yet tasteful. In short, an office
with furnishings that demand attention or seem to
cry out for comment would not be ideal. The
therapist-golfer need not turn the office into a
shrine for golf’s greatest legends; the therapist with
a penchant for antique cars would do well not to
litter the desk with scale models of 1928 Fords.
Somehow, there must be a middle ground between
an office that is cold and forbidding through its very
neutrality and one that is littered with obtrusive and
distracting objects.Note-Taking and Recording. All contacts with
clients ultimately need to be documented. However,
there is some debate over whether notes should be
taken during an interview. Although there are few
absolutes, in general, it would seem desirable to take
occasional notes during an interview.
A few key phrases jotted down will help the
clinician’s recall. Most clinicians have had the expe-
rience of feeling that the material in an interview is
so important that there is no need to take notes—
that the material will easily be remembered. How-
ever, after having seen a few additional patients, the
clinician may not be able to recall much from the
earlier interview. Therefore, a moderate amount of
note-taking seems worthwhile. Most patients will
not be troubled by it, and if one should be, the
topic can be discussed. Occasionally, a patient may
comment that what is said must be really important
since you are taking it down. Occasionally, too, a
patient may request that the clinician not take notes
while a certain topic is being discussed.
Most patients probably expect a certain amount
of note-taking. However, any attempt at taking ver-
batim notes should be avoided (except when admin-
istering a structured interview, discussed later). One
danger in taking verbatim notes is that this practice
may prevent the clinician from attending fully to the
essence of the patient’s verbalizations. An overriding
compulsion to get it all down can detract from a
genuine understanding of the nuances and signifi-
cance of the patient’s remarks. In addition, excessive
note-taking tends to prevent the clinician from
observing the patient and from noting subtle changesTHE ASSESSMENT INTERVIEW 167