Rapport is not, as is often thought by begin-
ning students, a state wherein the clinician is always
liked or always regarded as a great person. Rather, it
is a relationship founded on respect, mutual confi-
dence, trust, and a certain degree of permissiveness.
It is neither a prize bestowed by an awed client nor
a popularity contest to be won by the clinician.
Some patients have had past experiences that
will not easily permit them to accept even genuine
overtures for a professional relationship. But in most
cases, if the clinician perseveres in the proper role
and maintains an attitude of respect as she or he
searches for understanding, the relationship will
develop. A common mistake of beginning inter-
viewers in early interviews is to say something like,
“There, there, don’t worry. I know exactly what
you’re feeling.”Such comments may convince cli-
ents that the interviewer does not really know how
they feel. After all, how could this stranger possibly
know how I feel? Rapport will come, but it will
come through quiet attitudes of respect, acceptance,
and competence rather than through quick fixes.
Special Considerations. Rapport can be espe-
cially challenging to achieve in cases that involve
more than one individual or a unique referral
source. For instance, a family therapy or couples
therapy case involves simultaneously establishing a
connection with multiple individuals, each of whom
may have very different perspectives and varying
enthusiasm for attending the session. Interviews of
child and adolescent clients similarly require the psy-
chologist to establish rapport with both the parent(s),
who most often has initiated contact with the psy-
chologist, and the child, who may feel blamed or
stigmatized by this parent. Rapport also can be espe-
cially challenging when the client is aware that the
information collected during the interview likely will
be used to determine a school placement, to meet
employment criteria, or to formulate a legal disposi-
tion regarding child custody, legal sanctions, or mal-
treatment allegations. In each of these cases, it is
essential to remain cognizant of the challenges in
establishing quick and easy rapport and to consider
how this may affect the validity of the data that are
being collected.
Communication
In any interview, there must be communication.
Whether we are helping persons in distress or assist-
ing patients in realizing their potential, communi-
cation is our vehicle. The real problem is to identify
the skills or techniques that will ensure maximum
communication.Beginning a Session. It is often useful to begin
an assessment session with a casual conversation. A
brief comment or question about difficulties in
finding a parking space or even a banal comment
on the weather may help establish the clinician as a
real person and allay any fears the patient may have
had as to whether he or she can ever relate to a
“shrink.”But whatever its specific content, a brief
conversation designed to relax things before plung-
ing into the patient’s reasons for coming will usually
facilitate a good interview.Language. Of extreme importance is the use of
language that the patient can understand. Some ini-
tial estimate of the patient’s background, educa-
tional level, or general sophistication should be
made. The kind of language employed should
then reflect that judgment. It is offensive to speak
to a 40-year-old woman with a master’s degree in
history as if she were an eighth grader. It is not
necessary to infantilize people seeking help; asking
for help need not imply that one has a diminished
capacity to understand.
At the same time, it may be necessary to aban-
don psychological jargon to be understood by some
patients. And perhaps the depth of our understand-
ing is questionable if we cannot communicate
without resorting to four-syllable words. If we
find ourselves unwittingly using grandiose language
to extort admiration from patients, then something
is wrong. Similarly, clinicians who try to use“teen-
age” language when interviewing a 15-year-old
may wind up not only alienating the client but
looking foolish in the process. In short, if your
respect for the patient is intact, you generally
need not reach for shallower techniques.
In a related vein, it is important to use words
that will be interpreted by the patient as you meanTHE ASSESSMENT INTERVIEW 169