them to be. Very often, for example, asking a
mother how her son behaves is likely to prompt
the response,“Oh, he’s a good boy—he does just
what I tell him.”Sometimes psychologists become
so focused on concepts such as behavior that we
forget what these words mean to most people.
It is also important to clarify the intended
meaning of a word or term used by a client if
there are uncertainties or alternative interpretations.
For example, a clinician should not assume he or
she knows what a client means by the statement
“She’s abusive.”It may indicate that the individual
does not treat others particularly well, or it may
indicate that the individual is physically abusive—
something that warrants immediate intervention.
The Use of Questions. Maloney and Ward
(1976) observed that the clinician’s questions may
become progressively more structured as the inter-
view proceeds. They distinguish among several
forms of questions, including open-ended, facilita-
tive, clarifying, confronting, and direct questions.
Each is designed in its own way to promote commu-
nication. And each is useful for a specific purpose or
patient. Table 6-1 illustrates these types of questions.
Silence. Perhaps nothing is more disturbing to a
beginning interviewer than silence. However,
silences can mean many things. The important
point is to assess the meaning and function of
silence in the context of the specific interview.
The clinician’s response to silence should be rea-
soned and responsive to the goals of the interview
rather than to personal needs or insecurities.
Perhaps the client is organizing a thought or
deciding which topic to discuss next. Perhaps the
silenceisindicativeofsomeresistance.Butitisas
inappropriate to jump in and fill every momentary
silencewithchatterasitistosimplywaitoutthe
patient every time, regardless of the length of
the silence. Whether the clinician ends a lengthy
silence with a comment about the silence or
decides to introduce a new line of inquiry, the
response should facilitate communication and
understanding and not be a desperate solution to
an awkward moment.Listening. If we are to communicate effectively
in the clinician’s role, our communication must
reflect understanding and acceptance. We cannot
hope to do this if we have not been listening, for
it is by listening that we come to appreciate the
information and emotions that the patient is con-
veying. If we are concerned about impressing the
client, if we are insecure in our role, if we are
guided by motivations other than the need to
understand and accept, then we are not likely to
be effective listeners.
Many people, for example, when introduced to
someone, cannot recall the person’s name 2 minutes
later. The most common reason for this is a failure to
listen. They were distracted, preoccupied, or perhaps
so concerned about their own appearance that they
never really heard the name. Sometimes therapists
are so sure of an impression about the patient that
they stop listening and thereby ignore important
new data. The skilled clinician is one who has
learned when to be an active listener.T A B L E 6-1 Five Types of Interview Questions
Type Importance Example
Open-ended Gives patient responsibility and latitude for
responding
“Would you tell me about your experiences in
the Army?”Facilitative Encourages patient’s flow of conversation “Can you tell me a little more about that?”
Clarifying Encourages clarity or amplification “I guess this means you felt like...?”
Confronting Challenges inconsistencies or contradictions “Before, when you said...?”
Direct Once rapport has been established and the
patient is taking responsibility
“What did you say to your father when he
criticized your choice?”SOURCE: Maloney and Ward (1976).
170 CHAPTER 6