Clinical Psychology

The volunteer in this situation kept on reinfor-
cing the notion that she understood. The calm yet
confident manner of the volunteer seemed to reas-
sure the mother, who agreed to come in the next
afternoon and to bring her son along with her.
Obviously, the purpose of thecrisis interviewis
to meet problems as they occur and to provide an
immediate resource. Their purpose is to deflect
the potential for disaster and to encourage callers
to enter into a relationship with the clinic or make
a referral so that a longer-term solution can be
worked out. Such interviewing requires training,
sensitivity, and judgment. Asking the wrong ques-
tion in a case-history interview may only result in
a piece of misinformation. However, a caller who
is asked a wrong question on the telephone may
hang up. As clinical services begin to transcend
the boundaries of the conventional clinic, there

is a chance that they will be diluted by having

to operate in situations that offer less opportunity

for control. But the problems seem to be out-

weighed by the opportunity to intervene during

real crises.

The Diagnostic Interview

As mentioned in Chapter 5, clinical psychologists

evaluate patients according to DSM-IV criteria.

Insurance companies, research protocols, or even

court proceedings may require a diagnostic evalua-

tion. How clinicians arrive at such a formulation,

however, is for the most part left up to them. His-

torically, they used a clinical interview—a free-form

unstructured interviewwhose content varied greatly

from clinician to clinician. As might be expected,

this interviewing method often results in unreliable

ratings because two clinicians evaluating the same

BOX6-3 Clinical Psychologist Perspective: Thomas A. Widiger, Ph.D.

Dr. Thomas Widiger, a professor in the Psychology

Department of the University of Kentucky, is perhaps

best known for his work in the areas of classification

and diagnosis of mental disorders. In his career, he has

published close to 200 articles, books, or book chap-

ters. As one of the few psychologists intimately

involved in the latest revision of the diagnostic manual

of mental disorders, Dr. Widiger served as research

coordinator ofDSM-IV. Dr. Widiger is the author of

two semistructured interviews, the Personality Disorder

Interview-IV, or PDI-IV (Widiger, Mangine, Corbitt, Ellis,

& Thomas, 1995) and the Structured Interview for the

Five Factor Model of Personality (Trull & Widiger,

1997). We had the chance to ask Dr. Widiger a few

questions about his background, his perspective on the

field, and his thoughts on structured interviews.

What originally got you interested in the field of

clinical psychology?

I suppose that what originally got me interested in

clinical psychology was genetic dispositions and paren-

tal influences. However, my memory is that I was

interested in why I was the way I was. Most of my

friends who were in college were art majors, although

one was pre-dental and another was pre-medicine

(none were psychology majors). Those who did not

attend college worked in the fields of auto mechanics

and highway repair. For the first 2 years of college I

majored in creative writing. I wanted to be a novelist.

However, I did recognize that it would be very

difficult to make a reasonable living writing poetry and

novels. In the second semester of my sophomore year, I

took a course in abnormal psychology. I found it very

interesting, rivaling even an English literature course

that was taught by a very long-haired hippie who had

students over to his house to discuss Vonnegut, Heller,

and Castenada (the good old days). Clinical psychology

was a field that was concerned with issues that were

(or should be) of central importance to any individual’s

life—why you are the way you are and what you can

do about it. Perhaps my interest was typical for a

college-age student going through a normal period of

identity confusion, or perhaps it reflected a concern

with my own conflicts and struggles.

At the end of the semester, I asked the instructor

to recommend some additional readings. I was

attending a junior college, and this was the only

advanced course in psychology that was offered. He

recommended three books: Freud’sInterpretation of

Dreams, R. D. Laing’sDivided Self, and Sandor Ferenc-

zi’sSex in Psychoanalysis. I have no idea why he

included Ferenczi’s text along with Freud’s and Laing’s;

one can only speculate. In any case, I was fascinated

with the texts by Freud and Laing. I read them through

voraciously, bought additional books by Freud, Laing,

178 CHAPTER 6