interviews, the clinician attempts to gain a general
impression of the presenting problem and of the
variables that seem to be maintaining the problem
behavior (Goldfried & Davison, 1994). Other infor-
mation sought includes relevant historical data and
an assessment of the patient’s strengths and of past
attempts to cope with the problem. Also of interest
are the patient’s expectations regarding therapy.
Finally, when feasible, some initial establishment
and communication of therapeutic goals by the cli-
nician can be helpful. However, the basic goal of
the interview is to identify specific problem beha-
viors, situational factors that maintain the problem
behavior, and the consequences that result from the
problem behavior. It should also be noted that the
use of structured diagnostic interviews (see Chapter
6) is increasing among behavioral clinicians, who
view the symptoms of mental disorders as problem-
atic behaviors targeted for intervention.
Observation Methods
Naturalistic Observation
To assess and understand behavior, one must first
know what one is dealing with. It comes as no
surprise, then, that behavioral assessment employs
observationas a primary technique (Yoman, 2008).
A clinician can try to understand a person with a
phobia’s fear of heights, a student’s avoidance of
evaluation settings, or anyone’s tendency to over-
eat. These people could be interviewed or assessed
with self-report inventories. But many clinicians
would argue that unless those people are directly
observed in their natural environments, true under-
standing will be incomplete. To determine the fre-
quency, strength, and pervasiveness of the problem
behavior or the factors that are maintaining it,
behavioral clinicians advocate direct observation.
Of course, all this is easier said than done. Prac-
tically speaking, it is difficult and expensive to
maintain trained observers and have them available.
This is especially true in the case of adults who are
being treated on an outpatient basis. It is relatively
easier to accomplish with children or those with
cognitive limitations. It is likewise easier to make
observations in a sheltered or institutional setting.
In some cases, it is possible to use observers who
are characteristically part of the person’s environ-
ment (e.g., spouse, parent, teacher, friend, or
nurse). In certain instances, as we shall see later, it
is even possible to have the client do some self-
observation. Of course, there is the ever-present
question of ethics. Clinical psychologists must take
pains to make sure that people are not observed
without their knowledge or that friends and associ-
ates of the client are not unwittingly drawn into the
observational net in a way that compromises their
dignity and right to privacy.
For all these reasons, naturalistic observation
has not been used in clinical practice as much as it
might be. Indeed, observation is still more promi-
nent in research than in clinical practice. However,
one need not be a diehard proponent of the behav-
ioral approach to concede the importance of obser-
vational data. It is not unlikely that clinicians of
many different persuasions have arrived at incom-
plete pictures of their clients. After all, they may
never see them except during the 50-minute ther-
apy hour or through the prism of objective or pro-
jective test data. But because of the cumbersome
nature of many observational procedures, for years
most clinicians opted for the simpler and seemingly
more efficient methods of traditional assessment.
Naturalistic observation is hardly a new idea.
McReynolds (1975) traced the roots of naturalistic
observation to the ancient civilizations of Greece
and China. More than 60 years ago, Barker and
Wright (1951) described their systematic and de-
tailed recordings of the behavior of a 7-year-old
over 1 day (a major effort that took an entire
book). Beyond this, all of us recognize instantly
that our own informal assessments of friends and
associates are heavily influenced by observations of
their naturally occurring behavior. But observation,
like testing, is useful only when steps are taken to
ensure its reliability and validity. As we pursue these
topics, the reader may notice that a number of the
factors that affect the reliability and validity of
observations are basically the same as those discussed
in connection with the interview (see Chapter 6).262 CHAPTER 9