Interviewing and Diagnostic Exercises for Clinical and Counseling Skills Building
This book contains twenty client profiles to use in practicing interviewing and diagnostic skills. Ten profiles are of adult cases ranging in age from eighteen to seventy (chapters 3-12). Ten profiles are of child or teen cases ranging in age from seven to seventeen (chapters 13-22).
In addition to age, the twenty profiles vary in terms of ethnicity, gender, national origin, religion, socioeconomic status, presenting problems, and level of problem severity.
The instructor can have students simply read through these profiles and then complete the three sets of exercises that follow them.
These exercises help students develop diagnoses using the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV-TR), deepen their interviewing skills, and practice responding to important clinical issues as they relate to the client. Students can develop their skills more quickly if the clinical profiles are also used in role-play practice with interviewing skills.
In basic role playing, students are divided into teams of two. Before each practice session, one student reads a client profile and prepares to take on the role of “client.” The profile contains information about the feelings, thoughts, actions, and interpersonal patterns of the client as he or she participates in a diagnostic intake or initial interview. This allows the student to realistically portray the client and thus be an effective partner for the student taking the interviewer role.
Interviewing and diagnostic skills are complex and students will make mistakes. The major advantage of role plays is that the focus is on the interviewer’s skill building and not client welfare. Thus, you are not faced with any ethical dilemmas if one of your students does, for example, an ineffective screen for suicide. You don’t have to take over the session, as you might, with a truly suicidal client. Instead, you can put the interview on temporary hold while you coach your student on how to conduct an effective suicide assessment.
Once the student understands what to do, you can have the role playing begin again. Real clients, who have already undergone an inadequate or inappropriate screen, may alter their responses the second time around; you may remain unclear about the validity of the assessment which raises ethical concerns. In a role play, however, the role-play client can simply be instructed to start over again as if the first suicide screen did not occur. This gives the interviewer a fresh start.
At the end of this second screen, the role-play client can give the interviewer feedback about both the first and second experience of being screened for suicide. This type of immediate feedback, from both the instructor and the role-play client, can help solidify skill building so that the student is prepared when a real suicidal crisis arises.
Another advantage of role plays is that client confidentiality is not an issue. Thus, students who are not taking on either the client or interviewer role can watch the role-play interview and learn from observing. Although you can have your students watch interviews with real clients, many clients will not want to be observed. Even when they agree to be watched, they may be uncomfortable with, or unwilling, to disclose all the information that might be gained in a more confidential setting.
Finally, role plays can serve as a gatekeeping device. Students who appear to be progressing well in role plays can be assigned real clients to interview; these students are unlikely to jeopardize clients’ welfare through a lack of sufficiently honed skills. Those students who seem to be struggling can be given additional role-play practice before being assigned real clients.