Cover Page

A PRACTICAL GUIDE FOR SCHOOL PSYCHOLOGISTS AND SCHOOL COUNSELORS

INTERVIEWING FOR ASSESSMENT

 

 

MICHAEL HASS

 

 

 

 

 

 

 

 

 

Title Page

To my students, whose intelligence and desire to serve children, families, and schools inspire me to be the best practitioner, mentor, and teacher I can possibly be.

Acknowledgments

This is a better book because of the efforts of many people who have supported me and this project along the way. I am forever grateful to my colleagues at Chapman University—Anna Abdou, John Brady, Randy Busse, Jeanne Anne Carriere, Amy Jane Griffiths, Kelly Kennedy, and Hilary Leath—for their humor, companionship, intelligence, and unwavering commitment to our students. They have made so much more possible than I could ever have accomplished on my own.

I am also grateful to the Friends of the Book, who included Zoe Alvarez, Libby Barnish, Margie Curwin, Michael Doria, Sarah Ferrentino, Cynthia Olaya, and Pedro Olvera. They each gave prompt and insightful feedback that helped me stay focused on the goal of making this book as practical and useful as possible.

A big thanks to Patricia Harriman of FinalEyes Editing & Publishing Partners and the support team at John Wiley & Sons, including Darren Lalonde, Monica Rogers, Manish Luthra, and Shandhya Rajan.

Lastly, I am forever grateful to Nury for her support and ability to remind me of what is important when I lose track.

CHAPTER 1
Introduction to Interviewing for Assessment

Kelly is a 10-year-old girl with Down syndrome. She is in a fourth-grade general education classroom with a one-on-one aide. Kelly has received special education services since she was 3 years old and has been evaluated several times. After her last reevaluation, her parents asked for further assessment because, in their words, the last evaluation had not done enough to identify Kelly's strengths and had focused too much on standardized test scores and not enough on her actual performance in the classroom. The report written following the prior evaluation indicated test scores as well as her teacher's general descriptions of her behavior in the classroom.

PURPOSE AND GOALS OF THIS BOOK

Kelly illustrates two points that will be important throughout this book. One is that, although the quantitative data produced by standardized tests and behavior rating scales can be valuable, they cannot by themselves provide a holistic picture of a child. For this, it is necessary to talk with Kelly and the people who know her best—her parents and her teachers—to ask them focused questions and listen well to produce a description of Kelly that is authentic and credible. The second point is that these conversations are not simply in the service of arriving at a diagnosis. No one doubts that Kelly has Down syndrome. In addition, in Kelly's case, no one doubts that she has at least a mild intellectual disability or difficulties expressing herself verbally. This information is easily available to us via scores on standardized tests. What we do not know, aside from these broad brushstrokes, is what her unique strengths and challenges are. My assertion in this book is that the best way to arrive at this knowledge is through interviewing both Kelly and the important adults in her life. My overall goal in writing this book is to assist practitioners in being able to do this with skill and confidence.

Interviewing has long been embraced by mental health professionals as a flexible way of gathering information from the clients they work with. Furthermore, interviewing is so ubiquitous in society at large that we are said to live in what Atkinson and Silverman (1997) called “the interview society.” One only has to watch the news on television or pick up a magazine to find interviews being used to deliver information, shed light on issues, or simply unveil the experiences of a popular personality.

The importance of interviewing lies in its flexibility to be used for different purposes. In psychological or educational assessment, it can be used to better understand someone's social and cultural context, clarify clients' concerns, determine a formal classification or diagnosis, and/or gather information important for developing solutions to problems (e.g., Beaver & Busse, 2000; Vacc & Juhnke, 1997; Watkins, Campbell, Nieberding, & Hallmark, 1995). Interviewing is such a pervasive part of what counselors and psychologists are expected to do that, as Whitcomb and Merrell (2013) point out, it has become part of the mystique of being a mental health professional. Although interviewing is not the X-ray superpower laypeople imagine it to be, it is hard to envision a day going by in the lives of counselors or psychologists when they do not gather information from students, parents, or teachers by having conversations with them. This importance is reflected in the quantity of literature available on interviewing. For example, a search of the electronic catalog at the university where I teach, using the term clinical interviewing yielded almost 1,300 books and nearly 49,000 journal articles.

Yet despite its presence in the literature and apparent importance as a professional competency, interviewing is often an underutilized part of the assessment process, at least among school-based practitioners. Over the past several years, I have read dozens of psycho-educational evaluation reports and interacted with hundreds of participants in professional development workshops I lead. Although this is certainly limited data, my observation is that, although interviewing has been described as “the hallmark of assessment processes and perhaps the most common method used to obtain information to evaluate individuals” (Busse & Beaver, 2000, p. 235), it seems to take a back seat to other forms of evaluation data such as standardized tests.

At least some research supports this conclusion. For example, the results of a survey of 214 practicing school psychologists found that even with evaluations of children suspected of having the educational classification of Emotional Disturbance, a student interview was one of the most excluded assessment methods (Allen & Hanchon, 2013). This is especially striking given that the focus of evaluations to decide Emotional Disturbance is on social, behavioral, and emotional functioning; this emphasis calls for interviews of children, parents, and teachers.

In part, the underutilization of interviewing may be because interviewing for assessment demands a unique blend of both interpersonal skills and professional knowledge (Sattler, 1998; Whitcomb & Merrell, 2013). For example, to be competent at interviewing requires that practitioners possess knowledge of typical and atypical child development, formal classification systems (e.g., Diagnostic and Statistical Manual [DSM], American Psychiatric Association, 2013; Individuals with Disabilities Education Improvement Act [IDEIA], 2004; etc.) as well as the communication skills needed to flexibly respond to the demands of persons of different ages, persons with different social and emotional challenges, and persons with varied social and cultural backgrounds. This includes skills for fostering a collaborative relationship and skillful questioning strategies. School-based practitioners must also have a good understanding of learning, curriculum, and pedagogy. This unique combination of skills and knowledge can make interviewing for assessment difficult to learn and practice well.

Nonetheless, skillful interviewing is critical to being an effective school counselor or school psychologist and a fundamental part of the assessment process. Given its importance, the goal of this book is to help students and practitioners learn to be more comfortable and skillful using interviews to gather information from children, parents, and teachers. A secondary goal is for readers to better understand how interviews can be used with other assessment methods as part of a comprehensive assessment.

The ideas discussed here are drawn from my 35 years' experience as a school psychologist and psychotherapist, much of that spent working with children and youth with social, emotional, and behavioral challenges. It also comes from my nearly 20 years as an educator of school counselors and school psychologists and my efforts to better understand and teach the ideas and skills that are now part of this book. The outcome of this experience is several big ideas that form the basis of this book and the approach to interviewing that I advocate.

BIG IDEAS OF THIS BOOK

Interviewing for Assessment and Intervention, Not Just Diagnosis

Much of the literature on interviewing focuses on clinical interviewing. As Whitcomb and Merrell (2013) point out, the term clinical interviewing describes interviewing for the purpose of gathering information about behavioral, social, and emotional functioning in order to better understand problems in these areas. Broadly interpreted, this definition seems appropriate for both clinical and educational settings. Unfortunately, much of the literature on clinical interviewing more narrowly places a premium on accurate diagnosis with the assumption that this will lead to clear treatment recommendations. This logic is derived from the medical model with its emphasis on diagnosis and the close relationship between accurate classification and treatment (Kamphaus, Dowdy, Kim, & Chin, 2013). This approach, when applied to the kinds of human problems that mental health practitioners deal with, has been criticized on both philosophical and practical grounds (e.g., De Jong & Kim Berg, 2013; Kamphaus et al., 2013; Kraemer, 2014; Lopez et al., 2006; Sheridan & Gutkin, 2000).

These critiques, and the strengths and weaknesses of formal diagnoses based on a medical model, will be discussed in more depth in Chapter 8, but what is important for the moment is that these criticisms seem especially salient in school-based practice, where the viewpoint is more ecological and the emphasis is on problem-solving and prevention of problems (Burns, 2011). As Sheridan and Gutkin (2000) state it, “By focusing almost exclusively upon child/pathology-related factors, the medical model leads school psychologists to both ask and answer the wrong questions” (p. 486).

Because of these concerns, I have chosen to use the broader term interviewing for assessment and intervention rather than clinical interviewing. I start with the assumption that any school-based assessment can serve multiple purposes and that one of these may be to assist in making a determination about the type of problem that someone has. Yet, left here, interviews and assessments in general have limited utility. Chief among the limitations is that diagnoses often have limited clinical validity (Kamphaus et al., 2013). In other words, they do not contribute very much to the development of strategies, programs, or interventions that promote greater success and well-being, which is arguably the most important point of any assessment. Without this, interviews—and the assessments they are part of—are at best of limited value and at worst, hollow technical exercises.

Given the broader perspective of this book, later chapters will focus on the use of assessment interviews for different purposes, such as interviewing to gather background and contextual information, interviewing for strengths and resources, and interviewing to establish next steps and goals in addition to what has been traditionally considered clinical interviewing—that is, interviewing to establish an accurate diagnosis or classification.

Collaboration Is the First Goal of All Interviews

If, as noted earlier, the end goal of an assessment is to gather information that helps in the development of plans or programs that promote greater success and well-being, it is critical that an overarching purpose of any interview is to promote a collaborative working relationship with the interviewee. This is equally true if the person being interviewed is a child, parent, or other professional. In the context of clinical interviewing, this has been called diagnostic engagement (Cepeda & Gotanco, 2017), which is linked conceptually to what has been called the therapeutic alliance (Horvath, Del Re, Flückiger, & Symonds, 2011). The importance of relationship as a key variable in client change is well established in the literature on counseling and psychotherapy (e.g., Lambert, 2004; Norcross, 2001; Wampold, 2001). Although the focus of this book is not on therapy per se, the relationship between practitioners and clients also has important implications for interviewing for assessment.

As noted previously, the collaborative relationship between a psychotherapist and client has been conceptualized as a therapeutic alliance (Horvath et al., 2011). The therapeutic alliance has been described as having three components: (1) interpersonal bonds, (2) agreement on goals, and (3) collaboration on therapeutic tasks (Bordin, 1979, 1994). The first element can be seen as the development of a relationship that consists of mutual respect and trust (Horvath et al., 2011). The second and third elements involve the ability to collaboratively engage in the work of therapy (Hatcher & Barends, 2006). The results of the American Psychological Association Division of Psychotherapy Task Force on Empirically Supported Psychotherapy Relationships describe the relationship between therapeutic alliance and the effectiveness of therapy as demonstrably effective, their highest standard for evidence, and suggest that it has value apart from any specific theory or technique (Norcross, 2001).

My assumption is that the process of assessment is in the service of intervention, treatment, or therapy—broadly defined (e.g., later counseling or psychotherapy, educational interventions, behavior support plans, and the like). In other words, assessment is never a stand-alone activity but a step in a process that leads to helpful changes in a child's life. Given the importance of relationship in psychotherapy, I also assume that the odds of success in post-assessment interventions increase if there is a bond between the practitioner and the client and agreement on what is to be done and why. More specifically in the case of interviewing for assessment, I also argue that it is reasonable to assume that the quality and accuracy of the information gathered during an assessment will be improved when practitioners pay attention to the alliance early in the relationship.

If establishing a working relationship or alliance is important to client change, then an important question is, what can the practitioner do to help develop this kind of relationship? The answer to this question can best be explained both as a general stance or attitude toward clients and in terms of specific skills. This stance has been described as one of not knowing (Anderson & Goolishian, 1992). The skills that follow from this stance have been described in different ways, including microskills (Carkhuff, 2000; Truax & Carkhuff, 1967), O.A.R.S. in Motivational Interviewing (Miller & Rollnick, 2013), and skills for not knowing (De Jong & Kim Berg, 2013). These skills will be discussed in the context of interviewing for assessment in Chapter 4.

The Insider Perspective Is Important

For many, the judgments made from an interview seem more subjective and less defensible than the hard data of test scores and rating scales. Yet, without the information gained from interviewing, assessments can seem depersonalized and even off-putting to stakeholders such as parents and teachers. I have had the experience of working with many parents whose children had been assessed several times, but they remained dissatisfied because they did not “see” their children in the reports and assessment data.

Interviewing then adds important information about how different stakeholders (e.g., parents, teachers, students themselves) view a situation. This insider perspective not only offers ecological validity for information from other sources such as tests or behavior rating scales; it also helps cultivate the collaborative working relationship discussed earlier. Anthropologists have used the terms emic to describe the insider understanding of a phenomenon and the word etic to describe the perspective of those who observe a person or group as outsiders and analyze their observations using their own categories and systems of classification (Pelto & Pelto, 1986). Practitioners must balance their outsider, or etic, expert knowledge with a deep emic understanding of how the people they work with view their situations.

This balanced understanding comes from what the cultural anthropologist Clifford Geertz (1973) referred to as a thick description, by which he meant a description of not only a specific behavior, but enough rich contextual information so that the behavior becomes meaningful to an outsider. Although assessment serves multiple purposes, the overarching goal of any assessment is to make the unique strengths and challenges of children more meaningful to their parents, their teachers and other professionals who work with them, and the children themselves. It is also important that those we interview feel the relationship is not one-sided and that they are part of the assessment process. This is impossible without the insider perspective that only interviews can provide.

Focus on the Whole Person: Strengths as Well as Problems

Over the past several years a number of researchers and writers have focused on the notion that it is equally, if not more, important for assessments to account for someone's strengths and resources as for problems and psychopathology (e.g., Cox, 2006; Huebner & Gilman, 2003; Jimerson, Sharkey, Nyborg, & Furlong, 2004; Nickerson & Fishman, 2013). Suldo and Shaffer (2008) argue that psychopathology and wellness make important independent contributions to mental health. This argument is in keeping with evidence that suggests that symptoms, or psychopathology, alone do not account for the level of impairment in people with mental health disorders (Winters, Collett, & Myers, 2004) and that strengths and sources of resilience seem to contribute to positive outcomes more than deficits or risk factors alone (Garmezy, 1993; Werner & Smith, 1992).

The inclusion of strengths and resources in a comprehensive assessment has several advantages. Conversations about strengths facilitate the alliance discussed earlier by encouraging client engagement in the assessment process and subsequent treatment (Epstein, Hertzog, & Reid, 2001). These conversations also encourage practitioners to focus on the enhancement of skills and learning and not just on reducing symptoms or problem behaviors (Epstein et al., 2001; Nickerson & Fishman, 2013). Any approach to interviewing for assessment that does not include strengths and resources will provide a partial and incomplete picture of a child.

THE STRUCTURE OF THIS BOOK

The next three chapters set the stage for learning to interview for assessment and intervention by providing an overview of interviewing, detailing specific interviewing strategies, and discussing how to work with children of different developmental statuses and cultures. A separate chapter is devoted to observation during an interview, or what is often called a mental status exam.

The following chapters illustrate different uses of interviewing, including (a) interviewing to understand history and context, (b) interviewing to clarify and classify problems, (c) interviewing about academic performance, (d) interviewing to understand strengths and resources, (e) interviewing in high-risk situations such as crisis or threat, and (f) interviewing to establish motivation and commitment. In addition to a discussion of each of these applications of interviewing, each of these chapters will present a case study and sample interview transcripts to help the reader better understand how these skills look in practice with different clients. The last two chapters focus on communicating the key information from interviews to stakeholders either in conferences or meetings, or in written reports.

Chapter 1 Takeaway Points

REFERENCES

  1. Allen, R. A., & Hanchon, T. A. (2013). What can we learn from school-based emotional disturbance practices? Implications for practice and preparation in school psychology. Psychology in the Schools, 50(3), 290–299. doi:10.1002/pits.21671
  2. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
  3. Anderson, H., & Goolishian, H. (1992). The client is the expert: A not-knowing approach to therapy. In S. McNamee & K. Gergen (Eds.), Social construction and the therapeutic process (pp. 25–39). Newbury Park, CA: Sage.
  4. Atkinson, P., & Silverman, D. (1997). Kundera's “Immortality”: The interview society and the invention of the self. Qualitative Inquiry, 3, 304–325.
  5. Beaver, B. R., & Busse, R. T. (2000). Informant reports: Conceptual and research bases of interviews with parents and teachers. In E. S. Shapiro & T. R. Kratochwill (Eds.), Behavioral assessment in schools: Theory, research, and clinical foundations (2nd ed., pp. 257–287). New York, NY: Guilford Press.
  6. Bordin, E. S. (1979). The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy: Theory, Research & Practice, 16(3), 252–260. doi:10.1037/h0085885
  7. Bordin, E. S. (1994). Theory and research on the therapeutic working alliance: New directions. In A. O. Horvath & L. S. Greenberg (Eds.), The working alliance: Theory, research, and practice (pp. 13–37). Oxford, England: Wiley.
  8. Burns, M. K. (2011). School psychology research: Combining ecological theory and prevention science. School Psychology Review, 40(1), 132–139.
  9. Busse, R. T., & Beaver, B. R. (2000). Informant report: Parent and teacher interviews. In E. S. Shapiro & T. R. Kratochwill (Eds.), Conducting school-based assessments of child and adolescent behavior (pp. 235–273). New York, NY: Guilford Press.
  10. Carkhuff, R. R. (2000). The art of helping in the 21st century (8th ed.). Amherst, MA: Human Resource Development Press.
  11. Cepeda, C., & Gotanco, L. (2017). Psychiatric interview of children and adolescents. Arlington, VA: American Psychiatric Association.
  12. Cox, K. F. (2006). Investigating the impact of strength-based assessment on youth with emotional or behavioural disorders. Journal of Child and Family Studies, 15, 287–301.
  13. De Jong, P., & Kim Berg, I. (2013). Interviewing for solutions. Belmont, CA: Brooks/Cole, Cengage Learning.
  14. Epstein, M. H., Hertzog, M. A., & Reid, R. (2001). The Behavioral and Emotional Rating Scale: Long term test–retest reliability. Behavioral Disorders, 26(4), 314.
  15. Garmezy, N. (1993). Children in poverty: Resilience despite risk. Psychiatry, 56, 127–136.
  16. Geertz, C. (1973). The interpretation of cultures: Selected essays by Clifford Geertz. New York, NY: Basic Books.
  17. Hatcher, R. L., & Barends, A. W. (2006). How a return to theory could help alliance research. Psychotherapy: Theory, Research, Practice, Training, 43(3), 292–299. doi:10.1037/0033-3204.43.3.292
  18. Horvath, A. O., Del Re, A. C., Flückiger, C., & Symonds, D. (2011). Alliance in individual psychotherapy. Psychotherapy, 48(1), 9–16. doi:10.1037/a0022186
  19. Huebner, E. S., & Gilman, R. (2003). Toward a focus on positive psychology in school psychology. School Psychology Quarterly, 18, 99–102.
  20. Individuals with Disabilities Education Improvement Act, Pub. L. No. 108-446, 118 Stat. 2647 (2004).
  21. Jimerson, S., Sharkey, J., Nyborg, V., & Furlong, M. (2004). Strength-based assessment and school psychology: A summary and synthesis. The California School Psychologist, 9, 9–19.
  22. Kamphaus, R. W., Dowdy, E., Kim, S., & Chin, J. (2013). Diagnosis, classification, and screening systems. In D. H. Saklofske, C. R. Reynolds, & V. L. Schwean (Eds.), The Oxford handbook of child psychological assessment (pp. 182–201). doi:10.1093/oxfordhb/9780199796304.013.0009
  23. Kraemer, H. C. (2014). The reliability of clinical diagnoses: State of the art. Annual Review of Clinical Psychology, 10, 111–130. doi:10.1146/annurev-clinpsy-032813-153739
  24. Lambert, M. (2004). The efficacy and effectiveness of psychotherapy. In M. J. Lambert (Ed.), Bergin and Garfield's handbook of psychotherapy and behavior change (5th ed., pp. 139–193). New York, NY: Wiley.
  25. Lopez, S. J., Edwards, L. M., Pedrotti, J. T., Prosser, E. C., LaRue, S., Spalitto, S. V., & Ulven, J. C. (2006). Beyond the DSM-IV: Assumptions, alternatives, and alterations. Journal of Counseling & Development, 84(3), 259–267. doi:10.1002/j.1556-6678.2006.tb00404.x
  26. Miller, W. R., & Rollnick, S. (2013). Motivational interviewing: Helping people change. New York, NY: Guilford Press.
  27. Nickerson, A. B., & Fishman, C. E. (2013). Promoting mental health and resilience through strength-based assessment in US schools. Educational and Child Psychology, 30(4), 7–1.
  28. Norcross, J. C. (Ed.). (2001). Empirically supported therapy relationships: Summary report of the Division 29 Task Force. Psychotherapy, 38(4).
  29. Pelto, P. J., & G. H. Pelto (1986). Anthropological research: The structure of inquiry. Cambridge, England: Cambridge University Press.
  30. Sattler, J. M. (1998). Clinical and forensic interviewing of children and families. San Diego, CA: Author.
  31. Sheridan, S. M., & Gutkin, T. B. (2000). The ecology of school psychology: Examining and changing our paradigm for the 21st century. School Psychology Review, 29(4), 485–502.
  32. Suldo, S. M., & Shaffer, E. J. (2008). Looking beyond psychopathology: The dual-factor model of mental health in youth. School Psychology Review, 37, 52–68.
  33. Truax, C. B., & Carkhuff, R. R. (1967). Toward effective counseling and psychotherapy: Training and practice. Chicago, IL: Aldine.
  34. Vacc, N. A., & Juhnke, G. A. (1997). The use of structured clinical interviews for assessment in counseling. Journal of Counseling and Development, 75(6), 470–480.
  35. Wampold, B. E. (2001). The great psychotherapy debate: Models, methods, and findings. Mahwah, NJ: Erlbaum.
  36. Watkins, C. J., Campbell, V. L., Nieberding, R., & Hallmark, R. (1995). Contemporary practice of psychological assessment by clinical psychologists. Professional Psychology, Research and Practice, 26(1), 54–60.
  37. Werner, E. E., & Smith, R. S. (1992). Overcoming the odds: High risk children from birth to adulthood. Ithaca, NY: Cornell University Press.
  38. Whitcomb, S. A., & Merrell, K. W. (2013). Behavioral, social, and emotional assessment of children and adolescents (4th ed.). New York, NY: Routledge.
  39. Winters, N. C., Collett, B. R., & Myers, K. (2004). Ten-year review of rating scales, VII: Scales assessing functional impairment. Journal of the American Academy of Child and Adolescent Psychiatry, 44(4), 309–338. doi:10.1097/01.chi.0000153230.57344.cd