As a neuropsychologist, I spend a lot of my time administering and scoring and generally trying to make sense of standardized tests of cognitive and emotional functioning. And I love it! I love watching my clients as they solve problems and formulate verbal responses to questions they might not have considered before. I love the diagnostic process of "connecting the dots" among my data sources. Looking at inkblots, putting red-and-white blocks together, and copying complex geometric figures...all really good stuff.
But if you put me on a desert island and said, "David you can take one diagnostic tool with you as you set up your new practice on this island...." do you know which tool I'd pick?
Hands down, it'd be the clinical interview. What skillful clinicians are able to do with the diagnostic interview and the mental status examination is remarkable. When we really pay attention, and notice what we're paying attention to, and document all of that noticing, we're working with a powerful clinical tool.
If you're a clinician, you can probably estimate a client's general intellectual ability within 15 IQ points. We notice vocabulary, for example, or insight or problem-solving ability. Even with clients who are culturally different from us, we often "pick up" on smart. We know it when we see it.
And one of the best indicators of personality disorder in the adult interview is your body - the hair on the back of your neck or a tightening in your chest. What is that? What just happened in my body? And why? We begin to notice what we're noticing, and connecting the dots and asking "is my client saying or doing something right now which is associated with this feeling in my body? And is it just me and my counter-transference, or does he/she make other people feel that? And if so, how does that relate to what I've learned about the relationship history and vocational patterns?"
I'm fascinated by the really good clinicians who maximize their time with clients and come to understand the experience of another person by keen observation and skillful questioning. If you'd like to master the knowledge and skill set associated with a great clinical interview, come spend Saturday June 16, 2012, with me. I'm offering a full-day workshop (yes! CE credits!) in a convenient MetroWest location, and would love to see you there.
More info here.