Clinical interviews and their purpose

Clinical interviews are often described as purposeful conversations between a clinician and a client, with the main goal of collecting information about the client. This helps clinicians evaluate what the client shares willingly, how well they engage in back-and-forth discussion, and the overall organisation of their thinking.

Structured clinical interviews

Structured clinical interviews follow a fixed format, using a set of predetermined questions to guide the process. This approach ensures that every client is asked the same things in the same order, which promotes reliability and consistency across assessments.

Key features of structured interviews

• Standardised questions - Questions are carefully designed and consistent, ensuring that each client is interviewed in the same way.
• Diagnostic focus - They often help in identifying or ruling out specific mental health conditions, based on established criteria like those in the DSM.
• Applications - These interviews are useful for making diagnoses, conducting research on groups with similar symptoms, or evaluating participants in clinical trials. They can also detect if multiple conditions are present at once.

Unstructured clinical interviews

Unstructured clinical interviews offer more flexibility, allowing the conversation to flow naturally based on the client's input. Instead of a rigid list of questions, the clinician uses open-ended prompts to encourage the client to share freely.

Key features of unstructured interviews

• Open-ended questions - These encourage detailed responses.
• Client-led approach - The client has greater control to introduce topics or steer the discussion, with the clinician focusing on listening and following the client's lead.
• Alternative names - Sometimes called 'discovery interviews', 'guided conversations', or 'informal interviews'.

Vallentine et al.'s (2010) study: Psycho-educational group for detained offender patients

This study examined a specific application of interviews within a therapeutic programme. It focused on offender patients with schizophrenia in a high-security hospital. The researchers used both structured and semi-structured interviews, along with questionnaires, to evaluate the programme's impact.

Aims

The study aimed to investigate the usefulness and effectiveness of a psycho-educational group treatment programme. Specifically, the researchers wanted to assess outcomes like engagement in therapy, relapse prevention, care needs, violent incidents, and relationships with group facilitators.

Participants

The study involved 42 male participants, all detained in a high-security hospital and diagnosed with types of schizophrenia. They were referred for 20 sessions over a three-year period. Participants were categorised as 'completers' (those who finished the full programme) or 'non-completers' (those who dropped out).

Procedure

The programme consisted of 20 group sessions, each treated as an intervention to aid recovery and prevent relapse. Records were kept on aspects like medication changes, engagement levels, compliance with the programme, violent incidents, and verbal feedback.

Data collection methods:

• Interviews - Semi-structured interviews evaluated participants' experiences and relationships with facilitators. Responses were electronically transcribed and analysed for significant clinical changes.
• Questionnaires - Two types were administered: the CORE-OM (widely used to measure outcomes of clinical disorders) and the SCQ (30 item self-concept questionnaire asking for own perception of self-esteem).

Results

Of the 42 participants, 21 completed the programme.

Key findings included:

• From structured interviews - All 21 completers reported they would recommend the group to others.
• From semi-structured interviews - Participants appreciated sharing experiences, gaining understanding of symptoms and treatments, and finding hope for recovery. However, some found it unhelpful due to feelings of guilt about the past, discomfort with group discussions, or the early morning timing causing tiredness.
• From questionnaires - There was no significant clinical difference between completers and non-completers on the CORE-OM. However, combining CORE-OM and SCQ results showed that over 50% of participants experienced improved self-esteem.

Conclusions

The qualitative data from interviews indicated that participants valued the group for increasing their knowledge of schizophrenia, boosting confidence, and fostering a more positive outlook for the future.