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32 Becoming a Mental Health Professional Putting It in Practice 2.5 Staying in Control of the Interview Setting Imagine yourself confronted with the following scenario: An interviewing stu-dent calls a volunteer interviewee: “Hello, is Sally Sampson there?” “Yes, this is she.” “Sally, my name is Beth McNettle and I’m taking Interviewing 443. I believe you signed up to be interviewed for extra credit in your Psychology 101 class. I got your name, so I’m calling to set up a time.” “Oh sure. No problem . . . but it’s almost finals week. I’m pretty busy.” “Uh, yeah. I wanted to do this sooner in the semester, but uh, well, let’s see if we can find a time.” After much searching, they find a mutually agreeable time. Unfortunately, Beth forgot to check the room schedule and finds no rooms are available at the time chosen. She calls Sally back: “Sally, this is Beth McNettle again. I’m sorry, but there are no rooms avail-able at the time we decided.” Sally is a bit irritated, and it shows in her voice. Beth is feeling apologetic, in-debted, and a little desperate. There is only one week left in the semester. They discuss their limited options. Beth suggests, “Maybe I should call someone else.” Sally counters with: “Hey, look, I really want to do this. I need the extra credit. Why don’t you just come to my room? I live in University Hall, right here on campus.” Knowing she is violating the rules, Beth reluctantly agrees to do the inter-view in Sally’s dorm room. After all, it’s just a class assignment, right? What’s wrong with a nice, quiet dorm room? Who will ever know where the interview was conducted? Besides, it’s better than inviting Sally to herhouse, isn’t it? Beth asks Sally to make sure they will have the room to themselves. “No problem,” says Sally, sounding distracted. The next day, Beth arrives. It is late afternoon. It just happens to be the one hour designated as the time when residents can make as much noise as they please to compensate for quiet hours and finals stress. The Grateful Dead, Madonna, and Pearl Jam compete for air space. Sally’s friend from across the hall is getting her hair permed, which, except for the odor, should not be all that relevant, but somehow, Sally’s digital clock is being used to time the perm. No one besides Beth and Sally are actually in the room, but there are numerous in-terruptions and the phone rings six times, twice with calls for Sally. Unfortunately, this is a true story. Beth had the courage to report her rule violation and “horrible” experience. She shared with us her dismal failure in establishing any kind of meaningful communication with Sally and admitted feeling out of control. Although this example is extreme, it illustrates the importance of controlling the interview setting. Loss of control can happen easily. Foundations and Preparations 33 example, a new office manager or untrained staff member may knock on the door or enter without understanding the importance of privacy. In such cases, the interviewer should gently inform the intruder that the meeting is private. Second, there are legitimate interruptions that take a few minutes to manage. For ex-ample, the secretary at your seven-year-old daughter’s school telephones your office, indicating your child is ill and needs to be picked up from school. This interruption may require five minutes for the interviewer to contact a friend or family member who is free to pick up the child. In this situation, the interviewer should inform the client that a short break from their session is necessary, apologize, and then make the telephone calls. On returning to the session, the interviewer should apologize again, offer restitu-tion for the time missed from the session (e.g., ask the client “Can you stay an extra five minutes today?” or “Is it okay to make up the five minutes we lost at our next session?”), and then try, as smoothly as possible, to begin where the interview had been inter-rupted. Third, an interruption may bring information of some kind of personal or profes-sional emergency that requires your immediate presence somewhere else. If so, the in-terviewer should apologize for having to end the session, reschedule, and provide the rescheduled appointment at no charge (or refund the client’s payment for the inter-rupted session). Depending on one’s theoretical orientation, it may or may not be nec-essary or appropriate to disclose the nature of the emergency to your client. Usually, a calm, explanatory statement should suffice: “I’m sorry, but I need to leave because of an urgent situation that can’t wait. I hope you understand, but we’ll need to reschedule. This is very unusual, and I’m terribly sorry for inconveniencing you.” Often, giving clients general information about your leaving allays both their concern and their curiosity. Overall, key issues for handling interruptions are (a) modeling calmness and problem-solving ability, (b) apologizing for the interruption, and (c) compensating the client for any interview time lost because of the interruption. In addition, if the inter-viewer is taking notes when an interruption occurs, he or she should make certain the notes are placed in a secure file or given to the office manager before leaving the coun-seling office. Seating Arrangements When teaching interviewing, we routinely ask students how two people should sit dur-ing an interview. The variety of student responses to this question is surprising. Some students suggest a face-to-face seating arrangement, others like having a desk between themselves and clients, and still others prefer sitting at a 90- to 120-degree angle so that client and interviewer can look away from each other without discomfort. A few stu-dents usually point out that some psychoanalytically oriented psychotherapists still place clients on a couch, with the therapist seated behind the client and out of view. Some training clinics have predetermined seating arrangements. For example, our old clinic had a single, soft reclining chair along with two or three more austere wooden chairs available. Theoretically, the soft recliner provides clients with a comfortable and relaxing place from which they can freely express themselves. The recliner is also an ex-cellent seat to use for hypnotic induction, for teaching progressive relaxation, and for free association. Unfortunately, having a designated seat for clients can produce dis- 34 Becoming a Mental Health Professional comfort, especially during early sessions. In training facilities using such an arrange-ment, clients notoriously avoid the selected seat or complain of feeling they are on the throne or hot seat. Several factors dictate seating arrangement choices. Interviewer theoretical orienta-tion is one factor. Psychoanalysts often choose couches, behaviorists often choose re-cliners, and person-centered therapists usually emphasize the importance of having chairs of equal status and comfort. In classes, we consistently notice a connection be-tween students’ suggestions for seating arrangements and their personality styles. More assertive students tend to prefer the face-to-face arrangement, and students with needs for control more frequently like their clients on couches or recliners. You might try out a number of different seating arrangements to get a sense for what feels best. This does not necessarily mean you always choose whatever arrangement feels best to you, but discovering your preference may be enlightening. You should also remain sen-sitive to your clients’ preferences, as there are certain arrangements that feel better and worse to each of them. Generally, interviewer and client should be seated at somewhere between a 90- and 150-degree angle to each other during initial interviews. Benjamin (1981) states the ra-tionale for such a seating arrangement quite nicely: [I] prefer two equally comfortable chairs placed close to each other at a 90-degree angle with a small table nearby. This arrangement works best for me. The interviewee can face me when he wishes to do so, and at other times he can look straight ahead without my get-ting in his way. I am equally unhampered. The table close by fulfills its normal functions and, if not needed, disturbs no one. (p. 3) The 90-degree-angle seating arrangement is safe and conservative. It usually does not offend anyone. Nonetheless, many interviewers (and clients) prefer a less extreme angle so they can look at the client more directly but not quite face-to-face (perhaps at a 120-degree angle). In some cases, clients disrupt your prearranged seating by moving the chair to a dif-ferent position. Generally, we recommend that interviewers notinsist on any given seat-ing arrangement. If a client appears comfortable with an unplanned or unusual seating arrangement, simply allow the client to choose, make a mental note of this behavior, and proceed with the interview. An exception to this general rule can occur when a client (usually a child or adolescent) blatantly refuses to sit in an appropriate or re-sponsive position in the interviewer’s office. Note Taking Many therapists and writers have discussed note taking (Benjamin, 1987; Pipes & Dav-enport, 1999; Shea, 1998). Although some experts recommend that interviewers take notes only after a session has ended, others point out that interviewers do not have perfect memories and thus some ongoing record of the session is desirable (Benja-min, 1987; Shea, 1998). The bottom line is that, in some cases, note taking may of-fend clients, whereas in other cases, it may enhance rapport and interviewer credibility (Hickling, Hickling, Sison, & Radetsky, 1984). Clients’ reactions to note taking are usu-ally a function of their intrapsychic issues, interpersonal dynamics, previous experi-ences with note-taking behavior, and the tact of the interviewer while taking notes. Be-cause you cannot predict a client’s reaction to note taking in advance, you should offer an explanation when you begin taking notes during a session. Shea (1998) recommends the following approach: Foundations and Preparations 35 I frequently do not even pick up a clipboard until well into the interview. When I do begin to write, as a sign of respect, I often say to the patient, “I’m going to jot down a few notes to make sure I’m remembering everything correctly. Is that alright with you?” Patients seem to respond very nicely to this simple sign of courtesy. This statement of purpose also tends to decrease the paranoia that patients sometimes project onto note-taking, as they wonder if the clinician is madly analyzing their every thought and action. (p. 180) We agree that whenever interviewers take notes, they should introduce note taking in a courteous manner and proceed tactfully (i.e., the interviewer should always pay more attention to the client than to the notes). However, we recommend practicing your interviews both with and without taking notes. It is important to explore how it feels to take notes and how it feels not to take notes during a session. Rules for Note Taking The following list summarizes general rules for note taking. • Never allow note taking to interfere with interview flow or with rapport; always pay more attention to your client than to your notes. • Explain the purpose of note taking to clients. Usually, a comment about not hav-ing a perfect memory suffices. Alternatively, some clients are disappointed if you do not take notes; explain to them why you are choosing not to take notes. • Never hide or cover your notes or act in any manner that might suggest to clients that they do not or should not have access to your notes. • Never write anything on your notepad that you do not want your client to read. This means you should stick to the facts. If you write down personal observations you intended to keep to yourself, rest assured that your client will want to read what you have written. Clients with paranoid qualities will be suspicious about what you’ve written and may ask to read your notes or, in extreme cases, simply stand up and grab your notes (or read the notepad over your shoulder). • If clients ask to see what you’ve written, explore their concerns and offer to let them read your notes. Only occasionally do clients accept such an offer. However, when a client does, you’ll be glad you followed the previous rule. Videotape and Audiotape Recording If you record a session with video or audio equipment, you should do so as unobtru-sively as possible. In general, the more comfortable and matter-of-fact you are in dis-cussing the recording equipment, the more quickly clients become comfortable being recorded. This is easier said than done because as the interviewer, you will be more closely observed on the subsequent review of the tape; therefore, you may be even more nervous than your client about being tape-recorded. To reassure the client (but not yourself), you might say: “The main reason I have to record our session is so that my supervisor can watch me working. It’s to help make sure you get the best service possible and to make sure I’m using my counseling skills effectively.” Whenplanning to audiotape or videotape a session, you must obtain the client’s per-mission before turning on the recorder. Usually, permission is obtained on a written 36 Becoming a Mental Health Professional consent form. This is important for a number of reasons. Recording clients without their knowledge is an invasion of privacy and violates their trust. It is also important for ethical and legal reasons to explain possible future uses of the recording and how it will be stored, handled, and eventually destroyed. CASE EXAMPLE In an effort to obtain a fresh recording of interactions he was about to have with a new client, a student decided to start his audiotape recorder before the client entered the interviewing room. He assumed that, after preserving the important initial ma-terial on tape, he could then discuss the issue of tape recording with the client. Not surprisingly, when the client discovered she was being recorded, she was angry about her privacy being violated and refused to continue the interview. Furthermore, she delivered to the young man a punishing tirade against which he had no defense (and, of course, he conveniently recorded this tirade for himself). The student had unwit-tingly pinpointed one of the best ways of destroying trust and rapport early in an in-terview: He failed to ask permission to record the interview on tape. Wehave one final observation about taping. When you have conducted your best in-terview ever, you will inevitably discover there was a minor problem with the equipment and, consequently, your session either did not record properly or did not record at all. On the other hand, when you’ve conducted a session you’d rather forget, the equipment always seems to work perfectly and the session turns out to be the one your supervisor wants to examine closely. Because of this particular variation of Murphy’s Law, we rec-ommend that you carefully test the recording equipment before all your sessions. PROFESSIONAL AND ETHICAL ISSUES Before conducting real or practice interviews, interviewers should consider numerous professional and ethical issues. Beginning interviewers often struggle with dressing professionally, presenting themselves and their credentials (or lack thereof) comfort-ably, handling time boundaries, and discussing confidentiality. The remainder of this chapter focuses on how to deal with professional and ethical issues comfortably and ef-fectively. Self-Presentation You are your own primary instrument for a successful interview. Your appearance and the manner in which you present yourself to clients are important components of pro-fessional clinical interviewing. Grooming and Attire Deciding how to dress for your first clinical interviews can be difficult. Some students ignore the issue; others obsess about wearing just the right outfit. The question of how to dress may reflect a larger developmental issue: How seriously do you take yourself as a professional? Is it time to take off the Salvation Army sweats, or stop trying to cap-ture the title of Most Likely to Be on the Cover of Seventeen? Is it time to don the dreaded three-piece suit and come out to do battle with mature reality, as your parents ... - tailieumienphi.vn
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