The Intake Interview

HOW IS AN INTAKE INTERVIEW CONDUCTED?

◎Intake interviews are
generally conducted over a one
and one-half to two hour
session.

◎It should be clear to the

client that the assessment
session is not a therapy
session.

◎During intake interview, it is

important for therapists to ask
questions in a supportive &
empathetic manner.
The ability to connect with the patient, establish rapport &
demonstrate empathy is an important ingredient in the
assessment process.

(American Psychiatric Association, 2003)

Common Areas Asked
During the Intake Interview
I. IDENTIFYING INFORMATION

To gain an immediate sense

of the client & reason for the
evaluation.

This would normally include

age, gender, ethnicity,
marital status, reason for the
visit & referral source.
$
II. PRESENTING PROBLEM
To understand the source of
distress in the client’s own
words, obtain his or her
perception of the problem,
and assess the degree of
insight the client has
regarding the problem and
the chronicity of the
problem.
 Some questions the clinicians can ask:
• Why is the client seeking
therapy?\
• Is the problem chronic or recent?
• Is it always present or does it
occur only in some situations?
• Does the problem stem from
social or environmental factors?
• What is the explanation for the
problem according to the client,
family members or friends?
• What does the client perceive as
possible solutions to the problem?
III.HISTORY OF THE PRESENTING PROBLEM

◎To assist diagnostic

formulation by providing a
chronological account of and
perceived reasons for the
problem; to determine levels
of functioning since & prior to
the problem; to explore social
& environmental influences.
 Some questions the clinicians can ask:
o When did the present problem first occur
and what was going on when this
happened?
o Has the client had similar problems
before?
o How was the client functioning before
the problem occurred?
o What changes have happened since the
advent of the problem?
o Are the any family issues, value
conflicts, or societal issues involving
factors such as gender, ability, class,
ethnicity or sexual orientation that may
be related to the problem?
IV. PSYCHOSOCIAL HISTORY
To gather perceptions of past
and current functioning in
different areas of living and
understand early socialization
& life experiences including
expectations, values &
beliefs from the family that
may play a role in the
problem.
 Some questions to consider…
o How does the client describe his or
her level of social, academic, or
family functioning during childhood &
adolescence?
o Were there any traumatic
experiences?
o Were there any past experiences or
problems in socialization with the
family or community that may be
related to the current problem?
o How does your family respond to your
beliefs about gender, acculturation
and other diversity issues?
o What changes would you make in the
way your family functions?
V. STRENGTHS
Identifying strengths often
helps put a problem in
context and defines
support systems or positive
individual characteristics
that may help deal with
the problem.
 Questions to ask client…
o What are some attributes that
they are proud of?
o How have they successfully
handled problems in the past?
o What are some strengths of
the client’s family or
community?
o What are sources of pride
such as school or work
performance, parenting or
connection with the
community?
o How can these strengths be
used as part of the treatment
plan?
VI. MEDICAL HISTORY
Determination of medical, physical conditions, or limitations
that may be related to the psychological problem & important
for treatment planning.

o Possible questions to ask:

o Did the client suffer any major illnesses or physical problems

that might have affected their psychological state?
o How does the client perceive these conditions?
o Are they engaging in appropriate self-care?
o If there is some type of physical limitation or disability, how
has this influenced their life?
o What are responses to this condition
by family members, friends, or
society?
VII. SUBSTANCE ABUSE HISTORY
Substance abuse or dependence impacts diagnosis and treatment
Assessment in this area is important because substance abuse often occurs
concurrently with a number of mental disorders (APA, 2000).

Possible questions to ask…

o What is the client’s current and past use of alcohol, prescription medications
and illegal substances including age of use, duration and intensity?
o If client drinks alcohol, how much is consumed?
o Does the client (or family members) have concerns about substance abuse or
dependence?
o Has drinking or substance use ever affected the social or occupational
functioning of the client?
o What are the alcohol and substance use patterns of the client’s family and
closest friends?
VIII. RISK OF HARM TO SELF OR OTHERS
Clients may share information about suicidal or violent
thoughts; it is necessary to consider risk of potential for
self-harm or harm to others.

Possible questions:
• What is the client’s current emotional state?
• Are there strong feelings of anger, hopelessness or
depression?
• Is the client expressing intentions of self-harm?
• Does there appear to be the potential to harm others?
• Have there been previous situations involving dangerous
thoughts or behaviors?
Mental Status
Examination
(MS E )
MSE

• The clinician’s estimation of the emotional and cognitive

functioning of clients through the observation of their
verbal & nonverbal characteristics.

• However, because this exam is not conducted in a

collaborative manner, mistakes can occur as a result of the
therapist’s interpretation of client responses.

• Consideration should always be given to the potential

influence of situational, contextual, cultural, & other
diversity issues.

• The MSE helps to give a more complete picture of the

client and can be conducted informally during the intake
process.
 Parts of MSE
◎Physical Appearance

o While conducting the intake interview, the clinician makes mental note
of observations about the client, indicating any atypical behavioral or
physical characteristics.

o Is the manner of dress, self-care, behavior, cooperation, and activity

level appropriate for the individual’s age, social class, nd cultural
background?

o Are there situational variables that may be involved with observed

characteristics (anxiety, drug use, long work hours or lack of sleep)?

o Could the responses observed be due to anxiety over participating in an

intake process or discomfort with the person doing the assessment?
◎Mood and Affect
o Provides important diagnostic clues
◎Possible questions:
o What is the overall emotional state of the client?
o Does he/she appear to be depressed, irritable, anxious,
restless, hostile, and so on?
o Are there moment to moment emotional changes?
o is there emotion or affect appropriate to the content
they are describing?
o Does it appear that emotional expression is influenced by
cultural factors?
◎Speech
o A client’s speech pattern can lead to clues related to possible mental and
organic disorders.
o Is the speech slurred, slowed or pressured?
o Is the communication logical, organized, fluent and easy to understand?
o Does the client respond quickly to questions or require a period of time to
process information?
o Does the client appear to have racing thoughts or frequent shifts from topic
to topic?
o What is the volume of the client’s speech?
o Does the client perseverate(i.e., say the same thing over and over again)?
o Is the communication unusually vague or overly detailed?
o Does it appear that age, cultural factors, or inexperience with English
language are affecting communication?
◎Motor Activity

Observation of the client’s activity level (hyperactivity or very slow,

deliberate movements), degree of restlessness or motoric agitation,
tremors, compulsive behaviors, facial or tic behaviors, throat-clearing
or excessive eye-blinking, atypical gait or posturing, closing of the eyes,
staring episodes, or fluttering of the eyelids can provide important
diagnostic information
 ◎It is also important to note COGNITIVE FUNCTIONING
in the ff. areas:

o Attention – does the client display appropriate attention or seem easily distracted?
Is the client responsive to the therapist?

o Fund of knowledge – does the client process accurate knowledge of basic

information such as historical or current events?

o Orientation – does the client know who he or she is, the day of the week, who she
or he is talking to and why? Does the client appear to be confused?
o Abstract Ability – Can the client think abstractly? This may be
apparent through conversations. The questions here may not
seem diagnostic however, difficulty in responding may lead to a
decision to conduct further assessment.

o Memory – does the client experience or report problems with

short, intermediate, or long-term memory? Does the client
remember what was just discussed or what happened several
hours or days ago? Are childhood experiences easily recalled?

o Insight – Does the client have an understanding of the nature of

their problem?

o Level of Intelligence – what is the therapist’s estimation of the

client’s intelligence? Is there any evidence of s cific learning
problems?
The Intake Interview