Home » Counselor Intern » LCDC Exam 2014 » 8 Practice Domains » The First Interview – Addictions Counseling

The First Interview – Addictions Counseling

1.  Goals in a first interview

a.  Allow the client to tell you her/his story in her/his own words

b.  Let the client know that you understand what she/he believes, even when it includes that she/he does not need to be there.

c.   This is not the moment to express that you may disagree with client.

2.  The first interview with the self-referred adult

a.  The client feels the need to explore the possibility of getting therapy.

3.  Prepare yourself  in advance

a.  Has the client been in the therapy before?

b.  Review documentation

    • Medical history
    • Psychiatric evaluation
    • Biopsychosocial assessment
    • Previous clinician’s notes

c.    Ask yourself

    • What don’t I know that I need to know?
    • Write down notes and questions you want to ask before calling the client to set up an appointment
    • Add a healthy dose of skepticism to everything you find out

4.  What to ask your supervisor before the first interview

a.  Any questions you have after reading documents provided on the client

b.  Whom to include in the interview

c.   How long the session should last

d.  How often should you see the client

e.  How to introduce your self

f.    When and how to record sessions

5.  When calling the client, remember that

a.  Your relationship with the client starts right there

b.  How should you introduce yourself to the client

c.   Be professional and concerned

d.  Remember that this is NOT a therapy session

e.  Maintain confidentiality from this moment on

    • Find out if, and under what circumstances, you are required by law not to maintain confidentiality.
    • Except in those circumstances (above), always get written consent from the client to share identifying information to other agencies
    • Telephone calls: remember that even the fact that the individual is a client is confidential information.
    • When necessary use fictious names and situations

6.  The room set up is important

a.  Keep it comfortable and simple

b.  How would YOU feel coming here?

7.  Before you start the interview

a.  Select an assessment instrument, based on

    • Your agency
    • The age of the client
    • Reliable
    • Valid

b.  Explain the assessment process to the client

8.  Ask your supervisor how you should gather information during the session

a.  Taking notes?

b.  Just listening?

c.   Audiotaping?

d.  Videotaping?

e.  Using a computer?

9.  During the interview/session

a.  Start where the client is

b.  Your concern is the client’s feelings

c.   Keep self-disclosure to the minimum

d.  The focus is on the client, not on you

e.  Practice active listening

f.    Do not put words or feelings into your client’s mouth

g.  Ask who, what, when, where, and how

h.  Don’t ask WHY

    • It assumes client knows the answer to his/her problem
    • Client might feel attacked and therefore act defensive
    • They might tell you more than they are ready to share
    • If client tells you more than they meant to, they might never come back

10. Presenting problem

a.  Why is the client here now?

    • Basic data

11. At the end of the session

a.  Leave enough time to ask your client if there are any questions

b.  Ask client if she/he would like to come back

c.   Give the client a card with information about her/his next appointment

d.  Walk your client to the door

e.  Be aware of the door-knob syndrome

    • Client waits to tell you something very important until there is not time left to discuss it
    • You can end the session by saying “That sounds like something we should talk about. Let’s begin with that next week.
    • You NEVER let a client leave your office if you have a sense that she/he might hurt her/himself or others.

Reference: Where to Start and What to Ask – Susan Lukas 

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11 Comments

  1. kathleen says:

    Thanks Samantha!

  2. Tim Prentice says:

    What are your thoughts on the use of mind mapping in therapy?

    • Hi Tim. I think the Mind Mapping Approach (MMA) is a great idea! I don’t know a lot about it, to be honest. From what I know I think it is a very organized and fun form of brainstorming. Ideal for brief therapies, behavior modification techniques, and solution-focused approaches. What do you think about it? You probably know more about MMA than I do.

      • I think the approach is a great way to tie ideas together and to show a literal map of thoughts, behaviors, and relationships. It could make a great visual tool to show clients patterns. On the down side, it might be a distraction to map it out while also trying to be present at the same time. I think the concept could be rewarding for the client. By the way, my paper came across very well, I saw were I could have developed a couple ideas more. It could be a good paper to expand on down the road.

        Tim

      • Definitely. Congrats! I was glad to hear about your paper. I’m sure you would have gone into more depth, but you did not have enough time. You can keep working on your paper and publish it in the future. I would be happy to publish any notes and knowledge you would like to share. I have a few students sharing their notes here, one of them is Yvette McBride Thomas, I’m sure you have read some of her posts. Anyways, the invitation is open if you ever want to. Thanks a lot for your comments!

      • Tim Prentice says:

        Thanks for the encouragement. I would like wise encourage you to look into mind mapping as a tool for therapy. I also appreciate the invitation to publish any notes and information. Most larger assignment, a student is given a substantial amount of time. This paper had two weeks plus 3 smaller papers and assignments. Hey, Samantha, take care and thanks for the feedback.

        Tim

      • Tim Prentice says:

        I want to ask a question regarding math. Upon first visiting your site, I saw you enjoy math. What advice could you give to someone who struggles in that area? I am very interest in learning, but for somereason math brings on anxiety. I go blank, sometimes its like a foreign language, just hard to comprehend and get a hold of. This is one area that has held me back. If I’m going to move on to grad school I need to get a better grasp. Seriously, its a little devil that eats at me.

      • I’ve been a math tutor for many years and I always tell the students that learning math is like learning another language, in fact, math is a universal language. Which math classes have you taken, and which ones do you need to take?? I can tell you that statistics is the most important math class I have ever taken. This class is necessary for graduate school because of all the research articles we have to read. If you know statistics you will always have a job ;). And just like learning a second language, my advise is to practice math every day; study all the basics to have a good foundation; take good notes and visit the tutoring lab at school every day for 1hr minimum. Most importantly, be patient and give yourself time to understand these concepts little by little. The unknown always causes anxiety, it is normal. I like math but that does not mean it does not make me anxious when I don’t know what to do :D So get together with other students to review math exercises together. Youtube offers so many tools to learn math through video tutorials. Math is not difficult if you do it step by step. Most students get anxious at not knowing if the result is correct; many get anxious because they focus so much on getting to the answer/result. When you write down every step of a math problem and read carefully what you are given and what you need to find, then the anxiety decreases. The more organized you are when doing math, the better. Just like mind mapping, it always works!

        I hope this helps :)

      • Thanks. I haven’t had math for some time. I know I will need statistics for grad school, and I really want that. Here’s the thing, I can follow step and take note, however, in my mind i go blank and feel like it is such a hard concept to grasp. It might not be , but cognitively, that is how it feels. This has been an area that has held me back in many areas of life.I get most sciences, I get psychology, english, and other concept for the most part. I will keep in mind what you said. If you have other suggestions, please pass it on. For me not going to grad school would be the end to a lot of goals. Thanks,

        Tim

      • Hi Tim. I know math might be intimidating sometimes. The best thing to do is practice math little by little. I don’t suggest to wait until you have to take a math class. That adds extra pressure. Take an easy math class when you don’t need it, and start with the basics. Community colleges offer developmental math classes. I have taught math at college level, from developmental courses to very complicated math. I have noticed that, when students don’t have a good foundation they develop this anxiety. All of my students from developmental (basic) math classes have succeeded because they took their time building that foundation. Consider the possibility of taking a basic math class when you don’t need it ;)

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