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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 


Contributor: Yvette McBride Thomas

Diagnosis— the meaning or interpretation that is derived from assessment information and is usually translated in the form of some type of classification system.

  • A description of a person’s condition and not a judgment of a person’s worth
  • A common misconception is that a classification of mental disorders classifies people, when actually what are being classified are mental disorders that people have. For this reason, the text of DSM-IV…avoids the use of such expressions as ‘a schizophrenic’ or ‘an alcoholic’ and instead uses the more accurate, but admittedly more cumbersome, ‘an individual with schizophrenia’ or ‘an individual with alcohol dependence’” (DSM IV-TR, APA, p. xxxi).
  • Diagnoses are important for:
    1. Insurance company reimbursement
    2. Developing a proper treatment plan
    3. To be able to communicate with other professionals, counselors must be able to speak about, understand, or report a client diagnosis
  • Diagnostic decisions are an evolving process and not a static event.
  • Diagnosis and treatment planning are now such standard components of counseling practice that a failure to diagnose on some level or a lack of professional diagnostic training may be construed as unethical (p. 335).

Nota bene:

  • Dual diagnosis—a substance abuse diagnosis with a co-occurring mental health diagnosis in the same individual.
  • Substance abuse counselors (e.g. LCDCs, ADCs) do not diagnose mental health disorders. We can only diagnose alcohol/drug addiction problems.

Resource: Gladding, S.T. (2011). Counseling: A comprehensive profession (7th ed.). Upper Saddle, NJ: Pearson-Merrill.


The intake is the administrative and initial assessment procedures for admissions into a program. Every new client goes through this process.

Global Criteria

  • Complete require documents for admissions into the program.
  • Obtain signed consents in order to protect client’s confidentiality and rights.

Miller, Geri. “Learning the Language of Addiction Counseling.” 2nd ed.

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