10.2 Interviewing Principles and Techniques

Interviewing is both an assessment method and a therapeutic intervention. The ASWB Clinical exam treats interviewing as a distinct competency: you must know the techniques, when to use each, and how to adapt them for involuntary, resistant, culturally diverse, and traumatized clients.

Why It Matters for the Exam

Interviewing vignettes test whether you can choose the right response in a moment — open vs closed, reflect vs interpret, confront vs support. Many wrong answer choices are technically valid techniques used at the wrong moment. The exam rewards clinicians who match technique to purpose (assessment vs therapeutic) and to client stage and cultural context.

Open-Ended vs Closed Questions

• Open-ended questions invite narrative and exploration: "What brings you in today?" "How have things been since the last visit?" They are the backbone of the assessment interview's opening and of exploratory therapeutic work.
• Closed questions seek specific information: "How many hours did you sleep?" "Have you ever been hospitalized?" They are appropriate for risk screening, MSE elements, and confirming details — not for opening.

A skilled interview moves from open to closed: open to open the story, closed to fill in specifics. A common exam error is overusing closed questions early, which constrains the narrative.

Active Listening and Reflection

Active listening is the intentional attending to both content and affect. Its components:

• Paraphrasing — restating the client's words in similar language to confirm understanding ("You're saying the last two weeks have felt unbearable at work")
• Reflecting — mirroring the feeling, sometimes deeper or broader than the client stated ("It sounds like beneath the anger is a deep grief")
• Summarizing — pulling together several statements or a chunk of session ("Let me make sure I have this right: in the past month, you've lost your job, your partner moved out, and your mother was hospitalized...")
• Clarification — asking for more when ambiguous ("When you say 'losing it,' what does that look like for you?")
• Silence — allowing space; not every pause needs to be filled. Silence often surfaces material the client would otherwise withhold.
• Empathic responding — communicating that the client's experience is understood and matters, the foundation of alliance

Motivational Interviewing (MI)

Motivational interviewing (MI), developed by Miller and Rollnick, is a collaborative, goal-oriented style of communication designed to strengthen motivation for change. It is especially useful with ambivalent, involuntary, or substance-using clients.

MI Spirit

The spirit of MI is partnership, acceptance, compassion, and evocation — not expert-driven confrontation.

OARS

The core techniques are summarized by OARS:

• Open-ended questions — "What would you like to see different in your life?"
• Affirmations — genuine acknowledgement of strengths and efforts ("It took courage to come in today despite the warrant")
• Reflections — listening for the meaning beneath the words, including amplified reflection (reflecting back slightly amplified to provoke reconsideration) and double-sided reflection (capturing both sides of the ambivalence: "On one hand you want to stop drinking; on the other, drinking is the only thing that dulls the memories")
• Summaries — collecting, linking, and transitional summaries

Change Talk vs Sustain Talk

The clinician deliberately elicits and strengthens change talk (Desire, Ability, Reasons, Need — the DARN categories; and Commitment, Activation, Taking steps — the CAT categories). The clinician reduces sustain talk (arguments for the status quo). When sustain talk arises, the clinician reflects it without strengthening it and redirects toward change talk.

Stages of Change (Transtheoretical Model)

Prochaska and DiClemente's transtheoretical model describes how people change. Matching intervention to stage dramatically improves outcomes.

flowchart LR
    PC[Precontemplation] --> C[Contemplation] --> P[Preparation] --> A[Action] --> M[Maintenance]
    M -.relapse.-> C
    style PC fill:#fbe3e1
    style M fill:#e1f0de

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Assessment Interview vs Therapeutic Interview

The two purposes overlap but are not identical. The assessment interview gathers data: history, presenting problem, risk, mental status, functioning, supports. The clinician asks more, follows structured areas, and is information-oriented. The therapeutic interview uses the same techniques but aims at insight, affective processing, or behavior change. The exam may test which stance is appropriate when — for example, on intake, the assessment stance dominates even though alliance matters.

Cultural Considerations in Interviewing

Culturally competent interviewing requires:

• Self-awareness of one's own cultural lens and assumptions
• Knowledge of the client's cultural norms around eye contact, hierarchy, disclosure, family roles, expressions of distress
• Skill in adapting — for example, addressing the eldest family member first in some cultures, allowing family to be present for the interview when the client wishes, normalizing culturally shaped expressions (e.g., somatic presentation of distress)
• Humility — asking rather than assuming: "In your family or community, how do people usually handle this?"

The exam tests both over-attribution (assuming a behavior is 'cultural' when it is individual) and under-attribution (missing that a presentation is normative within a culture).

Working with Resistant, Reluctant, and Involuntary Clients

Court-mandated or involuntarily admitted clients often start in precontemplation. Effective techniques:

• Validate the lack of choice without arguing ("I understand this wasn't your idea")
• Find common ground — the client usually wants something even if not the mandated goal ("What would make this worth your time?")
• Use reflective listening rather than confrontation
• Emphasize autonomy — the client still controls what they say
• Set clear frames about confidentiality limits and what is reported

Vignette

A 28-year-old man court-mandated for substance use assessment sits silently, arms crossed, and says, "I'm only here because the judge said so." The wrong answer is to lecture him about consequences. The correct answer is reflective, autonomy-respecting: "This isn't your idea, and you're here because the court required it. I'm going to ask some questions, and you decide what to share. Is there anything about your situation you'd want me to understand, even if not what they're looking for?"

Obtaining Sensitive Information: Trauma-Informed, Normalizing, Permission-Giving

When asking about trauma, suicidality, substance use, sexuality, or abuse, the clinician:

1. Prepares the client — explains why the information is needed and how it will be used
2. Normalizes — frames the question as routine ("I ask all my clients about...")
3. Gives permission — explicit permission to decline ("You don't have to answer anything you're not ready to")
4. Controls pace — the client sets the pace; the clinician returns to difficult areas only when ready

This is the trauma-informed approach: the client regains control over disclosure, which itself is therapeutic.

Communication Skills Assessment and Nonverbal Communication

A complete interview assesses the client's communication skills: fluency, vocabulary, ability to describe internal states, eye contact, reciprocity, and congruence between verbal and nonverbal. The clinician notes nonverbal behavior — posture, facial expression, gesturing, distance, tears, smiling, agitation — and discrepant cues (verbal content smiling while describing loss). Nonverbal behavior is part of the MSE (Section 10.3) but is observed throughout the interview.

Incorporating Collateral Information

Collateral information — prior records, prior evaluations, school reports, family member input (with the client's consent) — rounds out the assessment. The clinician weighs collateral against the client's report, looks for convergent and divergent data, and does not privilege one source uncritically. Collateral is especially important when the client has limited insight, is in psychosis, or is cognitively impaired.

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Exam Pattern

When the vignette asks for the next response in a moment, the correct answer is almost always a reflective or open-ended response that demonstrates active listening and meets the client where they are. Lecturing, confronting prematurely, interpreting without foundation, or jumping to a technique before the alliance is built are common distractors.