Читать книгу Introduction to Abnormal Child and Adolescent Psychology - Robert Weis - Страница 155

The most important component of psychological assessment is the diagnostic interview. The interview usually occurs during the first session, and it can extend across multiple sessions. The interview usually involves the child and his or her parents, and it can sometimes include extended family members, teachers, and other people knowledgeable about the child’s functioning. Some clinicians prefer to interview children and parents together, whereas other clinicians interview them separately (Sommers-Flanagan, 2018).

One purpose of the interview is to begin to establish rapport with the family. By the end of the interview, the family members should feel that the therapist understands their concerns, that she offers a viable solution to address these concerns, and that they can work together to help the child. Rapport is especially important when treating children and adolescents, because many youths are reluctant to participate in therapy. For example, Sara may feel angry, resentful, or embarrassed that her parents brought her to therapy. Her parents, in turn, are likely exasperated by Sara’s school refusal. To build rapport, the therapist will acknowledge these feelings and offer hope that therapy will improve the situation (Allen & Becker, 2020).

A second purpose of the interview is to identify the family’s presenting problem—that is, the family’s primary reason(s) for seeking help. The therapist will gather information about when the problem began, how long it has lasted, and what steps the family has taken to solve it. The therapist also assesses whether all family members agree on the presenting problem. For example, Sara’s parents might identify Sara’s school refusal as the main problem, whereas Sara might view her parents’ nagging as more concerning. Therapists often give each family member time to explain the problem from his or her perspective (Kearney, Freeman, & Bacon, 2020).

A third purpose of the interview is to obtain information about the child’s psychosocial history and current functioning (Table 4.1). Typically, clinicians interview the child, parents, and teachers to gather this information. Sometimes, clinicians will also review the child’s academic and medical records. A thorough psychosocial history assesses the child’s functioning at home, at school, and with peers in the community (Reynolds & Kamphaus, 2015).

Very often, a final purpose of the interview is to arrive at an initial diagnosis for the child. Most clinicians review diagnostic criteria informally during the interview and psychosocial history. Some clinicians administer a structured diagnostic interview, which systematically reviews all of the major psychiatric diagnoses to determine whether the child meets criteria for any diagnosis (Kearney et al., 2020).

For example, the Schedule for Affective Disorders and Schizophrenia for School Aged Children (Kiddie-SADS) is the most widely used semistructured diagnostic interview for children and adolescents. After gathering information about the child’s presenting problem and psychosocial history, the clinician administers the Kiddie-SADS to parents and children. The interview consists of initial questions that screen children for the major DSM-5 diagnoses, such as anxiety disorders, depressive disorders, and conduct problems. If the parents or child endorse these screening questions, the clinician will systematically review symptoms to see if the child meets DSM-5 criteria for any specific disorder (Kaufman et al., 2016).