Diagnostic interview in psychology: characteristics and functions

The interview is one of the most important tools in psychology, being used in order to make different types of exploration that allow the psychologist to find unobservable content that needs to be evaluated.

More specifically, the diagnostic interview in psychology is a tool used by mental health professionals, in this case being within the clinical and health context, with the aim of exploring the possible psychopathologies or the causes of the psychological discomfort that the patient who comes to query.

In this article We will see in greater detail the diagnostic interview in psychology, as well as some of the most used techniques during the course of it.

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What is the diagnostic interview in psychology?

The diagnostic interview in psychology and mental health is a resource widely used by psychologists and psychiatrists, in a clinical or health context, in order to make a diagnostic exploration and possible psychopathologies, or simply in order to search for the origin of the psychological discomfort or suffering that has led to the person who has come to the consultation to receive help professional.

It should be noted that the most important thing is not to formulate a diagnostic label, but to find the most appropriate psychological treatment that allows the psychologist to help his patient.

When executing a diagnosis in psychology or an exploration of the mental health of a patient, the criteria of the diagnostic systems are usually taken as a reference. recognized worldwide, such as the DSM-5 of the American Psychiatric Association, or the ICD-10 and the recently published ICD-11, both of the World Health Organization.

However, these manuals have been developed based on a wide variety of mental health clinical pictures, but they do not present indications about how to proceed to carry out a diagnosis or explore the root of psychological distress. Therefore, it is important that mental health professionals have some knowledge about how to conduct an interview diagnosis through a series of questions that facilitate the diagnosis or allow to find the causes of the psychological discomfort that the patient presents. patient.

Throughout the diagnostic interview in psychology, the psychologist promotes the establishment of a good alliance therapy through openness, honesty, and collaboration and by showing that there is going to be a confidentiality. The psychologist puts into practice fundamental skills in the profession, such as empathy wave active listening.

Notably The purpose of the diagnostic interview in psychology is not merely to formulate a diagnostic label. about some psychopathology or mental disorder, although it must be taken into account that the clinical diagnosis plays a fundamental role. However, this type of interview also serves to find the psychological treatment and the tools that the psychologist must use to help his patient.

It is also important to note that There is no single style of diagnostic interview in psychology, rather each psychologist outlines his or her personal style throughout his professional career as he gains experience with all kinds of cases in consultation. However, there are a number of essential aspects that most psychologists tend to take into account when conducting a diagnostic interview.

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What is it for?

The diagnostic interview in psychology and mental health is usually used with the objective of carrying out an initial exploration that is of great help to the psychologist in order to make the first decisions about the way forward during the following therapy sessions. It is common that this interview is complemented with different psychological evaluation instruments that allow the psychologist to contrast what he has collected during the diagnostic interview.

The diagnostic interview in psychology serves as an initial exploration tool that makes it possible to determine if the patient can be evaluated or need a more urgent intervention, and may need to be referred to a professional from another specialty (p. g., neurologist), as well as it allows to have a first reference that allows to determine where the diagnostic exploration should follow (p. g., complementing the exploration through the diagnostic interview through the use of psychological evaluation tests).

In short, the diagnostic interview in psychology is a tool that allows the psychologist to have some initial diagnostic impressions that mark the course of the diagnostic evaluation, as well as the selection of the most appropriate psychological treatment or the determination of a referral to another clinical specialty. For this reason, this first exploration offered by the diagnostic interview must be carried out in the most reliable way possible, parking aside any expectations or stereotypes that the psychologist may have initially formed regarding the patient.

Phases and guidelines to follow

Next we will see what are the fundamental guidelines that are usually considered when carrying out an initial exploration through the diagnostic interview in psychology.

1. initial observation

The first task in the diagnostic interview in psychology is the initial observation that allows the psychologist to notice a series of details about the patient during the first seconds of the interview, such as those listed below:

• Sex.
• Age.
• Hygiene and health appearance, as well as their way of dressing.
• Ethnic group.
• State of consciousness (alert, lethargic, stupor)
• Posture and movements.
• Expressions.
• Eye contact (noticing if he maintains it or avoids it).
• Notice if he makes strange movements.

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2. Screening through questions

The diagnostic interview in psychology is a good detection tool through a series of questions, existing numerous of them with a wide validation through empirical investigations that have allowed to demonstrate that there are questions that have a higher quality when making an initial detection and a possible diagnosis in psychology.

These questions should not be considered as a diagnostic criterion in themselves, but they do allow as a first filter so that the psychologist can choose throughout the interviews the most relevant issues to determine the reasons why the patient has come to the consultation, as well as the origin of their possible discomfort psychological.

Therefore, the clinician uses questions that are oriented to the aspects that are most relevant for the diagnosis or determination of the causes of discomfort that the patient suffers in order to find the most suitable treatment.

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3. Exploration

During the diagnostic interview in psychology are also carried out a series of informal questions in order to explore various aspects in the patient:

• General level of attention during the conversation, as well as sustained, focused and selective.
• The patient's language, analyzing fluency, articulation, rhythm, inflections or the way of expressing himself.
• Analysis of thought, by assessing its associative capacity or possible inconsistencies.
• Assessment of the patient's orientation (space-time, vital and historical and current).
• Evaluation of short and long-term memory, evaluation of possible distortions.
• Assessment of the patient's anamnesis or life history.
• Evaluation of the patient's affective state (self-perception, motivation, non-verbal expressions, etc.).

4. Use of complementary instruments

It is very useful that the diagnostic interview in psychology is complemented with other psychological evaluation instruments in order to contrast the results of the tests with the conclusions drawn during the interview to enable a more complete diagnosis and comprehensive.

These complementary instruments offer the possibility of evaluating possible psychosocial problems or carrying out an evaluation of the global functioning of the patient about the degree of dependence when carrying out basic activities for daily life in case that the psychologist considers them necessary when carrying out the diagnostic interview in psychology; to do this, you could use the Katz index or Katz Functional Scale.

Tests that assess the patient's subjective state of health can be used (for example, through the SF-12 test - "12-Item Short-Form Health Survey”) or through the brief Quality of Life scale (for example, WHOQOL - “World Health Organization Quality of Life Questionnaire”).

It is also possible to use complementary psychological tests to the diagnostic interview in psychology to evaluate more extensive functional contents of the patient, such as through the Mini-Mental test (“Mini-Mental State Examination”) that serves to make an evaluation of the subject at a cognitive level if any possible deterioration.