Interviewing Strategies with Sexually Abusive Youth

SUMMARY

Adolescents who have sexually abused may pose a serious problem for both the community and the treatment provider concerning the management of risk and the application of effective intervention strategies. Fundamental to providing good clinical treatment is an assessment that results in an individualized treatment plan specifically tailored to the young person's needs. An integral but often overlooked part of this involves interviewing clients in a way that elicits accurate information and facilitates the development of a therapeutic relationship upon which effective therapy can be undertaken. This article will describe interviewing strategies and highlight the importance of the client-therapist relationship in providing effective therapeutic interventions.     

Interviews by Telephone and in Person: Quality of Responses and Field Performance

A small carefully controlled field experiment tests the effectsof alternative interviewing strategies on the quality of responsesand on field performance. Measures include ability to answercomplex knowledge and attitudinal items, response validity,and willingness and consistency in providing personal information.Field performance is assessed by examining differential lengthof the interview, number of contacts required, suitable timesfor interviewing, respondent preferences for interview strategy,and interviewer effects.     

The Milan Principles of Hypothesising,Circularity and Neutrality in Dialogical Family Therapy: Extinction,Evolution, Eviction… or Emergence?

The primary aim of the three Milan principles of hypothesising, circularity and neutrality was to proffer an effective methodology for interviewing families, with a secondary aim of casting off the stereotypical personal therapist qualities such as intuition, charisma and concern. The progression of the principles from the original Milan model through to contemporary approaches is intriguing. The following article consists of two sections. First it tracks the progression of the three principles through the Milan, post‐Milan and postmodern approaches to family therapy. Given their recursive nature, they are revealed as responsive to developments in theory and practice, as well as the influence of the wider societal context. The second section of the article explores hypothesising, circularity and neutrality in the contemporary approach of dialogical family therapy. The relevance of the three principles to the therapeutic process, the therapeutic role and the therapeutic relationship is considered. Such an exploration does not seek definitive answers or ‘truths’, but seeks to conceptualise a vague ‘knowing’ that there is continual learning and growth in grappling with the tensions in this field, in remaining ever curious, in asking the questions …     

Resilience,mental health and Assertive Community Treatment

Clinicians try to promote resilience by building an effective therapeutic relationship with their clients. Assertive Community Treatment (ACT) is an established approach for providing services to individuals with severe mental illness who have not fared well in the regular mental health system. This work underscores the importance of a resilient therapeutic relationship in preventing relapse and assuring adherence to therapeutic outcomes. Persistent psychiatric illness takes a toll on the resilience of the client, while the relationship work takes a toll on the resilience of the clinician. This article explores the concept of relational resilience between clinician and client as a dynamic process of shared success and failure, progress and regression through cycles of crisis, stabilization, relapse, and partial recovery. This is a qualitative study exploring how ACT clinicians promote and sustain resilience and is based on interviews with social workers, nurses, occupational and recreational therapists, coordinators, and psychiatrists.     

Integrating Research and Practice into an Interviewing Skills Project

This paper reports an approach to improving the integration of research and practice instruction by engaging students in a research project. Through the project, the students evaluate an effort to improve their interviewing and relationship-building skills. The skills-development component relies primarily on student role playing and peer feedback, and was implemented as part of a required second-year master of social work research course. Two randomized experimental evaluations of the project’s effectiveness in improving interviewing skills yielded inconsistent results. The authors describe strategies for teaching and assessing interviewing skills and for teaching research.     

Treatment Engagement Using Motivational Interviewing for Low-Income, Ethnically Diverse Mothers with Postpartum Depression

Postpartum depression (PPD) places women, and their children, at risk for many untoward outcomes including lack of responsivity, low self-efficacy, and insecure infant attachment. Especially at risk for untreated PPD are low-income, ethnically diverse mothers. Seeking and accepting treatment for depression may be impeded by the many psychological and social barriers that mothers may bring with them. Obstacles might include a lack of resources (e.g., lack of transportation or child care), stigma, distrust, and a lack of knowledge about stress and depression. To reduce these and other barriers to treatment, this paper points to the value of utilizing motivational interviewing techniques to engage and retain low-income, ethnically diverse women for treatment of PPD. Following a review of PPD and related barriers to treatment, a case study is presented with example dialogue. The suggestions for practice represent starting points for effective engagement of women in any number of treatments provided by social and health services settings. With federal mandates to screen for depression in many settings and to provide treatment, using motivational interviewing may be an effective prelude to treatment adherence.     

“I Learned the Bad Things I'm Doing”: Adolescent Mothers' Perceptions of a Relationship Education Program

The purpose of this study was to explore what pregnant and parenting adolescent mothers felt they learned from a relationship education program. A total of 148 primarily Hispanic adolescent mothers who participated in the Strengthening Relationships Program took part in focus-group interviews. Narratives revealed that adolescent mothers perceived the program as effective in changing how they communicated and dealt with conflict with their partners. Specifically, they reported understanding the importance of communication and effective conflict-resolution strategies. In addition, narratives revealed adolescent mothers grew in self-awareness as a result of their program participation. These findings affirm the importance of providing relationship education to adolescent parents.     

Adapted Couple Therapy (ACT) for Pathological Gamblers: A Promising Avenue

The study of the effectiveness of treatment for pathological gambling constitutes a field that is still largely unexplored. To date, the models assessed primarily target the individual and include little or no involvement of the family circle. Yet, the deleterious effects of gambling on loved ones and especially spouses are well recognized. Further, the addition of a couple modality to individual treatment has been shown to be effective on many levels in the treatment of substances use disorders. This article therefore proposes a critical review of (1) the literature providing a better understanding of the complex interactions between the couple relationship and pathological gambling, (2) studies on the effects of couple therapies on gamblers and their partners. We then present the therapeutic model developed by our team of clinician-researchers in collaboration with actors from Québec clinical settings: Adapted Couple Therapy (ACT) for pathological gamblers. In the Québec context, this model will serve as a complement to an individual cognitive-behavioral treatment model that has been proven effective and is employed throughout the Canadian province. The assessment of couple therapies could reveal avenues of solutions to better assist pathological gamblers who tend to drop-out of treatment and relapse.     

The evaluation of treatment in therapeutic communities: Problems of design and implementation

The evaluation of therapeutic communities provides an opportunity to explore the relationship between evaluation methodologies and the constraints imposed by the nature of the treatment setting. In most therapeutic communities the environment represents the primary vehicle of treatment and, as a result, virtually every aspect of the program's operations are, directly or indirectly, related to the treatment goals. This paper examines some of the problems this situation creates for the evaluation of such programs. It suggests that the need to develop an effective working relationship with the program becomes the primary concern of the evaluation process, and it analyzes the use of specific techniques involved in establishing this type of relationship. Such an approach may be useful in other settings where the unique characteristics of the program become the primary constraint in evaluation design and implementation.     

Spiritual Competence: What It Is,Why It Is Necessary,and How to Develop It

Various professional standards underscore the importance of providing effective services to all people, including those from diverse religious backgrounds. Yet despite these standards, studies have repeatedly found that most social workers receive little training in navigating this aspect of diversity during their graduate educations. To address this lack of training, the present article discusses a concept that is foundational for effective service provision with spiritual clients from diverse religious backgrounds—spiritual competence. More specifically, this article outlines what spiritual competence is and why it is important in therapeutic work, and then offers a number of strategies for developing spiritual competence. As such, this article helps equip practitioners to provide more ethical, effective services in a nation characterized by increasing religious diversity.     

BSW students and interviewing: physiological,psychological, and pedagogical perspectives from Canada

The acquisition of interviewing skills is a hallmark of social work education; however, few studies have examined the experience of learning these skills from the students’ perspective. This qualitative study undertaken in Ontario, Canada, examined Bachelor of Social Work (BSW) students’ perceptions of interviewing. Individual interviews were conducted with second-year BSW students (n = 17) following their completion of an interviewing course. The following six themes emerged as to how students perceived learning interviewing skills: 1) emotional responses; 2) physiological responses; 3) psychological responses; 4) coping strategies; 5) the need for constructive criticism; and 6) the role of the course instructor. The study suggests that instructors normalize the presence of negative emotions and provide more structure and instructions for giving and receiving feedback when using role-plays.     

Recognizing Abuse and Neglect in People with Severe Cognitive and/or Communication Impairments

ABSTRACT

It is widely acknowledged that physical abuse of persons with severe developmental disabilities is prevalent, usually perpetrated by a residential care provider and is rarely reported. However, no solid research on the topic has been reported. This article notes the lack of information about protective services directed to the developmentally disabled population and lack of coordination between agencies serving people with developmental disabilities and those providing protective services. The signs and symptoms of abuse in the developmentally disabled population, the alternative communication strategies required when interviewing, and the special skills needed for case assessment are presented. The author ends with a series of federal, state, and community level policy recommendations.     

Traditional versus Western perceptions of mental illness: women of Moroccan origin treated in an Israeli mental health center

This paper focuses on the problems encountered in providing Westernized psychiatric treatment to a population with traditional healing beliefs. The sample comprised women of Moroccan origin living in Israel undergoing treatment for psychiatric disorders (N=38), and their treating psychiatrists (N=9). Ethnographic interviews were conducted among both groups. The results revealed that the symptoms, perceptions of the illness, and problems encountered in the therapeutic relationship differed across three age groups, young women (20–30 years), more mature women (31–42 years), and older women (43–60 years). While cultural conflict appeared to affect the development of mental illness in each group, this was most pronounced among women in the middle age range. Moreover, problems in the therapeutic alliance were greatest in this age group. The data from the therapists indicated that they maintained a Western perspective in both their understanding and diagnoses of these patients' illnesses. The different perspectives of the therapists and each of the three groups of women are discussed. It is concluded that professionals treating traditional populations must avoid imposing Western standards, and consider the treatment in the context of cultural beliefs. The developmental stages of the individual, and the stage of acculturation must also be taken into account if treatment is to be effective.     

Conceptualising ‘The Relationship’ in Intensive Key Worker Support as a Therapeutic Medium

Across various welfare and justice systems, intensive key worker support is a model of working considered effective for individuals and families identified as having multiple and complex needs. The high profile ‘troubled families’ programme in England is the most recent prominent example of such a model. The key worker role is to assess an individual’s needs, carry out support planning, provide and/or co-ordinate the delivery of supportive interventions and complete care plan reviews. This requires the key worker to work on a one-to-one basis with individuals which, in turn, demands the ability to form effective relationships. In this paper and using evidence from a number of studies, I look at how the key worker-client relationship is developed and maintained. I examine the skills, processes and communication strategies that allow key workers to engage clients, build relationships and drive change. I also explore the notion that the key worker-service user relationship is itself a ‘therapeutic’ medium and is therefore a productive practice in its own right. The paper suggests that while key workers might not be trained therapists or counsellors, they might be equipped to address some emotional challenges that individuals with complex needs face and build therapeutic relationships with them.     

Interviewing strategies with young people: the ‘secret box’, stimulus material and task‐based activities

This paper reflects on the use of a range of interviewing strategies carried out with 13–14 year olds for a research project about young people's problems and coping strategies. The advantages and disadvantages of using both group and individual interviews with various task‐based activities (grouping and ranking exercises, spider diagrams and charts) and stimulus material (problem pages, video clips and common phrases) are examined. The development and use of an innovative technique, the ‘secret box’, is also discussed. The mix of techniques alongside straightforward questioning was designed to offer variety to engage young people's interest, to account for their different preferences, to stimulate discussion about a potentially sensitive topic and to help to lessen the unequal power relationship between the adult researcher and the young participant. Copyright © 2002 John Wiley & Sons, Ltd.     

Incorporating eye tracking into cognitive interviewing to pretest survey questions

In this study, we investigated whether incorporating eye tracking into cognitive interviewing is effective when pretesting survey questions. In the control condition, a cognitive interview was conducted using a standardized interview protocol that included pre-defined probing questions for about one-quarter of the questions in a 52-item questionnaire. In the experimental condition, participants’ eye movements were tracked while they completed an online version of the questionnaire. Simultaneously, their reading patterns were monitored for evidence of response problems. Afterward, a cognitive interview was conducted using an interview protocol identical to that in the control condition. We compared both approaches with regard to the number and types of problems they detected. We found support for our hypothesis that cognitive interviewing and eye tracking complement each other effectively. As expected, the hybrid method was more productive in identifying both questionnaire problems and problematic questions than applying cognitive interviewing alone.     

Effective medication management

The effectiveness of a drug treatment is based on its efficacy, tolerability, safety, and acceptability. Effective medication management implies that the process of selecting and managing prescribed drugs results in an optimal patient outcome. Effectively prescribing medications includes gaining a mastery of drug knowledge, learning the nuts and bolts of treatment using medication, and appreciating the fundamental importance of psychotherapeutic and psychoeducational processes in medication management. Nurses have an essential role in providing effective medication management, given their direct level of patient contact and their collaborative relationship with physicians.     

The parallels between undue influence, domestic violence, stalking, and sexual assault

The dynamics of undue influence (UI) have many similarities with domestic violence, stalking, and grooming behavior used by some sexual predators. This article will help practitioners-particularly law enforcement investigators and prosecutors-better recognize UI as a pattern of behaviors, not an isolated incident. Understanding the dynamics of UI will enhance professionals' appreciation of the responses of victims and the manipulative nature of exploiters. Strategies that have been used effectively with domestic violence, stalking, and some sexual abuse cases may provide remedies for victims of UI and criminal justice options for holding perpetrators accountable. Enhanced awareness of these dynamics should lead to improved investigations, more effective strategies when interviewing and working with victims, and more successful prosecutions of perpetrators who use UI to financially exploit an older person.