The role of counselor dispositions in clinical interviewing

The role of counselor dispositions in clinical interviewing and assessment How the counselor’s role and personal dispositions are crucial in the gathering of information in therapeutic interview and assessment Jennifer Gobble, LPC, NCC

Interpersonal qualities of clinicians that are helpful during clinical interviewing • You might list things like empathy, genuineness, acceptance, professional behavior, flexibility, awareness, patience, sincerity as important interpersonal qualities • Multi-cultural sensitivity and knowledge • Unbiased, non-judgmental, objective rather than subjective • Careful to refrain from emphasizing or sharing personal opinions or advice • Staying focused on building rapport and gathering as much information as possible

Counselor Dispositions • All of the qualities that we just mentioned and discussed fall under counselor dispositions • The Council for Accreditation of Counseling and Related Educational Programs (CACREP) provides a definition for professional counseling dispositions to include the commitments, characteristics, values, beliefs, interpersonal functioning and behaviors that influence both the counselor’s professionalism and their interactions with clients and colleagues.

Counselor dispositions further defined • Pope and Kline (1999) noted acceptance, emotional stability, open-mindedness, empathy, genuineness, flexibility, interest in people, confidence, sensitivity, fairness, warmth, friendliness, resourcefulness, sympathy, nonthreatening, tolerance, awareness, capability, patience, sincerity, cooperative, and socialbility.

The therapeutic relationship/alliance • It is the job of the counselor to build a therapeutic relationship in order to help the client tell their story and eventually break through blind spots that may be preventing them from seeing themselves, their problems and the unexplored opportunities. • The client must be able to feel empathy, warm positive regard and respect from the counselor • The client must perceive acceptance and safety • The client begins to trust the counselor

Dispositions influence on therapeutic relationship • The dispositional character that is held by the counselor is the biggest factor in establishing therapeutic relationship (Duba, Paez & Kindsvatter, 2010). • Counselor dispositions impact therapeutic alliance through their influence on the counselor-client relationship (Ackerman & Hilsenroth, 2003). • Carl Rogers (1961) stated that the person of the counselor has a greater impact on therapeutic process than the skills and techniques that they use and this was further supported by Cavanagh (1982) who felt that a counselor’s personality is more important that their skills or knowledge.

The clinical interview • A distinct form of interviewing that involves a face-to-face verbal and nonverbal exchange between a clinician and client designed to gather data that is needed for diagnosis and treatment of the client • Key to the appropriate assessment and diagnosis of a client • Without the gathering of ALL of the information and the ability to engage the client in the interviewing process, we cannot adequately and appropriately diagnose the client and develop a plan of treatment.

Role of the counselor in Interviewing • The counselor must elicit a combination of social, medical, education, familial, psychological, developmental and other information from the client or informant • This information is oftentimes difficult for the client to revisit or disclose, lots of personal information and trauma. • The counselor must immediately begin to build rapport • The interpersonal or DISPOSITIONAL factors of the clinician influence the willingness of the client to provide accurate information.

The skill of clinical interviewing • In a study by Langsley & Yager (1988) showed that 99. 4% of respondents felt that the interview was the highest ranked skill for psychiatrists and mental health clinicians • Miller (2017) found a strong predictive relationship between counselor dispositions such as empathy with client outcomes • The technique of interviewing requires strategic use of questions, reflections, affirmations and summaries, all which relate to counselor dispositions, to help strengthen the client’s motivation for change and to be forthcoming and accurate in the interview.

A closer look • A clinician exhibiting poor work ethic, which is a reflection of one’s values and attitudes regarding ethical behavior at work, begins a clinical interview with a client requesting community mental health services or therapeutic counseling: – The clinician rushes through the interview in order to finish quickly and take a break – The client feels rushed and doesn’t have ample time to reflect and provide accurate information – The client doesn’t feel valued or cared for by the interviewing clinician and decides that the services are not for him causing him to opt out of services and treatment that are crucial for his safety and well-being

Open discussion • Are there situations or stories that you can share where you saw how a counselor’s personal dispositions or beliefs, biases or values interfered with an interview process and the ability to adequately assess a client or build the necessary rapport with a client? • What was the impact on the client? • What are some ways that we can bring awareness of counselor dispositions to counselors and clinicians in direct care?

Evolution of counselor dispositions • Counselors and clinicians can enhance their clinical interviewing skills through the self-assessment of dispositional factors. • The development of a strong professional identity and the ability to be self-aware both keys to the development of appropriate counselor dispositions that are in line with the profession • Finding mentors and seeking feedback can assist counselors in training with exploring their beliefs, attitudes and characteristics and measuring them with the overall Identity of professional counseling.

References • • Allen, D. N. & Becker, M. L. (2019). Clinical Interviewing, Amsterdam, Academic Press. Christensen, J. , Dickerman, C. , Dorn-Medeiros, C. , Christensen, J. & Dickerman, C. (2018). building a consensus of the professional dispositions of counseling students, The Journal Counselor Preparation and Supervision, Vol. 11(1), 11. Council for Accreditation of Counseling and Related Educational Programs. (2016). Standards for accreditation. Alexandria, VA: Author. Retrieved from http: //www. cacrep. org/for-programs/2016 -cacrep-standards/ Iwata, B. A. , Wong, S. E. , Riordan, M. M. , Dorsey, M. F. & Lau, M. M. (1982). Assessment and training of clinical interviewing skills: Analog analysis and field replication, Journal of Applied Behavioral Analysis, 15(2), 192 -203. Miller, W. R. & Moyers, T. B. (2017). Motivational interviewing and the clinical science of Carl Rogers, Journal of Consulting and Clinical Psychology, 85(8), 757 -766. Pope, V. & Kline, W. (1999). The personal characteristics of effective counselors: What 10 Experts think, Psychological Reports, Vol. 84 (3), 1339 -1344. Rogers, C. (1961). On becoming a person. Boston: Houghton Mifflin.