Unit 5 DB: Record Keeping

Resources: https://work.chron.com/social-work-interviewing-skills-16544.html
Four-step writing process for professional practice. (2018). In Weisman, D., & Zornado, J. L., Professional writing for social work practice, Second Edition (Vol. Second edition). Springer Publishing Company.

Chapter 7: Effective Intake Interviewing Skills
Chapter Introduction
⦁ Chapter Seven addresses Social Work Case Management Standard 5, Assessment.
⦁ Chapter Seven addresses Human Service–Certified Board Practitioner Competency 2, Interviewing and Intervention Skills.
For clients, like those at Adult Community Support, or if someone wants to go into counseling services, there is a number to call that’s advertised on the website. If people drop in and want to get engaged in services, we will direct them through the intake line. They will call the intake line and describe what’s going on for them. The intake specialist will gather some initial information about eligibility through Medicare, Medicaid, those sorts of things. Then, we will assign that person to a case manager who is capable of doing intakes.
From Ellen Carruth, 2012, text from unpublished interview. Used with permission.
This chapter focuses on effective interviewing in case management: the attitudes and characteristics of interviewers, the skills that make them effective interviewers, how these skills are used in structured interviews, and the pitfalls to avoid when interviewing. For each section of the chapter, you should be able to accomplish the following objectives.
Attitudes and Characteristics of Interviewers
⦁ List two reasons why the attitudes and characteristics of the case manager are important to the interview process.
⦁ Describe four populations of clients that may require the case manager’s approach to be culturally sensitive.
⦁ Name five characteristics that make a good interview.
⦁ Describe a physical space that encourages positive interactions between the client and the case manager.
⦁ List barriers that discourage a positive interview experience.
Essential Communication Skills
⦁ List the essential communication skills that contribute to effective interviewing.
⦁ List three interviewing skills.
⦁ Support the importance of listening as an important interviewing skill.
⦁ Offer a rationale for questioning as an art.
⦁ Write a dialogue illustrating responses that a case manager might use in an intake interview.
Interviewing Pitfalls
⦁ Name four interviewing pitfalls.
⦁ Describe each of these pitfalls.
7-1Introduction
Interviewing is described in Assessment Phase of Case Management as directed conversation or professional conversation. Many helpers consider it an art as well as a skilled technique that can be improved with practice. In case management, the intake interview is a starting point for providing help. Its main purpose is to obtain an understanding of the problem, the situation, and the applicant. A clear statement of the intentions of the interview helps the case manager and the client reach the intended outcomes.
Intake in our agency occurs on a regular basis, every Monday morning. We get clients from lots of sources, from the courts primarily. These are parolees or sometimes they are clients on probation and they are about to be released. Several of us conduct the intake; it is one of my favorite parts of my job. In my setting, many clients come in with handcuffs on and with armed guards if they are still in the custody. So my job during the intake is to assess attitudes for release, health, communicable diseases, and their history of violence. Because of the underlying danger to self and others, this intake is critical.
—Director, homeless shelter and recue mission, Miami, Florida
The intake interview is important because here you set the stage for future work and represent the policy, process, and atmosphere of the agency. In the first contacts with the family, you need to gain information from the family, but you also need to be credible as a helper. Some of our clients are really smart, very educated, while others are unsure of what their problems are. They don’t know what they need and cannot articulate this. We try to gain a holistic picture of the family and the situation; we want to gather as much information as we can.
—Director and case manager, children’s services, New York, New York
I like to listen carefully to what the individuals being interviewed say about themselves. Listening is the key here. I don’t think that I can tell clients as much as they can tell me. Once clients begin talking, they even surprise themselves, because they actually know so much about their situations. For instance, they will ask a question and then they will answer it. They are the experts in their own lives. Just be with them. That is important.
—Caseworker, family services, Bronx, New York
These quotations from case managers illustrate some important skills that are needed during the interviewing process. At the homeless shelter and rescue mission in Florida, the interviewer screens by seeking specific information about attitude, communicable diseases, and violent behavior. The director/case manager at the children’s services agency begins her contact with families by using questions to grasp the big picture. She makes a distinction between questions in general and the right questions. The caseworker at family services in the Bronx emphasizes listening as a critical skill in the interviewing process. It is her belief that clients will tell their problems if given an opportunity. Each of these professionals describes interviewing in a different way, but a common thread is respect for the considerable skills involved in using the interview to gain an understanding of the client’s situation.
A number of factors influence interviewing in the helping professions. Some factors apply directly to the interviewer, such as attitudes, characteristics, and communication skills. In addition, factors such as gender, race, ethnicity, and power influence the process. Others are determined by the agency under whose auspices the interview occurs: the setting, the purpose of the agency, the kinds of information to be gathered, and recordkeeping. This chapter explores many of these factors.
The intake interview is usually the first face-to-face contact between the helper and the applicant. In some agencies, the person who does the intake interview will be the case manager; other agencies have staff members whose primary responsibility is intake interviews. Interviews are also a part of the subsequent case management process, and some of the skills used in the intake interview apply there, too. This chapter uses the term case manager to refer to the helping professional who is conducting the interview.
7-1aAttitudes and Characteristics of Interviewers
The case manager’s attitudes and characteristics as an interviewer are particularly important during the initial interview because this meeting marks the beginning of the helping relationship. Research supports the view that the personal characteristics of interviewers can strongly influence the success or failure of helping (Sommers-Flanagan & Sommers-Flanagan, 2015). In fact, they concluded after a review of numerous studies that these personal characteristics are as significant in helping as the methods that are used.
One approach to the attitudes and characteristics of interviewers is a framework that looks at two sets of critical attitudes: one related to self and the other related to how one treats another person. Consistent research confirms this approach (Brammer & McDonald, 2003; Combs, 1969; Sommers-Flanagan & Sommers-Flanagan, 2015). Those related to self include self-awareness and personal congruence, whereas respect, empathy, and cultural sensitivity are among the attitudes related to treatment of another person. Elsewhere in the literature, other perspectives on helping attitudes and characteristics have as common themes the ability to communicate, self-awareness, empathy, responsibility, and commitment (Woodside & McClam, 2015).
The case manager communicates helping attitudes to the applicant in several ways, including greeting, eye contact, facial expressions, and friendly responses. The applicant’s perceptions of the case manager’s feelings are also important to his or her impression of the quality of the interview. Communicating warmth, acceptance, and genuineness promotes a climate that facilitates the exchange of information, which is the primary purpose of the initial interview. The following dialogue illustrates these qualities.
Interviewer:
(STANDS AS APPLICANT ENTERS) HELLO, MR. JOHNSON (SHAKES HANDS AND SMILES). MY NAME IS CLYDE DUNN—CALL ME CLYDE. I’LL BE TALKING WITH YOU THIS MORNING. PLEASE HAVE A SEAT. DID YOU HAVE ANY TROUBLE FINDING THE OFFICE?
Applicant:
NO, I DIDN’T. MY DOCTOR IS IN THE BUILDING NEXT DOOR, SO I KNEW THE GENERAL LOCATION.
Interviewer:
GOOD. SOMETIMES THIS COMPLEX IS CONFUSING BECAUSE THE BUILDINGS ALL LOOK ALIKE. HAVE YOU ACTUALLY BEEN TO THE HARD ROCK CAFE IN CANCUN (POINTING TO THE APPLICANT’S SHIRT)?
Applicant:
NO, I HAVEN’T. A FRIEND BROUGHT ME THIS T-SHIRT. I REALLY LIKE IT.
Interviewer:
THEY CERTAINLY ARE POPULAR. I SEE THEM ALL OVER THE PLACE. WELL, I’M GLAD YOU COULD COME IN THIS MORNING. LET’S TALK ABOUT WHY YOU’RE HERE.
The case manager communicates respect for the applicant by standing and shaking hands. It is also easy to imagine that Clyde Dunn is smiling and making eye contact with Mr. Johnson. Clyde takes control of the interview by introducing himself, suggesting how Mr. Johnson might address him, and asking him to have a seat. His concern about Mr. Johnson finding the office and his interest in the T-shirt communicate warmth and interest in him as a person. Clyde also reinforces Mr. Johnson’s request for help in a supportive way. All these behaviors reflect an attitude on Clyde’s part that increases Mr. Johnson’s comfort level and facilitates the exchange of information.
The positive climate created by such a beginning should be matched by a physical setting that ensures confidentiality, eliminates physical barriers, and promotes dialogue. It is disconcerting to the applicant to overhear conversations from other offices or to be interrupted by phone calls or office disruptions. He or she is sharing a problem, and such events may lead to worries about the confidentiality of the exchange. Physical barriers between the client and the case manager (most commonly desks or tables) also contribute to a climate that can interfere with relationship building. As much as the physical layout of the agency allows, the case manager should meet applicants in a setting where communication is confidential and disruptions are minimal. It is preferable to have a furniture arrangement that places the case manager and the applicant at right angles to one another without tables or desks between them and that facilitates eye contact, positive body language, and equality of position.
One barrier that a case manager may confront is the reluctance of those coming for help to believe that another individual may understand their problems. For instance, for many people, life is difficult, and they have few places to turn for help. Many individuals live in poverty, have inadequate educational opportunities, have a disproportionate chance of getting involved in the criminal justice system (as either a victim or a perpetrator), possess few useful job skills, are unemployed, and/or suffer major health problems (Factline, 2012). Since the economic downturn and beyond, many individuals and families have continued to experience economic insecurity (Burns & Russonello, 2015). This means fewer individuals are graduating from high school, there is a decrease in the number of high school graduates attending college, and even fewer are finding employment. Results include fewer resources for housing, food, and health care. Taking time to listen to and explore with those seeking help for the difficulties they experience may begin to build the relationship needed for both the interview and the subsequent case management work.
A sensitive case manager is also cognizant of other kinds of barriers, such as sexism, racism, ethnocentrism, ageism, and attitudes toward sexual orientation. We introduced the importance of this type of sensitivity in Chapter Five. Problems inevitably arise if the case manager allows any biases or stereotypes to contaminate the helping interaction. To help you think about your own biases and stereotypes, indicate whether you believe each of the following statements is true or false.
T F Boys are smarter than girls when it comes to subjects like math and science.
T F Men do not want to work for female bosses.
T F Mothers should stay home until their young children are in school.
T F Women cannot handle the pressures of the business world.
T F Asians are smarter than other ethnic groups.
T F People on welfare do not want to work.
T F People who do not attend church have no moral principles.
T F A mandatory retirement age of 65 is necessary because people at that age have diminished mental capacity.
T F The older people get, the lower their sexual interest and ability becomes.
T F Gays are incapable of commitment in relationships.
Class Discussion
Checking Your Biases
As we indicated in the text, paying attention to your own cultural biases is important during the case management process, especially during the intake interview. Take a few moments as a class, in small groups, or as an individual and note your responses to these aforementioned statements. How did you respond to these statements? Each statement reflects an unjustified opinion that is based solely on a stereotype of gender, race, age, or attitude toward sexual orientation. Talk about any difficulties you encountered. How do you think these reactions would influence how you conduct an intake interview? How would your reactions influence the client participating in the intake?
Share these thoughts with your classmates.
Even though we discussed a multicultural perspective by studying about diverse populations in Chapter Five, we now present some ideas about working with diverse clients during an intake interview. As we discussed, sensitivity to issues of ethnicity, race, gender, age, and sexual orientation is important for the case manager when conducting interviews. Many clients and families have backgrounds very different from that of the case manager.
Case managers should ask themselves, “How do I become sensitive to my clients and relate to them in a way that respects and supports their race, culture, gender, age, and sexual orientation, especially during the intake interview?”
Each Client Is Unique
It is easy to stereotype cultural, racial, gender, or age groups, but clients cannot be understood strictly in terms of their particular culture. For example, poverty-stricken homeless clients share values and experience similar life events, but they are not all the same. During interviews, case managers must take special care to get to know each individual client rather than categorizing him or her as a member of one particular group. For example, one case manager at a housing development for the homeless in New York City explained how she struggles to see each individual as unique: “I work on seeing individuals as unique every day. It is easy to see one client and then see a whole host of clients that have the ‘same’ issue or problem. I try to look for what makes a person unique.”
Language has Different Meanings
Do not assume that words mean the same thing to everyone who is interviewed. When the case manager asks interview questions, clients sometimes do not understand the terminology. Likewise, words or expressions that clients use may have a very different meaning for the interviewer. For example, questions about family and spouse are familiar subjects in an intake interview. When clients talk about “partners” or “family,” these terms can have various meanings, depending on the cultural background and life experiences of the individual being interviewed. For example, in the Native American culture, the family is an extended one that includes many members of the clan. For gay men and lesbian women, the word partner has the special meaning of “significant other.”
Another example of language having different meanings arises when working with a client who is deaf. One general rule of thumb is to avoid idioms and figurative language, such as “Cat got your tongue?” Someone who is hearing impaired may respond, “Where is the cat?” after interpreting the phrase literally. A second general rule is to be aware of words with multiple meanings. For example, hard may mean difficult—or it could mean rigid or unyielding. Words with multiple meanings are difficult for individuals with hearing impairment.
The barrier of language for non–English-speaking individuals is still relevant. Frequently, interpreters are not available. Even with interpreters present, clients indicate that they still do not understand what information is provided. They do not feel understood (Factline, 2012). This hinders how those interviewed ask questions, answer questions, and engage with the intake interview process.
Explain the Purpose of the Intake Interview and the Case Manager’s Role
Clients may show up for the interview without understanding its purpose or the role of the interviewer in the helping process. Confidentiality may also be an important issue for them—sharing information about themselves and others may be contrary to the rules of their culture. For example, for many people raised in Asian cultures, to describe a problem to someone who is not in the family implies making the matter public, which is considered to bring shame to the family.
7-1bClients may be Different from You
In Chapter Five we introduced diverse populations as a way of emphasizing the importance of recognizing the uniqueness of your client.
As we focus on the intake interview, it is important for you to recognize that the individual comes from a culture different from yours. There are several aspects of culture that are important to note.
These include how the client identifies himself or herself according to the following aspects: culture and race, the family of origin of the client, the social institutions that are important for the client, and the use of technology in the client’s world (Woodside, 2018), see Figure 7.1.
Figure 7.1Aspects of Culture

We have assembled some suggestions for developing sensitivity in interviewing individuals with certain cultural backgrounds (Brammer, 2012; Choudhuri, Santiago-Rivera, & Garrett, 2012; Duan & Brown, 2016; Sue & Sue, 2012). These are meant to be guidelines and points of awareness; they should be consulted with discretion. As we mentioned, individuals seldom exhibit all the characteristics of their cultural group. Again, some of this information introduces new ideas because it focuses on the intake interview.
Interviewing Clients of Native American Origin
In many Native American cultures, sharing information about oneself and one’s family is difficult. It is important not to give others information that would embarrass the family or imply wrongdoing by a family member. Listening behaviors such as maintaining eye contact and leaning forward are considered inappropriate and intrusive in some Native American cultures. For many Native Americans, trust increases as you become more involved in their lives and show more interest in them. Making home visits and getting to know the family can significantly improve an interviewer’s chances of getting relevant information. Native Americans tend not to make decisions quickly. The slowness of the process could influence how soon the client is willing to share information or make judgments (Lee, 2013).
Native American cultures sometimes incorporate a fatalistic element—a belief that events are predetermined. During the initial stages of the process, the client may not understand how his or her responses and actions can influence the course of service delivery.
Interviewing Clients with a Common Background of Spanish Language and Hispanic Customs
Individuals living in the United States who are of Mexican, Central and South American, or Caribbean ancestry are often referred to as Hispanic, Latino, or Chicano. There is actually little agreement on the appropriate term for identification across groups and even within subgroups. Although they share some commonalities, they may differ in appearance, country of origin, date of immigration, location and length of time in the United States, customs, and proficiency in English. Case managers should be sensitive to terminology and avoid stereotypes (Duan & Brown, 2016).
Many cultures with this common background view informality as an important part of any activity, even the sharing of information. Taking time to establish rapport with the client before direct questioning begins is helpful.
Some people of this origin may be perceived as submissive to authority because they appear reticent or reluctant to answer questions. Their behavior, in fact, may be shyness or the natural response to a language barrier.
The father may be seen as aloof as he performs his roles of earning a living for the family and establishing the rules. The mother and other members of the family tend to assume more nurturing roles. Questions that do not take these roles into consideration may be misinterpreted by the clients or may suggest to them that the interviewer is an outsider incapable of understanding their culture or of helping them.
Fatalism often plays a role in these cultures. These clients may not see any point in discussing the future, preferring to talk about the present (Brammer, 2012).
Interviewing African Americans
Many African Americans do not believe that they receive the same treatment from social service agencies and professionals as White Americans. Reactions to this belief include a distrust of the human service delivery system, anger about discriminatory treatment, or both. This distrust may result in a reluctance to share information during the intake interview. During the intake interview, it is important to focus on concrete issues that can be connected to services. This approach shows respect for the client’s right to expect fair treatment and quality services (Sue & Sue, 2012).
When being interviewed by a White professional, an African American may feel powerless or believe that his or her input does not matter. Consideration of cultural values such as family characteristics, extended family and friends, educational orientation and experiences, spirituality, and racial identity may help demonstrate to the client that his or her input does matter (Sue & Sue, 2012).
Interviewing Women
Many women do not know how to talk about the difficulties that they are experiencing, and they may not know how to respond to the questions they are asked. Some have had few opportunities to discuss their problems and may believe they do not have the right to complain. Listening carefully is very important.
Anger may play a part in the initial interview. Many women come to the helping process frustrated, either because their efforts have been unrecognized or because they believe that others expect them to be perfect. Often this anger must be expressed before any information can be gathered.
Women often feel powerless and do not expect the bureaucracy to serve them well. They may be reluctant to communicate and doubtful that the interview or the process as a whole can make a difference (Brammer, 2012).
Women may also fill different roles in their lives that may conflict or cause confusion. When interviewing about client strengths, women from some traditional cultures in the United States may defer to males and elders and subordinate their own individuality, yet at work and at school, they may be assertive and confident. Without exploration, these differences may be perceived as weaknesses but, in fact, the flexibility and role shifts may be strengths. Learning about roles and demands contributes to an understanding of the client’s situation.
Women may be overly dependent as clients and assume that the case manager will take complete control of the interview. They may want the interviewer to be the one to identify problems and possible goals. In such cases, care should be taken to give the woman opportunities and encouragement to respond more fully (Sue & Sue, 2012).
Interviewing Elderly Clients
In this society, elderly people are often disregarded and devalued. During the interview, the case manager must show respect for the elderly client’s answers and opinions about the issues discussed. Such a client needs to be assured that his or her responses are important and have been heard by the helper.
Give special attention to the elderly client’s description of support in his or her environment. Many live in an environment of decreasing support (changing neighborhood, death of friends) and with decreasing mobility. Others live with limited family support. These clients may not realize how their environment has changed.
Elderly clients may be reluctant to share their difficulties for fear of losing much of their independence. They may understate their needs or overstate the amount of support they have, hoping to avoid changes in their living conditions, such as being removed from their homes or relinquishing their driving privileges (Duan & Brown, 2016).
Interviewing Individuals with Disabilities
Although individuals with disabilities are not traditionally considered a cultural group, it is important to develop sensitivity to the issues these individuals may encounter. Attitudes toward people with disabilities are often based on the amount of information and education about disabilities and on the amount of contact a person has had with individuals with disabilities (Brammer, 2012). These factors are also the best predictors of positive attitudes toward people with disabilities. Case managers working with this population need to know about mental, physical, and emotional disabilities; the onset of disability; acceptance of disability; disabilities as handicaps; accommodations; and treatment.
A major source of information about a disability is the client. As with other clients, establish the helping relationship by building rapport and trust. Then, address the disability or condition. Is it the problem? If not, then does it affect the problem? Is it even related to the reason why the client is seeking services? Do not make assumptions about why the individual is there or about the disability, and do not generalize. Each person is unique. Case managers also need to increase self-awareness about their own attitudes and knowledge. Know your limits and control your reactions. Increase your knowledge by learning from your client about a particular disability, the difficulties faced, and the environmental situations that are problematic.
Interviewing Sexual Minorities
In this society, discrimination against members of the lesbian, gay, bisexual, and transgender (LGBT) community is practiced in religious, legal, economic, and social contexts. This discrimination exists as an obvious external practice as well as a more subtle internal practice. To begin work with individuals who are part of the LGBT community, case managers need information about lifestyle issues and challenges these individuals confront. Issues include understanding the effects of prejudice, developing a positive identity, and becoming more aware of community resources. Those in the LGBT community also experience a loss of support from family and friends and are often victimized and harassed. One way case managers can establish a positive atmosphere is by using nonheterosexist language such as “partners” instead of “husband and wife.” Intake forms can be revised to use nonheterosexist language (Sue & Sue, 2012). It is also important to conduct intake interviews that focus on the special issues described that this community experiences.
7-1cEssential Communication Skills
Communication forms the core of the interviewing process. When interviewing, communication is the transmission of messages between applicant and helper. As the first face-to-face contact, the interview is a purposeful activity for both participants. In many cases, the motivation is a mutual desire to decide whether the applicant is in the right place for the needed services. This is a negotiation that is facilitated by effective communication skills.
An important skill that promotes the comfort level of the applicant and lays the foundation for a positive helping relationship is using language the person understands. This means avoiding the use of technical language. For example, terms such as eligibility, resources, and Form 524 may not mean much to an applicant who has not become familiar with the human services system. Another example is to imagine that the interviewer is discussing the benefits of taking a vocational or interest test. Rather than going into detail about the validity or reliability of the test, the case manager should discuss how it might help the applicant establish a vocational objective. Using language or words the applicant does not understand tends to create distance and disengagement.
Congruence between verbal and nonverbal messages is another way to facilitate the interaction between an applicant and a case manager. A major part of the meaning of a message is communicated nonverbally, so when conflict is apparent between the verbal and nonverbal messages, the applicant is likely to believe the nonverbal message. A common example of this is the person who says, “Yes, I have time to talk with you now” while looking at the phone or looking through her desk drawer for a folder. The lack of eye contact or any other encouraging nonverbal message communicates to us that the person is busy or preoccupied with other matters.
Another skill that facilitates the interview process is active listening—making a special effort to hear what is said, as well as what is not said. An interviewer who is sensitive to what the applicant is communicating, nonverbally as well as verbally, gains additional information about what is really going on with the individual. This ability is particularly helpful in situations in which the presenting problem may differ from the underlying problem and in interviews with individuals from other cultures. Later in the chapter, we present a more detailed discussion of listening as it relates to the intake interview.
A popular way to elicit information is by asking questions. Questioning is an art as well as a skill. Unfortunately, case managers do not often develop their professional questioning skills, relying instead on questioning techniques that have served them well in informal or friendly encounters. Typically, this means asking questions that focus on facts, such as “What happened?”, “Who said that?”, “Where are you?”, or “Why did you react that way?” Questions such as these usually lead to other questions, placing the burden of the interview on the case manager and allowing the applicant to settle into a more passive role. The applicant’s participation is then limited to answering questions, so the interview may begin to feel like the game “Twenty Questions.” Skillful questioning combined with effective responding helps elicit information and keep the interaction flowing. Appropriate questioning and responding techniques are introduced later in this chapter.
Patterns of communication vary from culture to culture, according to religion, ethnicity, gender, and lifestyle differences. In the dominant culture in the United States, it is effective to use a reflective listening approach when feelings are important. Many of the techniques that are useful in this approach are not appropriate for all cultures. For example, eye contact is inappropriate among some Eskimos. The sense of space and privacy is different for Middle Easterners, who often stand closer to others than Americans do. Some people from Asian cultural backgrounds may prefer more indirect, subtle approaches of communication. Thus, a single interviewing approach may have different effects on people from various cultural backgrounds. The skillful and sensitive case manager must be aware of these differences.
Both spoken language and body language are expressions of culture. Many helpers work with clients from several cultures, each with their own assumptions and ways of structuring information. Both talking and listening provide many occasions for misunderstanding. A director and case manager at a comprehensive community service center in St. Louis, Missouri, talks about the necessity of understanding various cultural backgrounds.
We serve individuals and families from a variety of cultures. For example, 30 of our clients are male and the rest are female. Fifty-five percent are African Americans, 17% are White, and the rest are Asian and Hispanic … We also have a few individuals and families from the Middle East and a few Native Americans.
Their staff members are continually learning about the meaning of words and expressions used by a diversity of clients. When staff members do not understand or are lost in translation, they ask the clients to help them understand.
Assigning great significance to any single gesture by the applicant is also risky, but a pattern or a change from one behavior to another is often meaningful (Sielski, 1979). Once again, the key is the case manager’s awareness during the interview process.
Now that you have read about general guidelines for essential communication, let us focus on the specific skills of listening, questioning, and responding.
7-1dInterviewing Skills
Interviewing skills aim to enhance communication, which involves both words and nonverbal language. Spoken language varies among individuals and cultures. Spoken language is challenging to understand because it is always changing, it is usually not precise, and it is ambiguous. Body language, which is also important and challenging to understand, includes body movement, posture, facial expression, and tone of voice. Knowing the ways in which body language varies culturally can help the interviewer fathom the thoughts and feelings of the applicant.
In talking with an applicant, the case manager must strive for effective communication, making sure that the receiver of the message understands the message in the way the sender intended. In the intake interview, the case manager listens, interprets, and responds. To understand the applicant’s problem as fully as possible, the case manager constantly interprets the meanings of behaviors and words. He or she should always have a “third ear” focused on this deeper interpretation.
At the same time, the applicant is interpreting the words and behaviors of the case manager. A case manager who is an effective interviewer can help the applicant make connections and interpretations. Also contributing to correct interpretations and connections is a good working relationship between the two of them, good timing, and sensitivity to whether the material being discussed is near the applicant’s level of education or experience.
A caseworker at the family services agency in New York City describes the initial meeting at her agency. She is sensitive to how clients are treated during this first visit; she expresses concern that without sensitive treatment, the clients may not return.
You have to be very careful with each client who comes to your agency for the first time. For most individuals, asking for help is a major step in their lives. You cannot create barriers. Several times, I have been busy and have told clients to come back in an hour or two. I remember one time in particular. A homeless man brought his young daughter to our door. We asked if he would like to wait, but he said “no.” He and the daughter never returned.
A local police detective in California who works with gang-related crimes and gang members explains his approach to relationships.
I approach gang members in a casual way. They know I am a cop. I talk to them about how things are in their world, family, friends, the neighborhood, fun, and school. I share some things about myself and the neighborhood where I grew up. Once I have them engaged in conversation, I think they begin to see me as a person, not as a cop, and I honestly try to see them as a person, not just a member of a gang. All in all, I want them to tell me what is happening with them, the gang, and the neighborhood. I always ask them what they would do if they were not in a gang.
Both of these helping professionals are experienced at intake interviewing. They value the helping relationship and recognize its importance in the service delivery that is to follow. To establish the relationship they use communication skills, such as listening, questioning, and responding. These are discussed and illustrated next, with excerpts from intake interviews.
7-1eListening
Listening is the way most information is acquired from applicants for services. The case manager listens to the applicant’s verbal and nonverbal messages. “Listening with the eyes” means observing the applicant’s facial expressions, posture, gestures, and other nonverbal behaviors, which may signal his or her mood, mental state, and degree of comfort. Verbal messages communicate the facts of the situation or the problem and sometimes the attendant feelings. Often feelings are not expressed verbally, but nonverbal messages provide clues. A good listener should be sensitive to the congruence (or lack of it) between the client’s verbal and nonverbal messages. The case manager must pay careful attention to both forms of communication.
Good listening is an art that requires time, patience, and energy. The case manager must put aside whatever is on his or her mind—whether that is what to recommend for the previous client, the tasks to be accomplished by the end of the day, or making a grocery list—to focus all attention on the applicant. The case manager must also be sensitive to the fact that his or her behavior gives the applicant feedback about what has been said. During the interview, the case manager must also recognize cultural factors that play into the interpretation of body language. For example, the proper amount of eye contact and the appropriate space between case manager and applicant may vary according to the cultural identity of the applicant. As you can see, listening is complicated. What behaviors characterize good listening? How are attentiveness and interest best communicated to the applicant?
Attending behavior, responsive listening, and active listening are terms that indicate ways in which case managers let applicants know that they are being heard. The following five behaviors are a set of guidelines for the interviewer (2014, pp. 68–70). They can be easily remembered by the acronym SOLER, Square, Open, Lean, Eye Contact, and Relaxed.
S: Face the client squarely; that is, adopt a posture that indicates involvement.
O: Adopt an open posture. Crossed arms and crossed legs can be signs of lessened involvement with or availability to others. An open posture can be a sign that you are open to the client and to what he or she has to say.
L: Remember that it is possible at times to lean toward the other. The word lean can refer to a kind of bodily flexibility or responsiveness that enhances your communication with a client.
E: Maintain good eye contact. Maintaining good eye contact is a way of saying, “I am with you. I am interested. I want to hear what you have to say.”
R: Try to be relatively relaxed. Being relaxed mean two things. First, it means not fidgeting nervously or engaging in distracting facial expressions. Second, it means becoming comfortable with using your body as a vehicle of personal contact and expression.
Attending behavior is another term for appropriate listening behaviors. Eye contact, attentive body language (such as leaning forward, facing the client, facilitative and encouraging gestures), and vocal qualities such as tone and rate of speech are ways for the interviewer to communicate interest and attention (Ivey, Ivey, & Zalaquett, 2014). Attending behavior also means allowing the applicant to determine the topic.
Epstein provides additional guidelines for good listening (1985, pp. 18–19). This information, written in 1985, has withstood the test of time.
⦁ Be attentive to general themes rather than details.
⦁ In listening, be guided by the purpose of the interview to screen out irrelevancies.
⦁ Be alert to catch what is said.
⦁ Normally, do not interrupt, except to change the subject intentionally, to stop excessive repetition, or to stop clients from causing themselves undue distress.
⦁ Let the silences be, and listen to them. The client may be finished, or thinking, or waiting for the practitioner, or feeling resentful. Resume talking when you have made a judgment about what the silence means, or ask the client if you do not understand.
My Story
Sharon Bello, Entry 7.1
I remember my first meeting with Tom Chapman. I had filled out the application for services, and then Tom met with me to explain more about the agency. He told me what I could expect if I was accepted for services. He described this time together as an initial interview. Marianne asked me if I would review the recommendations by Epstein and then discuss how these applied to my interview with Tom Chapman. She told me that it would be good to have the participant perspective for this first visit to the agency. I use a table here to record my thoughts. Marianne wrote the guidelines for interviewing in the left column. My ideas and experiences are in the right column (see Table 7.1).
Table 7.1
An Example of Soap Notes: Tom Chapman’s Soap Notes Related to Sharon Bello
Epstein’s guidelines for interviewing Sharon’s (my comments) thoughts about her initial interview
1. Be attentive to general themes rather than details. I thought that most of the time we really talked about specific parts of my life. Tom began the interview by talking with me about the agency and what I could expect in my work with the agency. For instance, we talked about what the application for services looked like. He told me about the three steps I would participate in before I was either accepted for services or rejected. He didn’t use the word rejected. But that is how it felt to me. Then, he talked about confidentiality and what would happen with the records that we were putting together. And he told me some about his own work. He also told me some about the relationship he hoped that we would have.
2. In listening, be guided by the purpose of the interview to screen out irrelevancies. I thought that we kept to the application form during the time we spent together. We would look at the application that I filled out and then talked about each of the items. We added to the form, sometimes changed it, and then made a list of things that I needed to do to follow-up on the application. I didn’t mind working with Tom. He seemed interested in helping me.
3. Be alert to catch what is said. I thought Tom paid attention to what I said. One thing that I liked was that he would ask me, “This is what I heard you say. Is this correct? Did I miss anything?” One thing that made the entire conversation difficult is that Tom was using a computer to fill out the application. So, lots of times he was looking at the computer or we both were looking at the computer. Lots of times he was not looking at me. I did think that he tried to listen to what I said. But when he was on the computer we were definitely not face-to-face.
4. Usually, do not interrupt, except to change the subject intentionally, to stop excessive repetition, or to stop clients from causing themselves undue distress. When I think about that first meeting, I can remember how emotional I was. The application did not ask me to talk about some of the things that were really important to me. I think that I must have repeated myself. It was difficult to talk about my son’s death. It was also troubling to talk about how frustrated I was about not being able to do a job that I love. And I don’t think that I could adequately describe the pain I was and am in. And I also felt I was a failure for not being about to provide for my other two children. I tried to talk about these things. I knew that Tom wanted us to fill out the form so we didn’t spend as much time as I would have liked to talk about the difficulties that I confront everyday.
5. Let the silences be, and listen to them. The client may be finished, or thinking, or waiting for the practitioner, or feeling resentful. Resume talking when you have made a judgment about what the silence means, or ask the client if you do not understand. I don’t remember about silences. When we finished an item on the application we moved right along to the next item. I am not complaining, but I would have liked to have some silences where I felt I could move away from the application.

A skillful listener also hears other things that may help him or her understand what is going on. A shift in the conversation may be a clue that the applicant finds the topic too painful or too revealing, or it might indicate that there is an underlying connection between the two topics. Another consideration is what the applicant says first. “I’m not sure why I’m here” and “My probation officer told me to come see you” give clues about the applicant’s feelings about the meeting. Also, the way the applicant states the problem may indicate how he or she perceives it. For example, an applicant who states, “My mother says I’m always in trouble” may be signaling a perception of the situation that differs from the mother’s. Concluding remarks may also reveal what the applicant thinks has been important in the interview. The skilled interviewer also listens for recurring themes, what is not said, contradictions, and incongruencies.
Good listeners make good interviewers, but as you have just read, listening is a complex activity. It requires awareness of one’s own nonverbal behaviors, sensitivity to cultural factors, and attention to various nuances of the interaction. It is further complicated by the fact that people seeking assistance do not always say what they mean or behave rationally. However, the use of good listening skills always increases the likelihood of a successful intake interview.
7-1fQuestioning
Questioning, a natural way of communicating, has particular significance for intake interviews. It is an important technique for eliciting information, which is a primary purpose of intake interviewing. Many of us view questioning as something most people do well, but it is, in fact, a complex art. This section elaborates on questioning skills, introduces the appropriate use of questions, identifies problems that should be considered, and explores the advantages of open inquiry as one way to elicit information.
Questioning is generally accepted by some as low-level or unacceptable interviewer behavior (Egan, 2014). Others view it as a complex skill with many advantages (Ivey et al., 2014). Let us explore its complexity and its advantages.
There are several reasons why questioning is a complex skill. Questioning may assist and inhibit the helping process, it can establish a desired as well as an undesired pattern of exchange, and it can place the client in the one-sided position of being interrogated or examined by the helper.
For these reasons, we may consider questioning an art form. The wording of a question is often less important than the manner and tone of voice used to ask it. A counselor also serving as a care coordinator at a family-focused agency in Tucson, Arizona, says this:
As a counselor and as a care coordinator, I have to think and act like a detective … this is especially true when I make a home visit. I enter the home as a stranger and I take in all of the information I can with all of my senses. … I go way beyond the formal five-page assessment that I have to fill out about each potential client and family.
A case manager at the School for the Deaf in Knoxville concurs:
[The] way that I learn about my clients, I have to be curious about who they are, where they are, and why they are what they are. To do this I must appear interested but not too nosy.
Too many questions will confuse the applicant or produce defensiveness, whereas too few questions place the burden of the interview on the client and may lead to the omission of some important areas for exploration. The pace of questions influences the interview, too. If the pace is too slow, then the applicant may interpret this as lack of interest, but a pace that is too fast may cause important points to be missed. A delicate balance is required.
What are the advantages of questioning? One is that questioning saves time. If the case manager knows what information is needed, then questioning is a direct way to get it. Questioning also focuses attention in a particular direction, moves the dialogue from the specific to the general as well as from the general to the specific, and clarifies any inaccuracies, confusion, or inconsistencies. Let us examine some examples of the appropriate uses of questioning (see Figure 7.2).
Figure 7.2Ways to Use Questions

After each example, you are asked to provide two relevant questions.
To Begin the Interview
Could you tell me a little about yourself? What would you like to talk about? Could we talk about how I can help?
You work at the county office on aging. A woman comes in with her elderly mother. List two questions that you might use to begin the interview.
To Elicit Specific Information
How long did you stay with your grandmother? What happens when you refuse to do as your boss asks? Who do you think is pressuring you to do that? Can you give me an example of a time when you felt that way?
Voices from the Field
Counseling Intake Interview Questionnaire
The following intake interview, posted on the Internet, reflects the approach one counselor uses to gain initial information about clients. She asks clients to complete the following form. This form provides just one example of the questions case managers can ask during the intake interviewing process.
Intake Interview
The following questions may help me to better assist you in the counseling process. If for any reason you do not want to answer the questions, then you do not have to. You may leave any question blank. During the course of therapy, I may ask follow-up questions based on your answers. Again, these questions and the answers you provide may likely increase my ability to be helpful.
⦁ Client Name
⦁ Date
⦁ Age
⦁ Who suggested that you should come to see me?
⦁ OK to thank referral?YesNo
⦁ In your own words, why are you seeking counseling at this time?
⦁ Have you had counseling in the past?YesNo
⦁ Who did you see?
⦁ Approximate dates?
⦁ Was it a good experience?YesNo
⦁ Why or why not?
⦁ Please list any medications you are currently taking.
⦁ Have you ever gone to the hospital for mental health reasons?
YesNo
⦁ Have you ever gone to the hospital for substance abuse reasons?
YesNo
⦁ Approximate dates?
⦁ Where did you go?
⦁ In your own words, what do you hope to gain from counseling?
⦁ What do you see as your strengths? (For couples, please identify relationship strengths)
⦁ If you or any of your family has a history of any of the following, please indicate and describe briefly.
Health problems
Mental health problems
Substance abuse problems
History of abuse (physical, emotional, or sexual)
Legal problems
Economic problems
Occupational problems
Housing problems
Thanks for taking the time to complete this form. We can talk about your reactions and any concerns in our next session.
© Semmler, P. (n.d.). Intake Interview. Retrieved from http://pamsemmler.com/forms.php
A client tells you about mistreatment by her boss at her new job. She claims that she is being sexually harassed. What two questions would you ask to help you understand what happened?
To Focus the Client’s Attention
Why don’t we focus on your relationship with your daughter? What happens when you do try to talk to your husband? Of the three problems you have mentioned today, which one should we discuss first?
A client facing surgery is worried about how the surgery will go, who will care for her children while she is in the hospital, and whether she will be fired for missing so much work. She wrings her hands and seems ready to burst into tears. What are two questions you could use to focus her attention?
To Clarify
Could you describe again what happened when she left? How did you feel about that conversation compared with others you have had with him? What is different about these two situations?
A young man shares his anguish over his mother’s death a year ago. You notice that he is smiling, and you are confused about what he is really saying. Write two questions that would help you clarify what is going on.
To Identify Client Strengths
What is a current problem you have also faced in the past? Can you now use the same resources to solve your current problem? What did you do to keep the problem from turning into a crisis?
A young woman with a disability is questioned to assess functioning level and suitability for a program that requires her to ride public transportation. Write two questions that would help you identify her strengths.
These scenarios are examples of interview situations in which the case manager might legitimately use questions. In all of them, the general rule of questioning applies. Question to obtain information or to direct the exchange into a more fruitful channel.
Although questioning may seem to be the direct path to information, sometimes this strategy can have negative effects. Long, Paradise, and Long (1981) suggest that interviewers should not rely on questions to carry the interaction or interview. This is particularly problematic for beginning helpers because people generally have a tendency to ask a question whenever there is silence (discussed later in this section). Questions may also be inappropriate when the case manager does not know what to say. Asking questions nervously may lead to more questions, which can put the case manager in the position of focusing on thinking up more questions rather than listening to what the client is saying. Prematurely questioning to assess client strengths during the interview can also be problematic and may be viewed as rejection by the client.
An overreliance on questioning can create other problems for both interviewers and clients. For the client, too many questions can limit self-exploration, placing him or her in a dependent role in which the only responsibility is to respond to the questions. A client may also begin to feel defensive, hostile, or resentful at being interrogated. Using too many questions may place the case manager in the role of problem solver, giving him or her most of the responsibility for generating alternatives and making decisions. In the long term, overreliance on questioning leads to bad habits and poor helping skills. Using questions to exclude other types of helping responses eventually results in the withering of these other skills (as discussed in Closed and Open Inquiries).
In conclusion, questioning is an important strategy for effective interviewing, but it is more than a strategy for obtaining information. Because of the subtleties of questioning, the matter of its appropriate use in interviewing, and the potential problems, questioning is an art that requires practice. The skillful case manager who uses questioning to the best advantage knows when to use open and closed inquiries to gather information during the intake interview. These types of questions are discussed next.
Closed and Open Inquiries
The questions used in intake interviews can be categorized as either open or closed inquiries. Determining which one to use depends on the case manager’s intent. If specific information is desired, then closed questions are appropriate: “How old are you?”, “What grade did you complete in school?”, or “Are you married?” If the case manager wants the client to talk about a particular topic or elaborate on a subject that has been introduced, then open questions are preferred: “What is it like being the oldest of five children?”, “Could you tell me about your experiences in school?”, or “How would you describe your marriage?”
Closed questions elicit facts. The answer might be yes, no, or a simple factual statement. An interview that focuses on completing a form generally consists of closed questions like those in the previous paragraph. However, the interviewer must be cautious, because a series of closed questions may cause the client to feel defensive, sensing an interrogation rather than an offer of help. One approach is to save the form until the end of the interview, review it, and complete the unanswered questions at that time. If the completion of an intake form is allowed to take precedence in the interview, then the case manager misses the opportunity to influence the client’s attitudes toward the agency, getting help, and, ultimately, service provision. Perhaps just as importantly, information that could be acquired through listening and nonverbal messages may be missed if the interviewer is focused on writing answers on the intake form.
Open inquiries, however, are broader, allowing the expression of thoughts, feelings, and ideas. This type of inquiry requires a more extensive response than a simple “yes” or “no.” The exchange of this type of information contributes to building rapport and explaining a situation or a problem. Consider the following example.
Father:
I’M HAVING TROUBLE WITH THE OLDEST BOY, WILLIAM. HE’S IN TROUBLE AGAIN AT SCHOOL.
Interviewer 1:
HOW OLD IS WILLIAM?
Interviewer 2:
COULD YOU TELL ME MORE ABOUT WHAT’S GOING ON?
Interviewer 1’s response is a closed question that asks for a simple factual answer. Interviewer 2’s response is an open inquiry that asks the father to elaborate on what he thinks is happening with William. This allows William’s father to determine what he wishes to tell the interviewer about the situation. Such an open inquiry emphasizes the importance of listening—to what the individual says first, how he or she perceives the problem, and what is considered important.
You now should understand how valuable open inquiries can be in intake interviewing. They also provide an opportunity for the clients to introduce topics, thereby putting them at ease by allowing discussion of their problems in their own way and time. Besides providing the information that the case manager needs, open inquiries encourage the exploration and clarification of the client’s concerns.
Four methods are commonly used to introduce an open inquiry (Evans, Hearn, Uhlemann, & Ivey, 2016). Each is presented here with an example of a client statement, the interviewer’s response, and the kind of information that the client might volunteer in response to the open inquiry.
⦁ “What” questions are fact-oriented and elicit factual data.
Mr. Cagle:
I’M HERE TO GET FOOD STAMPS. HERE’S MY APPLICATION.
Interviewer:
LET’S REVIEW IT TO MAKE SURE YOU’VE COMPLETED IT CORRECTLY. WHAT’S YOUR INCOME?
Mr. Cagle:
WELL, I MAKE MINIMUM WAGE AT MY JOB, AND MY WIFE DON’T MAKE MUCH EITHER. WE HAVE THREE CHILDREN AND WE LIVE IN A LOW-INCOME APARTMENT.
⦁ “How” inquiries are people-oriented, encouraging responses that give a personal or subjective view of a situation.
Tamisha:
MY BOYFRIEND DOESN’T LIKE MY PARENTS, AND WHEN WE ARE ALL TOGETHER, NOBODY AGREES WITH ANYONE ABOUT ANYTHING.
Interviewer:
HOW DO YOU FEEL ABOUT THAT?
Tamisha:
I HATE IT. EVERYONE IS SO UNCOMFORTABLE. I WANT EVERYONE TO GET ALONG, BUT I DREAD THE TIMES WE HAVE TO BE TOGETHER. SOMETIMES I FEEL LIKE SOMEBODY WILL YELL AT SOMEONE ELSE OR EVEN HIT SOMEBODY.
⦁ “Could,” “could you,” or “can you” are the kinds of open inquiries that offer the client the greatest flexibility in responding. These inquiries ask for more detailed responses than the other types.
Juan:
I HATE SCHOOL. MY TEACHER DOESN’T LIKE ME. SHE’S ALWAYS ON MY CASE ABOUT STUFF.
Interviewer:
COULD YOU DESCRIBE A TIME WHEN SHE WAS ON YOUR CASE?
Juan:
WELL, I GUESS. LIKE YESTERDAY, SHE WAS MAD AT ME BECAUSE I WAS LATE TO CLASS … BUT I WAS ONLY 5 MINUTES LATE. THEN, SHE CALLED ON ME TO ANSWER A QUESTION. WELL, I HADN’T READ THE STUFF BECAUSE I LOST THE BOOK, SO HOW COULD I ANSWER THE QUESTION? I MEAN, GIVE ME A BREAK.
The fourth type of open inquiry is the “why” question, which experienced interviewers often avoid because it may cause defensiveness in clients. Examples of “why” questions that may do this are “Why did you do that?” and “Why did you think that?” Phrased this way, these questions may be perceived as judgments that the client should not have done something, felt a certain way, or had certain thoughts. Less risky “why” questions are those phrased less intrusively: “Why don’t we continue our discussion next week?” and “Why don’t we brainstorm ways that you could handle that?”
In what follows, we analyze some excerpts from an intake interview that occurred in juvenile court. Tom Rozanski is the case manager who was assigned to court on that particular day. In some such cases, the juvenile is remanded to state custody that very day; that is, he or she can leave the courthouse only to go to a local or state detention facility. The juvenile in this case, Jonathan Douglas, has been charged with breaking and entering. He has a history of substance abuse and school truancy and is well known to the judge, who finds him guilty and remands him to state custody. The case then comes under the jurisdiction of an Assessment, Care, and Coordination Team (ACCT), which takes responsibility for assessing the case, developing a plan of services, and coordinating the needed services among the agencies that are involved with the plan. Tom finds on this day that court is very crowded. Once Jonathan Douglas has been remanded to state custody, Tom asks him to follow him into the hall, and the initial intake interview occurs there. Jonathan’s parents also join them, as do two officers, who suspect that Jonathan will run if he gets the chance. They stand together in the hall for a brief interview so that Tom can gather enough information to arrange placement that afternoon. Here is what happens.
Tom:
JONATHAN, MY NAME IS TOM. (SHAKES HANDS) I WORK FOR THE ASSESSMENT, CARE, AND COORDINATION TEAM. WE ARE RESPONSIBLE FOR ASSESSING YOUR CASE AND PLANNING SERVICES FOR YOU.
Jonathan:
(LIMPLY SHAKES HANDS AND LOOKS EVERYWHERE BUT AT TOM)
Tom:
JONATHAN, ARE YOU LISTENING? PLEASE LOOK AT ME. ARE YOU ON ANY DRUGS RIGHT NOW?
Jonathan:
(UNINTELLIGIBLE RESPONSE)
Tom realizes that it is futile to try to talk with Jonathan now and hopes that in a few hours he will be down from whatever drugs he has taken.
Tom:
MR. AND MRS. DOUGLAS, I AM TOM ROZANSKI, A CASE MANAGER FOR THE ASSESSMENT, CARE, AND COORDINATION TEAM IN THIS COUNTY. LET ME REVIEW FOR YOU WHAT HAS HAPPENED. THE JUDGE FOUND JONATHAN GUILTY OF BREAKING AND ENTERING. BECAUSE OF HIS PRIOR RECORD, HE IS IN STATE CUSTODY, AND IT IS MY JOB TO FIND A PLACE FOR HIM TO STAY WHILE WE EVALUATE HIS CASE. I NEED SOME BASIC INFORMATION RIGHT NOW. CAN YOU HELP ME?
Ms. Douglas:
YES, WE WANT TO HELP HIM ANY WAY WE CAN.
Tom:
DOES JONATHAN LIVE WITH EITHER OF YOU?
Ms. Douglas:
HE STAYS WITH ME ONCE IN A WHILE, BUT MOSTLY HE STAYS WITH HIS DAD.
Tom:
MR. DOUGLAS, COULD YOU DESCRIBE HIS BEHAVIOR WHEN HE STAYS WITH YOU?
Ms. Douglas:
WELL, I GUESS HE GOES TO SCHOOL SOMETIMES. WHEN I LEAVE FOR WORK, I TRY TO GET HIM UP. I DON’T KNOW IF HE GOES, THOUGH. SOMETIMES HE’S HERE WHEN I GET HOME AND SOMETIMES HE ISN’T. HE’S A BIG BOY NOW, AND I CAN’T DO MUCH WITH HIM, SO I JUST LET HIM BE.
Tom:
DO EITHER OF YOU HAVE HEALTH INSURANCE?
Both Parents:
NO.
The interview lasts approximately 5 minutes more, and Tom obtains some key information about the family situation. He has very little time and needs specific information, so he hurriedly asks closed questions. “What is your address, Mr. Douglas?” “What grade is Jonathan in?” “Has he had a medical examination recently?” Finally, Tom has enough information to complete most of the intake form. That afternoon, he meets with Jonathan and makes another attempt to talk with him. He is relieved to find Jonathan more communicative at this meeting. Here is an excerpt; note Tom’s use of open inquiries.
Tom:
JONATHAN, I WOULD LIKE TO TALK WITH YOU ABOUT WHAT’S GOING TO HAPPEN. I’D ALSO LIKE YOU TO TELL ME YOUR SIDE OF WHAT’S GOING ON.
Jonathan:
(LOOKS AT TOM BUT MAKES NO COMMENT)
Tom:
WHEN WE FINISH TALKING, DEPUTY JOHNSTON WILL TAKE YOU TO MOUNTAINVIEW HOSPITAL, WHERE YOU WILL SPEND THE NEXT 2 WEEKS. DURING THAT TIME, WE WILL TALK AGAIN, YOU WILL TAKE SOME TESTS, AND YOU WILL MEET WITH A GROUP OF YOUNG PEOPLE WHO ARE YOUR AGE. AT THE END OF THAT TIME, WE WILL DEVELOP A PLAN OF SERVICES FOR YOU. NOW, COULD YOU TELL ME ABOUT YOURSELF?
Jonathan:
WELL, I’M 15. I DON’T LIKE SCHOOL AND I DON’T GET ALONG WITH EITHER OF MY PARENTS. MY MOTHER DOESN’T WANT ME SINCE SHE MOVED, AND MY DAD DOESN’T CARE IF I’M AT HOME OR NOT.
Tom:
THIS IS THE FIRST TIME YOU HAVE BEEN IN TROUBLE FOR BREAKING AND ENTERING. WHAT HAPPENED?
Jonathan:
WELL, I WAS WITH THESE GUYS AND WE NEEDED MONEY FOR SOME POT. IT LOOKED EASY. I THINK I MADE A MISTAKE.
Tom:
YEAH. IT SEEMS SO. LET’S TALK ABOUT WHAT YOU CAN DO NOW. WHAT KIND OF CHANGES WOULD YOU LIKE TO SEE?
Jonathan:
WELL, I DON’T WANT TO GO TO JAIL AND I DON’T WANT TO GO TO RED RIVER [A JUVENILE CORRECTIONAL FACILITY]. I CAN’T STAY HOME THOUGH. THEY DON’T CARE ABOUT ME AND I DON’T CARE ABOUT THEM.
Tom:
HOW WOULD YOU DESCRIBE YOUR RELATIONSHIP WITH YOUR PARENTS?
Jonathan:
WE DON’T HAVE A RELATIONSHIP. THEY DON’T CARE ABOUT ME. SOMETIMES I STAY WITH MY MOM, BUT SHE’S LOOKING FOR ANOTHER HUSBAND AND SHE DOESN’T WANT ME AROUND. MY DAD, HE JUST DOESN’T WANT TO BE BOTHERED.
Tom:
HMM. SOUNDS AS THOUGH YOU’RE NOT SURE IF THERE’S A PLACE FOR YOU WITH THEM. WHAT CHANGES WOULD YOU LIKE TO SEE IN YOUR RELATIONSHIP WITH YOUR PARENTS?
Jonathan:
I WISH THEY … WISH … I WISH THEY LIKED ME.
Tom:
I SEE. COULD YOU GIVE ME AN EXAMPLE OF WHAT THEY WOULD DO IF THEY LIKED YOU?
Jonathan:
I DON’T KNOW.
Tom:
CAN YOU DESCRIBE A TIME WHEN YOU DID SOMETHING THEY LIKED?
Jonathan:
MY MOM LIKES IT WHEN I COME IN EARLY. MY DAD, HE DOESN’T CARE.
Tom:
WHAT HAVE YOU DONE TO PLEASE YOUR MOM?
Jonathan:
(PAUSES) I CLEANED UP THE KITCHEN ONCE.
In this excerpt, Jonathan mentions his family and school in his first response. Tom picks up on the family situation and decides to explore it with Jonathan. He has talked with the parents, and although they are not living together, he senses that both are interested in Jonathan and willing to help him but do not seem to know what to do, and they feel that Jonathan rebuffs any overtures they make. Tom is trying to discover what kind of support may be available to Jonathan from his parents and how receptive he would be to it. Tom uses open inquiries in his conversation with Jonathan to elicit the boy’s thoughts and feelings about this issue. The use of “what” questions gets at factual information, and the “how” questions are aimed at people-oriented information.
In summary, case managers who are good interviewers use both open and closed inquiries, although open inquiries are preferred whenever possible. They are also careful to ask one question at a time and to avoid asking consecutive questions of a kind that might create the feel of a cross-examination. What other types of responses do interviewers use? Responding suggests other ways of responding to clients in an interview situation.
7-1gResponding
A case manager might use various kinds of responses during the course of an intake interview. Of course, the type of response depends on the intent at that particular point. Let us review some of the most common responses. In the following material, each response is followed by an example of its use. Joe Barnes, a recent parolee, has returned home and is having a difficult time with his wife. His parole officer, sensing that the relationship is in trouble, suggests that Joe should see a counselor at the Family Service Center.
Minimal Responses
Sometimes called verbal following, minimal responses let the client know that you are listening. “Yes,” “I see,” “Hmm,” and nodding are minimal responses. Using them is important when getting to know the applicant.
Joe Barnes:
I’M HERE BECAUSE MY PROBATION OFFICER THOUGHT IT WOULD BE A GOOD IDEA FOR ME TO TALK WITH SOMEONE ABOUT THINGS AT HOME. THINGS HAVEN’T BEEN VERY GOOD SINCE I CAME HOME.
Mike Matson:
I SEE.
Paraphrase
This response is a restatement (in different words) of the main idea of what the client has just said. It is often shorter and can be a summary of the client’s statement. Paraphrasing lets the client know that the case manager has absorbed what was said.
Joe:
I JUST DON’T KNOW WHAT THE TROUBLE IS. I WAS GLAD TO GET HOME, AND I THOUGHT MY WIFE WOULD BE GLAD TO HAVE ME THERE. BUT WE FIGHT ABOUT EVERYTHING—EVEN STUFF LIKE WHEN TO FEED THE DOG. I DON’T KNOW WHAT TO DO.
Mike:
YOU DON’T KNOW WHAT’S HAPPENING BETWEEN YOU AND YOUR WIFE SINCE YOU GOT HOME. SOUNDS LIKE IT’S PRETTY UNPLEASANT FOR BOTH OF YOU … AND YOU’RE WONDERING WHAT TO DO ABOUT IT.
Reflection
Sometimes people get out of touch with their feelings, and reflection can help them become more aware. The feelings may not be named by the individual but, rather, communicated through facial expression or body language. For example, a flushed face or a clenched fist may show anger. The case manager’s reflective response begins with an introductory phrase (“You believe,” “I gather that,” “It seems that you feel”) and then clearly and concisely summarizes the feelings the case manager perceives.
Joe:
YES. I DON’T KNOW HOW WE CAN CONTINUE TO LIVE LIKE THIS. I KNOW SHE IS REALLY ANGRY ABOUT ME GETTING IN TROUBLE WITH THE LAW, BUT I’VE PAID MY DUES, LEARNED MY LESSON. I DON’T PLAN TO EVER GET IN THAT MESS AGAIN.
Mike:
I GATHER THAT YOU REALLY DO FEEL BAD ABOUT WHAT YOU DID, BUT YOU WOULD LIKE TO PUT THE PAST BEHIND YOU AND FOCUS ON THE FUTURE AND HOW TO MAKE YOUR MARRIAGE WORK.
Reflection is a response that facilitates a discussion of the client’s feelings, particularly when he or she may feel threatened by such a discussion. It is also helpful as a way to check and clarify the case manager’s perception of what was said during the interview.
Clarification
Clarifying helps the case manager find out what the client means. When the case manager is confused or unsure about what has taken place, it is more productive to stop and clarify at the time than to continue.
Joe:
I GOT SO ANGRY LAST WEEK BECAUSE SHE WOULDN’T LISTEN TO ME AND SHE DIDN’T SEEM TO CARE THAT I WAS HOME. I WAS YELLING, SHE WAS YELLING, SHE THREW A BOWL AT ME, AND I ALMOST HIT HER.
Mike:
SOUNDS TO ME LIKE YOU GOT SO ANGRY AND FRUSTRATED THAT YOU WERE ALMOST OUT OF CONTROL.
Class Discussion
Practice with Questioning
Both asking questions and responding are ways that you can improve your communication with a client and enhance the outcomes of the intake interview. Review the information about questions and responses. Then, have a 5-minute conversation with a friend and ask one of the following questions:
⦁ Tell me about one of the most important events of your life.
⦁ Think about yesterday and tell me something about the event that really stands out to you.
⦁ Tell me something special about yourself.
⦁ Add one of your own questions.
Record the conversation.
Listen to the recorded conversation and then transcribe it.
For each of the times you spoke, note if you asked a question or provided a response to your friend, or if you added new information to the conversation.
Answer the following questions:
⦁ What types of questions did you ask?
⦁ How did your friend respond to each of your question?
⦁ What types of responses did you then make?
⦁ How do you think your friend felt about each question?
⦁ When you responded, what information did you add to the discussion?
⦁ How did your friend respond to your new information?
What insights did you gain from this exercise?
Share this information with your classmates.
Want to Know More? Reducing the Blind Dimension
Rehabilitation counseling field services introduced case managers with responsibility for seeing clients through the entire service delivery process. In the ERIC archives, the authors found a document prepared by Rubin and Farley in 1980 designed to train rehabilitation counselors in the case management process. Particularly intriguing is how the article describes one objective of the intake interview as “decreasing three dimensions.” It indicates that one of the goals of the intake interview is to inform both client and helper and to gather information unknown to both. Page 10 of Rubin and Farley’s participant workbook explains how to decrease the blind, hidden, and unknown dimensions.
Decreasing the Blind Dimension
During the intake process, the client needs much information. Extensive client participation and involvement are desired throughout the rehabilitation process but are very crucial during the intake process. The client needs information about the rehabilitation agency, its role and function, services that are offered, the objectives of those services, and eligibility requirements to decide if the rehabilitation agency can meet his/her needs. Your role and the client’s rights and responsibilities are other areas to be discussed with the client very early. You are more likely to practice effective information dissemination by knowing the information needed by the client and the most effective and efficient way to communicate that information.
Decreasing the Hidden Dimension
The client has much information needed by the counselor. You are more involved with the task of collecting information during the intake process than at any other time during the rehabilitation process. The hidden dimension is more likely to be diminished when you are aware of all of the information collection areas that should be explored and when you are an effective facilitator of free client expression and self-revealing behavior.
Decreasing the Unknown Dimension
The blind dimension is decreased via effective information dissemination. The hidden dimension is decreased via effective information collection. During this information exchange process, additional information known neither by the client nor by the counselor becomes known. The unknown dimension is further decreased via information from external sources, such as medical evaluation, psychosocial evaluation, and vocational evaluation.
Rubin, S. E., & Farley, R. C. (1980). Intake interview skills for rehabilitation counselors: A trainer’s guide. Fayetteville, AR: Rehabilitation Research and Training Center. Retrieved from http://www.eric.ed.gov/PDFS/ED218535.pdf
Summarizing
With this response, the interviewer provides a concise, accurate, and timely summing up of the client’s statements. It also helps organize the thoughts that have been expressed in the course of the interview. Summarizing is used to begin an interview when there is past material to review. It is also useful during the interview when a number of topics have been raised. Summarizing directs the client’s attention to the topics and provides direction for the next part of the interview.
From the summary, the client can choose what to discuss next. Summarizing is also useful when the client presents a number of unrelated ideas or when his or her comments are lengthy, rambling, or confused; a summarizing response can add direction and coherence to the interview. Finally, summarizing is a way to close the interview. The case manager goes over what has been discussed. Prioritizing next steps or topics becomes easier at this point.
Joe:
I TOLD HER I DIDN’T CARE WHAT SHE THOUGHT. I’M SURE SHE KNEW WHAT I MEANT EVEN THOUGH I DIDN’T KNOW WHAT I MEANT. SHE WON’T GIVE ME A CHANCE. I AM TRYING HARD, SO WHAT DOES IT MEAN TO HER THAT I HAVE BEEN GONE? SHE HAS NO IDEA WHAT I HAVE BEEN THROUGH.
Mike:
LET ME SEE IF I CAN SUMMARIZE WHAT WE’VE TALKED ABOUT TODAY. RETURNING HOME HAS BEEN VERY DIFFICULT FOR YOU AND YOU’RE CONFUSED ABOUT YOUR RELATIONSHIP WITH YOUR WIFE. SHE STILL SEEMS ANGRY ABOUT YOUR TROUBLE WITH THE LAW, AND THE TWO OF YOU JUST CAN’T SEEM TO COMMUNICATE.
Joe:
I GUESS THAT’S ABOUT IT.
Mike:
LET’S FOCUS ON THE COMMUNICATION PROBLEMS AT OUR NEXT MEETING.
The following is an excerpt from an intake interview that incorporates all the responses that you have just read about: open and closed inquiries, minimal responses, paraphrases, reflection, clarification, summarization, interpretation, confrontation, and informing. Notice how and when the case manager uses each response and the client’s reaction to it.
Mathisa walked into the AIDS Community Center one Wednesday evening at approximately 8 o’clock. She had come to talk to a counselor because she had just discovered that her best friend had AIDS. Her friend had told Mathisa and no one else, and Mathisa was scared. She did not know what to tell her friend, and she did not know what to do. Mathisa passes by the center on her way to school each morning, but she had barely noticed it. And now she was here.
A young man came up to her and introduced himself. She said “Hi,” but did not want to tell him her name. In fact, she really did not want anyone to know that she was there. He asked her if she had come to talk and she nodded. He led her into a small room that had three comfortable chairs. He sat in one and pointed to one where she could sit.
The young man, Dean, started by telling Mathisa about the agency and about his job as a service coordinator. He also talked to her about the confidentiality policies of the agency.
Dean:
I’M GLAD YOU’RE HERE.
Mathisa:
I’M NOT SURE I’M GLAD TO BE HERE. I’VE NEVER BEEN IN THIS PLACE BEFORE.
Dean:
IT’S SCARY TO BE IN A PLACE FOR THE FIRST TIME. WE’RE ALWAYS GLAD TO WELCOME NEWCOMERS AND VISITORS. (SMILES) WHAT’S GOING ON?
Mathisa:
(PAUSES) I’M HERE FOR A FRIEND.
Dean:
YOUR FRIEND IS VERY LUCKY THAT YOU COULD COME FOR HIM OR HER. HOW DID YOU DECIDE TO COME HERE?
Mathisa:
WELL, THIS IS A PLACE I PASS EVERY MORNING ON MY WAY TO SCHOOL. SOMETIMES I WONDER WHAT IT’S LIKE HERE. AND TODAY I KNEW THAT I NEEDED TO COME. CAN I BE SURE THAT NOBODY WILL FIND OUT WHAT I TELL YOU?
Dean:
YES, WHAT YOU TELL ME STAYS BETWEEN THE TWO OF US. CONFIDENTIALITY IS VERY IMPORTANT TO YOU.
Mathisa:
I HAVE SOME INFORMATION, AND I DON’T WANT ANYONE ELSE TO KNOW. I DON’T KNOW WHAT I CAN DO.
Dean:
UMM … (NODS)
Mathisa:
YOU NEED TO KNOW WHAT BEFORE YOU CAN HELP, I GUESS.
Dean:
COULD YOU DESCRIBE THE EVENT THAT BROUGHT YOU HERE?
Mathisa:
I’M JUST SO SCARED AND I DON’T KNOW WHAT TO DO.
Dean:
IT’S SCARY HAVING INFORMATION AND NOT HAVING ANY IDEA WHAT TO DO WITH IT. HOW DO YOU THINK I CAN HELP YOU?
Mathisa:
I DON’T KNOW FOR SURE. BUT I DO KNOW THAT YOU UNDERSTAND AIDS AND YOU HELP PEOPLE WITH AIDS. I ONLY KNOW WHAT THEY TAUGHT US IN SCHOOL. (MATHISA IS OBVIOUSLY IN DISTRESS; SHE IS ALMOST IN TEARS AND IS CHOOSING HER WORDS CAREFULLY.)
Dean:
YOUR QUIET VOICE AND YOUR TEARS LET ME KNOW THAT THE REASON YOU CAME IS VERY UPSETTING TO YOU.
Mathisa:
(NODS)
Dean:
(SILENCE)
Mathisa:
MY BEST FRIEND JUST TOLD ME THAT SHE HAS AIDS. SHE GOT TESTED WHEN SHE WAS ON A TRIP A MONTH AGO. SHE WENT TO A STATE THAT DOES NOT ASK YOUR REAL NAME. SHE JUST FOUND OUT YESTERDAY. SHE’S REALLY BLOWN AWAY BY IT. NO ONE ELSE KNOWS—NOT EVEN HER PARENTS.
Dean:
SHE TOLD YOU AND YOU DON’T KNOW WHAT TO DO.
Mathisa:
I DON’T REALLY KNOW ANYTHING ABOUT IT. I DON’T WANT HER TO DIE, AND I DON’T WANT TO DIE. HER BOYFRIEND DOESN’T KNOW, AND I DON’T KNOW WHAT SHE’LL TELL HER PARENTS. SHE MAY EVEN RUN AWAY OR KILL HERSELF, BUT WHAT IF THE TESTS ARE WRONG? AND SEEING THE REALLY SICK PEOPLE HERE MAKES ME THINK THAT I DON’T WANT TO LIVE.
Dean:
MATHISA, I’M NOT SURE WHAT YOU SAID JUST THEN; YOU SAID THAT YOU DIDN’T WANT YOUR FRIEND TO DIE, AND THEN YOU SAID THAT YOU DIDN’T WANT TO LIVE.
In this interview, Dean promoted good rapport with Mathisa by providing a good physical setting. It was simple, without distractions; they sat in close proximity, with no barriers between them, in comfortable chairs. Perhaps most important, it was an environment that was private. Dean introduced himself and assured her of confidentiality so that Mathisa felt comfortable beginning to talk.
Dean used a combination of open inquiries and responses. His first open inquiry was “Can you tell me why you’re here?” This was designed to elicit a fact from Mathisa. She did not elaborate, but she did give enough information to continue the conversation. Dean also used “how” and “could” questions to encourage Mathisa to provide more information.
Dean’s responses included a paraphrase (“Confidentiality is very important to you”) as well as reflection (“Your quiet voice and your tears let me know that the reason you came is very upsetting to you”). Both of these responses helped Mathisa understand that Dean was actively listening to her and had heard what she had said. He had also interpreted her nonverbal messages.
At the conclusion of this excerpt from the interview, Dean used clarification (“I’m not sure what you said just then …”) to try to sort through the information that Mathisa had given. In the remainder of the interview, Dean will continue to find out more about the problem and its implications for Mathisa and her friend. When they finish talking, Dean will summarize what has transpired and perhaps suggest where the relationship can go at that point.
7-1hInterviewing Pitfalls
Clearly, interviewing requires a great deal of skill. An effective interviewer is one who listens attentively, questions carefully, and uses other helpful responses to elicit information and promote client understanding. However, caution is necessary. The desire to be helpful and the anxiety of conducting that first interview can lead to a number of pitfalls. Four of them are discussed here.
Premature Problem Solving
This arises from a desire to be helpful to the applicant by removing the pain, the discomfort, or the problem itself as soon as possible. Unfortunately, if the interviewer suggests a change, strategy, or solution before the problem has been fully identified and explored, this may address a symptom of the presenting problem rather than the actual problem. Premature problem solving may cause the client to lose confidence in the case manager’s knowledge and skills or to become impatient. Also, premature problem solving undermines the client’s self-determination and can lead to false assumptions or misinterpretation of what the client says, and steer him or her in the wrong direction. In the case of mental illness, misdiagnosis can result.
Giving Advice
In attempting to solve the problem or offer a solution, the case manager may mistakenly give advice. When given hurriedly and before the problem has been explored sufficiently, advice may be seen as indicating a lack of interest or thoroughness. The client may also feel misunderstood, or he or she may superficially agree, without intending to follow through. Giving advice also tends to diminish the client’s level of responsibility, self-determination, and partnership in problem solving.
Overreliance on Closed Questions
The pitfall of overuse of closed questions has been discussed elsewhere in this chapter. Remember that closed inquiries are usually directive and focused on facts; they rarely provide the opportunity for exploration. A series of closed inquires might also make the client defensive. Once this feeling is established, it is difficult to overcome.
Rushing to Fill Silence
Because silence is often awkward in everyday social situations, beginning helpers as well as seasoned professionals are sometimes uncomfortable with pauses and rush to fill them, believing that silence indicates that nothing is happening. In fact, silence does have meaning. The client may be waiting for direction from the interviewer, thinking about what has transpired so far, or just experiencing an emotion. Constant dialogue can be a false signal that something is happening. Skillful case managers learn to listen to silence.
Class Discussion
Examining Pitfalls of Intake Interviewing
As we indicated in the text, there are some pitfalls that can occur during the intake or initial interview. Paying attention to those can help you develop your interviewing skills. Set aside time in class to conduct a 5-minute interview with another class member. The interview will focus on the experience in this class. Use the following questions:
⦁ What were your expectations for the class on case management?
⦁ What are your experiences to date in the class on case management?
⦁ How do your experiences differ from your expectations?
⦁ How are your experiences the same as your expectations?
⦁ What recommendations do you have for the remainder of the term?
⦁ How will you focus your work in the class?
Use the following table to record your experience as an interviewer or interviewee related to the pitfalls of conducting an interview.
Pitfalls
Premature problem solving
Overreliance on closed questions
Rushing to fill the silences
Your Response to Your Interview Experience
Share your experiences with your classmates.
Deepening Your Knowledge: Case Study
Marcus works for Tribe Solutions, a provider of behavioral counseling services to adolescents on a Native American reservation in southern Florida. He started the position 2 months ago, and just last week he received some training on intake interviewing with the expectation that he would be able to conduct his own intakes by the end of the month.
After his second opportunity to shadow Marcia, a veteran counselor with more than a decade of experience at the site, Marcus sat down to make notes of his observations about the intake interview process. Marcus has noticed that his office is very different than Marcia’s. Because he has been so busy since starting the job, many of his belongings and files are disorganized. His office furniture consists of a large desk, a filing cabinet, an office chair, and a straight-back chair in the corner of the room. In contrast, Marcia’s office is very inviting, with plants, artwork, and a warm, open space between three comfortable chairs. Marcus has wondered if these physical characteristics have any impact on the clients’ experience.
Marcus also observed Marcia’s friendliness and inviting style with her clients. Although she has to confront them on many occasions, she consistently conveys an attitude of caring and helpfulness. Even though the paperwork for the intake interview indicates a highly structured series of questions, Marcia often lets her clients lead for portions of the conversation before returning to the script. Marcia told Marcus that she believes her attitude and framing of client issues must focus on support and encouragement because Native American youth come from a marginalized culture and often view outsiders with skepticism and hostility. Marcus remains unsure of how to balance this approach with the program’s expectation that delinquent youth must be held accountable for their actions, and he thinks that Marcia’s infrequent eye contact does little to help convey her stated attitude. Marcus is troubled by the indifference toward life circumstances and behavioral problems he has observed in Marcia’s clients and wonders why Marcia does not give her clients more advice. Marcia is also careful in conversation with clients to be sure that they understand the content and meaning of their dialogues, which often seems unnatural to Marcus.
When considering Marcia’s interactions with clients, Marcus has trouble understanding how she chooses between questioning and active listening. He has little confidence that he will be able to distinguish between the appropriate moments for these delicate skills. After taking these notes, Marcus realizes that he is very unsure about his suitability for the job. He decides to meet with Marcia the next day to discuss his questions and concerns.
⦁ Morgan, C. (2012). Unpublished manuscript, Knoxville, Tennessee. Used with permission.
Discussion Questions
⦁ Why is it important for Marcus to try to model the physical space of his office more closely to what he has seen in Marcia’s office?
⦁ How would you rate Marcia’s cultural sensitivity toward her clients, as indicated by Marcus’s statements? How should she approach this topic with Marcus to help him better understand the steps he needs to take?
⦁ If you were in Marcia’s role of discussing these questions with Marcus, which issues would you see as most important, and how would you go about answering them for Marcus?
Author Note: We think that it is important for you to review the chapter you just read. We suggest the following.
⦁ First, re-read the class discussion questions in the text and answer these as comprehensively as possible.
⦁ Second, once you complete the discussion questions, review the ⦁ Chapter Summary, define the ⦁ Key Terms, and answer the questions in ⦁ Reviewing the Chapter.
⦁ Third, make notes of what stands out for you during your review. Also, record any questions that you might have.
⦁ Finally, take time to discuss the Questions for Discussion with another class member, either face-to-face or online. Answering these questions with a peer will help you solidify the understanding you have of the contents of the chapter.