Article :
Young, J. C., Davidson, J. A., & Gross, A. M. (2010). Clinical Interviewing with Children. Handbook of Clinical Psychology Competencies, 209‑236. https://doi.org/10.1007/978-0-387-09757-2_8
Introduction
This article which is named “clinical interviewing with children” was released by Young, Davidson and Gross in 2010. It was published on handbook of clinical psychology competencies. Authors investigate the different specificities of the clinical interview conducted with children and the target audience is mental health professionals.
Summary
Clinical interview is a process by which information is obtained about a patient through direct communication with him or with relevant referees (Craig, 1989). It has different objectives: diagnosis, conceptualization of cases and implementation of appropriate care. The format of the interview can be structured (very standardized, short answers, closed questions), semi-structured (allows more extensive speech) or unstructured (no prior orientation). These different formats therefore meet different objectives.
Intrinsic factors
The interview must be adapted to the child’s level of development, it is therefore necessary to have solid knowledge of the normal development of the child and of the alterations that may occur. This will select the topics that will be covered in the interview. Furthermore, language must be as appropriate as possible to the child’s level of development (cognitive and emotional), especially in the case of speech and language disorders that may affect understanding and response. The format of the questions must therefore be adapted to the child since it directly influences the accuracy and quality of the information provided. The symptomatic presentation of developmental disorders can vary in children and adults, but also depending on the gender of the child. Boys, for example, are more inclined to externalize the problem (aggressiveness) while girls will tend to internalize (depression, anxiety).
Extrinsic factors
Environmental and cultural factors can impact a child’s development (undernourishment, physical / sexual abuse, parental expectations, etc.) and should be given special attention by the psychologist. The culture of the child is a predominant factor. It will then be as necessary as possible to reduce cultural barriers (ethnicity, gender, age, socio-economic status, language barrier). As a therapist, it’s about being clear about your own cultural biases. These biases may be related to cultural differences in nonverbal behavior and communication style. It is also essential to take into account the phenomenon of acculturation, which can lead to psychological symptoms of distress and behavioral difficulties (acculturative stress). As a result of these phenomena, cultural minorities tend to be misdiagnosed.
We will keep in mind that during the interviews, it will be important to consider the child in his global universe : his family relations, friends, school and homework, extra-curricular activities, centers of interest, conscience of self and feelings. Particular attention should be paid to the functioning of the home and to the relationships that the child has with each member of his family. The relationship with peer groups, which becomes more and more important with age, can also shed new light on the problem (social anxiety, bullying, aggression, etc.)
The therapeutic relationship
The interview with the child is made up of several major dimensions necessary for it to run smoothly. First of all, building a relationship and an alliance is sometimes made difficult because the appointment is made by a third party (parents, legal guardians, etc.). The child may then feel betrayed, anxious, punished. To reassure him, it is advisable to let him explore the room, and provide him with toys suitable for his age. During the interview, this will mean limiting potential distractions and adopting a more flexible framework than with adults, by allowing the child to move and move around, for example. Reinforcements vary by age, primary for the little ones (candies) and secondary for the older ones, and should be accompanied by expressions of interest and attention.
Confidentiality is also an essential element, it will then be necessary to establish with the child what can be said to adults and to see with the whole family what will be said to the institutions. It is important to mention our obligation to postpone what is said if we feel that there is a danger for the child for those around him.
Conclusion
Thus, the clinical interview with the child requires taking into consideration a set of developmental factors (language, level of understanding, developmental disorders, etc.), environmental factors (culture, family, trauma, peers, etc.). Several elements are fundamental to creating a therapeutic alliance with the child (trust, respect for confidentiality, reassurance, etc.). As a result, the therapeutic alliance will make it possible to better target dysfunctional or problematic behaviors and to obtain as much information as possible on this subject, while putting them in perspective with environmental factors.