IUC TRAINING ACADEMY INTERVIEW MODULE ADULTS

1. IUC TRAINING ACADEMYINTERVIEW MODULEADULTS Colleen Friend, Ph.D., LCSW California State University, Los Angeles

2. Welcome! Content Outline for Adult Clients A. Multiculturalism and Cultural Competence B. Principles of Ethnographic Interviewing C. Interview Practice is Guided by ASFA Core Values D. Shift into Using a Strengths-Based Approach E. Motivational and Solution-Focused Interviewing Summarized F. Sample Questions, Review of Interview Techniques, Suicide Assessment, Preparing for an Interview, and Neglect Red Flags G. Role Play Directions, Role Play, Video Selections, and Video Worksheet

3. Multiculturalism & Cultural Competence What is Culture? The way of life of a people. The sum of their learned behavior, patterns, attitude, etc.; it includes beliefs, preferences, verbal and nonverbal communication styles and relationship patterns. We see the world via our own cultural filters. What each person like you already “knows.”

4. Multiculturalism & Cultural Competence What is cultural competence? • Knowing how to negotiate cultural differences and being willing to conduct human interactions in a respectfully responsible and responsive manner … that protects / preserves the dignity of individuals. It is more than knowledge; it is a state of mind and way of life.

5. Multiculturalism & Cultural Competence Five Elements of Cultural Competence As an Individual: • Awareness and acceptance of difference • Awareness of own cultural values • Understanding dynamics of difference • Development of cultural knowledge • Ability to adapt practice to the cultural context of the client

6. Multiculturalism & Cultural Competence As an Organization: • Valuing diversity • Participating in cultural self-assessment • Managing the dynamics of difference • Institutionalizes cultural knowledge • Adapts to diversity

7. Multiculturalism & Cultural Competence What are the “isms”? racism sexism classism ageism disable-ism heterosexism

8. Principles of Ethnographic Interviewing Disproportionality in Child Welfare Los Angeles County Children receiving DCFS services Caucasian 3,829 11.9% Hispanic 17,724 55.2% African American 9,596 29.9% Asian Pacific Islander 595 1.9% American Indian 127 0.4% Filipino 186 0.6% Other 71 0.2% Note:Data from June 2009 LA County DCFS Fact Sheet.

9. Principles of Ethnographic Interviewing How we Bridge the Gap As a cultural anthropologist: Worker is a guest, client is cultural guide Expert is a person from that culture Guide becomes the teacher and interviewer is the student

10. Principles of Ethnographic Interviewing

11. Principles of Ethnographic Interviewing What is ethnographic interviewing? It is a method of inquiry in which the interviewer controls the structure but not the content of the interview. Two Assumptions • Language and words are windows into the interviewee’s world • The narrative produced encourages healing through a process of self-discovery, valuing, and moving out of the victim role.

12. Principles of Ethnographic Interviewing Parts of the interview • Rapport building • Asking “Global Questions” that focus on perceptions of self, norms, what feels like help, etc? • Use of “Cover Terms” and descriptive questions specific to the guide’s culture, convey important symbolism • “Descriptors Questions” are characteristic of the guide’s cover terms • Use of “Summary” reflects interviewer’s listening; should show the client’s perspective, allow for collaborative decision-making and identify culturally appropriate services.

13. Interviews are Guided by ASFA Core Values • Shortened timelines to permanency • Safety for children, especially for those in foster care • Stability and well being for children, especially for those in foster care

14. Public Child Welfare has Shifted into Strengths-Based Approach PCW and the Strengths-Based Approach • Recognize a shift into building on strengths • Model empathy and offering support • Focus on “good” and use that to build a positive chain • Treat family as expert on themselves and extended family affiliates as helpers • Conduct problem-solving in partnership • Create an atmosphere that is open to feedback; and model it first

15. Public Child Welfare has Shifted into Strengths-Based Approach • Look for opportunities to reinforce positive change • Test whether or not you are communicating in a respectful manner; would you want someone from DCFS to treat your family member this way? • See yourself in a partnership with your supervisor • Keep track of what you are learning and where you get stuck • Interviewer’s job is to maintain the focus and direction of the interview

16. Consider Three Interviewing Approaches • Narrative • Motivational • Solution-Focused Evidence to support these approaches differs We will examine each, then summarize their different uses, and apply each in an exercise

17. Narrative Interviewing for Adults • What is it? A style of interviewing; uses prompts such as “tell me about it..” That encourages the client to narrate about their own experience. The interviewer listens attentively and compassionately. • Benefits • Establishes the client as the expert in his/her own experience, from his/her own cultural vantage point • Potentially draws out material your way not be able to reach through traditional interviewing • May be useful in rapport building • Has the power to illuminate issues when there are large cultural differences between the client and interviewer

18. Narrative Interviewing for Adults • Benefits (continued) • Can reveal a range of attitudes and beliefs about receiving “help” which affects your relationship • Once elicited, you can analyze, identifying complex motives, themes and constraints. • Considerations • Clients vary in their abilities to organize their stories • Interviewer minimizes interruptions. • Requires a commitment of time do well.

19. Traditional vs. Motivational/solution-focused

20. Summary: Motivational and Solution-Focused Interviewing Motivational Interviewing: • Is a directive, client centered approach (or counseling style) for eliciting behavior change by helping clients to engage in change talk when exploring and resolving ambivalence • Is based on an understanding of change stages, the particular stage of change your client is in and what triggers change • Assumes that readiness to change is not a client trait, but a fluctuating product/process of interpersonal relationships • DEARS: Develop the discrepancy, Express Empathy, Avoid argumentation, Roll with resistance, Support self efficiency • Research: Well supported and effective ; rated “level 1” by the California Evidence Based Clearing House (CEBC)

21. Summary: Solution-Focused Interviewing Solution Focused Interviewing • Is a system of intervening that emphasizes: • Client as competent co-constructor of goals and an expert in making them happen • Interviewer operates as a not knowing discoverer • Generating “solution talk” with an appreciation for client’s strengths and resources • Resistance is not a client trait, but can be generated in the interview interaction • Construct interview “moves” based on solution-focused techniques which do influence outcomes by uncovering the client’s own solution

22. Stages of Change *Anticipate/recycling before lasting maintenance is achieved. Note: Some earlier works from DiClemente and Prochaska identify “Relapse” as a separate stage, and an integral part of change. 22

23. Sumamry: Motivational terviewing 5 GENERAL BASIC SKILLS: AROSE • Affirmation • Reflective Listening • Open Ended Questions • Summarization • Eliciting Change Talk

24. Review: Reflective Listening and Statements • Simple Reflection • Paraphrase • Reflection of Feeding • Double Side Reflection

25. .Review Summarization: • Pulls together reflective listening and prepares the client to move on. • Check with client for accuracy and perspective. Change Talk: • Assesses desire, ability, reason, need or commitment to change Asks evocative questions, explore pros and cons, ask for narrative.

26. Summary: Solution-Focused Interviewing TECHNIQUES: • Use questions to draw out the client’s position: “What needs to happen for our talk to be useful?” • Treat your client as an expert to diminish defensiveness: “How is not signing the contract useful to you?” • Use normalizing, brief statements: “Of course, sure, yes, that’s understandable.” • Use Partializing: “What part of ‘x’ did you agree with?”

27. Summary: Solution-Focused Interviewing TECHNIQUES: • Affirm your client’s perceptions: “What would it take for them to know what a good mother you are?” • Develop goals: elicit his/her description of what will be different when solved; work with small increments • Explore for exceptions: what was happening when situation was less severe (“wh” questions) using scaling and miracle questions. • Co-construct goals: Use scaling questions to establish a baseline and what the client thinks it would take to get to the next level.

28. Summary: Solution-Focused Interviewing TECHNIQUES: • Co-construct hope: Use “miracle” questions to facilitate making a concrete plan from a wish or dream. • End of session feedback: Construct messages that acknowledge strengths based on goals and what needs to happen on co-constructed goals (give homework). • Evaluate client progress: done together; use scaling questions to assess baseline and change • RESEARCH: Probably a promising practice; not rated by California Evidence Based Clearing House (CEBC)

29. Motivational interviewing:Sample Questions, Review of Interview Techniques Pick one question from this list that you can see having immediate utility in your future interviewing. Explain your choice. • How is this a concern for you? (Open-ended question) • What things could be a problem? (Open-ended question) • What do you think will happen if you don’t make a change? (Open-ended question, shifting focus) • Ok, so you didn’t make it, but each attempt can move you closer to success. (Reframe) • Do you remember a time when things were going well? What changed? (Open-ended questions) • Inquire about the good things i.e. what do you like about.... (Open-ended question) • You are a very resourceful person. (Affirmation)

30. Motivational interviewing:Sample Questions, Review of Interview Techniques • You’ve got a point there. (Support) • What are your options? What could you do? (Open ended questions) • “This requires commitment/effort, maybe you’re not motivated/ready yet.” (Complex Reflection) • On the one hand, you want Jimmy to come home, on the other hand, he has special needs that require your constant supervision. (Double Sided Reflection) • On the other hand, you have seen the health risk cigarettes pose, on the other hand, nothing else seems to calm you down. (Double Sided Reflection)

31. Solution-focused interviewing:Sample Questions, Review of Interview Techniques Pick one question from this list that you can see having immediate utility in your future interviewing. Explain your choice. • What have you thought about doing so far? (Open-ended question) • So, that was helpful, what else did you do. (What else question) • Was there ever a time when you were not doing x? (Exception-seeking question) • How would you re create that time? (Exception-seeking) • What needs to happen for our talk to be useful to you? (Lead-in question) • So when you are saying serenity prayer, what will you be doing differently? (Future-oriented question)

32. Solution focused interviewing:Sample Questions, Review of Interview Techniques • Wow! You’ve been sober for 3 months, how did you do it? (Coping question) • On a scale of 1 – 10 (one being the lowest score and 10 being the highest), how are you doing now? [Note: This question can be modified to be more specific, i.e., doing with your depression? The follow-up question is: Can you describe a (number) for me? And eventually: What would it take to move that to a (one number in a desirable direction)? What would be different?] (Scaling question)

33. solution focused interviewing:Sample Questions, Review of Interview Techniques • What part of the issue did you agree with? (Lead-in question) • What would let you know the situation was improving? (Open-ended question) • Does the judge know that you have been making all these efforts? (Relationship question) • How could you get that to happen? (Open-ended question) • Suppose there were a miracle cure tomorrow, what would that look like? (Miracle question) • Could it be that you really want to make sure your client is safe? (Question framed in tentative language)

34. Sample Questions, Review of Interview Techniques,

35. Differential Use of Interviewing Techniques • You can create your own approach through differential use of these techniques: • Narrative: • Use when there is a cultural gap between interviewer/client. Assure that you have enough time. • Employ selectively when there is a part you are not getting. • Motivational: • Use when ambivalence seems to be present and you want to explore the client’s stage of change and willingness to engage in change talk. • Stage of change and willingness to engage in change talk. • Can help lower conflict by putting the client in control of goals, etc.

36. Differential Use of Interviewing Techniques (Cont.) • Solution Focused: • Similar to Motivational, use to explore change, your questions are probes for excavating the solution from the client “expert”. • This process also deflects conflict, and relies on the interviewer accepting a role in the creation of resistance. • End of session feed back and complement can move the relationship into a positive realm.

37. Practice Example • Consistent use of these approaches requires continued training and supervision. • In the Practice Example we use for Neglect (at the end of this module) prepare to use three techniques / questions from each of these approaches. • Use them differentially, when the need arises.

38. PREPARING FOR AN INTERVIEW • Review the record or referral. What do I “know?” As an investigator, is my mind open to new information; am I equally interested in information that may disconfirm my hypothesis? • What is my role and purpose? • Did I do my homework from the last home call? • Conscious caseworker decisions: where to conduct, who to interview first? • Should the visit be announced or unannounced?

39. PREPARING FOR AN INTERVIEW (Cont) • Jurisdiction: Although there been a cross report to LE, do they need to know I am going there now? What will be the plan if I can’t get in? • Should I bring another worker? Should I go with LE? • Assess my safety plan. • Anticipate problems (what could happen?); formulate strategies. • Have I filled out an itinerary? • Do I need to consult with my supervisor or lead worker?

40. PREPARING FOR AN INTERVIEW (Cont) • Write a short list of reminders. • Do I have material to take notes during or immediately after? • Should I bring a car seat? • Do I have a map or book of maps, cell phone, gas, etc.? • Plan: Where will I park? What time of day to conduct? Will I have to do other follow-up immediately? • Am I feeling anxious?

41. High risk for neglect: red flags • Single parent, young mother • Own history of abuse /neglect* in family of origin • Unrealistic expectations of children (the younger the child, the higher this concern) • Depression • Impulsivity • Meets adult needs through child • Child’s behavior may exacerbate parental behavior. *Research indicates about one-third repeat this.

42. Role Play Directions, Role Play, Video Selections, and Video Worksheet