Tuesday, December 05, 2006

New Version of Client Change Interview Schedule (IPEPPT Version, 12/06)

Entry for 5 December 2006:

This version is simpler and uses a more logical order than the previous versions. It is thus a better starting place for practice-based research protocols, including translation into other languages. In fact, I made this one in order to provide my Italian colleague, Alberto Zucconi, with a better version for translation into Italian.

See complete Instructions and record form at:

Interview Strategy: This interview works best as a relatively unstructured empathic exploration of the client’s experience of therapy. Think of yourself as primarily trying to help the client tell you the story of his or her therapy so far. It is best if you adopt an attitude of curiosity about the topics raised in the interview, using the suggested open-ended questions plus empathic understanding responses to help the client elaborate on his/her experiences. Thus, for each question, start out in a relatively unstructured manner and only impose structure as needed. For each question, a number of alternative wordings have been suggested, but keep in mind that these may not be needed.
  • Ask client to provide as many details as possible
  • Use the “anything else” probe (e.g., "Are there any other changes that you have noticed?"): inquire in a nondemanding way until the client runs out of things to say
Introduction given to clients: After each phase of treatment, clients are asked to come in for an hour-long semi-structured interview. The major topics of this interview are any changes you have noticed since therapy began, what you believe may have brought about these changes, and helpful and unhelpful aspects of the therapy. The main purpose of this interview is to allow you to tell us about the therapy and the research in your own words. This information will help us to understand better how the therapy works; it will also help us to improve the therapy. This interview is audio-recorded for later transcription. Please provide as much detail as possible.

Interview Schedule:

1. General Questions: [about 5 min]
1a. How are you doing now in general?
1b. What has therapy been like for you so far? How has it felt to be in therapy?
1c. What medications are you currently on? (interviewer: record on form, including dose, how long, last adjustment, herbal remedies)

2. Changes: [about 10 min]
2a. What changes, if any, have you noticed in yourself since therapy started? (Interviewer: Reflect back change to client and write down brief versions of the changes for later. If it is helpful, you can use some of these follow-up questions: For example, Are you doing, feeling, or thinking differently from the way you did before? What specific ideas, if any, have you gotten from therapy so far, including ideas about yourself or other people? Have any changes been brought to your attention by other people?)
2b. Has anything changed for the worse for you since therapy started?
2c. Is there anything that you wanted to change that hasn’t since since therapy started?

3. Change Ratings: [about 10 min] (Go through each change and rate it on the following three scales:)
3a. For each change, please rate how much you expected it vs. were surprised by it? (Use this rating scale:)
(1) Very much expected it
(2) Somewhat expected it
(3) Neither expected nor surprised by the change
(4) Somewhat surprised by it
(5) Very much surprised by it

3b. For each change, please rate how likely you think it would have been if you hadn’t been in therapy? (Use this rating scale:)
(1) Very unlikely without therapy (clearly would not have happened)
(2) Somewhat unlikely without therapy (probably would not have happened)
(3) Neither likely nor unlikely (no way of telling)
(4) Somewhat likely without therapy (probably would have happened)
(5) Very likely without therapy (clearly would have happened anyway)

3c. How important or significant to you personally do you consider this change to be? (Use this rating scale:)
(1) Not at all important
(2) Slightly important
(3) Moderately important
(4) Very important
(5) Extremely important

4. Helpful Aspects: [about 10 min] Can you sum up what has been helpful about your therapy so far? Please give examples. (For example, general aspects, specific events)

5. Attributions: [about 5 min] In general, what do you think has caused the various changes you described? In other words, what do you think might have brought them about? (Including things both outside of therapy and in therapy)

6. Resources: [about 5 min]
6a. What personal strengths do you think have helped you make use of therapy to deal with your problems? (what you’re good at, personal qualities)
6b. What things in your current life situation have helped you make use of therapy to deal with your problems? (family, job, relationships, living arrangements)

7. Problematic Aspects: [about 5 min]
7a. What kinds of things about the therapy have been hindering, unhelpful, negative or disappointing for you? (For example, general aspects. specific events)
7b. Were there things in the therapy which were difficult or painful but still OK or perhaps helpful? What were they?
7c. Has anything been missing from your treatment? (What would make/have made your therapy more effective or helpful?)

8. Limitations: [about 5 min]
8a. What personal weaknesses do you think have made it harder for you to use therapy to deal with your problems? (things about you as a person)
8b. What things in your life situation have made it harder for you to use therapy to deal with your problems? (family, job, relationships, living arrangements)

9. Suggestions. [about 5 min] Do you have any suggestions for us, regarding the research or the therapy? Do you have anything else that you want to tell me?

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