Tuesday, December 04, 2007

Client Change Review: A Therapist Self-Administered Version of the Change Interview (12/07)

Entry for 4 December 2007:

I developed this simplified version of the Client Change Interview in 2001, specifically for postgraduate students and other therapists or counsellors to use with their own clients, in situations in which it is not feasible to have a colleague or researchers interview one’s client. This revised version is presented here as a therapeutic task, and should be adapted to the particular counselling situation and client.

Task Marker: Client describes sense of significant progress; or reaches previously-agreed-upon review point (e.g., 8 or 10 sessions; end of therapy; end of semester).

General Approach. Facilitate an empathic exploration of the client’s experience of therapy/ counselling. For each topic listed, use open-ended questions plus empathic understanding responses to help the client elaborate on his/her experiences. Use the “anything else” probe (e.g., "Are there any other changes that you have noticed?") in a nondemanding way until the client runs out of things to say. This task should take 20-30 minutes.

Schedule of Questions:
1. What medications are you currently taking (can include dose, how long, last adjustment, herbal remedies)
2. What has therapy/counselling has been like so far? (How it has felt to be in therapy?)
3. What differences/changes (if any) have you noticed since therapy/counselling started? (e.g., doing, feeling, or thinking things differently from before; ideas about self or others; changes brought to your attention by others)
4. Has anything have changed for the worse since therapy/counselling started?
5. What do you feel has helped bring about these changes? What has helped make them possible?
6. Is there anything that hasn’t changed since therapy/counselling started, that you client wished had?
7. What has been most helpful about your therapy/counselling so far? (please give examples; may include general aspects, specific events).
8. Has there been anything about your therapy/counselling that might have been hindering, unhelpful, negative or disappointing? (may include general aspects, specific events).
9. Has there been anything about your therapy/counselling that has been difficult or painful but still OK or perhaps helpful?
10. Has anything been missing from therapy/counselling? Do you have any suggestions for improving it?

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