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Intake interviews are critical for effective therapy Intake interviews represent the first formal and prolonged contact that a therapist or counselor has with a client As such, the intake often is the first step toward developing a strong therapeutic alliance Since the goal of the intake is to gather information, the client does most of the talking By default, the therapist does a great deal of respectful listening with the occasional use of open-ended questions to guide the interview Some therapists like to introduce themselves and then break the ice by asking the client, What prompted you to seek help at our center or a similar type of question Somewhere very early in this interview you might briefly interrupt the process by asking the client if it is okay for you to take notes of what is being said, in order to remember the details.

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Fair enough. And I ll admit that there are occasions when thinking of a grid in terms of ratings which are numbers, and rating scales made up of words, obscures the fact that all of this is simply a way of expressing underlying preferences; in other words, of representing the choices which a person makes in his or her thinking well before they re put into symbols. We ll get on to that eventually. For the time being, it suits my purposes to teach the essentials of the grid as a simple, but powerful, rating-scale technique.

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Usually the client is quite amenable to allowing you to do this and will understand the value of taking notes Asking for permission to take notes validates the rights of the client in the therapeutic process The client will appreciate that you respect her or his rights in session by asking for permission to take notes, and she or he is usually more likely to trust your motives after your being respectful in this way After a person begins talking, use of a motivational interviewing style can be quite helpful to keep him or her talking so you can glean more information A motivational interviewing style gives the client evidence that you are listening carefully and are genuinely interested in learning more.

If you want to be a Mentat to a One-Dimensional Expert, you d better be an expert yourself, and you d better show your respect for the OneDimensional Expert. If you want to be a Mentat to a Rigid Believer, show that you believe what the Rigid Believer believes and then some. (You might not have to behave as if you believe it. Some people still trust Jimmy Swaggart. He certainly talks a good game.) If you want to be a Mentat to a Distracted Consumer, talk only about popular subjects, and keep the dialogue simple. In other words, follow the lead of Larry King. In his August 20, 2001, column in USA Today, King talks about Drew Carey s recent angioplasty; lavishes praise on a new Michael Douglas thriller and a book by Patrick Walsh, M.D., on prostate cancer; pleads for patience from those who would pan Bill Clinton s memoirs before publication; and offers brief thoughts on abortion, capital punishment, the lack of an NFL team in Los Angeles, Marc Rich, Tim Hudson, and Hideo Nomo mostly in three sentences or less. That s 10 almost completely unrelated pop subjects in about 700 words. Talk about a Distracted Consumer. If you want to be a Mentat to a Critical Thinker, get ready to prove it over and over. A Critical Thinker s trust is complex and situational, and a given Mentat is trusted to perform only in a certain context. Critical Thinkers keep score, too, which can be embarrassing to Mentats who frequently get it wrong.

One motivational interviewing strategy that can be quite helpful is to ask a client about a typical day in his or her life, and how drug use is a part of such a day Frequently such a question can break the ice while providing a large amount of information about the client I like to let the client talk freely about his or her life at first, to hear his or her story, in order to reduce any nervousness or anxiety the client may have about therapy Later, I can go back and ask more detailed questions to fill in the biographical holes in the interview Many treatment centers have standardized intake interview templates that prompt you to ask about different domains of a person s life to provide a comprehensive psychosocial history.

Some of these templates can be quite detailed, with numerous, very specific questions designed to gather a wide range of information However, using only the intake template risks making the interview seem quite impersonal to the client I would recommend a balance between asking the standardized questions as needed and encouraging the client share her or his story as it occurs to her or him This style might be thought of as guided interviewing rather than structured interviewing Structured written summaries of intake interviews (see Figure 41 as an example) are placed into the client s chart As you can see by this example, there are certain areas of information that you will want to investigate with the client during the intake First, you want to document basic identifying information, as well.

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