James Morrison First Interview Analysis
Reflection on First Interview
Sensitive Subjects The area of sensitive subjects as defined by James Morrison in The First Interview (2014) includes five topics. The first topic I broached was regarding substance use. The subject of alcohol use does not bring up issues for me except that I struggled to know if I should probe more or not when we initially talked about his drinking. I was unsure of myself because I did not readily remember the amounts of alcohol that would indicate a concern. In the end, my instinct was that it was not a problem for him now, so I left it where it was. I asked about any other substance use which did not bring up any issues for me. I was reasonably comfortable asking about sexual orientation. I was relieved …show more content…
that Al didn’t bring up any sexual identity issues. For me, I would have been uncomfortable and unsure given that we are also classmates. I did not ask about his sex life because I sensed defensiveness and deflection with his statement: “I’ve been in a relationship with loving life and doing my thing.” When asking about suicide, I stumbled over my words, and it was awkward. I had some anxiousness in asking the question, and then I was unsure of where to take it with Al’s response. When I asked about any experience with violence, I was surprised for him to discuss discrimination at that moment but I can understand why he did. I don’t think I was as empathetic in my response as I could have been because I was caught off guard. Thinking about a “little Al” being called names left me feeling sad and angry. For me, asking about sexual violence or abuse was the hardest topic to approach, especially because of our gender differences. I have assisted women who have been raped, and it is always a hard story for me to hear. I was relieved that in this session we could move onto another topic.
Thoughts and Feelings In this interview/assessment, I was hindered because of my anxiousness about my performance. I struggled, particularly in the beginning to stay in the moment, so I believe this will happen until I am comfortable with the process of the first interview. When I am concerned about my performance and inadequacies, I am less able to be present and help the client. I was challenged with those subjects that I have little experience with such as substance misuse or sexual identity issues. I find that I am the most judgmental about the misuse of substances than anything else. I have a lifetime of assuming it was about choice and not about it being a disorder. Those thoughts have been so automatic that I have struggled to root them out.
Another example from this interview was my comment about “because you were the boy” which is based on cultural stereotype and gender. In this case, it was about having an older sibling and not either of those other areas. I thought I knew, but I didn’t. I think these types of assumptions also hinder a session. My curiosity or interest in others facilitates the interview.
I just enjoy knowing people. I almost always can develop a positive regard for the person sitting across from me, especially when I hear their story.
Areas of Clinical Interest The seven areas of clinical interest are key signposts during the first interview. During this interview, Al did not demonstrate any confusion, delusions, memory defects, speech that was difficult to follow, etc. In contrast, Al showed insight when discussing his anxiety at work when he stated, “how am I going to find out how to figure this out…It’s a good anxiety.” No indications of cognitive problems or psychosis were present. When discussing substance use, Al did state that he does have alcohol on occasion. He explained that typically “if I go, grab beers with friends; I’ll probably limit myself to three beers.” Recently he reported that “I get there and I have like one beer and I’m just exhausted…I just want to go to bed.” Al did not report any personal, occupational, or social consequences regarding any current substance use. In response to questions about his mood, Al did describe it as “reactive” and “short-tempered.” Also, he stated: “on those days that I have the energy or the desire to go, sometimes after 20 minutes, I’m already frustrated…like I’d rather be alone
sometimes.” Another area of clinical interest is anxiety. Al’s chief complaint is that he is “overwhelmed.” He reported, “I want it to be graduation, so I don’t have to be worried about everything.” Further, he stated, “and I get anxious to think about what I want to do afterward.” Physical complaints from Al included sleep disturbances and low energy. He described his sleep pattern as “go to bed by 10 or 10:30 usually, but depending on how much school work or things I have to do before the next day, that could be later. And then I wake up earlier because I’m worried that I need to get ready for the day.” In describing his energy, he stated, “my energy level for everything seems to be just a lot less.” He described his appetite as remaining constant. Al affirmed, “I have really great friends. I have great relationships with co-workers and classmates.” Other than anxiety as previously stated, no signal areas for social or personality problems were present.
Use of Empathy Morrison describes the expression of empathy as “on some level, you can feel as your patient feels.” From my viewpoint, I was empathetic during the entire interview. In contrast, when reviewing the tape, I failed on multiple occasions to express that empathy using feeling words. One example was in response to his sharing about discrimination, I stated, “that’s very difficult.” At the beginning of the interview, Al confirmed after most of my reflections with a “yeah” or “mm-hmm” and frequently nodded. He also was engaged in the full interview which is an indicator of rapport. One example, when I did express a feeling, was when Al stated, “and I get really overwhelmed and stressed out about all that sort of stuff” and I replied, “so you’re feeling anxious right now.” Notwithstanding, I was there with him but did not adequately identify feelings in response to his statements. Initially, I did, but then I popped back up to the surface and stayed there.
Client Theme Al described himself with “I think I have always been anxious.” Also, the latest episode of worry and anxiety is due to his belief that he is overwhelmed. He is “chasing whatever the next thing to do is.” With the worry, he has experienced sleep disturbances: “it seems like I’m getting less and less sleep.” Additionally, he reported his “energy level for everything seems to be just a lot less,” and his mood is “reactive.” He has positive social relationships, and the current stressors are short-term.
Sensitive Subjects The area of sensitive subjects as defined by James Morrison in The First Interview (2014) includes five topics. The first topic I broached was regarding substance use. The subject of alcohol use does not bring up issues for me except that I struggled to know if I should probe more or not when we initially talked about his drinking. I was unsure of myself because I did not readily remember the amounts of alcohol that would indicate a concern. In the end, my instinct was that it was not a problem for him now, so I left it where it was. I asked about any other substance use which did not bring up any issues for me. I was reasonably comfortable asking about sexual orientation. I was relieved …show more content…
that Al didn’t bring up any sexual identity issues. For me, I would have been uncomfortable and unsure given that we are also classmates. I did not ask about his sex life because I sensed defensiveness and deflection with his statement: “I’ve been in a relationship with loving life and doing my thing.” When asking about suicide, I stumbled over my words, and it was awkward. I had some anxiousness in asking the question, and then I was unsure of where to take it with Al’s response. When I asked about any experience with violence, I was surprised for him to discuss discrimination at that moment but I can understand why he did. I don’t think I was as empathetic in my response as I could have been because I was caught off guard. Thinking about a “little Al” being called names left me feeling sad and angry. For me, asking about sexual violence or abuse was the hardest topic to approach, especially because of our gender differences. I have assisted women who have been raped, and it is always a hard story for me to hear. I was relieved that in this session we could move onto another topic.
Thoughts and Feelings In this interview/assessment, I was hindered because of my anxiousness about my performance. I struggled, particularly in the beginning to stay in the moment, so I believe this will happen until I am comfortable with the process of the first interview. When I am concerned about my performance and inadequacies, I am less able to be present and help the client. I was challenged with those subjects that I have little experience with such as substance misuse or sexual identity issues. I find that I am the most judgmental about the misuse of substances than anything else. I have a lifetime of assuming it was about choice and not about it being a disorder. Those thoughts have been so automatic that I have struggled to root them out.
Another example from this interview was my comment about “because you were the boy” which is based on cultural stereotype and gender. In this case, it was about having an older sibling and not either of those other areas. I thought I knew, but I didn’t. I think these types of assumptions also hinder a session. My curiosity or interest in others facilitates the interview.
I just enjoy knowing people. I almost always can develop a positive regard for the person sitting across from me, especially when I hear their story.
Areas of Clinical Interest The seven areas of clinical interest are key signposts during the first interview. During this interview, Al did not demonstrate any confusion, delusions, memory defects, speech that was difficult to follow, etc. In contrast, Al showed insight when discussing his anxiety at work when he stated, “how am I going to find out how to figure this out…It’s a good anxiety.” No indications of cognitive problems or psychosis were present. When discussing substance use, Al did state that he does have alcohol on occasion. He explained that typically “if I go, grab beers with friends; I’ll probably limit myself to three beers.” Recently he reported that “I get there and I have like one beer and I’m just exhausted…I just want to go to bed.” Al did not report any personal, occupational, or social consequences regarding any current substance use. In response to questions about his mood, Al did describe it as “reactive” and “short-tempered.” Also, he stated: “on those days that I have the energy or the desire to go, sometimes after 20 minutes, I’m already frustrated…like I’d rather be alone
sometimes.” Another area of clinical interest is anxiety. Al’s chief complaint is that he is “overwhelmed.” He reported, “I want it to be graduation, so I don’t have to be worried about everything.” Further, he stated, “and I get anxious to think about what I want to do afterward.” Physical complaints from Al included sleep disturbances and low energy. He described his sleep pattern as “go to bed by 10 or 10:30 usually, but depending on how much school work or things I have to do before the next day, that could be later. And then I wake up earlier because I’m worried that I need to get ready for the day.” In describing his energy, he stated, “my energy level for everything seems to be just a lot less.” He described his appetite as remaining constant. Al affirmed, “I have really great friends. I have great relationships with co-workers and classmates.” Other than anxiety as previously stated, no signal areas for social or personality problems were present.
Use of Empathy Morrison describes the expression of empathy as “on some level, you can feel as your patient feels.” From my viewpoint, I was empathetic during the entire interview. In contrast, when reviewing the tape, I failed on multiple occasions to express that empathy using feeling words. One example was in response to his sharing about discrimination, I stated, “that’s very difficult.” At the beginning of the interview, Al confirmed after most of my reflections with a “yeah” or “mm-hmm” and frequently nodded. He also was engaged in the full interview which is an indicator of rapport. One example, when I did express a feeling, was when Al stated, “and I get really overwhelmed and stressed out about all that sort of stuff” and I replied, “so you’re feeling anxious right now.” Notwithstanding, I was there with him but did not adequately identify feelings in response to his statements. Initially, I did, but then I popped back up to the surface and stayed there.
Client Theme Al described himself with “I think I have always been anxious.” Also, the latest episode of worry and anxiety is due to his belief that he is overwhelmed. He is “chasing whatever the next thing to do is.” With the worry, he has experienced sleep disturbances: “it seems like I’m getting less and less sleep.” Additionally, he reported his “energy level for everything seems to be just a lot less,” and his mood is “reactive.” He has positive social relationships, and the current stressors are short-term.