University Essay: Critique of Substance-Use Interview in Psychology

This essay offers a critical evaluation of a substance-use interview designed as a training tool by the Victorian Dual Diagnosis Initiative. The essay analyzes the interviewer's initial contact, demonstrating empathetic and non-judgmental approaches. It assesses the interviewer's ability to establish respect and rapport, emphasizing the importance of a therapeutic relationship and active listening. The essay evaluates the interviewer's ability to identify the interviewee's readiness to change, their understanding of the impact of substance abuse on the client's health and lifestyle, and their identification of stressors. The essay also examines the overall engagement level and communication skills displayed during the interview, highlighting areas for improvement such as initial contact and time constraints. The conclusion summarizes the strengths of the interview while acknowledging the limitations and suggesting improvements to enhance the assessment process. This essay provides an in-depth review of the interview process and the skills required for effective mental health assessment.

Running head: CRITIQUE OF SUBSTANCE-USE INTERVIEW
Assessment 1 Essay
Name of the Student
Name of the University
Author Note

1CRITIQUE OF SUBSTANCE-USE INTERVIEW
Co-occurring disorders are considered to be present among people who suffer from
substance-abuse disorders, in conjunction with a range of mental illnesses. Substance-use
disorders usually encompass alcohol or drug abuse and dependence (Pettinati, OʼBrien and
Dundon 2015). It is considered imperative in the scope of mental health practice that all mental
health workers, including psychologists, counselors, therapists, psychiatrists are responsible for
maintain and establishing effective therapeutic relationship with their clients, regardless of the
prevailing mental conditions (Sucala et al. 2012). These healthcare workers are expected to
conduct psychological assessments that help them gain a sound understanding of the underlying
factors that might have contributed to the co-occurring condition (Jorm 2012). The essay will
critically evaluate an interview that was designed by the Victorian Dual Diagnosis Initiative in
the form of a training tool for counselors and ventral health workers.
Interviewer’s initial contact- Appropriate initial contact is regarded as an essential pre-
requisite before conduction of an interview. In the video, Jess was found to introduce herself to
the client Steve, as an assessor who will assess co-occurring mental concern in the patient. It was
observed that while introducing herself, she shook hands with Steve. She adopted a formal
approach while establishing initial contact. According to evidences, this contact is facilitated by
demonstration of an empathetic approach by the individuals (Gudiño, Martinez and Lau 2012).
Professional mental health workers are trained to adopt a non-judgmental listening style, which
in turn demonstrates a genuine willingness to cater to the demands of the clients (Yanos et al.
2012). Jess could have established a better initial contact by asking Steve about the place he
lives, how did he begin the day, and if he faced any difficulty to reach the centre. Research
findings also state that there are a large number of social stigma and stereotypes associated with
mental health that results in discrimination against the sufferers (Meyer 2013). This makes the

2CRITIQUE OF SUBSTANCE-USE INTERVIEW
patients socially isolated and they find it difficult to become a part of the community. A positive
self-esteem and self-confidence is also considered of utmost importance for fighting against
mental health problems (Corrigan and Rao 2012). The client Steve failed to maintain eye contact
with the assessor on being approached. He also checked the time from a wall clock, which in
turn signifies his restlessness. He was asked whether he had been to such services before.
Although it is required that mental professionals should ask open-ended questions, this question
demonstrates that the assessor was judgmental of his condition.
Respect and rapport shown by the interviewer- A successful mental treatment or
assessment depends on the commitment demonstrated by the workers their professional role and
development of a therapeutic rapport with the clients. Building effective rapport forms the basis
of professional fulfillment and success (Thompson and McCabe 2012). It is required to gain a
sound understanding of the history, preferences and demands of the client, pertaining to a
particular issue or presenting health problem (Morgan et al. 2012). Jess talks about the service
that will be provided to the client and does not forget to mention that Steve will be subjected to a
normal assessment. Steve is found to positively acknowledge the same. This signifies that the
interviewer demonstrated some form of respect towards the client by trying to make him feel
comfortable in the setting. The interactive session could have been made more engaging by
considering the patient as the utmost priority. Furthermore, respecting the privacy and autonomy
of a client, while providing care services, is crucial in mental health assessments (Wilson and
Deane 2012). Listening to a speaker and providing feedback at regular intervals is considered
exclusive for mental health therapy (Gunasekara et al. 2014). Jess was found to display active
listening skills during the conversation and gave Steve adequate time to respond to her questions.

3CRITIQUE OF SUBSTANCE-USE INTERVIEW
Interviewee’s readiness to change- Behavior changes refer to the changes in personal
habits and opinions to change the recurrence of a particular health problem. Adoption of such
behavioral change approaches help in improving the overall health and wellbeing of the
individuals (Hibbard and Greene 2013). Jess was found to ask Steve about the coping strategies.
Moreover, during the last segment of the interview, Steve was also asked to speak about his
family, and the effect of his drinking habits on his family life. This resulted in an emotional
meltdown and Steve became overwhelmed by the unpleasant feelings, which he failed to hide
from the assessor. These questions helped Steve to realize that he is not taking adequate
measures to prevent his alcoholism. The assessor Jess failed also asked open-ended questions
regarding his opinion on the ways by which he can recover from the alcohol dependence. Thus, it
can be stated that Jess took all efforts to retrieve relevant information from her client, for
formulating a successful recovery program.
Interviewer’s identification of substance abuse effect on client’s health and lifestyle-
There are short-term and long-term changes of substance abuse and alcoholism on mental health
such as, depression, paranoia, aggression, hallucination, and anxiety (Smeets et al. 2013).
However, research findings have established correlation with substance abuse impacts on
lifestyle and family life. Induced substance abuse have been found to exert negative effects on
spouses, parents, and children (Orford et al. 2013). Understanding the perspective and attitude of
the client regarding potential impacts of substance abuse forms an essential part of most recovery
programs. Jess was able to successfully recognize the limits of alcohol to which the client Steve
was subjected. Her questions were also specific in determining whether Steve had a clear
understanding of the probable negative effects that his condition exerted on his life. According to
research evidences, mental disorders and abuse reduce the likelihood of an individual gaining

4CRITIQUE OF SUBSTANCE-USE INTERVIEW
employment. Co-occurring mental health concerns raise apprehensions regarding the concerned
individual in the society, thereby resulting in discrimination against them (Mizock and Mueser
2014). Jess questioned Steve about the his alcohol consumption frequency. Her questions also
helped in understanding that Steve was socially isolated. All kinds of mental health assessments
are expected to make the concerned professionals prioritize their working areas. Focus should be
given on the problems presented by the client and the effect of the prevailing mental health
condition. These questions helped in determining that in addition to being separated from his
family due to alcoholism, Steve was suffering from financial problems as well. Although there
were loopholes on the part of the assessor in the previous sections, Jess was able to gain
sufficient information regarding Steve’s job. Jess was also able to realize that Steve had lost his
driving license years back. This part of the interview contained both open and closed-ended
questions that helped the assessor to gather enough information regarding the client. Therefore,
the assessor was able to identify the impacts of co-occurring mental health disorder on the
overall wellbeing and lifestyle of the patient.
Identification of stressors- Stress is considered as an inevitable part of life and arises in
situations when the victims are subjected to prolonged conditions that disrupt their mental peace.
Research evidences state that stress disturbs the physical and mental wellbeing of all individuals.
Moreover, ineffective coping strategies and stressful events are found to play a considerable role
in relapse of drug abuse (Keller et al. 2012). The assessor Jess tried to gain a deeper
understanding of whether the stressful events faced by the client increase his susceptibility of
having suicidal ideations to escape from reality. Her open-ended questions were successful in
making Steve tell that although he consumed sleeping pills to reduce his sleeping problems, he
never had the intention of attempting suicide. The assessor was also successful in making him

5CRITIQUE OF SUBSTANCE-USE INTERVIEW
tell about the emotional distress that he faces due to separation from his sons. Core
communication skills in mental health nursing often encompasses effective interpersonal skills
that are central to the duty of a mental health worker. These skills facilitate establishment of a
therapeutic alliance with the clients (Nørgaard et al. 2012). Jess portrayed accurate professional
duties and was able to communicate well with Steve, which in turn helped her gain information
about absence of suicidal histories in the client’s family. She stayed calm during the interview
and was able to reduce the stress of the client. This helped her realize that Steve wanted to rake
all possible efforts to get his children back.
Overall engagement- The level of engagement as seen in the interview can be denoted as
good. However, the assessor should have been more approachable at the beginning of the
interview, which would have facilitated easier rapport establishment. Steve appears to be
extremely stressed due to his co-occurring mental health condition. Formulation of an effective
therapeutic relationship would have made him discuss more about the factors that probably
contributed to his alcoholism. Moreover, the total time for the interview was also less. Allotting
more time to understand the needs of the client in a better way would have been helpful. Thus, it
can be stated that there was moderate engagement of the interviewer with the client.
To conclude, it can be stated that Jess portrayed some good interpersonal communication
skills that helped her engage in a healthy conversation with the client, Steve. This helped her
collect relevant information related to the stress factors and their impact on his life and health.
She was able to smoothly conduct the entire interview. However, time constraint and less efforts
in initial contact were some of the major barriers in her approach.

6CRITIQUE OF SUBSTANCE-USE INTERVIEW
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